1
|
Formagini T, Teruel Camargo J, Perales-Puchalt J, Drees BM, Fracachan Cabrera M, Ramírez M. A culturally and linguistically adapted text-message Diabetes Prevention Program for Latinos: Feasibility, acceptability, and preliminary effectiveness. Transl Behav Med 2024; 14:138-147. [PMID: 37715986 DOI: 10.1093/tbm/ibad053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023] Open
Abstract
Despite the general positive outcomes of the Diabetes Prevention Program (DPP), the program's reach, adherence, and effectiveness among Latinos are still suboptimal. Text-message DPP can potentially overcome barriers and improve DPP outcomes for this group. We aimed to assess the feasibility, acceptability, and preliminarily effectiveness of a culturally and linguistically adapted text-message DPP for Latinos. We enrolled 26 eligible Spanish-speaking Latino adults at risk of developing type 2 diabetes (A1c = 5.7%-6.4%, body mass index ≥25) in a 6-month culturally and linguistically adapted text-message DPP. Participants received (i) two to three daily automated text-messages about healthy eating, physical activity, problem-solving skills, lifestyle change motivation, and logistics, (ii) on-demand keyword-driven messages, and (iii) on-demand chat messages with a DPP coach. Outcomes included feasibility (e.g. adherence), acceptability (e.g. satisfaction), and preliminary effectiveness (e.g. weight loss). Twenty-four participants completed the program and follow-up assessments. Participants' mean body weight changed from 191.2 to 186.7 pounds (P = .004); 45.8% of participants lost ≥3%, and 29.2% lost ≥5% of body weight. Body mass index and waist circumference were also reduced [0.9 kg/m2 (P = .003) and 1.1 cm (P = .03), pre-post]. Self-reported physical activity frequency was increased (P = .003). No statistically significant changes in diet quality were found. Most participants were satisfied with the program and perceived it to help prevent diabetes. Our pilot study of an innovative text-message DPP for Latinos demonstrated the program was acceptable, feasible, and potentially effective. Using text-message for DPP can reduce barriers to in-person participation by increasing the program's reach without compromising fidelity and effectiveness.
Collapse
Affiliation(s)
- Taynara Formagini
- Department of Family Medicine, University of California San Diego, San Diego, CA, USA
- School of Social Work, University of Central Florida, Orlando, FL, USA
| | - Juliana Teruel Camargo
- Minority Health and Health Disparities Population Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jaime Perales-Puchalt
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Betty M Drees
- University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
- The Graduate School of the Stowers Institute for Medical Research, Kansas City, MO, USA
| | - Monica Fracachan Cabrera
- Juntos Center for Advancing Latino Health, Department of Population Health, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Mariana Ramírez
- Juntos Center for Advancing Latino Health, Department of Population Health, University of Kansas School of Medicine, Kansas City, KS, USA
| |
Collapse
|
2
|
JOKAR MOZHGAN, ZANDI MITRA, EBADI ABBAS, MOMENAN AMIRABBAS, MARTINI MARIANO, BEHZADIFAR MASOUD. Adults' perceived health promotion needs in the prediabetes stage: a meta-synthesis study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E411-E428. [PMID: 38379738 PMCID: PMC10876036 DOI: 10.15167/2421-4248/jpmh2023.64.4.3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024]
Abstract
Introduction One of the methods to promote pre-diabetic patients' adherence to preventive behaviors and improving their lifestyle is to pay attention to their needs in the designed educational programs. Therefore, this study was conducted with the aim of identifying the needs of individuals with prediabetes. Methodology Three databases, including ISI/Web of Sciences, PubMed, Scopus were searched without time limitation until August 2022. The quality of the included studies was assessed using the Critical Appraisal Skills Programme tool. This study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines and to achieve the research goal, Sandelowski and Barroso's seven-step meta-synthesis method (2007) was used. Thematic synthesis was used to analyses the data. Results Out of the 1934 studies obtained, 34 studies were finally examined and 805 codes were recorded based on the extracted data. Through synthesizing and analyzing the primary studies, 8 main themes were extracted regarding individuals' needs in the prediabetes stage: Information needs, Cultural needs, psychological needs, Social support needs, Education needs, Financial needs, Service needs and Skill needs. Discussion and Conclusions The perceived needs and their types in each of the dimensions in detail can be a proper guide for designing educational programs and various interventions to control the prediabetes condition, leading to a reduction in the prevalence of type 2 diabetes in the society.
Collapse
Affiliation(s)
- MOZHGAN JOKAR
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - MITRA ZANDI
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - ABBAS EBADI
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Research Center for Life & Health Sciences & Biotechnology of the Police, Direction of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran
| | - AMIR ABBAS MOMENAN
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- TLGS Unit Manager, Tehran, Iran
| | - MARIANO MARTINI
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - MASOUD BEHZADIFAR
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|
3
|
Azar KMJ, Sudat S, Huang Q, Pressman AP, Szwerinski NK, Nasrallah C, Venditti EM, Romanelli RJ. Examining paradoxical session attendance and weight loss relationships in a clinic based lifestyle modification intervention. Obes Sci Pract 2023; 9:641-652. [PMID: 38090689 PMCID: PMC10712409 DOI: 10.1002/osp4.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 02/01/2024] Open
Abstract
Objective Evaluations of lifestyle modification interventions (LMIs), modeled after the Diabetes Prevention Program, have repeatedly shown a dose-response relationship between session attendance and weight loss. Despite this, not all participants had "average" weight loss experiences. Nearly one-third of LMI participants experienced unexpected, paradoxical outcomes (i.e., high attendance with little weight loss, and low attendance with clinically significant weight loss). Paradoxical weight-loss outcomes were characterized based on session attendance among participants in a group-based LMI in a real-world healthcare setting. This group-based LMI was delivered over 1 year to participants with the possibility of attending up to 25 sessions total. Methods LMI participants identified in 2010-2017 from electronic health records were characterized as having low (<75%) or high (≥75%) session attendance. Weight-loss outcomes were defined as expected (≥5%, high-attendance; <5%, low-attendance) or paradoxical (≥5%, low-attendance; <5%, high-attendance). Paradoxical-outcome-associated characteristics were identified using logistic regression. Results Among 1813 LMI participants, 1498 (82.6%) had low and 315 (17.4%) high session attendance; 555 (30.6%) had paradoxical outcomes, comprising 415 (74.8%) responders (≥5% weight-loss) and 140 (25.2%) non-responders (<5% weight-loss). Among participants with high session attendance, paradoxical non-responders were more likely to be female (odds ratio [OR]: 2.76; 95% confidence interval [CI]: 1.32, 5.77) and have type 2 diabetes (OR: 3.32; 95% CI: 1.01, 10.95). Among low-attendance participants, paradoxical responders were more likely to be non-Hispanic White and less likely to be non-Hispanic Black (OR: 0.35; 95% CI: 0.18, 0.69), non-Hispanic Asian (OR: 0.40; 95% CI: 0.22, 0.73), or Hispanic (OR: 0.53; 95% CI: 0.35, 0.80). Conclusions In a healthcare setting, nearly one-third of LMI participants experienced paradoxical outcomes. More research is needed to understand the facilitators and barriers to weight loss above and beyond session attendance.
Collapse
Affiliation(s)
| | - Sylvia Sudat
- Sutter HealthCenter for Health Systems ResearchPalo AltoCaliforniaUSA
| | - Qiwen Huang
- Sutter HealthCenter for Health Systems ResearchPalo AltoCaliforniaUSA
| | - Alice P. Pressman
- Sutter HealthCenter for Health Systems ResearchPalo AltoCaliforniaUSA
| | | | | | - Elizabeth M. Venditti
- Department of Psychiatry & Department of EpidemiologyDiabetes Prevention Support CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | |
Collapse
|
4
|
Losavio J, Keenan MJ, Gollub EA, Silver HJ. Factors that predict weight loss success differ by diet intervention type. Front Nutr 2023; 10:1192747. [PMID: 37599685 PMCID: PMC10434209 DOI: 10.3389/fnut.2023.1192747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/27/2023] [Indexed: 08/22/2023] Open
Abstract
Background Many types of diet intervention can achieve negative energy balance and successful weight loss in persons with obesity. However, within any dietary strategy, there is large inter-individual variation in the weight loss response. The aim of this study is to determine factors that predict weight loss success for diet interventions that vary by macronutrient and caloric composition. Methods Participants with BMI 30.0 to 49.9 kg/m2 self-selected one of three diet intervention trials for weight loss: low carbohydrate (LOW CHO), low fat (LOW FAT), or low calorie (LOW KCAL). Multivariable regression models were developed to determine the significance of predictor demographic, body composition, metabolic, clinical, and dietary variables for each diet type. Results Weight loss over 12-16 weeks averaging -5.1 ± 4.0 kg from baseline weight, p < 0.001, was not significantly different among diet types. Several different factors were identified that account for the inter-individual variance in weight loss success. Regardless of diet type, the most robust predictor of weight loss success was completion of the intervention, accounting for 20-30% of the variance. Factors predicting diet intervention completion were age, physical activity level, blood leptin level, blood pressure, and the amount of weight loss occurring. Differences by diet type in cardiometabolic risk factor reduction were identified with LOW CHO decreasing glycemia/insulinemia factors, LOW FAT decreasing lipidemia factors, and LOW KCAL decreasing inflammatory factors. Conclusion These data provide evidence to inform more precise and personalized approaches to diet intervention for weight loss and cardiometabolic health.
Collapse
Affiliation(s)
- Jordan Losavio
- College of Agriculture, Louisiana State University, Baton Rouge, LA, United States
| | - Michael J. Keenan
- College of Agriculture, Louisiana State University, Baton Rouge, LA, United States
| | - Elizabeth A. Gollub
- Louisiana State University Agricultural Center, Baton Rouge, LA, United States
| | - Heidi J. Silver
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, United States
| |
Collapse
|
5
|
Lin S, Zimmerman E, Datta S, Selby M, Chan T, Fant A. Curated collections for educators: Nine key articles and article series for teaching qualitative research methods. AEM EDUCATION AND TRAINING 2023; 7:e10862. [PMID: 37013134 PMCID: PMC10066497 DOI: 10.1002/aet2.10862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 06/19/2023]
Abstract
Background Qualitative research explains observations, focusing on how and why phenomena and experiences occur. Qualitative methods go beyond quantitative data and provide critical information inaccessible through quantitative methods. However, at all levels of medical education, there is insufficient exposure to qualitative research. As a result, residents and fellows complete training ill-equipped to appraise and conduct qualitative studies. As a first step to increasing education in qualitative methods, we sought to create a curated collection of papers for faculty to use in teaching qualitative research at the graduate medical education (GME) level. Methods We conducted literature searches on the topic of teaching qualitative research to residents and fellows and queried virtual medical education and qualitative research communities for relevant articles. We searched the reference lists of all articles found through the literature searches and online queries for additional articles. We then conducted a three-round modified Delphi process to select papers most relevant to faculty teaching qualitative research. Results We found no articles describing qualitative research curricula at the GME level. We identified 74 articles on the topic of qualitative research methods. The modified Delphi process identified the top nine articles or article series most relevant for faculty teaching qualitative research. Several articles explain qualitative methods in the context of medical education, clinical care, or emergency care research. Two articles describe standards of high-quality qualitative studies, and one article discusses how to conduct the individual qualitative interview to collect data for a qualitative study. Conclusions While we identified no articles reporting already existing qualitative research curricula for residents and fellows, we were able to create a collection of papers on qualitative research relevant to faculty seeking to teach qualitative methods. These papers describe key qualitative research concepts important in instructing trainees as they appraise and begin to develop their own qualitative studies.
Collapse
Affiliation(s)
- Sophia Lin
- Department of Emergency MedicineWeill Cornell MedicineNew YorkNew YorkUSA
| | - Elise Zimmerman
- Division of Emergency Medicine, Department of PediatricsUniversity of California at San DiegoSan DiegoCaliforniaUSA
| | - Suchismita Datta
- Department of Emergency MedicineNew York University Long Island School of MedicineMineolaNew YorkUSA
| | - Maurice Selby
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Teresa Chan
- Division of Emergency Medicine, Division of Education and Innovation, Department of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Abra Fant
- Department of Emergency MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| |
Collapse
|