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Ng BP, Ely E, Papali'i M, Cannon MJ. Delivering the National Diabetes Prevention Program: Assessment of Retention, Physical Activity, and Weight Loss Outcomes by Participant Characteristics and Delivery Modes. J Diabetes Res 2024; 2024:8461704. [PMID: 39165352 PMCID: PMC11335425 DOI: 10.1155/2024/8461704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 06/13/2024] [Accepted: 07/19/2024] [Indexed: 08/22/2024] Open
Abstract
Type 2 diabetes disproportionately affects older adults, persons from racial and ethnic minority groups, and persons of low socioeconomic status. It can be prevented or delayed through evidence-based interventions such as the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP). This analysis is aimed at evaluating the outcomes (i.e., retention, physical activity, and weight loss) associated with participation in the National DPP LCP by participant characteristics and delivery mode (i.e., in-person, online, distance learning, and combination) using the 2012-2018 Diabetes Prevention Recognition Program (DPRP) data. Across all delivery modes, there were generally no substantial differences in retention between male and female participants, but male participants tended to have higher physical activity and weight loss (e.g., average weight loss for in-person delivery: 5.0% for males and 4.3% for females). Older participants had better retention rates than younger participants in all delivery modes and mostly higher physical activity and weight loss except for distance learning delivery (e.g., average weight loss for in-person delivery: 5.1% for those aged 65+ and 3.3% for those aged 18-34). Among the seven racial and ethnic groups studied, retention was generally highest for non-Hispanic/Latino (NH)-White participants and lowest for Hispanic/Latino participants. Physical activity varied by racial and ethnic groups and delivery mode. NH-White participants generally had the most weight loss except for distance learning delivery, and NH-Black/African American participants had the least (e.g., average weight loss for in-person delivery: 5.1% for NH-White participants, 3.3% for both NH-Black/African American and NH-American Indian/Alaska Native participants, and other racial and ethnic minority groups ranged from 3.4% to 4.9%). Monitoring and identifying disparities across demographics and delivery modes, particularly across multiple racial and ethnic groups, provides information that can be used to improve the implementation of the National DPP LCP by tailoring the intervention to reduce disparities.
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Affiliation(s)
- Boon Peng Ng
- College of Nursing and DisabilityAging and Technology ClusterUniversity of Central Florida, Orlando, Florida, USA
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Ely
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michelle Papali'i
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael J. Cannon
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
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2
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Christensen JR, Konge MB, Devantier M, Brandt CJ, Gommesen JB, Kolind MI. Preferred Content in Occupational Therapy-Based Weight Loss Interventions: A Survey. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:199-208. [PMID: 35481436 DOI: 10.1177/15394492221088511] [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: 11/16/2022]
Abstract
Despite decades of attempts from doctors and dietitians to break the obesity curve, obesity rates are increasing in Denmark. To counteract this, municipal occupational therapy-based interventions are in development as part of the Danish Obesity Intervention Trial (DO: IT). The objective was to survey Danish adults on preferred content in an occupational therapy municipal weight loss intervention and determine if preferences differed by gender and age. A 21-item questionnaire was developed to explore preferences related to diet, physical activity, occupational balance, habits, and social relations. In all, 429 respondents were included. Chi-square statistics were performed to determine if preferences differed by gender and age. A total of 15 of the 21 items indicated gender-based differences in preferences. Two items indicated age-based differences. Notably, compared to men, women indicated significantly more interest in content relating to habit formation and occupational balance. Gender-based differences should be considered when developing a weight loss intervention.
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Affiliation(s)
- Jeanette Reffstrup Christensen
- Department of Public Health, University of Southern Denmark, Odense, Denmark.,Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Maria B Konge
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Martin Devantier
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Carl J Brandt
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Joakim B Gommesen
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mikkel I Kolind
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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3
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Ducraux P, Waeber G, Marques-Vidal P. Do Weight trajectories influence diabetes control? A prospective study in Switzerland (CoLaus study). Prev Med Rep 2021; 23:101473. [PMID: 34258179 PMCID: PMC8259406 DOI: 10.1016/j.pmedr.2021.101473] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/13/2021] [Accepted: 06/23/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Identify anthropometric trajectories among subjects with type 2 diabetes mellitus (T2DM), and associate them with glycaemic control. METHODS Prospective study including 268 community-dwelling participants with T2DM (34% women, mean age 68.7 ± 8.9 years) followed for 10.7 years (range: 8.8-13.6 years). T2DM control was considered for 1) fasting plasma glucose (FPG) < 7.0 mmol/L, or 2) HbA1c < 7.0% (53 nmol/mol). Changes in weight or waist and weight variability were considered. RESULTS One half (FPG) and one third (HbA1c) of participants presented with uncontrolled T2DM. Half of the participants presented with obesity and 75% with abdominal obesity. During follow-up, half of the participants maintained their weight, 25% gained > 5 kg, and 25% lost < 5 kg; almost half increased their waist by > 5 cm. Using FPG as criterion, participants who lost > 5 cm waist were more likely to be controlled: multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI): 3.10 (1.23-7.78). Participants with controlled T2DM also presented with a higher weight variability: multivariable adjusted mean ± standard error 4.8 ± 0.3 vs. 3.9 ± 0.3 kg, p = 0.028. Using HbA1c as criterion, participants who lost > 5 kg were less likely to be controlled: OR and (95% CI): 0.35 (0.18-0.66). Similar findings were obtained when restricting the analysis to participants who were diabetic throughout the whole study period. CONCLUSION In a Swiss community-based sample of participants with T2DM, T2DM control rates could be implemented. Neither weight nor waist variability was significantly and consistently associated with T2DM control.
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Affiliation(s)
- Pauline Ducraux
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
| | - Gérard Waeber
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
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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.
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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
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Entwistle TR, Miura K, Keevil BG, Morris J, Yonan N, Pohl M, Green AC, Fildes JE. Modifying dietary patterns in cardiothoracic transplant patients to reduce cardiovascular risk: The AMEND-IT Trial. Clin Transplant 2020; 35:e14186. [PMID: 33314283 DOI: 10.1111/ctr.14186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is common after cardiothoracic transplantation and causes substantial morbidity. AIMS To assess feasibility and potential effectiveness of dietary interventions to reduce CVD risk. MATERIALS AND METHODS In a pilot intervention, we recruited patients from a tertiary hospital and randomly allocated them to a Mediterranean or low-fat diet for 12 months. Feasibility was measured by patient participation, retention, and adherence. Changes in weight, body mass index (BMI), heart rate, blood pressure, glucose markers, and blood lipids were assessed using longitudinal generalized estimating equation regression models with 95% confidence intervals. RESULTS Of 56 heart and 60 lung transplant recipients, 52 (45%) consented, 41 were randomized, and 39 (95%) completed the study with good adherence to randomized diets. After 12 months, changes in many risk factors were seen in the Mediterranean and low-fat-diet groups, respectively, including mean BMI (-0.5 vs. 0.0 kg/m2 ), systolic/diastolic blood pressure +0.5/+0.1 vs -4.4/-3.5 mmHg; fasting glucose -0.26 vs -0.27 mmol/L; total cholesterol -0.56 vs -0.40 mmol/L. Changes in BMI and systolic/diastolic blood pressure in 49 eligible patients who did not take part were +0.7 kg/m2 and +2.5/+1.8 mmHg. DISCUSSION Dietary interventions in cardiothoracic transplant patients are feasible and potentially beneficial. CONCLUSION A definitive nutritional intervention study in these high-risk patients is warranted.
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Affiliation(s)
- Timothy R Entwistle
- The Ex-Vivo Lab, Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,The Transplant Centre, Manchester Foundation Trust, Manchester, UK
| | - Kyoko Miura
- Cancer and Population Studies, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Brian G Keevil
- Department of Clinical Biochemistry, University Hospital South Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Julie Morris
- Department of Medical Statistics, Manchester Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Nizar Yonan
- The Ex-Vivo Lab, Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | | | - Adele C Green
- Cancer and Population Studies, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,CRUK Manchester Institute and University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - James E Fildes
- The Ex-Vivo Lab, Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,The Transplant Centre, Manchester Foundation Trust, Manchester, UK
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Fealy S, Attia J, Leigh L, Oldmeadow C, Hazelton M, Foureur M, Collins CE, Smith R, Hure A. Demographic and social-cognitive factors associated with gestational weight gain in an Australian pregnancy cohort. Eat Behav 2020; 39:101430. [PMID: 32942238 DOI: 10.1016/j.eatbeh.2020.101430] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 01/01/2023]
Abstract
AIM To identify and describe the demographic and social-cognitive factors associated with excessive gestational weight gain using the Weight-Related Behaviours Questionnaire, within an Australian pregnancy cohort. BACKGROUND Supporting women to achieve optimal weight gain in pregnancy is complex. Social-cognitive factors are recognised antecedents to, and mediators of, weight related behaviour change. Less is known about their role during pregnancy. METHODS 159 women enrolled in a pregnancy cohort study completed the Weight-Related Behaviours Questionnaire (WRBQ) at approximately 19 weeks gestation, and total gestational weight gain was later measured at 36 weeks. Summary scores were reported descriptively. Multivariable logistic regression was used to test demographic (maternal age, pre pregnancy body mass index, parity, smoking status, marital status, education) and social-cognitive factors (weight locus of control, self- efficacy, attitudes towards weight gain, body image, feelings about motherhood, career orientation) as predictors of excessive gestational weight gain. FINDINGS Maternal age was the sole demographic factor predictive of excessive gestational weight gain. Older participants (34-41 yrs) were less likely to gain excessive weight when compare to younger participants (18-24 yrs): Odds Ratio 0.20, 95% Confidence Interval 0.05, 0.82. Body image (measured as personal satisfaction and perception of own weight) was the sole social-cognitive factor associated with excessive gestational weight gain. For every one unit improvement in body image score, there was a 33% decreased odds of excessive gestational weight gain (OR 0.67, 95% CI 0.53, 0.85). CONCLUSION This study suggests that younger maternal age and lower perceived body image are predictive of excessive gestational weight gain.
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Affiliation(s)
- Shanna Fealy
- Charles Sturt University, Faculty of Science, School of Nursing, Midwifery and Indigenous Health, 7 Major Innes Road, Port Macquarie, NSW 2444, Australia; University of Newcastle, Faculty of Health and Medicine, School of Nursing and Midwifery, University Drive, Callaghan, NSW 2308, Australia; University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - John Attia
- University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Michael Hazelton
- Charles Sturt University, Faculty of Science, School of Nursing, Midwifery and Indigenous Health, 7 Major Innes Road, Port Macquarie, NSW 2444, Australia; University of Newcastle, Faculty of Health and Medicine, School of Nursing and Midwifery, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Brain and Mental Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Maralyn Foureur
- University of Newcastle, Faculty of Health and Medicine, School of Nursing and Midwifery, University Drive, Callaghan, NSW 2308, Australia; Hunter New England Health Nursing and Midwifery Research Centre, Australia
| | - Clare E Collins
- University of Newcastle, Faculty of Health and Medicine, School of Health Sciences, University Drive, Callaghan, NSW 2308, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Ring Road, Callaghan, NSW 2308, Australia
| | - Roger Smith
- University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; University of Newcastle Priority Research Centre for Reproductive Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Department of Endocrinology, John Hunter Hospital, Newcastle, NSW, Australia
| | - Alexis Hure
- University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
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Secor M. Exercise and Obesity: The role of exercise in prevention, weight loss, and maintenance of weight loss. J Am Assoc Nurse Pract 2020; 32:530-537. [PMID: 32658173 DOI: 10.1097/jxx.0000000000000452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The dramatic increase in overweight and obesity rates poses a public health threat a mandate for nurse practitioners to address this challenge in clinical practice. Exercise plays an essential role in prevention, initial weight loss, and maintenance of weight loss and recommendations for physical activity differ for each category. Intensity of exercise, duration, and effectiveness of various types of physical activity are reviewed. Possible reasons why exercise-focused weight loss goals are not attained are also explored. Nurse practitioners are assuming an increasingly important role in combating the obesity epidemic and can make a positive impact by implementing effective, evidence-based, exercise-focused strategies for prevention, initial weight loss, and maintenance of weight loss.
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Affiliation(s)
- Mimi Secor
- Advanced Practice Education Associates, Lafayette, Louisiana
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Tanikawa Y, Kimachi M, Ishikawa M, Hisada T, Fukuhara S, Yamamoto Y. Association between work schedules and motivation for lifestyle change in workers with overweight or obesity: a cross-sectional study in Japan. BMJ Open 2020; 10:e033000. [PMID: 32354776 PMCID: PMC7213847 DOI: 10.1136/bmjopen-2019-033000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To investigate the association between work schedules and motivation for behavioural change of lifestyle, based on the transtheoretical model (TTM) in workers with overweight or obesity. DESIGN A cross-sectional observational study. SETTING A healthcare examination centre in Japan. PARTICIPANTS Between April 2014 and March 2016, we recruited 9243 participants who underwent healthcare examination and met the inclusion criteria, namely, age 20-65 years, body mass index (BMI) ≥25 kg/m2 and full-time workers. EXPOSURE Night and shift (night/shift) workers were compared with daytime workers in terms of motivation for behavioural change. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was action and maintenance stages of change (SOC) for lifestyle in TTM. In a subgroup analysis, we investigated interactions between characteristics, including age, sex, BMI, current smoking, alcohol habits, hours of sleep and working hours. RESULTS Overall, 1390 participants (15.0%) were night/shift workers; night/shift workers were younger (median age (IQR): 46 (40-54) vs 43 (37-52) years) and the proportion of men was lesser (75.4 vs 60.9%) compared with daytime workers. The numbers of daytime and night/shift workers in the action and maintenance SOC were 2113 (26.9%) and 309 (22.2%), respectively. Compared with daytime workers, night/shift workers were less likely to demonstrate action and maintenance SOC (adjusted OR (AOR): 0.85, 95% CI: 0.74 to 0.98). In a subgroup analysis that included only those with long working hours (≥10 hours/day), results revealed a strong inverse association between night/shift work and action and maintenance SOC (AOR: 0.65, 95% CI: 0.48 to 0.86). A significant interaction was observed between long working hours and night/shift work (P for interaction=0.04). CONCLUSIONS In workers with overweight or obesity, a night/shift work schedule was associated with a lower motivation for behavioural change in lifestyle, and the association was strengthened in those with long working hours.
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Affiliation(s)
- Yukihiro Tanikawa
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Miho Kimachi
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Minoru Ishikawa
- Health Examination Centre, Urasoe General Hospital, Urasoe, Japan
| | | | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University, Kyoto, Japan
- Centre for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
- Shirakawa STAR for General Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Huttunen-Lenz M, Raben A, Meinert-Larsen T, Drummen M, Macdonald I, Martínez JA, Handjieva-Darlenska T, Poppitt SD, Jalo E, Muirhead R, Schlicht W. Sociocognitive factors associated with lifestyle intervention attrition after successful weight loss among participants with prediabetes-The PREVIEW study. Public Health Nurs 2020; 37:393-404. [PMID: 32160348 DOI: 10.1111/phn.12718] [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: 11/20/2019] [Revised: 02/10/2020] [Accepted: 02/24/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Major risk factors for type 2 diabetes are lifestyle choices such as lack of physical activity (PA) and poor diet. Many individuals either do not take part or struggle to complete interventions supporting lifestyle changes. Demographic and theory-based sociocognitive factors associated with PREVIEW intervention attrition after successful weight loss were examined. METHODS Participants (1,856) who started the weight maintenance phase after completion of low-energy diet were retrospectively divided into three clusters depending on the point they left the trial. Discriminant analysis examined which demographic and theory-based sociocognitive variables were associated with cluster membership. RESULTS Most of the participants were women and well-educated. Two discriminant functions were calculated (χ2 (24) = 247.0, p ≥ .05, d = 0.78). The demographic variables, such as age and ethnicity, and the social cognitive variable outcome expectancies on the other side were associated with cluster membership. Older age, Caucasian ethnicity, and fewer expected disadvantages of PA were associated with high success. DISCUSSION The discriminant model gave insight into some factors associated with early attrition. For practitioners planning interventions it underlines the necessity to take extra attention to younger participants and to those being afraid that being physically active causes unpleasant ramifications.
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Affiliation(s)
- Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Thomas Meinert-Larsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Ian Macdonald
- School of Life Sciences, MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - José Alfredo Martínez
- Department of Nutrition and Physiology, Center for Nutrition Research, University of Navarra Pamplona, IDISNA Navarra, Pamplona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III IMDEAfood Madrid, Madrid, Spain
| | | | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Wolfgang Schlicht
- Department of Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany
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10
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Fielding-Singh P, Patel ML, King AC, Gardner CD. Baseline Psychosocial and Demographic Factors Associated with Study Attrition and 12-Month Weight Gain in the DIETFITS Trial. Obesity (Silver Spring) 2019; 27:1997-2004. [PMID: 31633313 PMCID: PMC6868338 DOI: 10.1002/oby.22650] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/26/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The purpose of this study was to examine correlates of failure-trial attrition and weight gain-in a randomized clinical weight-loss trial. METHODS The Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) trial included 609 adults (18-50 years; BMI 28-40). Participants were randomized to a 12-month healthy low-fat or healthy low-carbohydrate diet for weight loss. At baseline, participants completed psychosocial, demographic, and anthropometric measures. Stepwise logistic regressions identified baseline factors associated with (1) study attrition and (2) among trial completers, weight gain at 12 months. RESULTS Having higher baseline food addiction and self-efficacy was linked to treatment failure. Being younger, not having a college education, having higher outcome expectations and quality of life, and having lower social functioning and self-control increased the odds of trial attrition. Identifying as other than non-Hispanic white; not being married or cohabitating; having higher cognitive restraint and self-control; and having lower amotivation, family encouragement, and physical limitations increased the odds of gaining weight by treatment's end. CONCLUSIONS Participants' baseline psychosocial and demographic factors may support or impede successful weight loss. Trialists should attend to these factors when designing treatments in order to promote participants' likelihood of completing the trial and achieving their weight-loss goals.
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Affiliation(s)
- Priya Fielding-Singh
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Michele L. Patel
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
| | - Abby C. King
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
- Department of Health Research & Policy, Stanford University School of Medicine, Stanford, California, United States
| | - Christopher D. Gardner
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States
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