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Barrett S, Begg S, Sally H, O'Halloran P, Kunstler B, Bolam B, Kevin M, Kingsley M. Preventive healthcare practice by allied health professionals: Results from a cross-sectional survey in rural and regional Victoria. Aust N Z J Public Health 2024; 48:100192. [PMID: 39321739 DOI: 10.1016/j.anzjph.2024.100192] [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: 10/30/2023] [Revised: 08/11/2024] [Accepted: 08/28/2024] [Indexed: 09/27/2024] Open
Abstract
OBJECTIVES To describe the frequency of preventive healthcare practice (assess, advice, refer for support) provided by allied health professionals (AHPs) practicing in regional and rural healthcare settings to address smoking, diet and physical inactivity. To identify factors that influence the delivery of preventive healthcare practice. METHODS AHPs working in public healthcare services in the Loddon Mallee region of Victoria were surveyed. Clinicians reported on the proportion of clients where they had provided preventive care. Likert scale questions measured factors influencing preventive healthcare practice. RESULTS In total, 115 clinicians completed the survey. AHPs reported that they assess for smoking and physical activity behaviours but not diet. Preventive health practice that included providing advice or referrals for follow-on support was rarely undertaken. Availability of screening tools and automated referral letters increased the likelihood of preventive healthcare practice. CONCLUSIONS Greater attention to addressing modifiable lifestyle behaviours by AHPs might be warranted to match the rates of risk factors in rural and regional Victoria. Integrating support systems, for example, embedding screening questions within clinical assessments can assist preventive healthcare practice. IMPLICATION FOR PUBLIC HEALTH Many AHPs are not promoting healthy behaviours to prevent poor health. We present some strategies that could potentially improve this.
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Affiliation(s)
- Stephen Barrett
- Research and Innovation, Bendigo Health, Victoria, 3552, Australia; Holsworth Research Initiative, La Trobe University, Bendigo, Victoria, 3552, Australia.
| | - Stephen Begg
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, Bendigo, Victoria, Australia
| | - Harris Sally
- Allied Health Directorate, Bendigo Health, Victoria, 3552, Australia
| | - Paul O'Halloran
- Centre for Sport and Social Impact, La Trobe University, Melbourne, 3086, Australia; School of Psychology and Public Health La Trobe University Melbourne, 3086, Australia
| | - Breanne Kunstler
- BehaviourWorks Australia, Monash University, Melbourne, Australia
| | - Bruce Bolam
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, Bendigo, Victoria, Australia
| | - Masman Kevin
- Research and Innovation, Bendigo Health Care Group, Victoria, 3552, Australia
| | - Michael Kingsley
- Holsworth Research Initiative, La Trobe University, Bendigo, Victoria, 3552, Australia; Department of Exercise Sciences, University of Auckland, New Zealand
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Collins RA, Ashton LM, Burrows TL, Hutchesson M, Adam MTP, Clarke ED, Collins CE. No Money No Time Culinary Nutrition Website eHealth Challenge: A Pre-Post Evaluation of Impact on Diet Quality, Food Expenditure, and Engagement. Nutrients 2024; 16:2950. [PMID: 39275264 PMCID: PMC11397432 DOI: 10.3390/nu16172950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/22/2024] [Accepted: 08/29/2024] [Indexed: 09/16/2024] Open
Abstract
No Money No Time (NMNT) is a culinary nutrition website designed to optimize diet quality. The primary aim was to evaluate the impact of an online targeted nutrition challenge email campaign that encouraged engagement with NMNT and goal setting to improve diet quality and weekly food expenditure. A secondary aim was to assess NMNT engagement. Australian adults ≥18 years were recruited to the eHealth nutrition challenge delivered via weekly emails. Diet quality was assessed using the Healthy Eating Quiz (HEQ) diet quality tool. Engagement was assessed using email open and click-through rates. Intention-to-treat (ITT) analysis was conducted using mixed effects linear regression. Of 481 adults (49.7 ± 13.9 years, 84% female) who enrolled 79 (16%) completed the challenge. ITT results indicated statistically significant 6-week increases in diet quality score (+3.8 points p ≤ 0.001, d = 0.58) with sub-scale improvements in vegetables (+0.9 points, p = 0.01, d = 0.32), fruit (+1.2 points, p ≤ 0.001, d = 0.55), and dairy (+0.9 points, p ≤ 0.001, d = 0.58). There were significant post-challenge reductions in household spending on takeaway/snacks/coffee of AUD 8.9 per week (p = 0.01, d = 0.29), body weight reduction (-0.6 kg, p = 0.03, d = 0.26), and BMI (-0.2 kg/m2p = 0.02, d = 0.28). The email open rate remained constant at around 67% (56% to 75%), with an average click-through rate of 18% (7.1% to 37.9%). The eHealth nutrition challenge significantly improved diet quality while reducing BMI and money spent on discretionary foods. Strategies to scale the challenge should be tested as an innovative population strategy for improving diet quality, health indicators, and managing household food budgets.
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Affiliation(s)
- Rebecca A Collins
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Lee M Ashton
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- School of Education, College of Human & Social Futures, The University of Newcastle, Callaghan, NSW 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Melinda Hutchesson
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Marc T P Adam
- School of Information and Physical Sciences, College of Engineering, Science and Environment, The University of Newcastle, New Lambton Heights, NSW 2305, Australia
| | - Erin D Clarke
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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Nichol B, Haighton C, Wilson R, Rodrigues AM. Enhancing making every contact count (MECC) training and delivery for the third and social economy (TSE) sector: a strategic behavioural analysis. Psychol Health 2024:1-32. [PMID: 39086100 DOI: 10.1080/08870446.2024.2386289] [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: 12/04/2023] [Revised: 07/03/2024] [Accepted: 07/24/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE To enhance Making Every Contact Count (MECC, an opportunistic approach to health promotion), training in the Third and Social Economy (TSE, all groups and organisations primarily working towards social justice, outside of the government or household) by examining the degree to which the behavioural content of MECC training tackled significant factors influencing MECC delivery. METHODS AND MEASURES A strategic behavioural analysis design. Semi-structured interviews with service providers (n = 15) and users (n = 5) were coded for barriers and facilitators of MECC delivery using the Theoretical Domains Framework (TDF). Existing MECC training was coded for behaviour change techniques (BCTs) and intervention functions (IFs). The degree to which BCTs and IFs addressed the key TDF domains of influences on MECC delivery in the TSE were examined using prespecified tools. RESULTS Seven key TDF domains of influences in MECC delivery were identified. Overall, only 9/31 linked BCTs were utilised within MECC training, with percentage utilisation of relevant BCTs for each domain ranging from 0% to 66.7%. Training adequately addressed 2/7 key domains. CONCLUSION The TSE and healthcare share many common key TDF domains, although there are differences in how each are relevant. Limitations and recommendations for MECC training are discussed.
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Affiliation(s)
- Beth Nichol
- Department of Social Work, Education, and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Catherine Haighton
- Department of Social Work, Education, and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Rob Wilson
- Newcastle Business School, Northumbria University, Newcastle upon Tyne, UK
| | - Angela M Rodrigues
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
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Rodrigues AM, Nichol B, Wilson R, Charlton C, Gibson B, Finch T, Haighton C, Maniatopoulos G, Giles E, Harrison D, Orange D, Robson C, Harland J. Mapping regional implementation of 'Making Every Contact Count': mixed-methods evaluation of implementation stage, strategies, barriers and facilitators of implementation. BMJ Open 2024; 14:e084208. [PMID: 39038864 PMCID: PMC11268057 DOI: 10.1136/bmjopen-2024-084208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/28/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND The Making Every Contact Count (MECC) programme provides training and materials to support public-facing workers to encourage health-promoting behaviour change by using the day-to-day interactions between organisations and individuals. This project aimed to analyse MECC implementation through a comparative analysis of implementation stage, strategies used for implementation and enablers/barriers of the implementation process within a region in England-the North East and North Cumbria (NENC). METHODS A mixed-methods process evaluation was conducted applying normalisation process theory and theoretical domains framework. MECC programme documents were reviewed and mapped against specific criteria (eg, implementation strategies). An online mapping survey was conducted to establish current implementation/delivery of MECC within NENC settings (eg, local government, healthcare and voluntary community sector). Qualitative research, using individual interviews and group discussions, was conducted to establish further understanding of MECC implementation. RESULTS Our findings were informed by reviewing documents (n=5), surveying participants (n=34), interviews (n=18) and group discussions (n=48). Overall, the implementation of MECC within the region was at an early stage, with training mostly delivered between, rather than within, organisations. Qualitative findings highlighted factors that influence stakeholders to implement MECC (eg, organisational goals that were facilitated by MECC implementation, including the prevention agenda), supported resources that facilitate the implementation of MECC (eg, logic models) and enabling factors that promote MECC sustainability across the region (eg, buy-in from leadership and management). CONCLUSIONS The NENC MECC programme is built around regional leadership that supports the implementation process. This process evaluation identified key influences of MECC implementation across the region. We discuss evidence-based recommendation for policy and practice that can be taken forward to develop targeted strategies to support future MECC implementation. For example, a co-ordinated infrastructure and strategy is needed to combat delivery and implementation issues identified.
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Affiliation(s)
- Angela M Rodrigues
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Bethany Nichol
- Department of Social Work, Education and Community Wellbeing, Northumbria University Newcastle, Newcastle Upon Tyne, UK
| | - Rob Wilson
- Newcastle Business School, Northumbria University, Newcastle upon Tyne, UK
| | - Caroline Charlton
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Beckie Gibson
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
| | - Catherine Haighton
- Department of Social Work, Education and Community Wellbeing, Northumbria University Newcastle, Newcastle Upon Tyne, UK
| | | | - Emma Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Deborah Harrison
- Newcastle University Business School, Newcastle University, Newcastle upon Tyne, UK
| | - Denise Orange
- Office for Health Improvement & Disparities, Newcastle upon Tyne, UK
| | - Craig Robson
- North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Jill Harland
- North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
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Collange F, Baudot A, Verot É. [Impact of a program encouraging prevention in primary care on a daily and opportunistic basis]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2024; 69:37-40. [PMID: 38762232 DOI: 10.1016/j.soin.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2024]
Abstract
In France, clinical preventive practices are still underdeveloped and formalized, notably due to a lack of guidelines, despite the fact that a proactive and systematic prevention and health promotion strategy involving all healthcare professionals seems essential. The P3C program aims to encourage preventive clinical practices among healthcare professionals, and thus contribute to the emergence of a common culture of prevention.
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Affiliation(s)
- Fanny Collange
- CIC 1408 Inserm, CHU de Saint-Étienne, 25 boulevard Pasteur, 42055 Saint-Étienne, France
| | - Amandine Baudot
- CIC 1408 Inserm, CHU de Saint-Étienne, 25 boulevard Pasteur, 42055 Saint-Étienne, France; Unité de recherche clinique (URC), CHU de Saint-Étienne, 25 boulevard Pasteur, 42055 Saint-Étienne, France
| | - Élise Verot
- CIC 1408 Inserm, CHU de Saint-Étienne, 25 boulevard Pasteur, 42055 Saint-Étienne, France; Laboratoire Parcours santé systémique (P2S), UR4129, Faculté de médecine Laënnec-Bât B, 7-11 rue Guillaume-Paradin, 69372 Lyon, France; Institut PRESAGE, Chaire Hygée, Université Jean-Monnet, 10 rue de la Marandière, 42270 Saint-Priest-en Jarez, France
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Wittleder S, Reinelt T, Milanowski L, Viglione C, Jay M, Oettingen G. Testing Go/No-Go training effects on implicit evaluations of unhealthy and healthy snack foods. Psychol Health 2024; 39:573-593. [PMID: 35946400 DOI: 10.1080/08870446.2022.2105335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 07/11/2022] [Accepted: 07/19/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Despite intending to eat healthy foods, people often yield to temptation. In environments rife with unhealthy food options, a positive implicit evaluation of unhealthy foods may inadvertently influence unhealthy choices. This study investigates if and under which conditions implicit evaluations of unhealthy and healthy foods can be influenced by a computer-based Go/No-Go (GNG) training. DESIGN Undergraduate student participants (N = 161 participants; 117 females, 44 males; Mage = 19 years, SD = 2 years) completed a GNG training with two healthy (grape and nut) and two unhealthy (potato chip and cookie) stimuli. Participants were either instructed to inhibit their responses to the potato chip (No-Go Chips/Go Grape) or to a grape (No-Go Grape/Go Chips). MAIN OUTCOME MEASURE Implicit evaluations of chips and grapes were assessed using the Extrinsic Affective Simon Task. RESULTS This GNG training impacted implicit evaluations of chips, but not grapes. GNG training effects were stronger for participants with lower sensitivity for behavioural inhibition measured with the Behavioural Inhibition System scale. CONCLUSION GNG training might help people change implicit food evaluations. More research is needed to understand how individual and training characteristics affect outcomes with the goal of tailoring and optimising the GNG training to produce the strongest effect.
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Affiliation(s)
| | - Tilman Reinelt
- Family Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the Newborn, Department of Neonatology, University of Zurich, Zurich, Switzerland
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| | - Luiça Milanowski
- Department of Psychology, University of Hamburg, Hamburg, Germany
| | - Clare Viglione
- UC San Diego Herbert Wertheim School of Public Health and Longevity Science, San Diego University, San Diego, CA, USA
| | - Melanie Jay
- NYU Grossman School of Medicine, New York, NY, USA
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McKay FH, Zinga J, van der Pligt P. Could commercial meal kits be part of the solution to food insecurity during pregnancy? An Australian exploratory study. Nutr Diet 2024; 81:228-236. [PMID: 37845189 DOI: 10.1111/1747-0080.12845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 10/18/2023]
Abstract
AIM To explore the nutritional content of meal kits from two main Australian companies over a 6-week period against healthy eating guidelines for pregnancy. METHOD Across the 6-week period, weekly meal kits from both Provider 1 and Provider 2 were purchased, 36 individual meals were assessed. All data were analysed for the development of a macronutrient and micronutrient profile of meals. Extracted data were macronutrient, vitamin, and mineral composition, which were compared against the healthy eating guidelines for pregnant women in Australia and New Zealand. RESULTS Meal kits include higher levels of sodium, and lower levels of dietary fibre, calcium, magnesium, zinc, iron, thiamin, riboflavin, grains, and dairy when compared against the guidelines for healthy eating for pregnant women in Australia and New Zealand. CONCLUSIONS AND IMPLICATIONS Meal kits may increase meals prepared and consumed in the home, and thanks to the clear instructions and pre-portioned ingredients, may reduce stress related to food preparation. They have the potential to provide nutritionally adequate meals to pregnant women as a way to mitigate food insecurity or hunger during pregnancy and may provide some nutritional benefits and have the potential to remove some of the challenges with maintaining an adequate diet when pregnant.
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Affiliation(s)
- Fiona H McKay
- Faculty of Health, School of Health and Social Development/Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Julia Zinga
- Faculty of Health, School of Health and Social Development/Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Royal Women's Hospital, Parkville, Victoria, Australia
| | - Paige van der Pligt
- Faculty of Health, The Institute for Physical Activity and Nutrition (IPAN) and School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Department of Nutrition, Western Health, Footscray, Victoria, Australia
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Onofrei LM, Puiu M, Chirita-Emandi A, Serban CL. A comprehensive analysis concerning eating behavior associated with chronic diseases among Romanian community nurses. Front Public Health 2024; 12:1368069. [PMID: 38577280 PMCID: PMC10991806 DOI: 10.3389/fpubh.2024.1368069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Lifestyle factors, including inadequate eating patterns, emerge as a critical determinant of chronic disease. Apart from caring for patients, nurses should also take an active role in monitoring and managing their own health. Understanding the intricate relationship between nurses' eating behavior and managing their own health is crucial for fostering a holistic approach to healthcare, therefore our study aimed to evaluate eating behavior and demographic factors influencing chronic disease prevalence in a sample of community nurses from Romania. Methods Between October-November 2023, 1920 community nurses were invited to answer an online survey, using an advertisement in their professional network. Of them, 788 responded. In the survey, which included a semi-quantitative food frequency questionnaire with 53 food items, the Intuitive Eating Survey 2 (IES-2), and demographic items were used. Results A multivariate model was built for the prediction of the association between eating behavior and other factors associated with chronic diseases. The majority of participants were females (95.1%), with the largest age group falling between 40 and 49.9 years (48.2%). Regarding the EFSA criteria for adequate carbohydrate and fat intake, 20.2% of the group have a high intake of carbohydrates, respectively, 43.4% of the group have a high intake of fat. Analysis of chronic diseases indicated that 24.9% of individuals reported at least one diagnosis by a physician. The presence of chronic disease was associated with a low level of perceived health status, with an OR = 3.388, 95%CI (1.684-6.814), compared to those reporting excellent or very good perceived health status. High stress had an OR = 1.483, 95%CI (1.033-2.129). BMI had an OR = 1.069, 95%CI (1.032-1.108), while low carbohydrate diet score had an OR = 0.956, 95%CI (0.920-0.992). Gender and IES-2 did not significantly contribute to the model, but their effect was controlled. Discussion By unraveling the intricate interplay between nutrition, lifestyle, and health outcomes in this healthcare cohort, our findings contribute valuable insights for the development of targeted interventions and support programs tailored to enhance the well-being of community nurses and, by extension, the patients they support.
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Affiliation(s)
- Lidia-Manuela Onofrei
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Maria Puiu
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania
- Regional Center of Medical Genetics Timis, Clinical Emergency Hospital for Children “Louis Turcanu”, part of ERN ITHACA, Timisoara, Timis, Romania
| | - Adela Chirita-Emandi
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania
- Regional Center of Medical Genetics Timis, Clinical Emergency Hospital for Children “Louis Turcanu”, part of ERN ITHACA, Timisoara, Timis, Romania
| | - Costela Lacrimioara Serban
- Regional Center of Medical Genetics Timis, Clinical Emergency Hospital for Children “Louis Turcanu”, part of ERN ITHACA, Timisoara, Timis, Romania
- Department of Functional Sciences, Discipline of Public Health, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
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Russell RD, Black LJ, Purdue J, Daly A, Begley A. A collaborative approach to designing an online nutrition education program for people with multiple sclerosis. Disabil Rehabil 2024; 46:947-956. [PMID: 36908015 DOI: 10.1080/09638288.2023.2186499] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 02/24/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE People with multiple sclerosis (pwMS) want disease-specific dietary advice to reduce the confusion around diet. This study used co-design principles to develop an online nutrition education program for pwMS. METHODS Mixed-methods (multiphase sequential design). Phase 1: online survey (n = 114 pwMS) to explore preferred content and characteristics of a nutrition program and develop a draft program. Phase 2: feedback on the draft program from stakeholders (two meetings; n = 10 pwMS and multiple sclerosis (MS) health professionals) and pwMS (two workshops; n = 6) to produce a full program prototype. Phase 3: cognitive interviews (n = 8 pwMS plus 1 spouse) to explore acceptability and ease of comprehension of one module of the program, analysed using deductive content analysis. RESULTS Preferred topics were included in the program, which were further developed with consumer feedback. Cognitive interviews produced four themes: (1) positive and targeted messaging to motivate behaviour change; (2) "not enough evidence" is not good enough; (3) expert advice builds in credibility; and (4) engaging and appropriate online design elements are crucial. CONCLUSIONS Positive language appears to improve motivation to make healthy dietary changes and engagement with evidence-based nutrition resources. To ensure acceptability, health professionals can use co-design to engage consumers when developing resources for pwMS.IMPLICATIONS FOR REHABILITATIONCo-designed nutrition education programs can help people achieve high-quality diets in line with recommendations, but very few programs exist for people with multiple sclerosis (MS), and none were co-designedThe participatory research in this study was instrumental in ensuring that important information regarding program acceptability was identifiedCo-design can ensure that the language is appropriate for the target audience, and positive language appeared to improve motivation in people with MS to engage with the online nutrition education programWhere practical and feasible, health professionals should collaborate with MS consumers when developing resources, and use positive, empowering language.
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Affiliation(s)
- Rebecca D Russell
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Lucinda J Black
- Curtin School of Population Health, Curtin University, Perth, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, Australia
| | - Justine Purdue
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Alison Daly
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Andrea Begley
- Curtin School of Population Health, Curtin University, Perth, Australia
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Minian N, Mehra K, Lingam M, Dragonetti R, Veldhuizen S, Zawertailo L, deRuiter WK, Melamed OC, Moineddin R, Thorpe KE, Taylor VH, Hahn M, Selby P. Healthcare providers' perspectives on implementing a brief physical activity and diet intervention within a primary care smoking cessation program: a qualitative study. BMC PRIMARY CARE 2024; 25:16. [PMID: 38184559 PMCID: PMC10770944 DOI: 10.1186/s12875-023-02259-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/24/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Post-smoking-cessation weight gain can be a major barrier to quitting smoking; however, adding behavior change interventions for physical activity (PA) and diet may adversely affect smoking cessation outcomes. The "Picking up the PACE (Promoting and Accelerating Change through Empowerment)" study assessed change in PA, fruit/vegetable consumption, and smoking cessation by providing a clinical decision support system for healthcare providers to utilize at the intake appointment, and found no significant change in PA, fruits/vegetable consumption, or smoking cessation. The objective of this qualitative study was to explore the factors affecting the implementation of the intervention and contextualize the quantitative results. METHODS Twenty-five semi-structured interviews were conducted with healthcare providers, using questions based on the National Implementation Research Network's Hexagon Tool. The data were analyzed using the framework's standard analysis approach. RESULTS Most healthcare providers reported a need to address PA and fruit/vegetable consumption in patients trying to quit smoking, and several acknowledged that the intervention was a good fit since exercise and diet could improve smoking cessation outcomes. However, many healthcare providers mentioned the need to explain the fit to the patients. Social determinants of health (e.g., low income, food insecurity) were brought up as barriers to the implementation of the intervention by a majority of healthcare providers. Most healthcare providers recognized training as a facilitator to the implementation, but time was mentioned as a barrier by many of healthcare providers. Majority of healthcare providers mentioned allied health professionals (e.g., dieticians, physiotherapists) supported the implementation of the PACE intervention. However, most healthcare providers reported a need for individualized approach and adaptation of the intervention based on the patients' needs when implementing the intervention. The COVID-19 pandemic was found to impact the implementation of the PACE intervention based on the Hexagon Tool indicators. CONCLUSION There appears to be a need to utilize a flexible approach when addressing PA and fruit/vegetable consumption within a smoking cessation program, based on the context of clinic, the patients' it is serving, and their life circumstances. Healthcare providers need support and external resources to implement this particular intervention. NAME OF THE REGISTRY Clinicaltrials.gov. TRIAL REGISTRATION NUMBER NCT04223336. DATE OF REGISTRATION 7 January 2020 Retrospectively registered. URL OF TRIAL REGISTRY RECORD: https://classic. CLINICALTRIALS gov/ct2/show/NCT04223336 .
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Affiliation(s)
- Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
- Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Kamna Mehra
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
| | - Mathangee Lingam
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
| | - Rosa Dragonetti
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Scott Veldhuizen
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Laurie Zawertailo
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Wayne K deRuiter
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
| | - Osnat C Melamed
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Kevin E Thorpe
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Toronto, Canada
| | - Valerie H Taylor
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Margaret Hahn
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada
- Banting and Best Diabetes Centre, University of Toronto, Toronto, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada.
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
- Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Toronto, Canada.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
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11
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Pelly FE, Thurecht RL. Evaluation of an Environmental Nutrition Intervention at the 2018 Commonwealth Games. Nutrients 2023; 15:4678. [PMID: 37960331 PMCID: PMC10647693 DOI: 10.3390/nu15214678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
There has been an increasing expectation that the food provided for athletes at major competition events meets the specific dietary and performance needs of athletes. The aim of this study was to map the range of food service nutrition schemes that were implemented prior to and during a major competition event (2018 Commonwealth Games) and evaluate these schemes through staff training satisfaction, athlete feedback, and quality assurance checks. This study followed a case study design with nutrition schemes as follows: informing (nutrition labelling), enabling (staff training, nutrition service), and engineering (modification to menus and recipes). Overall, participants reported that they easily found items on the menu that met their nutritional/dietary needs. When asked how useful the schemes were in helping them to identify items that meet their needs, the majority of participants found the nutrition cards (n = 227, 71%) and serving staff (n = 212, 66%) 'useful/very useful'. 'Good/very good' ratings were received by >90% of respondents for speed of service, staff politeness, and knowledge of the menu. Participants (n = 316) who rated the nutrition staff as 'useful/very useful' gave a higher median rating for the menu. Past events have focused on the impact of a single component in the food environment; however, taking a whole systems approach resulted in more suitable food provision to meet the dietary needs of athletes.
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Affiliation(s)
- Fiona E. Pelly
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia;
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12
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Meade O, O'Brien M, Noone C, Lawless A, McSharry J, Deely H, Hart J, Hayes CB, Keyworth C, Lavoie K, McGowan O, Murphy AW, Murphy PJ, O'Reilly O, Byrne M. Exploring barriers and enablers to the delivery of Making Every Contact Count brief behavioural interventions in Ireland: A cross-sectional survey study. Br J Health Psychol 2023; 28:753-772. [PMID: 36843183 DOI: 10.1111/bjhp.12652] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/24/2023] [Indexed: 02/28/2023]
Abstract
OBJECTIVES The public health impact of the Irish Making Every Contact Count (MECC) brief intervention programme is dependent on delivery by health care professionals. We aimed to identify enablers and modifiable barriers to MECC intervention delivery to optimize MECC implementation. DESIGN Online cross-sectional survey design. METHODS Health care professionals (n = 4050) who completed MECC eLearning were invited to complete an online survey based on the Theoretical Domains Framework (TDF). Multiple regression analysis identified predictors of MECC delivery (logistic regression to predict delivery or not; linear regression to predict frequency of delivery). Data were visualized using Confidence Interval-Based Estimates of Relevance (CIBER). RESULTS Seventy-nine per cent of participants (n = 283/357) had delivered a MECC intervention. In the multiple logistic regression (Nagelkerke's R2 = .34), the significant enablers of intervention delivery were 'professional role' (OR = 1.86 [1.10, 3.15]) and 'intentions/goals' (OR = 4.75 [1.97, 11.45]); significant barriers included 'optimistic beliefs about consequences' (OR = .41 [.18, .94]) and 'negative emotions' (OR = .50 [.32, .77]). In the multiple linear regression (R2 = .29), the significant enablers of frequency of MECC delivery were 'intentions/goals' (b = 10.16, p = .02) and professional role (b = 6.72, p = .03); the significant barriers were 'negative emotions' (b = -4.74, p = .04) and 'barriers to prioritisation' (b = -5.00, p = .01). CIBER analyses suggested six predictive domains with substantial room for improvement: 'intentions and goals', 'barriers to prioritisation', 'environmental resources', 'beliefs about capabilities', 'negative emotions' and 'skills'. CONCLUSION Implementation interventions to enhance MECC delivery should target intentions and goals, beliefs about capabilities, negative emotions, environmental resources, skills and barriers to prioritization.
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Affiliation(s)
- Oonagh Meade
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Maria O'Brien
- Office of the Chief Clinical Officer, Health Services Executive, Cork, Ireland
| | - Chris Noone
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Agatha Lawless
- Making Every Contact Count, Health & Wellbeing, Strategy & Research, Health Services Executive, Waterford, Ireland
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Helen Deely
- Strategy & Research, Healthcare Strategy, Health Service Exectutive, Dublin, Ireland
| | - Jo Hart
- University of Manchester, Manchester, UK
| | - Catherine B Hayes
- Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Ireland
| | | | - Kim Lavoie
- University of Quebec at Montreal (UQAM) & Montréal Behavioural Medicine Centre, CIUSSS-NIM, Montréal, Canada
| | - Orla McGowan
- Health Service Executive Health and Wellbeing, Dublin, Ireland
| | - Andrew W Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, University of Galway, Galway, Ireland
| | - Patrick J Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, Discipline of General Practice, University of Galway, Galway, Ireland
| | - Orlaith O'Reilly
- Office of the Chief Clinical Officer, Health Services Executive, Kilkenny, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
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FISCELLA KEVIN, EPSTEIN RONALDM. The Profound Implications of the Meaning of Health for Health Care and Health Equity. Milbank Q 2023; 101:675-699. [PMID: 37343061 PMCID: PMC10509522 DOI: 10.1111/1468-0009.12660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023] Open
Abstract
Policy Points The meaning of health in health care remains poorly defined, defaulting to a narrow, biomedical disease model. A national dialogue could create a consensus regarding a holistic and humanized definition of health that promotes health care transformation and health equity. Key steps for operationalizing a holistic meaning of health in health care include national leadership by federal agencies, intersectoral collaborations that include diverse communities, organizational and cultural change in medical education, and implementation of high-quality primary care. The 2023 report by the National Academies of Sciences, Engineering, and Medicine on achieving whole health offers recommendations for action.
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14
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Haslam RL, Baldwin JN, Pezdirc K, Truby H, Attia J, Hutchesson MJ, Burrows T, Callister R, Hides L, Bonevski B, Kerr DA, Kirkpatrick SI, Rollo ME, McCaffrey TA, Collins CE. Efficacy of technology-based personalised feedback on diet quality in young Australian adults: results for the advice, ideas and motivation for my eating (Aim4Me) randomised controlled trial. Public Health Nutr 2023; 26:1293-1305. [PMID: 36755380 PMCID: PMC10346011 DOI: 10.1017/s1368980023000253] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/01/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE Web-based dietary interventions could support healthy eating. The Advice, Ideas and Motivation for My Eating (Aim4Me) trial investigated the impact of three levels of personalised web-based dietary feedback on diet quality in young adults. Secondary aims were to investigate participant retention, engagement and satisfaction. DESIGN Randomised controlled trial. SETTING Web-based intervention for young adults living in Australia. PARTICIPANTS 18-24-year-olds recruited across Australia were randomised to Group 1 (control: brief diet quality feedback), Group 2 (comprehensive feedback on nutritional adequacy + website nutrition resources) or Group 3 (30-min dietitian consultation + Group 2 elements). Australian Recommended Food Score (ARFS) was the primary outcome. The ARFS subscales and percentage energy from nutrient-rich foods (secondary outcomes) were analysed at 3, 6 and 12 months using generalised linear mixed models. Engagement was measured with usage statistics and satisfaction with a process evaluation questionnaire. RESULTS Participants (n 1005, 85 % female, mean age 21·7 ± 2·0 years) were randomised to Group 1 (n 343), Group 2 (n 325) and Group 3 (n 337). Overall, 32 (3 %), 88 (9 %) and 141 (14 %) participants were retained at 3, 6 and 12 months, respectively. Only fifty-two participants (15 % of Group 3) completed the dietitian consultation. No significant group-by-time interactions were observed (P > 0·05). The proportion of participants who visited the thirteen website pages ranged from 0·6 % to 75 %. Half (Group 2 = 53 %, Group 3 = 52 %) of participants who completed the process evaluation (Group 2, n 111; Group 3, n 90) were satisfied with the programme. CONCLUSION Recruiting and retaining young adults in web-based dietary interventions are challenging. Future research should consider ways to optimise these interventions, including co-design methods.
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Affiliation(s)
- Rebecca L Haslam
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jennifer N Baldwin
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Kristine Pezdirc
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Deborah A Kerr
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, Australia
| | | | - Megan E Rollo
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
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15
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A blended model to support brief interventions in primary care: A qualitative study of usability and acceptability of HealthEir in community pharmacy. Res Social Adm Pharm 2023; 19:807-820. [PMID: 36858904 DOI: 10.1016/j.sapharm.2023.02.008] [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: 06/14/2022] [Revised: 12/12/2022] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Brief interventions for lifestyle behaviour change are effective health promotion interventions. Primary care settings, including pharmacies, are the most frequently visited healthcare facilities and are well placed to provide brief health interventions. However, despite the evidence-based and policy guidance, barriers to brief interventions have limited their implementation. OBJECTIVES This study aimed to explore the usability and acceptability of HealthEir, a blended model with digital, print, and communication elements designed to support the delivery of brief health-promoting interventions in pharmacy practice. METHODS Usability tests using a think aloud protocol and set tasks (to assess usability) and semi-structured interviews (to assess acceptability) were conducted with fifteen patients and twelve pharmacists. Usability data were analysed deductively using Nielsen's five quality components of usability as a framework. Acceptability data were analysed using inductive thematic analysis. FINDINGS All participants found HealthEir straightforward to use and completed the required tasks without assistance. A small number of patient and pharmacist participants identified opportunity for improvement of the digital element. Acceptability was also high, with individual comments from participants identifying opportunity for improvements to HealthEir, and two patients identifying privacy or safety concerns. The majority of comments regarding acceptability reflected wider social and cultural challenges such as perceptions of the roles of pharmacists and pharmacies and the low priority of preventative health interventions. CONCLUSION HealthEir has been demonstrated to be a usable and acceptable support that has the potential to overcome barriers to delivery of brief interventions in pharmacies. Usability and acceptability testing identified minor changes that may further improve its design prior to piloting and implementation.
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16
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Croskey O, Clark MK. Individualized diet conversation in primary care: A pilot intervention. Nurse Pract 2023; 48:38-46. [PMID: 36975749 DOI: 10.1097/01.npr.0000000000000026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
BACKGROUND Most primary care providers do not routinely discuss nutrition and diet with their patients, largely due to lack of time, inadequate resources, and perceived complexity of the topic. This article describes development and implementation of a brief protocol for systematically assessing and discussing diet during routine primary care visits to increase the frequency of these conversations and improve patient health outcomes. METHODS The authors developed a protocol for assessing both nutrition and stage of change as well as a guide for engaging in patient-led conversations about nutrition. The protocol was modeled after Screening, Brief Intervention, and Referral to Treatment and informed by the Dietary Guidelines for Americans, the Transtheoretical Model of Behavior Change, and principles of motivational interviewing. It was implemented over three months at a rural health clinic staffed by one NP. RESULTS The protocol and conversation guide were easy to use with minimal training and seamlessly incorporated into clinic workflow. The likelihood of making diet changes increased significantly following the diet conversation, with persons who initially scored lower in readiness to change ultimately reporting significantly greater increases. CONCLUSION A protocol for assessing diet and engaging patients in a stage of change-appropriate diet conversation can be efficiently integrated into a single primary care visit and increase patients' intent to change their diet. Further investigation is needed to evaluate the protocol more completely and in multiple clinics.
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Córdoba García R, Camarelles Guillem F, Muñoz Seco E, Gómez Puente JM, San José Arango J, Ramírez Manent JI, Martín Cantera C, Del Campo Giménez M, Revenga Frauca J, Egea Ronda A, Cervigón Portaencasa R, Rodríguez Benito L. [PAPPS expert group: Lifestyle recommendations]. Aten Primaria 2022; 54 Suppl 1:102442. [PMID: 36435590 PMCID: PMC9705217 DOI: 10.1016/j.aprim.2022.102442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/24/2022] Open
Abstract
We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.
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Affiliation(s)
- Rodrigo Córdoba García
- Medicina de Familia y Comunitaria, Centro de Salud Delicias Sur. Coordinación del Grupo de ESPS, Zaragoza, España.
| | | | - Elena Muñoz Seco
- Medicina de Familia y Comunitaria, Unidad Básica de Salud Es Castell. Ibsalut, Menorca, España
| | - Juana M Gómez Puente
- Enfermería Familiar y Comunitaria, Centro de Salud San Carlos, San Lorenzo de El Escorial, Madrid, España
| | - Joaquín San José Arango
- Medicina de Familia y Comunitaria, Centro de Salud Vilagarcía. Grupo de Trabajo de Alimentación y Nutrición, Pontevedra, España
| | - José Ignacio Ramírez Manent
- Medicina de Familia y Comunitaria, Centro de Salud de Calviá, Instituto de Investigación Sanitaria Illes Balears (IdIsBa), Islas Baleares, España
| | - Carlos Martín Cantera
- Medicina de Familia y Comunitaria, Grupo de Investigación Estilos de Vida, IDIAP Jordi Gol, Barcelona, España
| | - María Del Campo Giménez
- Medicina de Familia y Comunitaria, Gerencia de Atención Integrada de Albacete, SESCAM, Albacete, España
| | | | - Ana Egea Ronda
- Medicina de Familia y Comunitaria, Consultorio de San Antonio de Benagéber, Valencia, España
| | | | - Laura Rodríguez Benito
- Medicina de Familia y Comunitaria, Manor Practice Surgery, Wallington Sutton, Londres, Reino Unido
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18
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Whatnall M, Clarke ED, Adam MTP, Ashton LM, Burrows T, Hutchesson M, Collins CE. Diet Quality of Adolescents and Adults Who Completed the Australian Healthy Eating Quiz: An Analysis of Data over Six Years (2016-2022). Nutrients 2022; 14:nu14194072. [PMID: 36235723 PMCID: PMC9570644 DOI: 10.3390/nu14194072] [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: 08/17/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Diet quality is influenced by demographics and can change over time. This study aimed to (1) compare diet quality among adolescents/adults who completed the online Healthy Eating Quiz (HEQ) by demographic characteristics, and (2) to evaluate change in score over time for repeat completers. HEQ data collected between July 2016 and May 2022 were analysed, including demographics (age, gender, vegetarian status, socio-economic status, number of people main meals are shared with, country), and diet quality calculated using the Australian Recommended Food Score (ARFS) (range 0−73) for respondents aged ≥ 16 years. Differences in ARFS by demographic characteristics and change in score over time, adjusted for age, gender and vegetarian status, were tested by linear regression. The participants (n = 176,075) were predominantly female (70.4%), Australian (62.8%), and aged 18−24 years (27.7%), with 4.0% (n = 7087) repeat completers. Mean ± SD ARFS was 33.9 ± 9.4/73. Results indicate that ARFS was significantly lower among males and significantly higher with increasing age group, higher socio-economic status, in vegetarians, those who shared main meals with others, and those living in Australia (p-values < 0.001). Mean change in ARFS over time (2.3 ± 6.9) was significantly higher for those with lower baseline scores (p < 0.001). Publicly available, brief dietary assessment tools have the potential to improve diet quality at the population level.
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Affiliation(s)
- Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Erin D. Clarke
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Marc T. P. Adam
- School of Information and Physical Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
| | - Lee M. Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Melinda Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
- Correspondence:
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Lemp JM, Nuthanapati MP, Bärnighausen TW, Vollmer S, Geldsetzer P, Jani A. Use of lifestyle interventions in primary care for individuals with newly diagnosed hypertension, hyperlipidaemia or obesity: a retrospective cohort study. J R Soc Med 2022; 115:289-299. [PMID: 35176215 PMCID: PMC9340092 DOI: 10.1177/01410768221077381] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/15/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Lifestyle interventions can be efficacious in reducing cardiovascular disease risk factors and are recommended as first-line interventions in England. However, recent information on the use of these interventions in primary care is lacking. We investigated for how many patients with newly diagnosed hypertension, hyperlipidaemia or obesity, lifestyle interventions were recorded in their primary care electronic health record. DESIGN A retrospective cohort study. SETTING English primary care, using UK Clinical Practice Research Datalink. PARTICIPANTS A total of 770,711 patients who were aged 18 years or older and received a new diagnosis of hypertension, hyperlipidaemia or obesity between 2010 and 2019. MAIN OUTCOME MEASURES Record of lifestyle intervention and/or medication in 12 months before to 12 months after initial diagnosis (2-year timeframe). RESULTS Analyses show varying results across conditions: While 55.6% (95% CI 54.9-56.4) of individuals with an initial diagnosis of hypertension were recorded as having lifestyle support (lifestyle intervention or signposting) within the 2-year timeframe, this number was reduced to 45.2% (95% CI 43.8-46.6) for hyperlipidaemia and 52.6% (95% CI 51.1-54.1) for obesity. For substantial proportions of individuals neither lifestyle support nor medication (hypertension: 12.2%, 95% CI 11.9-12.5; hyperlipidaemia: 32.2%, 95% CI 31.2-33.3; obesity: 43.9%, 95% CI 42.3-45.4) were recorded. Sensitivity analyses confirm that limited proportions of patients had lifestyle support recorded in their electronic health record before they were first prescribed medication (diagnosed and undiagnosed), ranging from 12.1% for hypertension to 19.7% for hyperlipidaemia, and 19.5% for obesity (23.4% if restricted to Orlistat). CONCLUSIONS Limited evidence of lifestyle support for individuals with cardiovascular risk factors (hypertension, hyperlipidaemia, obesity) recommended by national guidelines in England may stem from poor recording in electronic health records but may also represent missed opportunities. Given the link between progression to cardiovascular disease and modifiable lifestyle factors, early support for patients to manage their conditions through non-pharmaceutical interventions by establishing lifestyle modification as first-line treatment is crucial.
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Affiliation(s)
- Julia M Lemp
- Heidelberg Institute of Global Health, Heidelberg University and University Hospital, 69120 Heidelberg, Germany
| | - Meghana Prasad Nuthanapati
- Department of Economics and Centre for Modern Indian Studies, University of Goettingen, 37073 Göttingen, Germany
| | - Till W Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University and University Hospital, 69120 Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
- Africa Health Research Institute, Somkhele, Mtubatuba, 3935, South Africa
| | - Sebastian Vollmer
- Department of Economics and Centre for Modern Indian Studies, University of Goettingen, 37073 Göttingen, Germany
| | - Pascal Geldsetzer
- Heidelberg Institute of Global Health, Heidelberg University and University Hospital, 69120 Heidelberg, Germany
- Division of Primary Care and Population Health, Stanford University, Stanford, CA 94305, USA
| | - Anant Jani
- Heidelberg Institute of Global Health, Heidelberg University and University Hospital, 69120 Heidelberg, Germany
- Oxford Martin School, Oxford University, Oxford OX1 3BD, UK
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20
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van der Gaag M, Heijmans M, Ballester M, Orrego C, Niño de Guzmán E, Ninov L, Rademakers J. Preferences Regarding Self-Management Intervention Outcomes of Dutch Chronically Ill Patients With Limited Health Literacy. Front Public Health 2022; 10:842462. [PMID: 35646791 PMCID: PMC9130718 DOI: 10.3389/fpubh.2022.842462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background: For many chronically ill patients self-management of their disease is difficult. This may be especially true for people with limited health literacy as they are faced with additional challenges in the day-to-day management of their disease. Research has shown that self-management support is most effective when tailored to the needs and preferences of patients. Therefore, this study explores the preferences regarding self-management outcomes of chronically ill patients with limited health literacy. Methods A total of 35 patients with limited health literacy were invited to a concept-mapping procedure consisting of two card sorting tasks. Patients ranked 60 outcomes, which are often found in literature in relation to self-management, to the level that was important for themselves. Means were calculated for each outcome and domain, and differences within the group were analyzed. Results For patients with limited health literacy, satisfaction with care is the most important outcome domain. This domain includes overall satisfaction, the communication with health care providers, the provision of information and trust. At an outcome level, outcomes related to symptom management and improving competences to self-management scored very high. No differences between patient groups for age and sex were found. Conclusion Chronically ill patients with limited health literacy prefer a wide variety of outcomes for their self-management. Next to health related outcomes, patients mostly prefer to work on their competences for self-management. For health care professionals, acting on these patient preferences and building a solid relationship will enhance successful self-management.
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Affiliation(s)
| | - Monique Heijmans
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Marta Ballester
- Red de investigación en servicios de salud en enfermedades crónicas, Madrid, Spain.,Avedis Donabedian Research Institute (FAD), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carola Orrego
- Red de investigación en servicios de salud en enfermedades crónicas, Madrid, Spain.,Avedis Donabedian Research Institute (FAD), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ena Niño de Guzmán
- Department of Clinical Epidemiology and Public Health, Sant Pau Institute for Biomedical Research, Barcelona, Spain.,Ibero-American Cochrane Center (CCIb), Barcelona, Spain
| | | | - Jany Rademakers
- Netherlands Institute for Health Services Research, Utrecht, Netherlands.,Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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21
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Russell RD, Black LJ, Begley A. Nutrition Education Programs for Adults with Neurological Diseases Are Lacking: A Scoping Review. Nutrients 2022; 14:nu14081577. [PMID: 35458139 PMCID: PMC9030740 DOI: 10.3390/nu14081577] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 12/04/2022] Open
Abstract
The nutrition recommendation for most common neurological diseases is to follow national dietary guidelines. This is to mitigate malnutrition, reduce the risk of diet-related diseases, and to help manage some common symptoms, including constipation. Nutrition education programs can support people in adhering to guidelines; hence the aim of this scoping review was to explore what programs have been implemented for adults with neurological diseases. We conducted this review according to a published a priori protocol. From 2555 articles screened, 13 were included (dementia n = 6; multiple sclerosis n = 4; stroke survivors n = 2; Parkinson’s n = 1). There were no programs for epilepsy, Huntington’s, and motor neurone disease. Program duration and number of sessions varied widely; however, weekly delivery was most common. Just over half were delivered by dietitians. Most did not report using a behavior change theory. Commonly used behavior change techniques were instruction on how to perform a behavior, credible source, and behavioral practice/rehearsal. Evidence of nutrition education programs for adults with neurological diseases is lacking. Of those that are published, many do not meet best practice principles for nutrition education regarding delivery, educator characteristics, and evaluation. More programs aligning with best practice principles are needed to assess characteristics that lead to behavior change.
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Affiliation(s)
- Rebecca D. Russell
- Curtin School of Population Health, Curtin University, Perth, WA 6102, Australia; (R.D.R.); (L.J.B.)
| | - Lucinda J. Black
- Curtin School of Population Health, Curtin University, Perth, WA 6102, Australia; (R.D.R.); (L.J.B.)
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA 6102, Australia
| | - Andrea Begley
- Curtin School of Population Health, Curtin University, Perth, WA 6102, Australia; (R.D.R.); (L.J.B.)
- Correspondence: ; Tel.: +61-8-9266-2773
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22
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Tatta J, Nijs J, Elma Ö, Malfliet A, Magnusson D. The Critical Role of Nutrition Care to Improve Pain Management: A Global Call to Action for Physical Therapist Practice. Phys Ther 2022; 102:6492043. [PMID: 35023558 DOI: 10.1093/ptj/pzab296] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/06/2021] [Accepted: 11/29/2021] [Indexed: 02/06/2023]
Abstract
UNLABELLED Physical therapists have unique education in the comprehensive biopsychosocial assessment and treatment of chronic pain and its mechanisms. Recently, physical therapists have raised awareness regarding the impact of nutrition on promoting health and managing noncommunicable diseases. Robust evidence supports the implementation of nutrition in physical therapist education and practice. Of particular interest for the physical therapist are investigations that use dietary interventions for the treatment of chronic pain. Yet physical therapists have received little guidance regarding their role in nutrition care for pain management and may pass on opportunities to counsel their patients on the connection between nutrition and pain. Therefore, a clinical paradigm shift and unified voice within the profession is called on to encourage physical therapists to develop tailored multimodal lifestyle interventions that include nutrition care for the management of chronic pain. This Perspective describes evidence supporting the implementation of nutrition care in physical therapist practice, supports the role of nutritional pain management for physical therapists, and encourages the use of nutrition care for primary, secondary, tertiary, prevention, health promotion, and wellness related to chronic pain. To achieve these aims, this Perspective offers suggestions for how physical therapists can (1) enhance clinical decision making; (2) expand professional, jurisdictional, and personal scope of practice; (3) evolve entry-level education; and (4) stimulate new investigations in nutrition care and pain science research. In doing so, physical therapists can assert their role throughout the pain management continuum, champion innovative research initiatives, and enhance public health by reducing the impact of chronic pain. IMPACT The nutrition care process for pain management is defined as the basic duty to provide adequate and appropriate nutrition education and counseling to people living with pain. Including the nutrition care process as part of a multimodal approach to pain management provides an opportunity for physical therapists to assert their role throughout the pain management continuum. This includes championing innovative research initiatives and enhancing public health by reducing the impact of chronic pain for over 50 million Americans.
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Affiliation(s)
- Joe Tatta
- Integrative Pain Science Institute, New York, New York, USA
| | - Jo Nijs
- Integrative Pain Science Institute, New York, New York, USA.,Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.,Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Sweden. University of Gothenburg Center for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ömer Elma
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group, Brussels, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Dawn Magnusson
- Department of Physical Medicine and Rehabilitation-Physical Therapy Program, University of Colorado, USA
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23
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Ronto R, Saberi G, Leila Robbers GM, Godrich S, Lawrence M, Somerset S, Fanzo J, Chau JY. Identifying effective interventions to promote consumption of protein-rich foods from lower ecological footprint sources: A systematic literature review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000209. [PMID: 36962370 PMCID: PMC10021177 DOI: 10.1371/journal.pgph.0000209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/23/2022] [Indexed: 11/18/2022]
Abstract
Addressing overconsumption of protein-rich foods from high ecological footprint sources can have positive impacts on health such as reduction of non-communicable disease risk and protecting the natural environment. With the increased attention towards development of ecologically sustainable diets, this systematic review aimed to critically review literature on effectiveness of those interventions aiming to promote protein-rich foods from lower ecological footprint sources. Five electronic databases (Medline, Web of Science, Scopus, Embase and Global Health) were searched for articles published up to January 2021. Quantitative studies were eligible for inclusion if they reported on actual or intended consumption of protein-rich animal-derived and/or plant-based foods; purchase, or selection of meat/plant-based diet in real or virtual environments. We assessed 140 full-text articles for eligibility of which 51 were included in this review. The results were narratively synthesised. Included studies were categorised into individual level behaviour change interventions (n = 33) which included education, counselling and self-monitoring, and micro-environmental/structural behaviour change interventions (n = 18) which included menu manipulation, choice architecture and multicomponent approaches. Half of individual level interventions (52%) aimed to reduce red/processed meat intake among people with current/past chronic conditions which reduced meat intake in the short term. The majority of micro-environmental studies focused on increasing plant-based diet in dining facilities, leading to positive dietary changes. These findings point to a clear gap in the current evidence base for interventions that promote plant-based diet in the general population.
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Affiliation(s)
- Rimante Ronto
- Department of Health Sciences, Macquarie University, Sydney, Australia
| | - Golsa Saberi
- Department of Health Sciences, Macquarie University, Sydney, Australia
| | | | - Stephanie Godrich
- School of Medicine and Health Sciences, Edith Cowan University, Perth, Australia
| | - Mark Lawrence
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Shawn Somerset
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Jessica Fanzo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Josephine Y. Chau
- Department of Health Sciences, Macquarie University, Sydney, Australia
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24
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Characterizing the Health of Older Rural Australians Attending Rural Events: Implications for Future Health Promotion Opportunities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053011. [PMID: 35270704 PMCID: PMC8910001 DOI: 10.3390/ijerph19053011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 02/04/2023]
Abstract
This paper describes the health of older Australians (>65 years) attending rural events to inform health promotion interventions for rural populations. This cross-sectional study collected survey data and objective health measures between 2017 and 2020 at two events held in rural New South Wales, Australia. Participants included in the analysis were adults > 65 years of age. Data included demographic and health information, anthropometric measures (height, weight, waist circumference), and dietary and physical activity data. A total of 256 people > 65 years participated. Our sample, which was mostly male (59.0%), contained people aged between 66 and 75 years (72.3%). Participants lived in either a large rural (34.0%) or small rural town (22.3%), with low levels of education (60.9% did not complete high school). Dietary quality was rated as below average. All but 17.2% of the participants reported having a health condition. The risk of a health condition was associated with increasing age, lower education, and higher waist circumference, but not remoteness. Rural events may provide an opportunity to access, engage with, and understand the health of older rural Australians, especially males. They may offer ideal contexts for health and nutrition promotion opportunities in rural areas where access to health professionals is limited.
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25
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Meade O, O'Brien M, Mc Sharry J, Lawless A, Coughlan S, Hart J, Hayes C, Keyworth C, Lavoie KL, Murphy AW, Murphy P, Noone C, O'Reilly O, Byrne M. Enhancing the implementation of the Making Every Contact Count brief behavioural intervention programme in Ireland: protocol for the Making MECC Work research programme. HRB Open Res 2022; 5:6. [PMID: 35224443 PMCID: PMC8847722 DOI: 10.12688/hrbopenres.13481.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Brief behavioural interventions offered by healthcare professionals to target health behavioural risk factors (e.g. physical activity, diet, smoking and drug and alcohol use) can positively impact patient health outcomes. The Irish Health Service Executive (HSE) Making Every Contact Count (MECC) Programme supports healthcare professionals to offer patients brief opportunistic behavioural interventions during routine consultations. The potential for MECC to impact public health depends on its uptake and implementation. Aim: This protocol outlines the 'Making MECC Work' research programme, a HSE/Health Behaviour Change Research Group collaboration to develop an implementation strategy to optimise uptake of MECC in Ireland. The programme will answer three research questions: (1) What determines delivery of MECC brief interventions by healthcare professionals at individual and organisational levels? (2) What are patient attitudes towards, and experiences of, receiving MECC interventions from healthcare professionals? (3) What evidence-informed implementation strategy options can be consensually developed with key stakeholders to optimise MECC implementation? Methods: In Work Package 1, we will examine determinants of MECC delivery by healthcare professionals using a multi-methods approach, including: (WP1.1) a national survey of healthcare professionals who have participated in MECC eLearning training and (WP1.2) a qualitative interview study with relevant healthcare professionals and HSE staff. In Work Package 2, we will examine patient attitudes towards, and experiences of, MECC using qualitative interviews. Work Package 3 will combine findings from Work Packages 1 and 2 using the Behaviour Change Wheel to identify and develop testable implementation strategy options (WP 3.1). Strategies will be refined and prioritised using a key stakeholder consensus process to develop a collaborative implementation blueprint to optimise and scale-up MECC (WP3.2). Discussion: Research programme outputs are expected to positively support the integration of MECC brief behaviour change interventions into the Irish healthcare system and inform the scale-up of behaviour change interventions internationally.
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Affiliation(s)
- Oonagh Meade
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, H91 EV56, Ireland
| | - Maria O'Brien
- National Heart Programme, Integrated Care Programme for Chronic Disease, Clinical Design and Innovation, Office of the Chief Clinical Officer, Health Services Executive, Áras Sláinte, Wilton Road, Cork, T12 XRR0, Ireland
| | - Jenny Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, H91 EV56, Ireland
| | - Agatha Lawless
- Health & Wellbeing, Strategy and Research, Healthcare Strategy, c/o Health Promotion and Improvement Office, Health Service Executive, Waterford, X91 T256, Ireland
| | - Sandra Coughlan
- Strategic Planning and Transformation, Health Service Executive, Cork, T12 WP62, Ireland
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Manchester, M13 9PT, UK
| | - Catherine Hayes
- Public Health and Primary Care, School of Medicine, Trinity College Dubin, Dublin, D02 R590, Ireland
| | - Chris Keyworth
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Kim L Lavoie
- Montréal Behavioural Medicine Centre, CIUSSS-NIM, Hôpital Sacré-Cœur de Montréal, Montréal, Quebec, QC H4J 1C5, Canada
- Department of Psychology, University of Quebec at Montréal, Montréal, Quebec, QC H2L 2C4, Canada
| | - Andrew W Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, School of Medicine, NUI Galway, Galway, Ireland
| | - Patrick Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, School of Medicine, NUI Galway, Galway, Ireland
| | - Chris Noone
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, H91 EV56, Ireland
| | - Orlaith O'Reilly
- Health and Wellbeing Division, HSE South East, Public Health Department, Health Service Executive, Kilkenny, Ireland
| | - Health Psychology Public Advisory Panel
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, H91 EV56, Ireland
- National Heart Programme, Integrated Care Programme for Chronic Disease, Clinical Design and Innovation, Office of the Chief Clinical Officer, Health Services Executive, Áras Sláinte, Wilton Road, Cork, T12 XRR0, Ireland
- Health & Wellbeing, Strategy and Research, Healthcare Strategy, c/o Health Promotion and Improvement Office, Health Service Executive, Waterford, X91 T256, Ireland
- Strategic Planning and Transformation, Health Service Executive, Cork, T12 WP62, Ireland
- School of Medical Sciences, University of Manchester, Manchester, M13 9PT, UK
- Public Health and Primary Care, School of Medicine, Trinity College Dubin, Dublin, D02 R590, Ireland
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
- Montréal Behavioural Medicine Centre, CIUSSS-NIM, Hôpital Sacré-Cœur de Montréal, Montréal, Quebec, QC H4J 1C5, Canada
- Department of Psychology, University of Quebec at Montréal, Montréal, Quebec, QC H2L 2C4, Canada
- Health Research Board Primary Care Clinical Trials Network Ireland, School of Medicine, NUI Galway, Galway, Ireland
- Health and Wellbeing Division, HSE South East, Public Health Department, Health Service Executive, Kilkenny, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, H91 EV56, Ireland
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26
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Kullen C, Mitchell L, O'Connor HT, Gifford JA, Beck KL. Effectiveness of nutrition interventions on improving diet quality and nutrition knowledge in military populations: a systematic review. Nutr Rev 2022; 80:1664-1693. [PMID: 35020915 DOI: 10.1093/nutrit/nuab087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
CONTEXT Optimizing nutrition in military groups through improved diet quality and nutrition knowledge is key in supporting the high physical and cognitive demands. OBJECTIVE The objective of this investigation was to systematically review the effectiveness of nutrition interventions among military personnel in improving diet quality and/or nutrition knowledge. DATA SOURCES Medline, Embase, CINAHL, and Scopus were searched from the earliest records to May 2020. DATA EXTRACTION Data were extracted by 2 reviewers. The primary outcomes were diet quality and/or nutrition knowledge. DATA ANALYSIS Twenty studies were included. The main intervention approaches identified were nutrition education of individuals (i.e., education-based studies; EB) (n = 12), and manipulation of the food service environment (i.e., dining facility studies; DFACs) (n = 8). The most common strategies were face-to-face lectures (n = 8) for EB, and healthier menus (n = 7) and education of catering staff (n = 6) for DFAC interventions. Most studies (18/20) demonstrated favorable within-group effects; however, dietary changes were inconsistent. Five of 10 studies using a comparator group demonstrated positive between-group differences. CONCLUSION Although potential exists for improving diet quality and nutrition knowledge in military populations, the heterogeneity of the studies to date limits conclusions on the most efficacious strategies.
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Affiliation(s)
- Charina Kullen
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Lachlan Mitchell
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sport Science, University College Dublin, Belfield, Ireland
| | - Helen T O'Connor
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Janelle A Gifford
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Kathryn L Beck
- School of Sport Exercise and Nutrition, College of Health, Massey University, New Zealand
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27
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Koeder C, Kranz RM, Anand C, Husain S, Alzughayyar D, Schoch N, Hahn A, Englert H. Effect of a 1-Year Controlled Lifestyle Intervention on Body Weight and Other Risk Markers (the Healthy Lifestyle Community Programme, Cohort 2). Obes Facts 2022; 15:228-239. [PMID: 34923493 PMCID: PMC9021650 DOI: 10.1159/000521164] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/23/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The prevalence of obesity is high and increasing worldwide. Obesity is generally associated with an increased risk of chronic disease and mortality. The objective of the study was to test the effect of a lifestyle intervention on body weight and other chronic disease risk markers. METHODS A non-randomized controlled trial was conducted, including mostly middle-aged and elderly participants recruited from the general population in rural northwest Germany (intervention: n = 114; control: n = 87). The intervention consisted of a 1-year lifestyle programme, focussing on four key areas: a largely plant-based diet (strongest emphasis), physical activity, stress management, and community support. Parameters were assessed at baseline, 10 weeks, 6 months, and 1 year. The control group received no intervention. RESULTS Compared to the control, in the intervention group, significantly lower 1-year trajectories were observed for body weight, body mass index (BMI), waist circumference (WC), total cholesterol, calculated LDL cholesterol, non-HDL cholesterol, remnant cholesterol (REM-C), glucose, HbA1c, and resting heart rate (RHR). However, between-group differences at 1 year were small for glucose, HbA1c, and cholesterol (apart from REM-C). No significant between-group differences were found for 1-year trajectories of measured LDL cholesterol, HDL cholesterol, triglycerides, insulin, blood pressure, and pulse pressure. CONCLUSION The intervention successfully reduced body weight, BMI, WC, REM-C, and RHR. However, at 1 year, effectiveness of the intervention regarding other risk markers was either very modest or could not be shown.
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Affiliation(s)
- Christian Koeder
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
- *Christian Koeder,
| | - Ragna-Marie Kranz
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Corinna Anand
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Sarah Husain
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Dima Alzughayyar
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Nora Schoch
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
| | - Heike Englert
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
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28
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Prowse R, Carsley S. Digital Interventions to Promote Healthy Eating in Children: Umbrella Review. JMIR Pediatr Parent 2021; 4:e30160. [PMID: 34842561 PMCID: PMC8663671 DOI: 10.2196/30160] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/27/2021] [Accepted: 09/06/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND eHealth and web-based service delivery have become increasingly common during the COVID-19 pandemic. Digital interventions may be highly appealing to young people; however, their effectiveness compared with that of the usual face-to-face interventions is unknown. As nutrition interventions merge with the digital world, there is a need to determine the best practices for digital interventions for children. OBJECTIVE The aim of this study is to examine the effectiveness of digital nutrition interventions for children on dietary outcomes compared with status quo interventions (eg, conventional face-to-face programming or nondigital support). METHODS We conducted an umbrella review of systematic reviews of studies assessing primary research on digital interventions aimed at improving food and nutrition outcomes for children aged <18 years compared with conventional nutrition education were eligible for inclusion. RESULTS In total, 11 systematic reviews published since 2015 were included (7/11, 64%, were of moderate quality). Digital interventions ranged from internet, computer, or mobile interventions to websites, programs, apps, email, videos, CD-ROMs, games, telehealth, SMS text messages, and social media, or a combination thereof. The dose and duration of the interventions varied widely (single to multiple exposures; 1-60 minutes). Many studies have been informed by theory or used behavior change techniques (eg, feedback, goal-setting, and tailoring). The effect of digital nutrition interventions for children on dietary outcomes is small and inconsistent. Digital interventions seemed to be the most promising for improving fruit and vegetable intake compared with other nutrition outcomes; however, reviews have found mixed results. CONCLUSIONS Owing to the heterogeneity and duration of digital interventions, follow-up evaluations, comparison groups, and outcomes measured, the effectiveness of these interventions remains unclear. High-quality evidence with common definitions for digital intervention types evaluated with validated measures is needed to improve the state of evidence, to inform policy and program decisions for health promotion in children. Now is the time for critical, robust evaluation of the adopted digital interventions during and after the COVID-19 pandemic to establish best practices for nutrition interventions for children.
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Affiliation(s)
- Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.,Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON, Canada
| | - Sarah Carsley
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON, Canada
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29
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Stacey F, Delaney T, Ball K, Zoetemeyer R, Lecathelinais C, Wolfenden L, Seward K, Wyse R. A Cluster Randomized Controlled Trial Evaluating the Impact of Tailored Feedback on the Purchase of Healthier Foods from Primary School Online Canteens. Nutrients 2021; 13:2405. [PMID: 34371914 PMCID: PMC8308818 DOI: 10.3390/nu13072405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
Few online food ordering systems provide tailored dietary feedback to consumers, despite suggested benefits. The study aim was to determine the effect of providing tailored feedback on the healthiness of students' lunch orders from a school canteen online ordering system. A cluster randomized controlled trial with ten government primary schools in New South Wales, Australia was conducted. Consenting schools that used an online canteen provider ('Flexischools') were randomized to either: a graph and prompt showing the proportion of 'everyday' foods selected or a standard online ordering system. Students with an online lunch order during baseline data collection were included (n = 2200 students; n = 7604 orders). Primary outcomes were the proportion of foods classified as 'everyday' or 'caution'. Secondary outcomes included: mean energy, saturated fat, sugar, and sodium content. There was no difference over time between groups on the proportion of 'everyday' (OR 0.99; p = 0.88) or 'caution' items purchased (OR 1.17; p = 0.45). There was a significant difference between groups for average energy content (mean difference 51 kJ; p-0.02), with both groups decreasing. There was no difference in the saturated fat, sugar, or sodium content. Tailored feedback did not impact the proportion of 'everyday' or 'caution' foods or the nutritional quality of online canteen orders. Future research should explore whether additional strategies and specific feedback formats can promote healthy purchasing decisions.
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Affiliation(s)
- Fiona Stacey
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Tessa Delaney
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC 3125, Australia;
| | - Rachel Zoetemeyer
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Kirsty Seward
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Rebecca Wyse
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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Vega-Salas MJ, Caro P, Johnson L, Papadaki A. Socio-economic inequalities in dietary intake in Chile: a systematic review. Public Health Nutr 2021; 25:1-16. [PMID: 34247696 PMCID: PMC9991770 DOI: 10.1017/s1368980021002937] [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: 02/12/2021] [Revised: 06/02/2021] [Accepted: 07/07/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Understanding the socio-economic inequalities in dietary intake is crucial when addressing the socio-economic gradient in obesity rates and non-communicable diseases. We aimed to systematically assess the association between socio-economic position (SEP) and dietary intake in Chile. DESIGN We searched for peer-reviewed and grey literature from inception until 31 December 2019 in PubMed, Scopus, PsycINFO, Web of Sciences and LILACS databases. Observational studies published in English and Spanish, reporting the comparison of at least one dietary factor between at least two groups of different SEP in the general Chilean population, were selected. Two researchers independently conducted data searches, screening and extraction and assessed study quality using an adaptation of the Newcastle Ottawa Quality Assessment Scale. RESULTS Twenty-one articles (from eighteen studies) were included. Study quality was considered low, medium and high for 24, 52 and 24 % of articles, respectively. Moderate-to-large associations indicated lower intake of fruit and vegetables, dairy products and fish/seafood and higher pulses consumption among adults of lower SEP. Variable evidence of association was found for energy intake and macronutrients, in both children and adults. CONCLUSIONS Our findings highlight some socio-economic inequalities in diets in Chile, evidencing an overall less healthy food consumption among the lower SEP groups. New policies to reduce these inequalities should tackle the unequal distribution of factors affecting healthy eating among the lower SEP groups. These findings also provide important insights for developing strategies to reduce dietary inequalities in Chile and other countries that have undergone similar nutritional transitions.
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Affiliation(s)
- María Jesús Vega-Salas
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
| | - Paola Caro
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
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van der Haar S, Hoevenaars FPM, van den Brink WJ, van den Broek T, Timmer M, Boorsma A, Doets EL. Exploring the Potential of Personalized Dietary Advice for Health Improvement in Motivated Individuals With Premetabolic Syndrome: Pretest-Posttest Study. JMIR Form Res 2021; 5:e25043. [PMID: 34185002 PMCID: PMC8277310 DOI: 10.2196/25043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/11/2021] [Accepted: 05/19/2021] [Indexed: 12/12/2022] Open
Abstract
Background Dietary quality plays an essential role in the prevention and management of metabolic syndrome (MetS). Objective The aim of this pilot study is to organize personalized dietary advice in a real-life setting and to explore the effects on dietary intake, metabolic health, and perceived health. Methods We followed a one-group pretest-posttest design and included 37 individuals at risk of MetS, who indicated motivation to change dietary behavior. For a period of 16 weeks, participants received personalized advice (t=0 and t=8) and feedback (t=0, t=4, t=8, t=12 and t=16) on dietary quality and metabolic health (ie, waist circumference, BMI, blood pressure, lipid profile, fasting glucose levels, and C-peptide). Personalized advice was generated in a two-stage process. In stage 1, an automated algorithm generated advice per food group, integrating data on individual dietary quality (Dutch Healthy Diet Index; total score 8-80) and metabolic health parameters. Stage 2 included a telephone consultation with a trained dietitian to define a personal dietary behavior change strategy and to discuss individual preferences. Dietary quality and metabolic health markers were assessed at t=0, t=8, and t=16. Self-perceived health was evaluated on 7-point Likert scales at t=0 and t=16. Results At the end of the study period, dietary quality was significantly improved compared with the baseline (Dutch Healthy Diet Index +4.3; P<.001). In addition, lipid profile (triglycerides, P=.02; total cholesterol, P=.01; high-density lipoprotein, P<.001; and low-density lipoprotein, P<.001), BMI (P<.001), waist circumference (P=.01), and C-peptide (P=.01) were all significantly improved, whereas plasma glucose increased by 0.23 nmol/L (P=.04). In line with these results, self-perceived health scores were higher at t=16 weeks than at baseline (+0.67; P=.005). Conclusions This exploratory study showed that personalized dietary advice resulted in positive effects on dietary behavior, metabolic health, and self-perceived health in motivated pre-MetS adults. The study was performed in a do-it-yourself setting, highlighting the potential of at-home health improvement through dietary changes. Trial Registration ClinicalTrials.gov NCT04595669; https://clinicaltrials.gov/ct2/show/NCT04595669
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Affiliation(s)
- Sandra van der Haar
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
| | - Femke P M Hoevenaars
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Willem J van den Brink
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Tim van den Broek
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Mariëlle Timmer
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
| | - André Boorsma
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Esmée L Doets
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
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Evaluation of the B.strong Queensland Indigenous Health Worker Brief Intervention Training Program for Multiple Health Risk Behaviours. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084220. [PMID: 33923462 PMCID: PMC8073127 DOI: 10.3390/ijerph18084220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
Queensland’s B.strong brief intervention training program was a complex intervention developed for Aboriginal and Torres Strait Islander health workers to assist clients address multiple health risks of smoking, poor nutrition and physical inactivity. This study evaluates program effectiveness by applying the Kirkpatrick four-level evaluation model: (1) Reaction, participants’ satisfaction; (2) Learning, changes in participants’ knowledge, confidence, attitudes, skills and usual practice; (3) Behaviour, application of learning to practice; and (4) Results, outcomes resulting from training. A retrospective analysis was conducted on data for respondents completing pre-training, post-workshop and follow-up surveys. Changes in domains such as training participant knowledge, confidence, attitudes, and practices between survey times were assessed using paired-samples t-tests. From 2017–2019, B.strong trained 1150 health professionals, reaching targets for workshop and online training. Findings showed statistically significant improvements from baseline to follow-up in: participants’ knowledge, confidence, and some attitudes to conducting brief interventions in each domain of smoking cessation, nutrition and physical activity; and in the frequency of participants providing client brief interventions in each of the three domains. There was a statistically significant improvement in frequency of participants providing brief interventions for multiple health behaviours at the same time from pre-workshop to follow-up. Indigenous Queenslander telephone counselling referrals for smoking cessation increased during the program period. B.strong improved practitioners’ capacity to deliver brief interventions addressing multiple health risks with Indigenous clients.
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i-Rebound after Stroke-Eat for Health: Mediterranean Dietary Intervention Co-Design Using an Integrated Knowledge Translation Approach and the TIDieR Checklist. Nutrients 2021; 13:nu13041058. [PMID: 33805076 PMCID: PMC8064089 DOI: 10.3390/nu13041058] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/11/2021] [Accepted: 03/21/2021] [Indexed: 02/07/2023] Open
Abstract
Lifestyle interventions to reduce second stroke risk are complex. For effective translation into practice, interventions must be specific to end-user needs and described in detail for replication. This study used an Integrated Knowledge Translation (IKT) approach and the Template for Intervention Description and Replication (TIDieR) checklist to co-design and describe a telehealth-delivered diet program for stroke survivors. Stroke survivors and carers (n = 6), specialist dietitians (n = 6) and an IKT research team (n = 8) participated in a 4-phase co-design process. Phase 1: the IKT team developed the research questions, and identified essential program elements and workshop strategies for effective co-design. Phase 2: Participant co-design workshops used persona and journey mapping to create user profiles to identify barriers and essential program elements. Phase 3: The IKT team mapped Phase 2 data to the TIDieR checklist and developed the intervention prototype. Phase 4: Co-design workshops were conducted to refine the prototype for trial. Rigorous IKT co-design fundamentally influenced intervention development. Modifications to the protocol based on participant input included ensuring that all resources were accessible to people with aphasia, an additional support framework and resources specific to outcome of stroke. The feasibility and safety of this intervention is currently being pilot tested (randomised controlled trial; 2019/ETH11533, ACTRN12620000189921).
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Minian N, Lingam M, deRuiter WK, Dragonetti R, Selby P. Co-designing Behavior Change Resources With Treatment-Seeking Smokers: Engagement Events' Findings. Front Public Health 2021; 9:555449. [PMID: 33791263 PMCID: PMC8005552 DOI: 10.3389/fpubh.2021.555449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 02/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Primary care organizations are well-suited to help patients change their unhealthy behaviors. Evidence shows that risk communication and self-monitoring of behavior are is an effective strategy practitioners can use to promote health behavior change with their patients. In order for this evidence to be actionable, it is important to understand how patients would like this information to be communicated and to operationalize the self-monitoring resources. The objective of this study was to co-create resources that encourage behavior change based on the scientific evidence and from patients with lived experiences. Materials and Methods: Twenty-seven individuals who participated in a smoking cessation program and engaged in at least one other unhealthy behavior joined one of two engagement events. Each event was 3 h in duration and consisted of two exercises that provided support to participants in reaching a consensus about the types of messages they would like to receive from their practitioner as well as self-monitoring resources they would prefer to use. The first exercise followed an adapted version of the Consensus Methodology developed by the Institute of Cultural Affairs Canada, while the second exercise was in accordance to the Nominal Group Technique. Results: Participants' preference was to have practitioners convey messages to promote health behavior change that include positive affirmation and to monitor all their health behaviors using a single self-reported tracking sheet. Conclusions: This paper features the use of engagement events to reflect upon and identify potential resources that treatment seeking smokers prefer to receive while attempting to modify unhealthy behaviors. These resources can be used by health care providers in primary care settings to support health promotion interventions and assist their patients to increase their likelihood of adopting positive changes to risk behaviors.
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Affiliation(s)
- Nadia Minian
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mathangee Lingam
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Wayne K deRuiter
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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35
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Whatnall MC, Sharkey T, Hutchesson MJ, Haslam RL, Bezzina A, Collins CE, Ashton LM. Effectiveness of interventions and behaviour change techniques for improving physical activity in young adults: A systematic review and meta-analysis. J Sports Sci 2021; 39:1754-1771. [PMID: 33685357 DOI: 10.1080/02640414.2021.1898107] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Physical activity (PA) participation declines from adolescence to young adulthood. This review evaluates the effectiveness of interventions aiming to improve PA among healthy young adults (17-35 years), and the effectiveness of the behaviour change techniques (BCTs) used. Six electronic databases were searched up to December 2019, for randomized controlled trials aiming to achieve PA behaviour change among young adults. In total, 66 RCTs were included. Meta-analyses for moderate-vigorous PA (n = 11 studies), steps (n = 5 studies) and total PA (MET min/week, n = 11 studies) identified that intervention participants compared with control significantly increased PA at time points up to 3 months and >3 months. Narrative synthesis identified that 34 RCTs (52%) reported significant between group differences favouring the intervention for one or more PA outcome. BCTs with the highest effectiveness were material reward, valued self-identity and habit formation. However, the overall test of significance demonstrated no significant relationship between type or number of BCTs and effectiveness. This review identified interventions that improve steps, moderate-vigorous and total PA in young adults in the shorter-term, and BCTs associated with greater effectiveness. Further research is needed to determine strategies to achieve longer-term effectiveness of PA interventions in young adults.
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Affiliation(s)
- Megan C Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Thomas Sharkey
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Rebecca L Haslam
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Aaron Bezzina
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Lee M Ashton
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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Shagiwal SS, Groenestein E, Schop‐Etman A, Jongerling J, van der Waal J, Noordzij G, Denktas S. Effectiveness of behavioral interventions and behavior change techniques for reducing soft drink intake in disadvantaged adolescents: A systematic review and meta-analysis. Obes Sci Pract 2020; 6:708-734. [PMID: 33354348 PMCID: PMC7746974 DOI: 10.1002/osp4.452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 01/06/2023] Open
Abstract
Reducing sugar-sweetened beverage (SSB) intake is an important dietary target, especially among socioeconomically disadvantaged ethnic minority adolescents. This review and meta-analysis evaluated the effectiveness of behavioural interventions aiming to reduce SSB intake in socioeconomically disadvantaged ethnic minority adolescents and examined which behaviour change techniques (BCTs) were most effective. A systematic search was conducted using the PRISMA criteria. Quality assessments were done using the Cochrane criteria. In a narrative synthesis, studies were divided into effective and non-effective, and relative effectiveness ratios of individual BCTs were calculated. Pooled standardized mean differences (SMDs) and their 95% confidence intervals were estimated with random-effects models using cluster robust methods. Twenty-two studies were included in the qualitative synthesis. A meta-analysis (n = 19) revealed no significant between-group differences in reduction of SSB intake. Five self-regulatory BCTs had an effectiveness ratio >50%: feedback, goal-setting, action planning, self-monitoring and problem-solving/barrier identification. The risk of bias assessments were judged to be moderate to high risk for randomized controlled trials (RCTs) studies and low to moderate for pre-post studies. There was no indication of publication bias. In conclusion, self-regulatory BCTs may be effective components to change SSB behaviour. However, high-quality research is needed to evaluate the effectiveness of behavioural interventions and identify BCTs effective for reducing SSB intake among disadvantaged adolescents with ethnic minority backgrounds.
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Affiliation(s)
- S. S. Shagiwal
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - E. Groenestein
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - A. Schop‐Etman
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - J. Jongerling
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - J. van der Waal
- Department of Public Administration and Sociology, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - G. Noordzij
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
- Erasmus University CollegeErasmus UniversityRotterdamThe Netherlands
| | - S. Denktas
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
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Córdoba García R, Camarelles Guillem F, Muñoz Seco E, Gómez Puente JM, San José Arango J, Ramírez Manent JI, Martín Cantera C, Del Campo Giménez M, Revenga Frauca J. [PAPPS expert group. Lifestyle recommendations]. Aten Primaria 2020; 52 Suppl 2:32-43. [PMID: 33388116 PMCID: PMC7801215 DOI: 10.1016/j.aprim.2020.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 12/01/2022] Open
Abstract
Primary and secondary health determinants explain a large part of the morbidity and mortality observed in primary care. The recommendations of the Program of Preventive Activities and Health Promotion (PAPPS) of the semFyC are presented, for the promotion of a healthy lifestyle through intervention methodology and preventive actions in tobacco consumption, alcohol consumption, healthy eating, physical activity in free time and prevention of traffic accidents and child restraint systems. The most common clinical prevention guidelines are outlined. The recommendations are updated, new aspects are pointed out, such as the definition of low-risk alcohol consumption, and the bibliography is updated. For the main recommendations, specific tables are included that show the quality of the evidence and the strength of the recommendation.
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Affiliation(s)
- Rodrigo Córdoba García
- Medicina de Familia y Comunitaria, Centro de Salud Delicias Sur. Coordinador del Grupo de Educación Sanitaria y Promoción de la Salud (ESPS), Zaragoza, España.
| | | | - Elena Muñoz Seco
- Medicina de Familia y Comunitaria, Unidad Básica de Salud es Castell, Ibsalut, Es Castell, Menorca, España
| | | | - Joaquín San José Arango
- Medicina de Familia y Comunitaria, Centro de Salud Vilagarcía. Grupo de Trabajo de Alimentación y Nutrición, Pontevedra, España
| | - Jose Ignacio Ramírez Manent
- Medicina de Familia y Comunitaria, Centro de Salud de Calviá, Instituto de Investigación Sanitaria Illes Balears, IdIsBa, Calvià, Mallorca, España
| | - Carlos Martín Cantera
- Medicina de Familia y Comunitaria, Grupo de Investigación Estilos de Vida, IDIAP Jordi Gol, Barcelona, España
| | - María Del Campo Giménez
- Medicina de Familia y Comunitaria, Gerencia de Atención Integrada de Albacete, SESCAM, Albacete, España
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Minian N, Lingam M, Moineddin R, Thorpe KE, Veldhuizen S, Dragonetti R, Zawertailo L, Taylor VH, Hahn M, deRuiter WK, Melamed O, Selby P. Impact of a Web-Based Clinical Decision Support System to Assist Practitioners in Addressing Physical Activity and/or Healthy Eating for Smoking Cessation Treatment: Protocol for a Hybrid Type I Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e19157. [PMID: 32990250 PMCID: PMC7556369 DOI: 10.2196/19157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Modifiable risk factors such as tobacco use, physical inactivity, and poor diet account for a significant proportion of the preventable deaths in Canada. These factors are also known to cluster together, thereby compounding the risks of morbidity and mortality. Given this association, smoking cessation programs appear to be well-suited for integration of health promotion activities for other modifiable risk factors. The Smoking Treatment for Ontario Patients (STOP) program is a province-wide smoking cessation program that currently encourages practitioners to deliver Screening, Brief Intervention, and Referral to treatment for patients who are experiencing depressive symptoms or consume excessive amounts of alcohol via a web-enabled clinical decision support system. However, there is no available clinical decision support system for physical inactivity and poor diet, which are among the leading modifiable risk factors for chronic diseases. OBJECTIVE The aim of this study is to assess whether adding a computerized/web-enabled clinical decision support system for physical activity and diet to a smoking cessation program affects smoking cessation outcomes. METHODS This study is designed as a hybrid type 1 effectiveness/implementation randomized controlled trial to evaluate a web-enabled clinical decision support system for supporting practitioners in addressing patients' physical activity and diet as part of smoking cessation treatment in a primary care setting. This design was chosen as it allows for simultaneous testing of the intervention, its delivery in target settings, and the potential for implementation in real-world situations. Intervention effectiveness will be measured using a two-arm randomized controlled trial. Health care practitioners will be unblinded to their patients' treatment allocation; however, patients will be blinded to whether their practitioner receives the clinical decision support system for physical activity and/or fruit/vegetable consumption. The evaluation of implementation will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. RESULTS Recruitment for the primary outcome of this study is ongoing and will be completed in November 2020. Results will be reported in March 2021. CONCLUSIONS The findings of the study will provide much needed insight into whether adding a computerized/web-enabled clinical decision support system for physical activity and diet to a smoking cessation program affects smoking cessation outcome. Furthermore, the implementation evaluation would provide insight into the feasibility of online-based interventions for physical activity and diet in a smoking cessation program. Addressing these risk factors simultaneously could have significant positive effects on chronic disease and cancer prevention. TRIAL REGISTRATION ClinicalTrials.gov NCT04223336; https://clinicaltrials.gov/ct2/show/NCT04223336. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19157.
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Affiliation(s)
- Nadia Minian
- Nicotine Dependence Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Mathangee Lingam
- Nicotine Dependence Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Kevin E Thorpe
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Scott Veldhuizen
- Nicotine Dependence Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- Nicotine Dependence Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Laurie Zawertailo
- Nicotine Dependence Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Margaret Hahn
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Banting and Best Diabetes Centre, University of Toronto, Toronto, ON, Canada
| | - Wayne K deRuiter
- Nicotine Dependence Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Osnat Melamed
- Nicotine Dependence Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- Nicotine Dependence Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Ezekannagha O, Drimie S, von Fintel D, Maziya-Dixon B, Mbhenyane X. Validation of a roadmap for mainstreaming nutrition-sensitive interventions at state level in Nigeria. Nutr J 2020; 19:96. [PMID: 32907577 PMCID: PMC7488070 DOI: 10.1186/s12937-020-00612-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 08/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND National programs are often developed with little consideration to the sub-national local factors that might affect program success. These factors include political support, capacity for implementation of program and variation in malnutrition indices being tackled. State context factors are evident in the distribution of malnutrition (e.g. high prevalence or gap among Local Government Areas), in the implementation of nutrition-sensitive interventions (e.g. access to early childhood education) and in the political economic context (e.g. presence of external funding agencies). Context is shaped by the economy, population, religion, and poverty, which impact everyday lives. Considering these contexts, a roadmap was developed and validated. The aim of this paper is to report expert review and stakeholder validation to determine feasibility of the developed contextualised roadmap for two Nigerian states. METHODS A validation tool was developed and reviewed using three experts. The content review occurred in two rounds to obtain recommendation and revisions of the developed roadmap and the validation tool. A pilot test of the roadmap and validation tool was done using two stakeholders in South Africa. The roadmap and the validation tool were then sent to the stakeholders and potential end-users in Nigeria using electronic media. Two research assistants were also engaged to deliver and collect hard copies to those who preferred it. RESULTS Of the ten stakeholders invited, nine responded. All participants showed an adequate understanding of the roadmap as evidenced by the scores given. Responses regarding the translation of the roadmap to implementation varied. The majority (86,6%) either strongly agreed or agreed that the actions were translatable (43.0 and 43.6% respectively). CONCLUSIONS The final roadmap comprises of actions that are appropriate for the state's context. It is recommended that stakeholders or end-users of any programme must be involved in the validation of such contextual programmes to improve chances of success.
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Affiliation(s)
- Oluchi Ezekannagha
- Division of Human Nutrition, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
- International Institute of Tropical Agriculture, Ibadan, Nigeria
| | - Scott Drimie
- Division of Human Nutrition, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Dieter von Fintel
- Department of Economics, Stellenbosch University, Stellenbosch, South Africa
| | | | - Xikombiso Mbhenyane
- Division of Human Nutrition, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa.
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Sharkey T, Whatnall MC, Hutchesson MJ, Haslam RL, Bezzina A, Collins CE, Ashton LM. Effectiveness of gender-targeted versus gender-neutral interventions aimed at improving dietary intake, physical activity and/or overweight/obesity in young adults (aged 17-35 years): a systematic review and meta-analysis. Nutr J 2020; 19:78. [PMID: 32731865 PMCID: PMC7393713 DOI: 10.1186/s12937-020-00594-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/23/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Young adulthood has become synonymous with the development of poor lifestyle behaviours associated with an increased risk of preventable chronic disease in later years. Interventions aiming to improve health behaviours may be more engaging and effective if they are targeted to males or females than interventions with a gender-neutral approach. This review will examine the outcome effectiveness of gender-targeted and gender-neutral interventions targeting nutrition, physical activity or overweight/obesity in young adults (17-35 years). METHODS Six electronic databases were searched for randomised controlled trials (RCTs) published up to December 2019 that evaluated nutrition, physical activity and/or overweight/obesity interventions in young adults (17-35 years). An effective intervention was one where the change in one or more primary outcome was positive and statistically significantly different from baseline, compared with control, or if no control comparator, compared with another active intervention. Effectiveness of outcomes was compared between gender-targeted and gender-neutral studies. RESULTS In total 21,582 manuscripts were identified and 107 RCTs were included; 30 gender-targeted studies (28%) and 77 gender-neutral (72%). Most gender-targeted studies were female targeted (n = 22, 73%). Primary outcome/s were adiposity (n = 36, 34%), nutrition (n = 29, 27%), physical activity (n = 28, 26%), or a combination of (n = 14, 14%). A greater proportion of gender-targeted than gender-neutral studies were effective in improving nutrition (n = 6, 100% and n = 17, 74% of studies respectively) and physical activity outcomes (n = 6, 86% and n = 14, 67% respectively), where as a greater proportion of gender-neutral studies were effective in improving adiposity outcomes (n = 13, 59% and n = 5, 36% respectively). None of these differences were statistically significant. Meta-analyses for weight found no significant differences between gender-targeted and gender-neutral studies for weight loss or weight gain prevention studies. Meta-analysis for fruit and vegetable intake demonstrated a significantly greater increase in intervention participants in gender-targeted studies of +158 g/day for > 3 months. CONCLUSIONS Although differences in outcome effectiveness were identified between gender-targeted and gender-neutral studies, these were not significantly different. This is likely due to an insufficient number of studies to detect a difference. The meta-analysis for fruit and vegetable intake findings should be interpreted with caution due to including only two gender-targeted studies. The findings collectively are suggestive of a potential difference requiring further investigation. To truly determine the effectiveness of gender-targeted interventions, well-designed RCTs comparing gender-targeted interventions with gender-neutral and control are needed. REGISTRATION This systematic review is a secondary analysis of studies included in a systematic review examining the effectiveness of interventions targeting nutrition, physical activity, or overweight/obesity in young adults, for which a predefined protocol was registered with PROSPERO (CRD42017075795).
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Affiliation(s)
- Thomas Sharkey
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Megan C. Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Melinda J. Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Rebecca L. Haslam
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Aaron Bezzina
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Clare E. Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
| | - Lee M. Ashton
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Australia
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Thilsing T, Sonderlund AL, Sondergaard J, Svensson NH, Christensen JR, Thomsen JL, Hvidt NC, Larsen LB. Changes in Health-Risk Behavior, Body Mass Index, Mental Well-Being, and Risk Status Following Participation in a Stepwise Web-Based and Face-to-Face Intervention for Prevention of Lifestyle-Related Diseases: Nonrandomized Follow-Up Cohort Study. JMIR Public Health Surveill 2020; 6:e16083. [PMID: 32673269 PMCID: PMC7380905 DOI: 10.2196/16083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 03/10/2020] [Accepted: 04/12/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Recent evidence suggests the effectiveness of stepwise, targeted approaches for the prevention of lifestyle-related diseases with combinations of web-based and face-to-face interventions showing promising results. OBJECTIVE This paper reports on 1-year changes in health-risk behaviors, BMI, self-rated health, mental well-being, and risk of disease at 1-year follow-up after participation in a stepwise intervention that targeted persons at high risk of disease and persons with health-risk behavior. To this end, we distinguish between participants who took up the full intervention (web-based plus face-to-face) and those who received only the web-based intervention. METHODS The Early Detection and Prevention (Danish acronym: TOF) pilot study was conducted as a nonrandomized, 1-year follow-up intervention study in two municipalities in the Region of Southern Denmark. A total of 9400 citizens born between 1957 and 1986 (aged 29 to 60 years) were randomly sampled from participating general practitioner (GP) patient-list systems and were invited to take part in the study. Participants were subsequently stratified into risk groups based on their responses to a questionnaire on health-risk behavior and data from their GP's electronic patient record (EPR) system. All participants received a digital personal health profile with individualized information on current health-risk behavior and targeted advice on relevant health-risk behavior changes. In addition, patients at high risk of disease, as indicated by their digital health profile, were offered a targeted intervention at their GP. Patients who were not deemed at high risk of disease but who exhibited health-risk behaviors were offered a targeted intervention at their municipal health center (MHC). At 1-year follow-up, health-risk behaviors, self-rated health, BMI, and mental well-being were reassessed by questionnaire, and current information on diagnoses and medical treatment was retrieved from the EPRs. RESULTS Of 598 patients at high risk of disease or with health-risk behavior, 135 took up the targeted intervention at their GP or MHC and 463 received the personal health profile only. From baseline to 1-year follow-up, the number of patients with unhealthy eating habits decreased, mean mental well-being increased, and smoking prevalence decreased in patients who had received the digital personal health profile alone. Among patients who took up the targeted intervention, unhealthy eating habits and sedentary lifestyles decreased and significant reductions in mean BMI were observed. At 1-year follow up, no health-risk behaviors were detected among 17.4% of patients who at baseline had exhibited health-risk behaviors or high risk of disease. CONCLUSIONS A stepwise targeted preventive approach using web-based and face-to-face elements may lead to favorable lifestyle changes. Specifically, a web-based approach may improve smoking and eating habits and mental well-being, whereas supplementary face-to-face interventions may be necessary to improve exercise habits and BMI. TRIAL REGISTRATION ClinicalTrials.gov NCT02797392; https://clinicaltrials.gov/ct2/show/NCT02797392. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12875-018-0820-8.
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Affiliation(s)
- Trine Thilsing
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anders Larrabee Sonderlund
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jens Sondergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Nanna Herning Svensson
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Janus Laust Thomsen
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lars Bruun Larsen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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42
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Ashton LM, Sharkey T, Whatnall MC, Haslam RL, Bezzina A, Aguiar EJ, Collins CE, Hutchesson MJ. Which behaviour change techniques within interventions to prevent weight gain and/or initiate weight loss improve adiposity outcomes in young adults? A systematic review and meta-analysis of randomized controlled trials. Obes Rev 2020; 21:e13009. [PMID: 32064761 DOI: 10.1111/obr.13009] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/30/2020] [Accepted: 01/30/2020] [Indexed: 12/17/2022]
Abstract
Young adulthood is associated with the highest rate of weight gain compared with any other adult age group. This review evaluates the effectiveness of interventions with adiposity outcomes among young adults and identifies which behaviour change techniques (BCTs) are most effective. BCT utilization was assessed using Michie's 93-item BCT Taxonomy v1. Six electronic databases were searched for randomized controlled trials assessing change in adiposity in young adults (17-35 years) until December 2019; identifying 21,582 articles. Fifty-one studies were included. Meta-analyses for weight (n=19 studies), body mass index (BMI) (n=20 studies), and waist circumference (n=10 studies) demonstrated no significant between-group differences at ≤3 or >3 months. There were no differences between interventions focusing on weight loss or weight-gain prevention. Narrative synthesis showed significant between-group differences in weight change, favouring the intervention in 14/43 (33%) studies. In studies assessing BMI and waist circumference, this was 31% (11/36) and 25% (4/16). Two BCTs had a percentage effectiveness ratio >50% in weight loss interventions; social support (unspecified) and self-monitoring behaviour, and one in weight-gain prevention interventions; and goal-setting (outcome). Findings demonstrate initial potential for these types of BCTs and can help build cumulative evidence towards delivering effective, cost-efficient, and replicable interventions.
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Affiliation(s)
- Lee M Ashton
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Thomas Sharkey
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Megan C Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Rebecca L Haslam
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Aaron Bezzina
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Elroy J Aguiar
- Department of Kinesiology, College of Education, University of Alabama, Tuscaloosa, Alabama
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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43
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Hernandez Roman J, Patel S. Why Do Lifestyle Recommendations Fail in Most Patients with Nonalcoholic Fatty Liver Disease? Gastroenterol Clin North Am 2020; 49:95-104. [PMID: 32033766 DOI: 10.1016/j.gtc.2019.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Nonalcoholic fatty liver disease has been recognized as a major health burden. The efficacy and safety profile of pharmacotherapy in the treatment of nonalcoholic fatty liver disease remains uncertain; therefore, lifestyle modification is the first line of treatment. Based on available data, patients should optimally achieve at least a 5% to 10% weight reduction for histologic improvement. There is no clear consensus on the optimal diet or exercise regimen. Sustainability of any intervention is key to success; however, compliance has been a major issue in clinical trials. This finding underscores the importance of multidisciplinary strategies to achieve targeted weigh loss.
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Affiliation(s)
- Jose Hernandez Roman
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Samarth Patel
- Division of Gastroenterology and Hepatology, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA; Division of Gastroenterology and Hepatology, Virginia Commonwealth University, 1200 E Broad St, Richmond, VA 23298-0342, USA.
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44
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Quicke JG, Holden MA, Bennell KL, Allison K. Where to From Here? Is There a Role for Physical Therapists in Enacting Evidence-Based Guidelines for Weight Loss in Adults With Osteoarthritis Who Are Overweight? Phys Ther 2020; 100:3-7. [PMID: 31596467 DOI: 10.1093/ptj/pzz135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 06/09/2019] [Accepted: 06/09/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Jonathan G Quicke
- Primary Care Centre Versus Arthritis, School for Primary, Community, and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom
| | - Melanie A Holden
- Primary Care Centre Versus Arthritis, School for Primary, Community, and Social Care, Keele University
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia
| | - Kim Allison
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne
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Santaló MI, Gibbons S, Naylor PJ. Using Food Models to Enhance Sugar Literacy among Older Adolescents: Evaluation of a Brief Experiential Nutrition Education Intervention. Nutrients 2019; 11:nu11081763. [PMID: 31370275 PMCID: PMC6723152 DOI: 10.3390/nu11081763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 01/10/2023] Open
Abstract
Adolescent diets high in sugar are a public health concern. Sugar literacy interventions have changed intake but focused more on children, adults, and early adolescents and on sugar sweetened beverages rather than total sugar consumption. Food models are an efficacious experiential learning strategy with children. This study assessed the impact of two 45 min nutrition lessons using food models on adolescents’ sugar literacy. Classes (n = 16) were randomized to intervention or control with knowledge, label reading skills, intentions to limit sugar consumption measured at baseline and follow-up. Two hundred and three students aged 14 to 19 from six schools on Vancouver Island, BC, Canada participated in the study. Adolescents’ knowledge of added sugar in foods and beverages and servings per food group in a healthy diet was limited at baseline but improved significantly in the intervention condition (F(1, 201) = 104.84, p < 0.001) compared to controls. Intention to consume less added sugar increased significantly after intervention (F(1, 201) = 4.93, p = 0.03) as did label reading confidence (F(1, 200) = 14.94, p < 0.001). A brief experiential learning intervention using food models was efficacious for changing student’s knowledge about sugar guidelines and sugar in food, label reading confidence, and intention to change sugar consumption.
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Affiliation(s)
- María Isabel Santaló
- School of Exercise Science, Physical and Health Education, Faculty of Education, University of Victoria, Victoria, BC V8P 5C2, Canada.
| | - Sandra Gibbons
- School of Exercise Science, Physical and Health Education, Faculty of Education, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, Faculty of Education, University of Victoria, Victoria, BC V8P 5C2, Canada.
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Bartlem K, Wolfenden L, Colyvas K, Campbell L, Freund M, Doherty E, Slattery C, Tremain D, Bowman J, Wiggers J. The association between the receipt of primary care clinician provision of preventive care and short term health behaviour change. Prev Med 2019; 123:308-315. [PMID: 30930261 DOI: 10.1016/j.ypmed.2019.03.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 02/25/2019] [Accepted: 03/28/2019] [Indexed: 11/26/2022]
Abstract
Primary healthcare services are recommended to provide preventive care to address chronic disease risk behaviours. However, all care elements are infrequently provided, and there is a need to understand the impact of partial care provision on behaviour change. This study examined the association between variable levels of preventive care receipt from primary care clinicians on short-term behaviour change for four risk behaviours. A survey was undertaken with 5639 Australian community health service clients (2009-2014). Clients self-reported: engagement in risk behaviours (tobacco smoking, harmful alcohol consumption, inadequate fruit and/or vegetable consumption, physical inactivity) in the month prior to and four week post their community health service appointment; receipt of preventive care during appointments (assessment, advice, referral/follow-up) for each behaviour. Univariate regression models explored the association between change in risk status and preventive care received. The odds of behaviour change for those receiving all three care elements was significant for all behaviours, compared to no care, ranging from 2.02 (alcohol consumption, 95% CI 1.16-3.49) to 4.17 (inadequate fruit and/or vegetable consumption, 95% CI 2.91-5.96). Receipt of both assessment and advice increased the odds of behaviour change, compared to no care, for all behaviours except smoking, ranging from 2.32 (physical inactivity, 95% CI 1.60-3.35) to 2.83 (alcohol consumption, 95% CI 1.84-4.33). Receipt of 'assessment only' increased the odds of behaviour change, compared to no care, for inadequate fruit and/or vegetable consumption (OR = 2.40, 95% CI 1.60-3.59) and physical inactivity (OR = 2.81, 95% CI 1.89-4.17). Results highlight the importance of primary care clinicians providing best practice preventive care to maximise client behaviour change.
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Affiliation(s)
- Kate Bartlem
- School of Psychology, University of Newcastle, Callaghan, Australia; Hunter New England Population Health, Wallsend, Australia.
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Kim Colyvas
- School of Mathematical and Physical Sciences, University of Newcastle, Callaghan, Australia
| | - Libby Campbell
- Hunter New England Population Health, Wallsend, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Megan Freund
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Emma Doherty
- Hunter New England Population Health, Wallsend, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | | | - Danika Tremain
- Hunter New England Population Health, Wallsend, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Jenny Bowman
- School of Psychology, University of Newcastle, Callaghan, Australia
| | - John Wiggers
- Hunter New England Population Health, Wallsend, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
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Magriplis E, Sialvera TE, Papadopoulou A, Efstathiou SP, Trautwein EA, Goumas G, Dimakopoulos I, Papavasiliou K, Koutsouri A, Zampelas A. Effectiveness and easiness of adherence to behavioural guidelines for diet and lifestyle changes for cholesterol‐lowering: the Increasing Adherence of Consumers to Diet & Lifestyle Changes to Lower (
LDL
) Cholesterol (
ACT
) randomised controlled trial. J Hum Nutr Diet 2019; 32:607-618. [DOI: 10.1111/jhn.12667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- E. Magriplis
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
| | - T. E. Sialvera
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
| | - A. Papadopoulou
- Center for Cardiovascular Disease Prevention Hygeias Melathron Infirmary Athens Greece
| | - S. P. Efstathiou
- Center for Cardiovascular Disease Prevention Hygeias Melathron Infirmary Athens Greece
| | | | - G. Goumas
- Department of Cardiology Euroclinic Athens Greece
| | - I. Dimakopoulos
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
| | - K. Papavasiliou
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
| | | | - A. Zampelas
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
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Feasibility and Preliminary Efficacy of the Eating Advice to Students (EATS) Brief Web-Based Nutrition Intervention for Young Adult University Students: A Pilot Randomized Controlled Trial. Nutrients 2019; 11:nu11040905. [PMID: 31018565 PMCID: PMC6520699 DOI: 10.3390/nu11040905] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 02/08/2023] Open
Abstract
Young adult university students are a priority population for nutrition intervention. This study assessed the feasibility and preliminary efficacy of the EATS (Eating Advice to Students) brief (i.e., single use) web-based nutrition intervention for young adult university students. A 3-month pilot randomized controlled trial (RCT) was conducted with 124 students aged 17–35 from the University of Newcastle, Australia. Participants were randomized to EATS (n = 62) or attention control (n = 62). EATS aimed to improve four target eating behaviors (vegetables, fruit, discretionary foods, breakfast). Primary outcomes were feasibility (recruitment, retention, usage, program acceptability). Recruitment and retention numbers were recorded, the program acceptability was assessed by a process evaluation survey and the website usage was objectively tracked. Preliminary efficacy was assessed via changes in diet quality (primary), fruit, vegetables, discretionary foods and breakfast intake, measured using Food Frequency Questionnaire. Recruitment was completed in five weeks. Retention was 73% (90/124) at 3-months. Intervention participants used EATS 1.5 ± 1.0 times. Satisfaction with EATS was rated at 4.04 ± 0.74 (maximum five). Intervention participants significantly decreased the percentage energy/day from discretionary foods compared with control (−4.8%, 95%CI −8.6, −1.1, p = 0.012, d = −0.34). No significant between-group differences were observed for diet quality, fruit, vegetable or breakfast intakes. EATS demonstrated high feasibility, particularly for reach and acceptability. The university setting and a brief web-based intervention show promise in engaging young adults to improve their eating behaviors.
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Ashton LM, Sharkey T, Whatnall MC, Williams RL, Bezzina A, Aguiar EJ, Collins CE, Hutchesson MJ. Effectiveness of Interventions and Behaviour Change Techniques for Improving Dietary Intake in Young Adults: A Systematic Review and Meta-Analysis of RCTs. Nutrients 2019; 11:nu11040825. [PMID: 30979065 PMCID: PMC6520715 DOI: 10.3390/nu11040825] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/04/2019] [Accepted: 04/09/2019] [Indexed: 12/17/2022] Open
Abstract
Poor eating habits are common during young adulthood and influence chronic disease morbidity. This systematic review evaluates the effectiveness of interventions aiming to improve dietary intake among young adults and, identifies which behaviour change techniques (BCTs) are most effective. Six electronic databases were searched for RCTs published until October 2018, and evaluating behavioural interventions assessing change in dietary intake in young adults (17–35 years). Of the 18,779 articles identified, 54 were included. Forty studies focused on fruit and/or vegetable intake, of which 63% showed a significant between-group difference in favour of the intervention group. Meta-analysis (n = 17) demonstrated a significant increase in fruit and vegetable intake of +68.6 g/day after three months of intervention and +65.8 g/day for interventions >3 months when compared to control. A meta-analysis (n = 5) on total energy intake found no significant differences between groups. The BCTs with the highest effectiveness ratio were habit formation (100%), salience of consequences (83%) and adding objects to the environment (70%). The review highlights the potential of behavioural interventions to improve young adults’ fruit and vegetable intake but was less convincing for other dietary outcomes. Due to the lack of studies including each BCT, the BCTs imperative to success could not be identified.
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Affiliation(s)
- Lee M Ashton
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Thomas Sharkey
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Megan C Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Rebecca L Williams
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Aaron Bezzina
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Elroy J Aguiar
- Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, MA 01003, USA.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
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50
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Whatnall M, Patterson A, Hutchesson M. A Brief Web-Based Nutrition Intervention for Young Adult University Students: Development and Evaluation Protocol Using the PRECEDE-PROCEED Model. JMIR Res Protoc 2019; 8:e11992. [PMID: 30920382 PMCID: PMC6458536 DOI: 10.2196/11992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/14/2018] [Accepted: 12/10/2018] [Indexed: 12/17/2022] Open
Abstract
Background Young adults are a priority population for nutrition interventions because of the high prevalence of unhealthy eating behaviors, high risk of weight gain, and the importance of this life stage for developing lifelong eating behaviors. Innovative intervention strategies are needed to reach and engage young adults, whereas more detailed reporting of intervention development and testing would facilitate progress in this challenging research area. Objective This paper describes the development of the EATS (Eating Advice To Students) intervention, a targeted, brief Web-based nutrition intervention for young adult (17 to 35 years) university students, and describes the pilot randomized controlled trial (RCT) to assess intervention feasibility. Methods EATS was developed using the PRECEDE-PROCEED model. The development involved a cross-sectional survey of university students’ eating behaviors and determinants, a systematic review of brief nutrition interventions, and consultation with a project steering committee. EATS was developed as a website with 4 components: (1) brief screening quiz with personalized feedback, (2) provision of information, tips, and strategies for each target eating behavior (consumption of vegetables, fruit, discretionary foods, and breakfast) and 2 guided exercises to facilitate behavior change, (3) goal setting, and (4) creating strategies. A pilot RCT with students from the University of Newcastle, Australia, was conducted from February to July 2018. The students were randomized to EATS or a brief Web-based alcohol intervention (attention control). The process evaluation included intervention acceptability (Web-based survey postintervention completion) and objective usage data (collected in real time). Efficacy data (Web-based survey at baseline and 3 months) included diet quality, consumption of target food groups (eg, fruits and vegetables), alcohol intake, self-efficacy to perform target eating behaviors, and well-being. Results Collection of the 3-month follow-up data was completed in July 2018. Conclusions EATS presents an innovative solution to many of the difficulties faced in targeting young adults to improve their eating behaviors. Given the strong methodological approach undertaken, this study provides a significant contribution to advance this research area. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618000118202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374365&isReview=true (Archived by WebCite at http://www.webcitation.org/765o5fVwa) International Registered Report Identifier (IRRID) DERR1-10.2196/11992
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Affiliation(s)
- Megan Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Amanda Patterson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Melinda Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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