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Gravina D, Keeler JL, Akkese MN, Bektas S, Fina P, Tweed C, Willmund GD, Treasure J, Himmerich H. Randomized Controlled Trials to Treat Obesity in Military Populations: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:4778. [PMID: 38004172 PMCID: PMC10674729 DOI: 10.3390/nu15224778] [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: 09/16/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
In recent years, overweight and obesity have reached an alarmingly high incidence and prevalence worldwide; they have also been steadily increasing in military populations. Military personnel, as an occupational group, are often exposed to stressful and harmful environments that represent a risk factor for disordered eating, with major repercussions on both physical and mental health. This study aims to explore the effectiveness of weight loss interventions and assess the significance of current obesity treatments for these populations. Three online databases (PubMed, PsycInfo, and Web of Science) were screened to identify randomized controlled trials (RCTs) aiming to treat obesity in active-duty military personnel and veterans. Random-effects meta-analyses were conducted for body weight (BW) and body mass index (BMI) values, both longitudinally comparing treatment groups from pre-to-post intervention and cross-sectionally comparing the treatment group to controls at the end of the intervention. A total of 21 studies were included: 16 cross-sectional (BW: n = 15; BMI: n = 12) and 16 longitudinal (BW: n = 15; BMI: n = 12) studies were meta-analyzed, and 5 studies were narratively synthesized. A significant small overall BW and BMI reduction from baseline to post-intervention was observed (BW: g = -0.10; p = 0.015; BMI: g = -0.32; p < 0.001), together with a decreased BMI (g = -0.16; p = 0.001) and nominally lower BW (g = -0.08; p = 0.178) in the intervention group compared to controls at the post-intervention time-point. Despite limitations, such as the heterogeneity across the included interventions and the follow-up duration, our findings highlight how current weight loss interventions are effective in terms of BW and BMI reductions in military populations and how a comprehensive approach with multiple therapeutic goals should be taken during the intervention.
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Affiliation(s)
- Davide Gravina
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE5 8AF, UK; (J.L.K.); (M.N.A.); (S.B.); (J.T.); (H.H.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56127 Pisa, Italy
| | - Johanna Louise Keeler
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE5 8AF, UK; (J.L.K.); (M.N.A.); (S.B.); (J.T.); (H.H.)
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK;
| | - Melahat Nur Akkese
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE5 8AF, UK; (J.L.K.); (M.N.A.); (S.B.); (J.T.); (H.H.)
| | - Sevgi Bektas
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE5 8AF, UK; (J.L.K.); (M.N.A.); (S.B.); (J.T.); (H.H.)
- Department of Psychology, Hacettepe University, Ankara 06800, Türkiye
| | - Paula Fina
- Faculty of Psychology, Sigmund Freud University Vienna, Freudplatz 1, 1020 Vienna, Austria;
| | - Charles Tweed
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK;
- Royal Navy Reserve, London WC1N 1NP, UK
| | - Gerd-Dieter Willmund
- Bundeswehr Center for Military Mental Health, Military Hospital Berlin, 13, 10115 Berlin, Germany;
| | - Janet Treasure
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE5 8AF, UK; (J.L.K.); (M.N.A.); (S.B.); (J.T.); (H.H.)
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK;
| | - Hubertus Himmerich
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE5 8AF, UK; (J.L.K.); (M.N.A.); (S.B.); (J.T.); (H.H.)
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK;
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Meng F, Jiang Y, Yu P, Song Y, Zhou L, Xu Y, Zhou Y. Effect of health coaching on blood pressure control and behavioral modification among patients with hypertension: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud 2023; 138:104406. [PMID: 36473304 DOI: 10.1016/j.ijnurstu.2022.104406] [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: 12/24/2021] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Health coaching has emerged as a potential supporting tool for improving hypertension health behavior. However, health coaching efficacy on hypertension has not been reviewed systematically. OBJECTIVE To evaluate the effects of health coaching on blood pressure and behavioral changes among patients with hypertension in randomized controlled trials. DESIGN A systematic review and meta-analysis. METHODS We searched Medline (via PubMed), Web of Science, Embase, Cochrane Central Register of Controlled Trials, Proquest, and Scopus from inception to November 30, 2021. All randomized controlled trials that estimated the effects of health coaching on blood pressure and behavioral changes in adults with hypertension were included. The Cochrane risk-of-bias tool was used to evaluate the quality of the included studies. Standardized mean differences (SMD) and 95 % confidence intervals (CIs) were calculated using random-effects or fixed-effects meta-analysis. Sensitivity analysis and subgroup analysis were also conducted. RESULTS A total of 1655 studies were screened and 12 randomized controlled trials were selected for inclusion, with 2497 participants were included. Most of the studies were at low risk of bias and the quality of evidence was high. The meta-analysis demonstrated that health coaching could significantly reduce systolic blood pressure (SMD: -0.26, 95 % CI: -0.39, -0.13, p < 0.001) and diastolic blood pressure in hypertension (SMD: -0.13, 95 % CI: -0.22, -0.03, p = 0.009). In addition, health coaching showed statistically significant positive effects on dietary behaviors (SMD: 0.76, 95 % CI: 0.08, 1.44, p = 0.02) and self-efficacy (SMD: 0.39, 95 % CI: 0.05, 0.73, p = 0.02). Subgroup analysis indicated that the most common and effective type of health coaching was the phone-based interventions (systolic blood pressure: SMD: -0.27, 95 % CI: -0.44, -0.10, p = 0.002; diastolic blood pressure: SMD: -0.14, 95 % CI: -0.25, -0.03, p = 0.02). The effects of nurse-delivered interventions were larger than other health care professionals (systolic blood pressure: SMD: -0.42, 95 % CI: -0.68, -0.16, p = 0.002; diastolic blood pressure: SMD: -0.19, 95 % CI: -0.35, -0.04, p = 0.02). CONCLUSION Current evidence suggested that health coaching could reduce blood pressure, improve dietary behaviors, and increase self-efficacy among patients with hypertension and thus could be an effective and alternative method in the management of hypertension. The most common and effective types of health coaching were phone-based and nurse-delivered interventions. Thus, more strategies and policies may be needed to implement these types of interventions to more patients with hypertension.
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Affiliation(s)
- Fei Meng
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Yunxia Jiang
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Pengli Yu
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Yuting Song
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Lixue Zhou
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Yanhong Xu
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Yunping Zhou
- School of Nursing, Qingdao University, Qingdao, Shandong, China.
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Mellor R, Saunders-Dow E, Mayr HL. Scope of Use and Effectiveness of Dietary Interventions for Improving Health-Related Outcomes in Veterans: A Systematic Review. Nutrients 2022; 14:nu14102094. [PMID: 35631235 PMCID: PMC9147269 DOI: 10.3390/nu14102094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/13/2022] [Accepted: 05/15/2022] [Indexed: 01/13/2023] Open
Abstract
Military veterans often have numerous physical and mental health conditions and can face unique challenges to intervention and management. Dietary interventions can improve the outcomes in many health conditions. This study aimed to evaluate the scope of health conditions targeted with dietary interventions and the effectiveness of these interventions for improving health-related outcomes in veterans. A systematic literature review was performed following PRISMA guidelines to identify and evaluate studies related to veterans and dietary interventions. Five electronic databases were searched, identifying 2669 references. Following screening, 35 studies were evaluated, and 18 were related to a US national veteran weight-loss program. The included studies were critically appraised, and the findings were narratively synthesized. Study designs ranged from randomised controlled trials to cohort studies and were predominantly U.S. based. The intervention durations ranged from one to 24 months. The mean subject age ranged from 39.0 to 69.7 years, with often predominantly male participants, and the mean body mass index ranged from 26.4 to 42.9 kg/m2. Most dietary interventions for veterans were implemented in populations with overweight/obesity or chronic disease and involved single dietary interventions or dietary components of holistic lifestyle interventions. The most common primary outcome of interest was weight loss. The success of dietary interventions was generally moderate, and barriers included poor compliance, mental health conditions and large drop-out rates. The findings from this review illustrate the need for further refinement of dietary and lifestyle interventions for the management of veterans with chronic health conditions.
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Affiliation(s)
- Rebecca Mellor
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, QLD 4021, Australia;
- Correspondence:
| | - Elise Saunders-Dow
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, QLD 4021, Australia;
| | - Hannah L. Mayr
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia;
- Centre for Functioning and Health Research, Metro South Hospital and Health Service, Buranda, QLD 4102, Australia
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Khalesi S, Williams E, Irwin C, Johnson DW, Webster J, McCartney D, Jamshidi A, Vandelanotte C. Reducing salt intake: a systematic review and meta-analysis of behavior change interventions in adults. Nutr Rev 2021; 80:723-740. [PMID: 34921314 PMCID: PMC8907486 DOI: 10.1093/nutrit/nuab110] [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] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Prolonged high salt (sodium) intake can increase the risk of hypertension and cardiovascular disease. Behavioral interventions may help reduce sodium intake at the population level. OBJECTIVE The effectiveness of behavior change interventions to reduce sodium intake in adults was investigated in this systematic review and meta-analysis. DATA SOURCE The PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and EMBASE databases were searched. DATA EXTRACTION Narrative synthesis and random-effects meta-analyses were used to determine intervention efficacy. A total of 61 trials (46 controlled trials and 15 quasi-experimental studies) were included. RESULTS Behavior change interventions resulted in significant improvements in salt consumption behavior (eg, decrease in purchase of salty foods; increase in use of salt substitutes), leading to reductions in sodium intake as measured by urinary sodium in 32 trials (N = 7840 participants; mean difference, -486.19 mg/d [95%CI, -669.44 to -302.95]; P < 0.001; I2 = 92%) and dietary sodium in 19 trials (N = 3750 participants; mean difference -399.86 mg/d [95%CI, -581.51 to -218.20]; P < 0.001; I2 = 96%), equivalent to a reduction of >1 g of salt intake daily. Effects were not significantly different based on baseline sodium intakes, blood pressure status, disease status, the use of behavior change theories, or the main method of intervention delivery (ie, online vs face-to-face). CONCLUSION Behavior change interventions are effective at improving salt consumption practices and appear to reduce salt intake by >1 g/d. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020185639.
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Affiliation(s)
- Saman Khalesi
- Appelton Institute & School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton & Brisbane, Queensland, Australia
| | - Edwina Williams
- Appelton Institute & School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton & Brisbane, Queensland, Australia
| | - Christopher Irwin
- Menzies Health Institute Queensland and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - David W Johnson
- Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia. D.W Johnson is with the Metro South Integrated Nephrology and Transplant Services (MINTS), Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Danielle McCartney
- Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | | | - Corneel Vandelanotte
- Appelton Institute & School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton & Brisbane, Queensland, Australia
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Stan DL, Cutshall SM, Adams TF, Ghosh K, Clark MM, Wieneke KC, Kebede EB, Donelan Dunlap BJ, Ruddy KJ, Hazelton JK, Butts AM, Jenkins SM, Croghan IT, Bauer BA. Wellness Coaching: An Intervention to Increase Healthy Behavior in Breast Cancer Survivors. Clin J Oncol Nurs 2021; 24:305-315. [PMID: 32441691 DOI: 10.1188/20.cjon.305-315] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Regular physical activity after breast cancer diagnosis improves survival rates and quality of life (QOL). However, breast cancer survivors rarely meet guidelines for recommended levels of physical activity. Wellness coaching interventions (WCIs) have improved exercise and health behaviors in other patient populations. OBJECTIVES This study assessed the feasibility and effectiveness of WCIs for increasing physical activity in breast cancer survivors; secondary measures included changes in dietary habits, weight, and QOL. METHODS 20 obese or overweight breast cancer survivors who recently completed active breast cancer treatment were recruited into a single-arm, 12-week WCI pilot feasibility study. The intervention was comprised of one in-person wellness coaching visit followed by four telephone calls over 12 weeks and 12 weekly emails containing wellness recommendations. FINDINGS Significant improvements from pre- to postintervention were seen in physical activity level, dietary habits, and in some aspects of QOL. Forty percent of participants achieved the 3% postintervention weight-loss goal, but this was not sustained at 30 weeks.
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Sieczkowska SM, de Lima AP, Swinton PA, Dolan E, Roschel H, Gualano B. Health Coaching Strategies for Weight Loss: A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:1449-1460. [PMID: 33339042 DOI: 10.1093/advances/nmaa159] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/01/2020] [Accepted: 11/11/2020] [Indexed: 02/07/2023] Open
Abstract
Health coaching has emerged as a potential supporting tool for health professionals to overcome behavioral barriers, but its efficacy in weight management remains unclear. We conducted a systematic review and meta-analysis to synthesize and evaluate the quality of evidence supporting the use of self-reported health coaching for weight loss. Seven electronic databases (PubMed, Web of Science, Scopus, Cochrane, Psyinfo, Virtual Health Library, and Scielo) were independently searched from inception to May 2020. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation recommendations. Any study that investigated a self-reported health coaching intervention with the goal of inducing weight loss in individuals of any age, health, or training status was considered for inclusion. Quantitative data were analyzed using multilevel hierarchical metaregression models conducted within a Bayesian framework. A total of 653 studies were screened and 38 were selected for inclusion. The quality of evidence supporting outcomes based on the entire evidence base was very low and studies were deemed to have high risk of bias. Meta-analysis of controlled studies provided evidence of an effect favoring coaching compared with usual care but was trivial in magnitude [effect size (ES)0.5: -0.09; 95% credible interval (CrI): -0.17, -0.02]. The multilevel extension of Egger's regression-intercept test indicated the existence of publication bias, whereas a sensitivity analysis based only on those studies deemed to be of high quality provided no evidence of an effect of coaching on weight loss (ES0.5: -0.04; 95% CrI: -0.12, 0.09). Considered collectively, the results of this investigation indicate that the available evidence is not of sufficient quality to support the use of self-reported health coaching as a health care intervention for weight loss. This trial was registered at Prospective Register of Systematic Reviews (PROSPERO) as CRD42020159023.
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Affiliation(s)
- Sofia Mendes Sieczkowska
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Laboratory of Assessment and Conditioning in Rheumatology; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, BR
| | - Alisson Padilha de Lima
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Laboratory of Assessment and Conditioning in Rheumatology; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, BR.,School of Physical Education, Faculty IELUSC, Joinville-SC, BR
| | - Paul Alan Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Eimear Dolan
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Laboratory of Assessment and Conditioning in Rheumatology; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, BR
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Laboratory of Assessment and Conditioning in Rheumatology; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, BR
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Laboratory of Assessment and Conditioning in Rheumatology; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, BR
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An S, Song R. Effects of health coaching on behavioral modification among adults with cardiovascular risk factors: Systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2020; 103:2029-2038. [PMID: 32448627 DOI: 10.1016/j.pec.2020.04.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/29/2020] [Accepted: 04/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This meta-analysis examined effects of health coaching on physical activities, dietary behaviors, health responsibility, stress management, and smoking behaviors among populations with cardiovascular risk factors. METHODS Multiple electronic databases were searched for randomized controlled trials utilizing health coaching for people with cardiovascular risk factors to lead behavioral changes. The included studies were pooled to estimate the effect size for health coaching interventions on each of the health behaviors. RESULTS This meta-analysis included 15 randomized trials. Motivational interviewing and education sessions were common coaching interventions with telephone calls or face-to-face contacts as the main contact methods. Health coaching for health behaviors showed small but significant effect sizes on physical activities, dietary behaviors, health responsibility, and stress management except for smoking behaviors. CONCLUSION The study findings support that health coaching can induce positive behavioral changes among individuals with cardiovascular risk factors. Health coaching delivered by either expert or peer coaches would be easy to apply in clinical settings. PRACTICAL IMPLICATIONS Health care professionals should be aware that health coaching could provide effective motivation strategies to improve compliance of those who need to initiate and maintain their health behaviors. Health coaching could be easily delivered via telephone calls, text messages, or short-term face-to-face coaching.
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Affiliation(s)
- Seonuk An
- Chungnam National University, Daejeon 35015, Republic of Korea
| | - Rhayun Song
- Chungnam National University, Daejeon 35015, Republic of Korea.
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Collins RA, Baker B, Coyle DH, Rollo ME, Burrows TL. Dietary Assessment Methods in Military and Veteran Populations: A Scoping Review. Nutrients 2020; 12:E769. [PMID: 32183380 PMCID: PMC7146105 DOI: 10.3390/nu12030769] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/06/2020] [Accepted: 03/10/2020] [Indexed: 12/20/2022] Open
Abstract
Optimal dietary intake is important for the health and physical performance of military personnel. For military veterans, the complex nature of transition into civilian life and sub-optimal dietary intake is a leading contributor to the increased burden of disease. A scoping review was undertaken to determine what is known about the assessment and reporting of dietary intakes within both military and veteran populations. In addition, this review determines if studies reporting on the dietary intake of military personnel or veterans include comparisons with dietary guidelines. Six databases were searched to identify papers published from the database inception to April 2019. Observational and intervention studies were searched to identify if they assessed and reported whole dietary intake data, reported data exclusively for a military or veteran population, and included only healthy populations. A total of 89 studies were included. The majority of studies used one dietary assessment method (n = 76, 85%) with fewer using multiple methods (n = 13, 15%). The most frequent methodology used was food frequency questionnaires (FFQ) (n = 40, 45%) followed by 24-hour recalls (n = 8, 9%) and food records (n = 8, 9%). The main dietary outcomes reported were macronutrients: carbohydrate, protein, fat, and alcohol (n = 66, 74%) with total energy intake reported in n = 59 (66%). Fifty four (61%) studies reported a comparison with country-specific dietary guidelines and 14 (16%) reported a comparison with the country-specific military guidelines. In conclusion, dietary intake in military settings is most commonly assessed via FFQs and 24-hour recalls. Dietary intake reporting is mainly focused around intakes of energy and macronutrients. Most studies compare against dietary guidelines, however, comparison to specific military dietary guidelines is minimal.
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Affiliation(s)
- Rebecca A. Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (R.A.C.); (M.E.R.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia
| | - Bradley Baker
- Food and Nutrition, Land Division, Defence Science and Technology Group, Scottsdale 7260, Australia;
| | - Daisy H. Coyle
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (R.A.C.); (M.E.R.)
- The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia
| | - Megan E. Rollo
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (R.A.C.); (M.E.R.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia
| | - Tracy L. Burrows
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (R.A.C.); (M.E.R.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia
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Bishop L, Hemingway A, Crabtree SA. Lifestyle coaching for mental health difficulties: scoping review. JOURNAL OF PUBLIC MENTAL HEALTH 2018. [DOI: 10.1108/jpmh-04-2017-0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
UK mental health strategy calls for interventions that empower people to self-manage their condition. In lifestyle coaching, coach and client work collaboratively on positive behaviour change to improve client health. There is debate about the appropriateness of coaching for mental health, yet claims have not been supported with evidence. Therefore, the purpose of this paper is to explore the nature and scope of the existing research literature in this field.
Design/methodology/approach
Scoping review.
Findings
The growing evidence base shows positive outcomes of coaching; for instance, symptom reduction, enhanced self-management and achievement of personal goals.
Research limitations/implications
The evidence base is small and of variable quality, offering insights that warrant further exploration.
Practical implications
Coaching not only supports better self-management but also addresses further mental health strategy priorities (such as improved physical health and social functioning). Coaches need not be mental health experts; therefore coaching may be a cost-effective intervention.
Social implications
As mental ill-health prevalence continues to rise despite widespread use of Improving Access to Psychological Therapies and medication, there is a need to explore how novel approaches such as coaching might be integrated into mental healthcare.
Originality/value
This is the first study to collate the evidence on mental health coaching, highlighting its extensive potential, which should be further explored in research and practice.
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Alencar MK, Johnson K, Mullur R, Gray V, Gutierrez E, Korosteleva O. The efficacy of a telemedicine-based weight loss program with video conference health coaching support. J Telemed Telecare 2017; 25:151-157. [DOI: 10.1177/1357633x17745471] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Clinically significant weight loss is defined as a ≥5% of initial body weight loss within a 6-month period. The purpose of this study was to assess body weight change from a 12-week telehealth-based weight loss program that integrated health coaching via video conferencing. Methods A total of 25 obese participants (12 males, 13 females) were recruited for this fully online 12-week weight loss program. Participants were randomly assigned to either an intervention group or control group ( n = 13 intervention, body mass index (BMI) = 34.7 ± 4.5 kg/m2; n = 12 control, BMI = 34.4 ± 4.43 kg/m2). All participants were given access to a secure platform for data tracking and video conferencing with the research team. The intervention group met with the medical doctor once per month and with a registered dietitian, weekly. Control participants met with the research team at baseline and at 12 weeks. Independent samples t-tests and Chi-square tests were used via SPSS version 24 with significance set to p < 0.05. Results There was a significant difference between the intervention and control groups for body weight loss (7.3 ± 5.2 versus 1.2 ± 3.9 kg, respectively, p < 0.05) as well as for percent body weight loss (7.16 ± 4.4 versus 1.5 ± 4.1%, respectively, p < 0.05). Clinically significant weight loss was achieved in 9 out of 13 (69.2%) in the intervention group versus 1 out of 12 (8%) in the control group. Discussion Mobile phone-based health coaching may promote weight loss. Weekly video conferencing with education may be an applicable tool for inducing significant body weight loss in obese individuals.
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Affiliation(s)
- Michelle K Alencar
- Department of Kinesiology, California State University, Long Beach, CA, USA
- inHealth Medical Services, Inc. Los Angeles, CA, USA
| | - Kelly Johnson
- Department of Physical Therapy, University of Saint Mary, Leavenworth, KS, USA
| | - Rashmi Mullur
- Division of Endocrinology, Diabetes, and Metabolism, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Virginia Gray
- Department of Family and Consumer Sciences, Nutrition and Dietetics, California State University, Long Beach, CA, USA
| | - Elizabeth Gutierrez
- Department of Family and Consumer Sciences, Nutrition and Dietetics, California State University, Long Beach, CA, USA
| | - Olga Korosteleva
- Department of Mathematics and Statistics, California State University, Long Beach, CA, USA
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Weight Loss in Advanced Chronic Kidney Disease: Should We Consider Individualised, Qualitative, ad Libitum Diets? A Narrative Review and Case Study. Nutrients 2017; 9:nu9101109. [PMID: 29019954 PMCID: PMC5691725 DOI: 10.3390/nu9101109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 09/22/2017] [Accepted: 10/06/2017] [Indexed: 12/17/2022] Open
Abstract
In advanced chronic kidney disease, obesity may bring a survival advantage, but many transplant centres demand weight loss before wait-listing for kidney graft. The case here described regards a 71-year-old man, with obesity-related glomerulopathy; referral data were: weight 110 kg, Body Mass Index (BMI) 37 kg/m2, serum creatinine (sCr) 5 mg/dL, estimated glomerular filtration rate (eGFR) 23 mL/min, blood urea nitrogen (BUN) 75 mg/dL, proteinuria 2.3 g/day. A moderately restricted, low-protein diet allowed reduction in BUN (45–55 mg/dL) and good metabolic and kidney function stability, with a weight increase of 6 kg. Therefore, he asked to be enrolled in a weight-loss program to be wait-listed (the two nearest transplant centres required a BMI below 30 or 35 kg/m2). Since previous low-calorie diets were not successful and he was against a surgical approach, we chose a qualitative, ad libitum coach-assisted diet, freely available in our unit. In the first phase, the diet is dissociated; he lost 16 kg in 2 months, without need for dialysis. In the second maintenance phase, in which foods are progressively combined, he lost 4 kg in 5 months, allowing wait-listing. Dialysis started one year later, and was followed by weight gain of about 5 kg. He resumed the maintenance diet, and his current body weight, 35 months after the start of the diet, is 94 kg, with a BMI of 31.7 kg/m2, without clinical or biochemical signs of malnutrition. This case suggests that our patients can benefit from the same options available to non-CKD (chronic kidney disease) individuals, provided that strict multidisciplinary surveillance is assured.
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Murray J, Aboul-Enein BH, Bernstein J, Kruk J. Selected weight management interventions for military populations in the United States: a narrative report. Nutr Health 2017; 23:67-74. [PMID: 28429642 DOI: 10.1177/0260106017704797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Overweight and obesity continues to be a significant public health burden in the US and particularly among military personnel. Although the US Department of Defense mandates standardized physical activity requirements for military members, incidence and prevalence of overweight and obesity among military personnel continue to increase. Each military department controls their own interventional strategies for physical fitness and weight control. However, unique challenges such as geographic transients, lack of central standardization and empirical efficacy data across military departments, and chronic stress associated with military service adversely affect program outcomes. This brief narrative report explores overweight and obesity interventions among military populations from 2006 to 2016 and includes programmatic reviews of eight overweight and obesity interventions: The Prevention of Obesity in Military Community; Health Eating, Activity, and Lifestyle Training Headquarters (H.E.A.L.T.H); ArmyMOVE!; L.I.F.E.; Look AHEAD; Nutrition-focused Wellness Coaching; Go for Green; and LE3AN. A majority of these interventions did not report significant weight loss 6 months post intervention, and did not mention a theoretical foundation within the interventions. Further research to examine the importance of theory-based programming is warranted to improve process and outcome objectives.
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Affiliation(s)
- Jessica Murray
- 1 College of Professional Studies, Northeastern University, Boston, MA, USA
| | - Basil H Aboul-Enein
- 2 Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Joshua Bernstein
- 3 College of Graduate Health Studies, A.T. Still University of Health Sciences, Kirksville, MO, USA
| | - Joanna Kruk
- 4 Faculty of Physical Culture and Health Promotion, University of Szczecin, Szczecin, Poland
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Sforzo GA, Kaye MP, Todorova I, Harenberg S, Costello K, Cobus-Kuo L, Faber A, Frates E, Moore M. Compendium of the Health and Wellness Coaching Literature. Am J Lifestyle Med 2017; 12:436-447. [PMID: 30542254 PMCID: PMC6236633 DOI: 10.1177/1559827617708562] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 04/14/2017] [Accepted: 04/17/2017] [Indexed: 11/16/2022] Open
Abstract
Health and wellness coaching (HWC) for lifestyle behavior change is emerging as a
practice, role, and profession, in diverse health care, employee wellness, and
community settings. Health care professionals apply HWC as a behavior change
methodology for the prevention and treatment of diabetes, hypertension,
hyperlipidemia, heart disease, cancer, and other chronic disorders. The purpose
of this systematic review was to provide a comprehensive and organized
compendium of HWC literature. To date, extant HWC literature remains scattered
with no meaningful summary accessible. Lack of comprehensive summary stems from
lack of consensus on HWC definition and standards. We applied a recently
proposed, standardized definition of HWC to determine compendium inclusion
criteria for peer-reviewed, data-based literature from relevant search engines
(ie, PubMed, PsychInfo, and CINAHL). A systematic review process was executed
and ultimately yielded 219 articles meeting HWC inclusion criteria. Of these,
150 were data-based and the remainder were expert opinion or review-style
articles. A summary of results generally reveals HWC as a promising intervention
for chronic diseases though further research is needed in most categories. The
resulting HWC compendium organizes and describes the quantity and quality of
available literature for the use and benefit of HWC practitioners and
researchers.
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Affiliation(s)
- Gary A Sforzo
- Department of Exercise & Sport Sciences, Ithaca College, Ithaca, New York (GAS, SH, KC, LC).,Clearinghouse for Military Family Readiness at Penn State University, University Park, Pennsylvania (MPK, AF).,Institute of Coaching, McLean Hospital, Belmont, Massachusetts (IT, MM).,Harvard Medical School, Boston, Massachusetts (IT, EF, MM).,Stroke Institute for Research and Recovery, Spaulding Rehabilitation Hospital, Boston, Massachusetts (EF).,Wellcoaches Corporation, Wellesley, Massachusetts (MM)
| | - Miranda P Kaye
- Department of Exercise & Sport Sciences, Ithaca College, Ithaca, New York (GAS, SH, KC, LC).,Clearinghouse for Military Family Readiness at Penn State University, University Park, Pennsylvania (MPK, AF).,Institute of Coaching, McLean Hospital, Belmont, Massachusetts (IT, MM).,Harvard Medical School, Boston, Massachusetts (IT, EF, MM).,Stroke Institute for Research and Recovery, Spaulding Rehabilitation Hospital, Boston, Massachusetts (EF).,Wellcoaches Corporation, Wellesley, Massachusetts (MM)
| | - Irina Todorova
- Department of Exercise & Sport Sciences, Ithaca College, Ithaca, New York (GAS, SH, KC, LC).,Clearinghouse for Military Family Readiness at Penn State University, University Park, Pennsylvania (MPK, AF).,Institute of Coaching, McLean Hospital, Belmont, Massachusetts (IT, MM).,Harvard Medical School, Boston, Massachusetts (IT, EF, MM).,Stroke Institute for Research and Recovery, Spaulding Rehabilitation Hospital, Boston, Massachusetts (EF).,Wellcoaches Corporation, Wellesley, Massachusetts (MM)
| | - Sebastian Harenberg
- Department of Exercise & Sport Sciences, Ithaca College, Ithaca, New York (GAS, SH, KC, LC).,Clearinghouse for Military Family Readiness at Penn State University, University Park, Pennsylvania (MPK, AF).,Institute of Coaching, McLean Hospital, Belmont, Massachusetts (IT, MM).,Harvard Medical School, Boston, Massachusetts (IT, EF, MM).,Stroke Institute for Research and Recovery, Spaulding Rehabilitation Hospital, Boston, Massachusetts (EF).,Wellcoaches Corporation, Wellesley, Massachusetts (MM)
| | - Kyle Costello
- Department of Exercise & Sport Sciences, Ithaca College, Ithaca, New York (GAS, SH, KC, LC).,Clearinghouse for Military Family Readiness at Penn State University, University Park, Pennsylvania (MPK, AF).,Institute of Coaching, McLean Hospital, Belmont, Massachusetts (IT, MM).,Harvard Medical School, Boston, Massachusetts (IT, EF, MM).,Stroke Institute for Research and Recovery, Spaulding Rehabilitation Hospital, Boston, Massachusetts (EF).,Wellcoaches Corporation, Wellesley, Massachusetts (MM)
| | - Laura Cobus-Kuo
- Department of Exercise & Sport Sciences, Ithaca College, Ithaca, New York (GAS, SH, KC, LC).,Clearinghouse for Military Family Readiness at Penn State University, University Park, Pennsylvania (MPK, AF).,Institute of Coaching, McLean Hospital, Belmont, Massachusetts (IT, MM).,Harvard Medical School, Boston, Massachusetts (IT, EF, MM).,Stroke Institute for Research and Recovery, Spaulding Rehabilitation Hospital, Boston, Massachusetts (EF).,Wellcoaches Corporation, Wellesley, Massachusetts (MM)
| | - Aubrey Faber
- Department of Exercise & Sport Sciences, Ithaca College, Ithaca, New York (GAS, SH, KC, LC).,Clearinghouse for Military Family Readiness at Penn State University, University Park, Pennsylvania (MPK, AF).,Institute of Coaching, McLean Hospital, Belmont, Massachusetts (IT, MM).,Harvard Medical School, Boston, Massachusetts (IT, EF, MM).,Stroke Institute for Research and Recovery, Spaulding Rehabilitation Hospital, Boston, Massachusetts (EF).,Wellcoaches Corporation, Wellesley, Massachusetts (MM)
| | - Elizabeth Frates
- Department of Exercise & Sport Sciences, Ithaca College, Ithaca, New York (GAS, SH, KC, LC).,Clearinghouse for Military Family Readiness at Penn State University, University Park, Pennsylvania (MPK, AF).,Institute of Coaching, McLean Hospital, Belmont, Massachusetts (IT, MM).,Harvard Medical School, Boston, Massachusetts (IT, EF, MM).,Stroke Institute for Research and Recovery, Spaulding Rehabilitation Hospital, Boston, Massachusetts (EF).,Wellcoaches Corporation, Wellesley, Massachusetts (MM)
| | - Margaret Moore
- Department of Exercise & Sport Sciences, Ithaca College, Ithaca, New York (GAS, SH, KC, LC).,Clearinghouse for Military Family Readiness at Penn State University, University Park, Pennsylvania (MPK, AF).,Institute of Coaching, McLean Hospital, Belmont, Massachusetts (IT, MM).,Harvard Medical School, Boston, Massachusetts (IT, EF, MM).,Stroke Institute for Research and Recovery, Spaulding Rehabilitation Hospital, Boston, Massachusetts (EF).,Wellcoaches Corporation, Wellesley, Massachusetts (MM)
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Peyer KL, Ellingson LD, Bus K, Walsh SA, Franke WD, Welk GJ. Comparative effectiveness of guided weight loss and physical activity monitoring for weight loss and metabolic risks: A pilot study. Prev Med Rep 2017; 6:271-277. [PMID: 28409089 PMCID: PMC5385579 DOI: 10.1016/j.pmedr.2017.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 03/02/2017] [Accepted: 03/13/2017] [Indexed: 11/19/2022] Open
Abstract
Many consumer-based physical activity monitors (PAMs) are available but it is not clear how to use them to most effectively promote weight loss. The purpose of this pilot study was to compare the effectiveness of a personal PAM, a guided weight loss program (GWL), and the combination of these approaches on weight loss and metabolic risk. Participants completed the study in two cohorts: Fall 2010 and Spring 2011. A sample of 72 obese individuals in the Ames, IA area were randomized to one of 3 conditions: 1) (GWL, N = 31), 2) PAM, N = 29, or 3) a combination group (PAM + GWL, N = 29). Weight and metabolic syndrome score (MetS), computed from waist circumference (WC), BMI, blood pressure (BP), and lipids were assessed at baseline and following an 8-week intervention. Weight was also assessed four months later. Two-way (Group × Time) ANOVAs examined intervention effects and maintenance. Effect sizes were used to compare magnitude of improvements among groups. During the intervention, all groups demonstrated significant improvements in weight and MetS (mean weight loss = 4.16 kg, p < 0.001). Mean weight continued to decline modestly during follow-up, with average weight loss of 4.82 kg from baseline (p < 0.01). There were no group differences for weight loss but the PAM + GWL group had significantly larger changes in MetS score (d = 0.06-0.77). The use of PAM resulted in significant improvements in weight and MetS that were maintained across a four-month follow-up. Evidence suggests that the addition of GWL contributed to enhanced metabolic outcomes.
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Affiliation(s)
- Karissa L. Peyer
- University of Tennessee at Chattanooga, 105 Metropolitan Building, 518 Oak Street, Chattanooga, TN 37403, USA
- Corresponding author.
| | | | - Kathryn Bus
- Iowa State University, Department of Kinesiology, USA
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Murimi MW, Kanyi M, Mupfudze T, Amin MR, Mbogori T, Aldubayan K. Factors Influencing Efficacy of Nutrition Education Interventions: A Systematic Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:142-165.e1. [PMID: 27814976 DOI: 10.1016/j.jneb.2016.09.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 09/04/2016] [Accepted: 09/08/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To examine systematically factors that contribute to the efficacy of nutrition education interventions in promoting behavior change for good health based on their stated objective. In a departure from previous reviews, the researchers investigated factors that lead to success of various types of interventions. Critical analysis of these factors constituted the outcome of this review. METHODS This study followed Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria. A total of 246 original articles published between 2009 and 2015 in PubMed, Medline, Web of Science, Academic Search Complete, Science Direct, Cochrane Reviews, ERIC, and PsychLIT were initially considered. The number was screened and scaled down to 40 publications for the final analysis. Quality assessment was based on the Cochrane Handbook for Systematic Reviews of Intervention. Studies were rated as having low risk of bias, moderate risk, or high risk. RESULTS Efficacy of nutrition education interventions depended on major factors: interventions that lasted ≥5 months; having ≤3 focused objectives; appropriate design and use of theories; fidelity in interventions; and support from policy makers and management for worksite environmental interventions. CONCLUSIONS AND IMPLICATIONS Intervention duration of ≥5 months, ≤3 focused objectives, randomization, use of theories, and fidelity are factors that enhance success of interventions based on the results of this study.
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Affiliation(s)
- Mary W Murimi
- College of Human Sciences, Texas Tech University, Lubbock, TX.
| | - Michael Kanyi
- College of Human Sciences, Texas Tech University, Lubbock, TX
| | | | - Md Ruhul Amin
- College of Human Sciences, Texas Tech University, Lubbock, TX
| | - Teresia Mbogori
- College of Human Sciences, Texas Tech University, Lubbock, TX
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Muñoz Obino KF, Aguiar Pereira C, Caron-Lienert RS. Coaching and barriers to weight loss: an integrative review. Diabetes Metab Syndr Obes 2017; 10:1-11. [PMID: 28096687 PMCID: PMC5207339 DOI: 10.2147/dmso.s113874] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Coaching is proposed to raise a patient's awareness and responsibility for their health behaviour change by transforming the professional-patient relationship. OBJECTIVE To review the scientific literature on how coaching can assist in weight loss and improve a patient's state of health. METHODOLOGY An integrative literature search was performed using PubMed, Latin American and Caribbean Literature in Health Sciences, and Scientific Electronic Library Online. We selected articles that were published in Portuguese, English, and Spanish over the last 10 years. Data analysis was performed using a validated data collection instrument. RESULTS Among the 289 articles identified in the search, 276 were excluded because they did not address the leading research question, their full texts were not available on the Internet, or they were duplicate publications. Therefore, for the analysis, we selected 13 articles that we classified as randomized clinical studies (46.15%; n=6), cohort studies (30.76%; n=4), cross-sectional studies (7.69%; n=1), case studies (7.69%; n=1), and review articles (7.69%; n=1). Joint intervention (combined in-person and telecoaching sessions) constituted the majority of session types. The use of technical coaching was superior in reducing anthropometric measurements and increasing the levels of motivation and personal satisfaction compared with formal health education alone. CONCLUSION Coaching is an efficient, cost-effective method for combining formal education and treatment of health in the weight-loss process. Additional randomized studies are needed to demonstrate its effectiveness with respect to chronic disease indicators.
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Affiliation(s)
- Karen Fernanda Muñoz Obino
- Nutrology/Clinical Nutrition Unit, Ernesto Dornelles Hospital
- Correspondence: Karen Fernanda Muñoz Obino, Nutrology/Clinical Nutrition Unit, Ernesto Dornelles Hospital, Avenida Ipiranga, 1801 - Porto Alegre - RS, 90160-092, Brazil, Email
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Howard EP, Schreiber R, Morris JN, Russotto A, Flashner-Fineman S. COLLAGE 360: A Model of Person-Centered Care To Promote Health Among Older Adults. ACTA ACUST UNITED AC 2016; 1:21-30. [PMID: 28989995 DOI: 10.14302/issn.2474-7785.jarh-16-1123] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Health care leaders and providers have introduced the assumption the typical elder, even in the presence of complex, chronic disease and prevailing illness, is capable of assuming greater personal responsibility for their health care, with a shift from provider-centered to a person-centered model of care. For older adults who often and repeatedly face challenges managing and maintaining their health status, guidance and support is needed. In this study, COLLAGE 360, a comprehensive assessment system and wellness coaching program that focuses on prevention and wellness, care coordination and self-management of health care was implemented in one continuing care retirement community. Following completion of two assessment tools via directed conversation with a wellness coach, older adults developed an individualized vitality plan that outlined life goals, supporting goals and action plans for goal achievement. Results from this program suggest engagement in the assessment and wellness coaching process via the COLLAGE 360 program translated into sample older adults sensing that they live in a more supportive environment when compared with elders not receiving any wellness coaching. In addition, the older adults had positive effects in the areas of mood, loneliness, social interaction, health status, and life satisfaction. Strategies to improve health and well being need an extended focus beyond the older adult's medical conditions and consider psychological, spiritual and social needs with personal preferences being paramount. These issues are foundational to a person-centered, health promotion approach needed among this population.
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Affiliation(s)
- Elizabeth P Howard
- Northeastern University School of Nursing, 360 Huntington Avenue, Boston, MA 02115
| | - Robert Schreiber
- Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131
| | - John N Morris
- Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131
| | - Aline Russotto
- Orchard Cove, Hebrew SeniorLife, One Del Pond Drive, Canton, MA 02021
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Jordan M, Wolever RQ, Lawson K, Moore M. National training and education standards for health and wellness coaching: the path to national certification. Glob Adv Health Med 2015; 4:46-56. [PMID: 25984418 PMCID: PMC4424935 DOI: 10.7453/gahmj.2015.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The purpose of this article is twofold: (1) to announce the findings of the job task analysis as well as national training and education standards for health and wellness coaching (HWC) that have been developed by the large-scale, collaborative efforts of the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC) and (2) to invite commentary from the public. The rapid proliferation of individuals and organizations using the terms of health and/or wellness coaches and the propagation of private industry and academic coach training and education programs endeavoring to prepare these coaches has created an urgent and pressing need for national standards for use of the term health and wellness coach, as well as minimal requirements for training, education, and certification. Professionalizing the field with national standards brings a clear and consistent definition of health and wellness coaching and accepted practice standards that are uniform across the field. In addition, clear standards allow for uniform curricular criteria to ensure a minimal benchmark for education, training, and skills and knowledge evaluation of professional health and wellness coaches.
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Abstract
As technology continues to develop rapidly, the incidence of obesity also continues to climb at an alarming rate. The increase in available technology is thought to be a contributor in the obesogenic environment, yet at the same time technology can also be used to intervene and improve health and health behaviors. This article reviews the components of effective weight management programs and the novel role that technology, such as SMS, websites, and smartphone apps, is playing to improve the success of such programs. Use of these modern technologies can now allow for individualized treatment recommendations to be delivered to individuals remotely, increased self-monitoring/tracking of health-related data, broader and more rapid dissemination of health information/recommendations, and increased patient-dietician/physician contact. The use of technology in weight management programs results in improved long-term weight management, and in most cases improved cost-effectiveness. Rather than blaming increased food intake and sedentary lifestyle on technology, rapidly developing and innovative technologies should be used to our advantage and deployed to combat the obesity epidemic.
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Affiliation(s)
- L Anne Gilmore
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Abby F Duhé
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Mastellos N, Gunn LH, Felix LM, Car J, Majeed A. Transtheoretical model stages of change for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database Syst Rev 2014; 2014:CD008066. [PMID: 24500864 PMCID: PMC10088065 DOI: 10.1002/14651858.cd008066.pub3] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Obesity is a global public health threat. The transtheoretical stages of change (TTM SOC) model has long been considered a useful interventional approach in lifestyle modification programmes, but its effectiveness in producing sustainable weight loss in overweight and obese individuals has been found to vary considerably. OBJECTIVES To assess the effectiveness of dietary intervention or physical activity interventions, or both, and other interventions based on the transtheoretical model (TTM) stages of change (SOC) to produce sustainable (one year and longer) weight loss in overweight and obese adults. SEARCH METHODS Studies were obtained from searches of multiple electronic bibliographic databases. We searched The Cochrane Library, MEDLINE, EMBASE and PsycINFO. The date of the last search, for all databases, was 17 December 2013. SELECTION CRITERIA Trials were included if they fulfilled the criteria of randomised controlled clinical trials (RCTs) using the TTM SOC as a model, that is a theoretical framework or guideline in designing lifestyle modification strategies, mainly dietary and physical activity interventions, versus a comparison intervention of usual care; one of the outcome measures of the study was weight loss, measured as change in weight or body mass index (BMI); participants were overweight or obese adults only; and the intervention was delivered by healthcare professionals or trained lay people at the hospital and community level, including at home. DATA COLLECTION AND ANALYSIS Two review authors independently extracted the data, assessed studies for risk of bias and evaluated overall study quality according to GRADE (Grading of Recommendations Assessment, Development and Evaluation). We resolved disagreements by discussion or consultation with a third party. A narrative, descriptive analysis was conducted for the systematic review. MAIN RESULTS A total of three studies met the inclusion criteria, allocating 2971 participants to the intervention and control groups. The total number of participants randomised to the intervention groups was 1467, whilst 1504 were randomised to the control groups. The length of intervention was 9, 12 and 24 months in the different trials. The use of TTM SOC in combination with diet or physical activity, or both, and other interventions in the included studies produced inconclusive evidence that TTM SOC interventions led to sustained weight loss (the mean difference between intervention and control groups varied from 2.1 kg to 0.2 kg at 24 months; 2971 participants; 3 trials; low quality evidence). Following application of TTM SOC there were improvements in physical activity and dietary habits, such as increased exercise duration and frequency, reduced dietary fat intake and increased fruit and vegetable consumption (very low quality evidence). Weight gain was reported as an adverse event in one of the included trials. None of the trials reported health-related quality of life, morbidity, or economic costs as outcomes. The small number of studies and their variable methodological quality limit the applicability of the findings to clinical practice. The main limitations include inadequate reporting of outcomes and the methods for allocation, randomisation and blinding; extensive use of self-reported measures to estimate the effects of interventions on a number of outcomes, including weight loss, dietary consumption and physical activity levels; and insufficient assessment of sustainability due to lack of post-intervention assessments. AUTHORS' CONCLUSIONS The evidence to support the use of TTM SOC in weight loss interventions is limited by risk of bias and imprecision, not allowing firm conclusions to be drawn. When combined with diet or physical activity, or both, and other interventions we found very low quality evidence that it might lead to better dietary and physical activity habits. This systematic review highlights the need for well-designed RCTs that apply the principles of the TTM SOC appropriately to produce conclusive evidence about the effect of TTM SOC lifestyle interventions on weight loss and other health outcomes.
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Affiliation(s)
- Nikolaos Mastellos
- Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public Health, School of Public HealthSt Dunstans RoadLondonHammersmithUKW6 8RP
| | - Laura H Gunn
- Stetson UniversityIntegrative Health Science421 N Woodland BlvdUnit 8317DeLandFloridaUSA32723
| | - Lambert M Felix
- School of Public Health, Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public HealthSt Dunstans RoadLondonUKW6 8RP
| | - Josip Car
- Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public Health, School of Public HealthSt Dunstans RoadLondonHammersmithUKW6 8RP
| | - Azeem Majeed
- Imperial College LondonDepartment of Primary Care and Public HealthThe Reynolds Building, Charing Cross CampusSt Dunstan's RoadLondonUKW6 8RP
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