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Diriba D, Guta D. Adherence to lifestyle modifications and its associated factors among adult hypertensive patients attending their follow-up at public hospitals in West Shoa, Oromia, Ethiopia, 2023. J Hum Hypertens 2025; 39:192-198. [PMID: 39962235 DOI: 10.1038/s41371-025-00991-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 01/20/2025] [Accepted: 02/06/2025] [Indexed: 03/12/2025]
Abstract
Hypertension is a serious public health concern, disturbing millions of lives worldwide. Effective lifestyle modifications are the foundation for the prevention and control of hypertension. The aim of this study is to assess adherence to lifestyle modifications and associated factors among adult hypertensive patients in West Shoa, Oromia, Ethiopia. An institutional-based cross-sectional study design was employed from August 20 to September 20, 2023. A systematic random sampling technique was employed to select study participants. A binary logistic regression model was used to check the association between independent and outcome variables. The strength of the association was stated using an adjusted odds ratio with a 95% confidence interval and a p-value of < 0.05. The study included 316 study participants, with a 98.8% response rate. The magnitude of adherence to lifestyle modifications was 31% (95%CI: 25.7-36.1%). Age (AOR = 2.71, 95% CI: 1.19-6.19), residence (AOR = 0.19, 95%CI: 0.09-0.39), duration of treatment (AOR = 2.17, 95%CI: 1.14-4.13), attitude (AOR = 2.14, 95%CI: 1.06-4.30), perceived social support (AOR = 6.23, 95%CI: 3.18-12.22) and self-efficacy (AOR = 2.66, 95%CI: 1.25-5.69) were the independent predictors of lifestyle modifications adherence. This study found that adherence to lifestyle modifications was low among hypertensive patients.
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Affiliation(s)
- Demessie Diriba
- Departments of Nursing, Institute of Health, Dambi Dollo University, Dambi Dollo, Ethiopia.
| | - Dereje Guta
- Departments of Nursing, Institute of Health, Dambi Dollo University, Dambi Dollo, Ethiopia
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Gurbuz F, Geckil E, Gurbuz AS, Eklioglu BS. The relationship among heart health attitudes, socioeconomic factors, and HbA1c levels in adolescents with type 1 diabetes. Work 2025:10519815241300291. [PMID: 39973729 DOI: 10.1177/10519815241300291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2025] Open
Abstract
BACKGROUND Type 1 Diabetes is important chronic health problem that incidence increasing between the ages of 4-6 and 10-15, has multi-dimensional etiological factors. Cardiovascular diseases may develop due to diabetes and cause significant morbidity and mortality. Diabetes cause deterioration of vascular structure, and sudden onset of heart disease through various pathophysiological mechanisms. Controlling factors, especially diabetes management, is very important in preventing cardiovascular diseases. OBJECTIVE The study aimed to investigate the relationship between heart health attitudes, socioeconomic factors, and HbA1c levels in adolescents with Type 1 Diabetes. METHODS The study included 10-15-year-old adolescents with Type 1 Diabetes treated in pediatric endocrinology outpatient clinic provided they met the inclusion and exclusion criteria. Adolescents' heart health attitudes were evaluated with the cardiovascular health promotion attitude scale for children. HbA1c levels and socioeconomic characteristics of the adolescents were recorded. RESULTS The independent predictors of the group with favorable heart health attitudes were exercise duration, meal frequency, low economic status, and HbA1c levels. HbA1c levels were positively associated with nutrition, exercise, sedentary life, and smoking subscale scores as well as total scale scores. However, it was not associated with the scores of self-love and stress subscales. Low self-love and stress subscale scores were independent predictors of low economic status and explain why low economic status is a predictor of favorable heart health attitudes. CONCLUSIONS The cardiovascular health promotion attitude scale scores are associated with HbA1c levels, which is a predictor of increased cardiovascular diseases. This predictive ability of the scale makes its use meaningful.
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Affiliation(s)
- Funda Gurbuz
- Department of Paediatric Nursing, Necmettin Erbakan University Institute of Health Sciences, Konya, Turkey
- Vocational School of Health Services, KTO Karatay University, Konya, Turkey
| | - Emine Geckil
- Department of Pediatric Nursing, Necmettin Erbakan University Faculty of Nursing, Konya, Turkey
| | - Ahmet Seyfeddin Gurbuz
- Department of Cardiology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Beray Selver Eklioglu
- Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
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Rethorst CD, Demment MM, Ha S, Folta SC, Graham ML, Eldridge GD, Seguin-Fowler RA. Heterogeneity in Health Outcomes in the Strong Hearts, Healthy Communities-2.0 Multilevel Intervention in a Community-Randomized Trial: An Exploratory Study of Moderators. Nutrients 2024; 16:4353. [PMID: 39770974 PMCID: PMC11678296 DOI: 10.3390/nu16244353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 12/03/2024] [Accepted: 12/10/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND/OBJECTIVES Multilevel interventions have demonstrated efficacy in improving obesity and other related health outcomes. However, heterogeneity in individual responses indicates the need to identify the factors associated with responses and non-responses to multilevel interventions. The objective of this report is to identify the potential sources of heterogeneity through the exploration of the moderation effects of participant characteristics (sociodemographic and baseline physical/mental health) in the Strong Hearts, Healthy Communities-2.0 (SHHC-2.0) intervention. METHODS SHHC-2.0 is a 24-week multilevel intervention to improve people's diet and physical activity evaluated using a cluster-randomized, controlled trial design conducted with women aged 40 and older living in rural communities with an elevated risk of cardiovascular disease, defined as having a BMI > 30, or a BMI 25-30 plus < 1 weekly occurrence of 30 min of physical activity during leisure time. Linear mixed models were used to compare the between-group changes in the outcomes (weight, systolic blood pressure, hemoglobin A1c [HbA1c], and triglycerides), with an interaction term included for each potential moderator. RESULTS Within the sociodemographic characteristics, there were no differences in effectiveness by age, income, or baseline BMI status, but the participants with a high school education or less experienced less weight loss. Among their health history, only a history of hypertension was associated with differential outcomes; those with a history of hypertension demonstrated a greater reduction in systolic blood pressure. The participants with elevated depressive symptoms demonstrated greater weight loss and a greater reduction in the HbA1c level. CONCLUSIONS SHHC-2.0 was effective across a wide range of participants. The identified moderators (i.e., education level) may inform the future tailoring of the SHHC intervention to optimize the outcomes among participant subgroups, while more broadly, our findings can serve to inform the development and dissemination of multilevel interventions.
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Affiliation(s)
- Chad D. Rethorst
- Institute for Advancing Health Through Agriculture, Texas A&M University, Dallas, TX 75252, USA; (C.D.R.); (M.M.D.); (M.L.G.); (G.D.E.)
| | - Margaret M. Demment
- Institute for Advancing Health Through Agriculture, Texas A&M University, Dallas, TX 75252, USA; (C.D.R.); (M.M.D.); (M.L.G.); (G.D.E.)
| | - Seungyeon Ha
- Statistical Consultation Center, Texas A&M University, College Station, TX 77843, USA;
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA;
| | - Meredith L. Graham
- Institute for Advancing Health Through Agriculture, Texas A&M University, Dallas, TX 75252, USA; (C.D.R.); (M.M.D.); (M.L.G.); (G.D.E.)
| | - Galen D. Eldridge
- Institute for Advancing Health Through Agriculture, Texas A&M University, Dallas, TX 75252, USA; (C.D.R.); (M.M.D.); (M.L.G.); (G.D.E.)
| | - Rebecca A. Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, TX 77840, USA
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Åström H, Shang Y, Hagström H, Wester A. Persons with metabolic dysfunction-associated steatotic liver disease are at increased risk of severe depression. Liver Int 2024; 44:2551-2563. [PMID: 38949395 DOI: 10.1111/liv.16019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/07/2024] [Accepted: 06/17/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND AND AIM Few population-based studies have investigated the association between metabolic dysfunction-associated steatotic liver disease (MASLD) and depression. Additionally, it remains unclear if depression affects progression to major adverse liver outcomes (MALO) in MASLD. METHODS All patients in Sweden with newly diagnosed MASLD between 2006 and 2020 were identified from the National Patient Register. Each patient was matched on age, sex, inclusion year, and municipality with up to 10 comparators from the general population. Cox regression was used to compare rates of severe depression in persons with MASLD to the comparators. In persons with MASLD, Cox regression was used to estimate rates of MALO using severe depression before baseline or diagnosed during follow-up as a time-varying exposure. RESULTS We included 11 301 persons with MASLD and 104 205 comparators who were followed for a median of 3.9 (IQR 1.5-7.6) and 4.9 years (IQR 2.3-8.7), respectively. The median age was 56 years and 5576 of 11 301 (49.3%) persons with MASLD were male. Incident severe depression developed in 228 of 11 301 (2.0%) persons with MASLD and 1160 of 104 205 (1.1%) comparators (fully adjusted hazard ratio [HR] = 1.8, 95% CI = 1.5-2.1). Of persons with MASLD, 25 of 1229 (2.0%) of those with severe depression before or after baseline progressed to MALO compared to 322 of 10 326 (3.1%) of those without severe depression (fully adjusted HR = 1.0, 95% CI = .6-1.5). CONCLUSIONS We confirm an association between MASLD and severe depression. However, no association between severe depression and incident MALO was found, but conclusions are limited by few observed outcomes.
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Affiliation(s)
- Hanne Åström
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Ying Shang
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Hannes Hagström
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
- Division of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden
| | - Axel Wester
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
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Yin YH, Liu JYW, Välimäki M. "How difficult it is to change dietary behaviour" experience of older people with sarcopenic obesity: a qualitative study. BMC Geriatr 2024; 24:568. [PMID: 38951785 PMCID: PMC11218247 DOI: 10.1186/s12877-024-05157-0] [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: 01/04/2024] [Accepted: 06/17/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Dietary intervention is an important method to manage sarcopenic obesity, but the implementation in real world is difficult to achieve an ideal condition. This study aimed to the experiences of older people with sarcopenic obesity during the implementation of dietary behavioural change (DBC) intervention. METHODS This study is a semi-structured individual interview embedded within a pilot randomized controlled trial on community-dwelling older people with sarcopenic obesity. Purposive sampling was applied to invite 21 participants who had received a 15-week DBC intervention. The interviews were audio-recorded and transcribed verbatim. Content analysis was performed to analyze the data. RESULTS The themes for facilitators included: (a) Attach importance to self's health; (b) Family's support; (c) Concern self's body shape; (d) Instructor's support; (e) Regular food diary taken. The themes for barriers included: (a) Difficulties of taking food diary; (b) Difficulties of calculating the food amount; (c) Yield to offspring's appetite; (d) Misjudging self's or family's appetite. CONCLUSION Support from family members and instructor, caring about self's health and body image facilitated the intervention implementation. The complication of food amount estimation and diary record, personal sacrifice for next generations, and previous living experience were barriers for implementing the intervention. Overall, the older people with sarcopenic obesity can accept the design of DBC intervention program and have great willing to join.
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Affiliation(s)
- Yue-Heng Yin
- School of Nursing, Nanjing Medical University, 101 Long Mian Avenue, Nanjing, 211166, China.
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Maritta Välimäki
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
- , Turku, Finland
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Javadzade H, Vahedparast H, Khodaminasab A, Tahmasebi R, Reisi M, Kiani J. The effect of web-based education on self-care behaviors in cardiovascular patients: application of the pender's health promotion model. Arch Public Health 2024; 82:64. [PMID: 38725040 PMCID: PMC11080192 DOI: 10.1186/s13690-024-01299-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Coronary artery disease is the most common cardiovascular disease, the mortality rate of which is increasing significantly. The most important way to prevent a second attack in patients undergoing angioplasty is self-care, which can be influenced by several factors such as the patient's beliefs. Thus, the present study aimed to determine the effect of a web-based intervention based on the Pender's health promotion model in patients with cardiovascular disease. METHODS The present clinical trial study was conducted with 99 patients undergoing angioplasty treatment referring to Bushehr Heart Specialist Center. Random sampling was done and the participants were divided into two groups (50 subjects in intervention group and 49 subjects in control group). The data collection tool was a three-part questionnaire (including demographic information, a researcher-made questionnaire based on the health promotion model constructs, and self-care behaviors), which was completed in three stages (before, two weeks, and three months after the intervention). In addition to routine hospital services, the intervention group received multimedia training based on the constructs of the Pender's health promotion model from the website. The control group received usual hospital services. Data were analyzed with chi-square, independent T-test and repeated measure ANOVA using SPSS-22 software. RESULTS The results showed that 2 weeks and 3 months after the intervention, the mean scores of perceived benefits, perceived self-efficacy and perceived social support had a significant increase in the intervention group compared to the control group, but the mean score of perceived barriers had a significant decrease in the intervention group (p < 0.001). Regarding self-care behaviors, after the intervention, the mean scores of self-care behaviors, physical activity, healthy diet, medication adherence and stress management had a significant increase in the intervention group compared to the control group (p < 0.001), but no significant was observed between the two groups in terms of changes in the non-smoking (p = 0.38). CONCLUSION The results of the study showed that the web-based educational intervention based on the health promotion model is useful in improving the self-care behaviors of cardiac patients undergoing angioplasty. Nursing education and care have a great role in improving the self-care behaviors of cardiovascular patients. TRIAL REGISTRATION Registration number: IRCT2017080635429N2. Registration date: 09/03/2017 ( https://en.irct.ir/trial/26775 ).
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Affiliation(s)
- Homamodin Javadzade
- Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hakime Vahedparast
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Azime Khodaminasab
- Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Rahim Tahmasebi
- Department of Epidemiology & Biostatistics, School of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mahnoush Reisi
- Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Jamile Kiani
- Clinical Research Development Center, Shohadaye-Khalije-Fars Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
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Vázquez-Bolea N, Andueza N, Cuervo M, Navas-Carretero S. A Higher Adherence to the ALINFA Nutritional Intervention Is Effective for Improving Dietary Patterns in Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:559. [PMID: 38790554 PMCID: PMC11120244 DOI: 10.3390/children11050559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024]
Abstract
Food patterns are deteriorating and, consequently, not meeting nutritional recommendations. Learning about the adherence to a diet is crucial for understanding children's dietary habits. The objective of the present analysis was to assess the degree of compliance with the ALINFA nutritional intervention and the effectiveness of adherence groups, and to evaluate potential baseline factors predicting a higher adherence to the intervention. A total of 44 children aged 6 to 12 years-old participated in the eight-week intervention. A two-week dietary plan was specifically designed, providing participants with food products, ready-to-eat dishes, and recipes. An intake of 75% of calories of the prescribed diet was defined to divide the participants into high- and low-adherence groups (HA/LA, respectively). From the 44 participants, 24 showed a LA to the intervention, whereas 20 of them were in the HA group. Diet quality improved in both groups (p < 0.001), mainly by increasing cereals and nuts, and reducing pastries. A decrease in BMI z-score was observed (LA: p < 0.001; HA: p = 0.021). Fat mass (p = 0.002), LDL-c (p = 0.036), and CRP (p = 0.023) reductions were only achieved in the HA group, whereas leptin decreased only in the LA group (p = 0.046). All participants ameliorated their dietary habits, but those with better diet quality at baseline experienced greater enhancements in their nutritional status.
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Affiliation(s)
- Natalia Vázquez-Bolea
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Naroa Andueza
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Marta Cuervo
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
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Turner A, LaMonica HM, Moroney C, O'Leary F, Naismith SL, Flood VM. Knowledge, Attitudes, and Behaviours Concerning the Mediterranean Diet Among Older Adults in Australia. J Community Health 2023; 48:951-962. [PMID: 37289354 PMCID: PMC10248335 DOI: 10.1007/s10900-023-01237-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/09/2023]
Abstract
Despite the growing body of evidence demonstrating the positive health effects of the Mediterranean diet, it is not routinely recommended in practice and adherence is low in the general population in Australia. The knowledge-attitude-behaviour model explains how health behaviours are supported through a process of acquiring knowledge, developing attitudes, and forming behaviours. Evidence has suggested that having a high level of nutrition-related knowledge is associated with more positive attitudes, which is directly linked to positive dietary behaviours. However, reports of knowledge and attitudes towards the Mediterranean diet, and how these directly relate to behaviours in older adults, are lacking. This study explored Mediterranean diet-related knowledge, attitudes, and behaviours among community-dwelling older adults in Australia. Participants were adults aged 55 years and older who completed an online survey that contained three parts: (a) knowledge - Mediterranean Diet Nutrition Knowledge Questionnaire (Med-NKQ); (b) nutrition-related attitudes and behaviours, and barriers and enablers to dietary change; (c) demographics. The sample included 61 adults who ranged in age from 55 to 89 years. The overall knowledge score was 30.5 out of a possible 40 points, with 60.7% classified as having a high level of knowledge. Knowledge was lowest for nutrient content and label reading. Attitudes and behaviours were generally positive and were not associated with level of knowledge. The most common barriers to dietary change were perceived cost and lack of knowledge, and motivational factors. There are a number of key gaps in knowledge that should be addressed through targeted educational programs. Strategies and tools to overcome perceived barriers and improve self-efficacy are needed to facilitate positive dietary behaviours.
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Affiliation(s)
- Ashlee Turner
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Haley M LaMonica
- Faculty of Medicine and Health, Translational Research Collective, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Carissa Moroney
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Fiona O'Leary
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Discipline of Nutrition and Dietetics, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sharon L Naismith
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Brain and Mind Centre, Healthy Brain Ageing Program, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Victoria M Flood
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia.
- Faculty of Medicine and Health, The University of Sydney, University Centre for Rural Health, Northern Rivers, NSW, 2480, Australia.
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Al Daccache M, Al-Shaar L, Sibai AM, Ismaeel H, Badr K, Nasreddine L. Psychosocial characteristics are associated with adherence to dietary, drugs and physical activity recommendations amongst cardiovascular disease patients in Lebanon. PLoS One 2023; 18:e0287844. [PMID: 37874832 PMCID: PMC10597531 DOI: 10.1371/journal.pone.0287844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/13/2023] [Indexed: 10/26/2023] Open
Abstract
Cardiovascular diseases are increasing at an alarming rate worldwide, reaching epidemic proportions in countries of the Eastern Mediterranean Region, including Lebanon. Despite the growing number of patients suffering from cardiovascular diseases in Lebanon, there is scarce data on whether cardiac patients adhere to therapeutic dietary guidelines, drug prescriptions, and physical activity recommendations and whether such adherence differs according to sociodemographic, lifestyle, or psychosocial characteristics. A cross-sectional study was conducted among 367 Lebanese adult cardiovascular disease patients admitted for hospitalization at various hospital sites in Lebanon. Electronic medical records and a multi-component questionnaire were used to collect information on patients' characteristics. Dietary assessment was performed using a culture-specific validated food frequency questionnaire, and physical activity levels were assessed using the international physical activity questionnaire (IPAQ). Mental well-being was assessed based on the validated five-item well-being index (WHO-5), and drug adherence was evaluated using the Morisky medication adherence scale (MMAS-8). The majority of the patients were males (67.8%), overweight or obese (74%), smokers (62.1%), and unemployed or retired (54.5%). Almost 35% of the patients were lonely, and nearly one fourth were at a high risk of poor mental health. Approximately 43%, 70%, and 52% of the patients were found to have poor adherence to diet, drug, and physical activity recommendations, respectively. A lower sense of mental well-being was a significant predictor of low dietary and drug adherence. Surprisingly, overweight and obesity were associated with higher odds of dietary adherence. Male gender was positively associated with physical activity while loneliness was inversely associated with physical activity. This study showed that adherence to diet, drug, and physical activity recommendations was low in this patient population and identified several non-clinical characteristics that may affect adherence. These findings highlighted the need for considering patients' psychosocial characteristics in the treatment of patients with cardiovascular diseases.
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Affiliation(s)
- Melodie Al Daccache
- Faculty of Agricultural and Food Sciences, Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
- Faculty of Health Sciences, Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
| | - Laila Al-Shaar
- Faculty of Medicine, Department of Public Health Sciences, Pennsylvania State University, State College, Pennsylvania, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Abla Mehio Sibai
- Faculty of Health Sciences, Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
- Vascular Medicine Program, American University of Beirut, Beirut, Lebanon
| | - Hussain Ismaeel
- Vascular Medicine Program, American University of Beirut, Beirut, Lebanon
- Medical Services, Aman Hospital, Doha, Qatar
| | - Kamal Badr
- Vascular Medicine Program, American University of Beirut, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Lara Nasreddine
- Faculty of Agricultural and Food Sciences, Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
- Vascular Medicine Program, American University of Beirut, Beirut, Lebanon
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Mansour M, Parizad N, Hemmati Maslakpak M. Does family-centred education improve treatment adherence, glycosylated haemoglobin and blood glucose level in patients with type 1 diabetes? A randomized clinical trial. Nurs Open 2023; 10:2621-2630. [PMID: 36550064 PMCID: PMC10006630 DOI: 10.1002/nop2.1522] [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: 04/10/2021] [Revised: 09/28/2022] [Accepted: 11/20/2022] [Indexed: 12/24/2022] Open
Abstract
AIM To investigate the effect of family-centred education on treatment adherence, glycosylated haemoglobin and blood glucose level in patients with Type 1 Diabetes Mellitus. DESIGN Randomized controlled trial. METHODS Sixty patients with Type 1 Diabetes Mellitus were randomly allocated into the intervention and control group. Data were collected using demographic and Modanloo Adherence to Treatment Questionnaires. The patients received 12 family-centred educational sessions in the intervention group. RESULTS A significant difference was found in the mean score of treatment adherence between the two groups after the intervention (p < 0.001). The mean score of treatment adherence significantly increased in the intervention group after family-centred education. The mean score of Fasting Blood Glucose and Glycosylated Haemoglobin A1C significantly decreased in the intervention group after the intervention (p < 0.001). CONCLUSION Relevant authorities need to consider family-centred education as one of the most important education methods in Type 1 Diabetes Mellitus patients. TRIAL REGISTRATION IRCT20131112015390N4; August 21, 2020.
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Affiliation(s)
- Mahsa Mansour
- Nursing and Midwifery Faculty, Urmia, Iran.,Department of Medical Surgical Nursing, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Parizad
- Nursing and Midwifery Faculty, Urmia, Iran.,Patient Safety Research Center, Clinical Research Institute, Nursing & Midwifery School, Urmia University of Medical Sciences, Urmia, Iran
| | - Masumeh Hemmati Maslakpak
- Nursing and Midwifery Faculty, Urmia, Iran.,Department of Medical Surgical Nursing, Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Ruelas AL, Martínez Contreras TDJ, Esparza Romero J, Díaz Zavala RG, Candia Plata MDC, Hingle M, Armenta Guirado B, Haby MM. Factors influencing adults to drop out of intensive lifestyle interventions for weight loss. Transl Behav Med 2023; 13:245-254. [PMID: 36694376 PMCID: PMC10105866 DOI: 10.1093/tbm/ibac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Reducing ≥5% of body weight can decrease the risk of developing chronic diseases in adults with excess weight. Although Intensive Lifestyle Interventions (ILIs) that include cognitive-behavioral techniques to improve physical activity and eating habits are the best approach for losing weight, the failure to retain participants is a barrier to their successful implementation. We aimed to investigate the factors influencing adults to drop out of ILIs for weight loss at six months. We conducted retrospective multiple logistic regression analysis of 268 participants with excess weight (body mass index ≥ 25 kg/m2) from a multicenter study (n = 237, in-person ILI in five clinics, delivered by nutrition interns), and a randomized controlled trial (n = 31, one online ILI, delivered by a master's degree student). The same research team conducted both studies in Northern Mexico, using the same intervention components, and identical instruments and techniques to collect the data. We found that older participants (≥50 years) were less likely to drop out of the ILI for weight loss compared to participants <35 years old (OR = 0.34, 95% CI = 0.16-0.70). For each unit increase in the bodily pain scale of the SF-36 (less perceived pain), the risk of dropping out decreased by 2% (OR = 0.98, 95% CI = 0.97, 0.996), while a change in the interventionist during the 6-month intervention more than doubled the risk of dropping out (OR 2.25, 95% CI = 1.23-4.14). Retention in ILIs may be improved by ensuring that the same interventionist remains during the six-month intervention. In addition, ILIs may need further tailoring for younger ages and for participants with higher perceived pain.
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Affiliation(s)
- Alma L Ruelas
- Programa de Doctorado en Ciencias Químico Biológicas y de la Salud, Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México
| | - Teresita de Jesús Martínez Contreras
- Centro de Promoción de Salud Nutricional, Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México
| | - Julián Esparza Romero
- Unidad de Investigación en Diabetes, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera Gustavo Enrique Astiazarán Rosas, No.46, C.P. 83304, Hermosillo, Sonora, México
| | - Rolando Giovanni Díaz Zavala
- Centro de Promoción de Salud Nutricional, Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México
| | - Maria Del Carmen Candia Plata
- Departamento de Medicina y Ciencias de la Salud, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México
| | - Melanie Hingle
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Brianda Armenta Guirado
- Centro de Investigación en Nutrición y Salud Pública, Instituto Nacional de Salud Pública, Av. Universidad 655, col. Santa María Ahuacatitlán, Cuernavaca, Morelos, 62100, México
| | - Michelle M Haby
- Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Encinas y Rosales s/n Hermosillo, Sonora, 83000, México.,Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, 3010, Australia
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12
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Roordink EM, Steenhuis IHM, Kroeze W, Hoekstra T, Jacobs N, van Stralen MM. Social Environmental Predictors of Lapse in Dietary Behavior: An Ecological Momentary Assessment Study Amongst Dutch Adults Trying to Lose Weight. Ann Behav Med 2023:7000437. [PMID: 36694372 PMCID: PMC10354841 DOI: 10.1093/abm/kaac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND When losing weight, most individuals find it difficult to maintain a healthy diet. Social environmental conditions are of pivotal importance in determining dietary behavior. To prevent individuals from lapsing, insight in social environmental predictors of lapse in dietary behavior is needed. PURPOSE Identify social environmental predictors of lapse in dietary behavior, using ecological momentary assessment (EMA) amongst Dutch adults trying to lose weight. METHODS Adults (N = 81) participated in two 7-day EMA weeks. Six times a day semi-random prompts were sent. At each prompt, participants indicated whether a lapse had occurred and responded to questions assessing social support, descriptive norm, injunctive norm, social pressure, presence of others, and current location. Generalized estimating equations were used to examine associations with lapse. RESULTS Injunctive norm (OR = 1.07, 95% CI = 1.03-1.11), descriptive norm (OR = 1.04, 95% CI = 1.02-1.07), and social pressure (OR = 1.09, 95% CI = 1.05-1.14), all toward diverting from diet plans, predicted lapses. Social support toward sticking to diet plans and presence of others did not predict lapses. When controlling for a prior lapse, all other associations became nonsignificant. Lapses occurred most often at home and gradually occurred more often during the day. CONCLUSIONS Traditional public health perspectives have mainly focused on individual choice and responsibility for overweight related unhealthy lifestyles. This study shows that there may be opportunities to enhance intervention programs by also focusing on social norms and social pressure. The involvement of partners or housemates may create more awareness of the impact of (unintentional) social pressure on risk of lapsing, and reduce the level of exerted social pressure.
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Affiliation(s)
- Eline M Roordink
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.,Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS Ede, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Nele Jacobs
- Department of Lifespan Psychology, Faculty of Psychology, Open Universiteit, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
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13
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Adherence to lifestyle advice and its related cardiovascular disease risk among US adults with high cholesterol. Clin Nutr ESPEN 2022; 51:267-273. [DOI: 10.1016/j.clnesp.2022.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/11/2022] [Indexed: 11/20/2022]
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14
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Shahabi N, Kolivand M, Salari N, Abbasi P. The effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2: a randomized clinical trial. BMC Endocr Disord 2022; 22:36. [PMID: 35139832 PMCID: PMC8830007 DOI: 10.1186/s12902-022-00953-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/03/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Telenursing facilitates access to efficient care and acceptance and compliance with treatment at home. Given wide complications of lack of compliance with treatment in causing complications and progression of diabetes and role of the family in attending the patient, this study aimed to investigate the effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2. METHODS This was a randomized controlled clinical trial. The study population was patients with diabetes mellitus type 2 referred to Alzhara hospital at Gilan Gharb in 2019, of which 60 individuals out of them were classified randomly into two groups of intervention and control. Eight 30-min sessions of family-centered training were held through telenursing for the intervention group. Data were gathered before and after the intervention by standard questionnaire of Mudanlo in both groups and was analyzed using SPSS software version 22. RESULTS There was no significant difference among the two intervention and control groups before the study regarding demographic variables (p > 0.05). The scores of subscales of making effort for treatment, intention to take the treatment, adaptability, integrating illness into life, stick to the treatment, indecisiveness for applying treatment, and total score of compliance were significantly increased after training intervention (p = 0.001). CONCLUSIONS Results of the study indicates positive effects of performing family-centered empowerment pattern using telephone call follow-up on increasing compliance with diet regimen in patients. Therefore, it is recommended to perform family-centered patterns in health policy-makings and also hospitals and other diabetic patients.
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Affiliation(s)
- Negar Shahabi
- Department of Nursing, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Kolivand
- Department of Midwifery, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Nursing & Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parvin Abbasi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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15
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Haslam A, Love C, Taniguchi T, Williams MB, Wetherill MS, Sisson S, Weedn AE, Jacob T, Jernigan VBB. Development and Implementation of a Hybrid Online and In-Person Food Sovereignty and Nutrition Education Curriculum for Native American Parents: The FRESH Study. HEALTH EDUCATION & BEHAVIOR 2022; 50:430-440. [PMID: 34991400 PMCID: PMC9981305 DOI: 10.1177/10901981211067168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Food Resource Equity and Sustainability for Health ("FRESH") study is an Indigenous-led intervention to increase vegetable and fruit intake among Native American children. As part of this study, we developed a hybrid (online and in-person) food sovereignty and nutrition education curriculum for the parents of these children. This 16-week curriculum was developed to promote household- and community-level healthy eating and food sovereignty practices to parents of preschool-aged children residing in Osage Nation, Oklahoma. A total of 81 parent/caregivers participated in the curriculum component of the FRESH study, with a median age of 34 years (range: 23-54 years). Most study participants were female (88.9%) and less than half (45.7%) had an annual household income of more than US$50,000. Most were married or had a significant other (76.5%) and worked full-time (65.4%). The median total number of children in the home <18 years of age was three (range: 1-8). Participation among the 94 parents was 56% during the first week and was 12% in the final week. Having some college or technical training (vs. having a college degree) and having an annual household income of US$20,000-US$50,000 (vs. more than US$50,000) were associated with fewer sessions attended (p = 0.004 and 0.02, respectively) Being married (vs. not) was associated with higher attendance (p < .0001). Participation in a hybrid food sovereignty and nutrition education curriculum for parents was generally low, but income, education, and marital status were associated with curriculum participation. Our research adds to the literature by describing the development and implementation of this curriculum and recommendations for future research incorporating Indigenous approaches to health.
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Affiliation(s)
- Alyson Haslam
- University of California, San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Susan Sisson
- The University of Oklahoma—Tulsa, Tulsa, OK, USA
| | | | - Tvli Jacob
- Oklahoma State University, Tulsa, OK, USA
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16
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Pletsch-Borba L, Wernicke C, Apostolopoulou K, Spira D, Pohrt A, Hornemann S, Gerbracht C, Pfeiffer AFH, Spranger J, Mai K. Nutritional counseling frequency and baseline food pattern predict implementation of a high-protein and high-polyunsaturated fatty acid dietary pattern: 1-year results of the randomized NutriAct trial. Clin Nutr 2021; 40:5457-5466. [PMID: 34656026 DOI: 10.1016/j.clnu.2021.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/26/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS NutriAct is a 36-month randomized controlled multi-center trial designed to analyze the effects of a food pattern focusing on a high-protein and high-unsaturated fatty acids (UFA) intake on healthy aging. We aimed to determine factors associated with a successful modulation of dietary pattern after 12 months in elderly participants. METHODS 502 participants were randomized into either usual care control group including dietary recommendations of the German Nutrition Society (DGE) or an intervention group, which used supplementation of rapeseed oil and specifically designed foods as well as repetitive advices to implement a food pattern based on high intake of predominantly plant proteins, UFA and fiber (NutriAct pattern). Food intake was repeatedly assessed by 3-day food records at months 0, 3, 6 and 12. Linear regression models were used to investigate determinants of basal food intake and modulation of dietary pattern during the intervention. RESULTS Food records of 242 intervention and 246 control participants (median age 66 y, 37% males) were available at baseline and were included. At baseline, high BMI was related to higher protein and saturated fatty acids and lower fiber intake. The intervention resulted in higher intake of protein, mono- and polyunsaturated fatty acids (MUFA and PUFA) and fiber, and lower carbohydrate and saturated fatty acid consumption (all p < 0.001). While individuals who were already at baseline closer to the NutriAct pattern also achieved a diet closer to the proposed pattern at month 12, the strongest absolute changes (%E) of dietary behavior were seen in those with dietary patterns further away from the proposed pattern at baseline. Attendance to nutritional sessions was crucial to change MUFA, PUFA, fiber and carbohydrate intake. CONCLUSIONS A successful modification of dietary pattern was achieved by the performed intervention within 12 months. Baseline dietary habits and attendance to nutritional sessions were substantial determinants predicting changes in dietary pattern. CLINICAL TRIAL REGISTRATION The trial was registered at German Clinical Trials Register (drks.de) as DRKS00010049.
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Affiliation(s)
- Laura Pletsch-Borba
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany
| | - Charlotte Wernicke
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany
| | - Konstantina Apostolopoulou
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany
| | - Dominik Spira
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany
| | - Anne Pohrt
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Germany
| | - Silke Hornemann
- Human Study Center, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health; Charité Center for Cardiovascular Research, 10117, Berlin, Germany
| | - Christiana Gerbracht
- Human Study Center, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Andreas F H Pfeiffer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; Human Study Center, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health; Charité Center for Cardiovascular Research, 10117, Berlin, Germany
| | - Joachim Spranger
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health; Charité Center for Cardiovascular Research, 10117, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany.
| | - Knut Mai
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health; Charité Center for Cardiovascular Research, 10117, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
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17
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A valid self-help tool to measure the role of spousal support in the care of persons with diabetes mellitus. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-01001-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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18
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Alqahtani SA, Schattenberg JM. NAFLD in the Elderly. Clin Interv Aging 2021; 16:1633-1649. [PMID: 34548787 PMCID: PMC8448161 DOI: 10.2147/cia.s295524] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/12/2021] [Indexed: 12/25/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent disease globally. Current estimates are that 24% of the adult population, thus, one billion individuals worldwide, are affected. Interestingly, the prevalence of fatty liver seems to peak between 40─50 years of age in males and 60─69 years in females, often slightly decreasing in older (>70 years) cohorts. Furthermore, several risk factors for NAFLD development, such as hypertension, diabetes, hyperlipidemia, and obesity are higher in older adults. The diagnosis and management strategies in older adults are sometimes challenging, and certain age-specific factors have to be taken into account by healthcare professionals. In this review, we provide an overview of considerations relevant to the management and diagnosis of NAFLD in older adults (age >65 years) and discuss the types of pharmacological interventions available for the management of non-alcoholic steatohepatitis (NASH) in the aging population.
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Affiliation(s)
- Saleh A Alqahtani
- Liver Transplantation Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
| | - Jörn M Schattenberg
- Metabolic Liver Research Program, I. Department of Medicine, University Medical Center, Mainz, Germany
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19
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Zhang Q, Ruan Y, Hu W, Li J, Zhao J, Peng M, Wan R, Min X, He S, Liu Z. Perceived social support and diet quality among ethnic minority groups in Yunnan Province, Southwestern China: a cross-sectional study. BMC Public Health 2021; 21:1726. [PMID: 34551756 PMCID: PMC8459473 DOI: 10.1186/s12889-021-11787-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background Social support is an important health determinant and may affect dietary behaviors. The purpose of this study was to examine the relations between perceived social support and the Chinese Diet Balance Index-16 (DBI-16) among ethnic minority groups in Southwest China. Methods This cross-sectional study was conducted between May 2019 and August 2020 among six ethnic minority groups native to Yunnan Province (n = 3564). Perceived social support from family, friends and significant others were measured with the Multi-dimensional Scale of Perceived Social Support (MSPSS). Dietary data were obtained using a 100-item Food Frequency Questionnaire (FFQ) and a lifestyle questionnaire. Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD) which represent inadequate, excessive and unbalanced food intake respectively were calculated to measure the compliance with the recommendations of the Dietary Guidelines for Chinese 2016. Results One thousand four hundred ninety-six men and two thousand sixty-eight women were included. 51.2% of the subjects had moderate or high levels of inadequate intake; 21.3% had moderate or high levels of excessive intake; and 74.0% had moderate or high levels of unbalanced dietary intake. With potential confounders adjusted, support from family was negatively associated with inadequate intake, while support from friends was positively associated with inadequate and excessive intake. No significant associations were found between perceived social support from significant others and diet quality indicators. Conclusions An unbalanced diet is common among adults of the ethnic minority groups in Yunnan Province, Southwest China. Social support should be taken into account in designing nutrition interventions rather than focusing solely on individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11787-5.
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Affiliation(s)
- Qiang Zhang
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Yuan Ruan
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Wenmin Hu
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Juanjuan Li
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Jiang Zhao
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Min Peng
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Rong Wan
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Xiangdong Min
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Shaomei He
- Department of Chronic Disease Prevention, Lanping County Center for Disease Control and Prevention, Lanping, 671400, China
| | - Zhitao Liu
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, 650022, China.
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20
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Zahmatkeshan N, Rakhshan M, Zarshenas L, Kojuri J, Khademian Z. The Effect of Applying the Information-Motivation-Behavioral Skills Model on Treatment Adherence in Patients with Cardiovascular Disease: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2021; 9:225-237. [PMID: 34222543 PMCID: PMC8242410 DOI: 10.30476/ijcbnm.2021.88987.1563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/18/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Non-adherence complicates the management of patients with cardiovascular disease. This study aimed to determine the effect of applying the information-motivation-behavioral skills (IMB) model on the treatment adherence among these patients. METHODS This quasi-experimental study was conducted on 112 patients with cardiovascular disease in Nemazee and Al-zahra hospitals in Shiraz, Iran, from October 2019 to July 2020. Eligible patients were selected and divided into intervention and control groups. The intervention was based on an integration of IMB model constructs and included 10 motivational-educational sessions for three months, followed by telephone consultations for six months. Data were collected before, and three and six months after the end of the motivational-educational sessions using adherence questionnaire in patients with chronic diseases, and adherence in chronic disease scale for medication adherence. Data were analyzed using SPSS 22, and descriptive statistics, chi-square, independent t-test, and repeated measure ANOVA were performed. P<0.05 was considered significant. RESULTS The intervention and control groups were homogenous based on demographic characteristics. Repeated measure ANOVA findings revealed an increasing trend in the mean scores of the intervention group in treatment adherence from 51.10±3.20 at baseline to 66.40±5.50 three months and 73.80±6.80 six months after the end of the intervention (P<0.001). Furthermore, based on repeated measure ANOVA findings, the mean score of the intervention group in medication adherence significantly increased from 20.10+3 at baseline to 24.10+2.40 three months and 24.50+3.20 six months after the end of the intervention (P<0.001). CONCLUSION Applying the IMB model promoted adherence to treatment and medication among patients with cardiovascular disease. Therefore, such interventions are recommended for these patients.
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Affiliation(s)
- Nasrin Zahmatkeshan
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ladan Zarshenas
- Department of Nursing, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Kojuri
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Khademian
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Funuyet-Salas J, Martín-Rodríguez A, Pérez-San-Gregorio MÁ, Romero-Gómez M. Influence of Psychological Biomarkers on Therapeutic Adherence by Patients with Non-Alcoholic Fatty Liver Disease: A Moderated Mediation Model. J Clin Med 2021; 10:2208. [PMID: 34065216 PMCID: PMC8161151 DOI: 10.3390/jcm10102208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/14/2023] Open
Abstract
Our aim was to analyze whether depressive symptoms mediated the association between physical quality of life (QoL) and adherence to physical activity in patients with non-alcoholic fatty liver disease (NAFLD), as well as the association between social support and adherence to diet. We also examined whether self-efficacy exerted a moderating role in these associations. QoL (SF-12), social support (MSPSS), depressive symptoms (HADS), self-efficacy (GSE), physical activity (IPAQ) and diet (MEDAS) were evaluated in 413 biopsy-proven NAFLD patients. Mediation and moderated mediation models were conducted using the SPSS PROCESS v3.5 macro. Results showed that depressive symptoms mediated the relationship between physical QoL and adherence to physical activity (indirect effect = 6.248, CI = 1.917-10.727), as well as the relationship between social support and adherence to diet (indirect effect = 0.148, CI = 0.035-0.275). Self-efficacy also moderated the indirect effects of QoL and social support on therapeutic adherence through depressive symptoms. Specifically, the higher self-efficacy was, the lower the negative impact on the NAFLD patient's mental health. In conclusion, self-efficacy is defined as a protective factor for therapeutic adherence by NAFLD patients with a psychosocial risk profile. Self-efficacy should, therefore, be a main psychological target in future multidisciplinary NAFLD approaches.
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Affiliation(s)
- Jesús Funuyet-Salas
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Seville, 41018 Seville, Spain; (A.M.-R.); (M.Á.P.-S.-G.)
| | - Agustín Martín-Rodríguez
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Seville, 41018 Seville, Spain; (A.M.-R.); (M.Á.P.-S.-G.)
| | - María Ángeles Pérez-San-Gregorio
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Seville, 41018 Seville, Spain; (A.M.-R.); (M.Á.P.-S.-G.)
| | - Manuel Romero-Gómez
- UCM Digestive Diseases and Ciberehd, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville, University of Seville, 41013 Seville, Spain;
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Montazami M, Khalifehzadeh-Esfahani A, Keshvari M. Investigating the Effect of Family-Centered Self-Care Program based on Home Visits Regarding Dietary and Medication Regimen Adherence of Discharged Patients with Acute Coronary Syndrome. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:113-119. [PMID: 34036057 PMCID: PMC8132869 DOI: 10.4103/ijnmr.ijnmr_105_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/06/2019] [Accepted: 11/25/2020] [Indexed: 11/04/2022]
Abstract
Background Dietary and medication regimen adherence in patients with history of Acute Coronary Syndrome (ACS) is very important in preventing readmission and reducing the complications of the disease. The objective of the present study was to investigate the effect of the family-centered self-care program based on home visits dietary and medication regimen adherence in patients with ACS discharged from Shahid Chamran Hospital during 2017-2018. Materials and Methods This clinical trial was conducted on 80 ACS patients. The samples by using the random numbers table, were randomly divided into control and experimental groups. The routine interventions were administered for the control group, and family-centered self-care was conducted on patients of the experiment group. In order to obtain the quantitative data of this study, three questionnaires were used including demographic characteristics, Morisky questionnaire, and dietary adherence. Results The difference between the mean score of medication and diet regimen adherence in both groups before the intervention was not significant (p > 0.05). data was demonstrated that scores of medication and diet regimen adherence were significantly higher immediately and 6 weeks after the intervention; (f = 64.06, p < 0.001). Conclusions Family-centered self-care program based on home visits can be used as an effective method to increase the dietary and medication regimen adherence in ACS patients.
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Affiliation(s)
- Maryam Montazami
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mahrokh Keshvari
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Correlates of a southern diet pattern in a national cohort study of blacks and whites: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Br J Nutr 2021; 126:1904-1910. [PMID: 33632366 DOI: 10.1017/s0007114521000696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Southern dietary pattern, derived within the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, is characterised by high consumption of added fats, fried food, organ meats, processed meats and sugar-sweetened beverages and is associated with increased risk of several chronic diseases. The aim of the present study was to identify characteristics of individuals with high adherence to this dietary pattern. We analysed data from REGARDS, a national cohort of 30 239 black and white adults ≥45 years of age living in the USA. Dietary data were collected using the Block 98 FFQ. Multivariable linear regression was used to calculate standardised beta coefficients across all covariates for the entire sample and stratified by race and region. We included 16 781 participants with complete dietary data. Among these, 34·6 % were black, 45·6 % male, 55·2 % resided in stroke belt region and the average age was 65 years. Black race was the factor with the largest magnitude of association with the Southern dietary pattern (Δ = 0·76 sd, P < 0·0001). Large differences in Southern dietary pattern adherence were observed between black participants and white participants in the stroke belt and non-belt (stroke belt Δ = 0·75 sd, non-belt Δ = 0·77 sd). There was a high consumption of the Southern dietary pattern in the US black population, regardless of other factors, underlying our previous findings showing the substantial contribution of this dietary pattern to racial disparities in incident hypertension and stroke.
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NasiriZiba F, Kanani S. The Effect of Education with a Family-Centered and Client-Centered Approach on the Quality of Life in Patients with Stoma. J Caring Sci 2021; 9:225-230. [PMID: 33409167 PMCID: PMC7770391 DOI: 10.34172/jcs.2020.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/01/2019] [Indexed: 11/16/2022] Open
Abstract
Introduction: Colorectal cancer is known as the third leading cause of death from cancer in the world and the second cause of death in developing countries. Family care can positively affect the patient's general health system. The present study was conducted to determine and compare the effect of family-centered and client-centered training approaches on the life quality of individuals with digestive ostomy. Methods: This is a semi-experimental study conducted on 60 individuals. The individuals participating in the present study were chosen from either those with digestive ostomy or their attendants. The participants fulfilled the requirements (criteria) for entering the present study. For conducting the training procedure, both groups received family-centered or client-centered training. Two months later, the quality of life of the individuals with digestive ostomy was measured once more. The data were then analyzed in SPSS version 21 by using chi-squared test, paired t-test, and independent t-test. Results: According to the findings of the present study, there is no significant difference between the family-centered and the client-centered groups in terms of demographic features. By investigating the mean changes of both groups, There was a significant difference between quality of life score and spiritual-psychological aspect of scores before and after the intervention in the family-centered group. Conclusion: The findings of the present study showed that family-centered education can increase the quality of life for people with gastrointestinal ostomy. This study concluded that family-centered education can be considered an effective intervention in people with gastrointestinal ostomy.
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Affiliation(s)
- Fariba NasiriZiba
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Shadie Kanani
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
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25
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Basora J, Villalobos F, Pallejà-Millán M, Babio N, Goday A, Castañer O, Fitó M, Zomeño MD, Pintó X, Sacanella E, Paz-Graniel I, Salas-Salvadó J. Association between the Potential Influence of a Lifestyle Intervention in Older Individuals with Excess Weight and Metabolic Syndrome on Untreated Household Cohabitants and Their Family Support: The PREDIMED-Plus Study. Nutrients 2020; 12:E1975. [PMID: 32635152 PMCID: PMC7400558 DOI: 10.3390/nu12071975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022] Open
Abstract
This cross-sectional study aims to evaluate the association between the PREDIMED-Plus study lifestyle intervention and (i) adherence to the Mediterranean diet (MedDiet) and (ii) physical activity of cohabiting study participants, and to define the related social characteristics of the household members. Participants were a subsample of 541 cohabitants of the PREDIMED-Plus study. Adherence to the MedDiet, physical activity, anthropometric measurements, family function, and social support were assessed. Multiple linear regressions were applied to the data. Partners of the PREDIMED-Plus participants had higher adherence to the MedDiet compared to their sons/daughters (9.0 vs. 6.9 points). In comparison to partners with low adherence to the MedDiet, partners with high adherence were older, practiced more physical activity, ate more frequently with the PREDIMED-Plus participants, and had better family function (adaptability item). Compared to physically active partners, very active ones were older, more likely to be women, and had lower BMI and higher adherence to the MedDiet. In addition, they ate more frequently with the PREDIMED-Plus participants and had better family function. Using multiple lineal regressions, an increase in the adherence to the MedDiet of the PREDIMED-Plus participant, and better family function, were positively associated with their partner's adherence to the MedDiet. The PREDIMED-Plus intervention showed a positive association with adherence to the MedDiet of the study participants' partners. In addition, this association was influenced by the social characteristics of the household members.
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Grants
- P17/084 Strategic Plan of Research and Innovation in Health (PERIS) 2016-2020 for Primary Care Research Projects from the Health Department of the Generalitat de Catalunya
- PI13/01123, PI13/00462, PI13/00233, PI13/02184, , PI14/00728, PI16/01094, PI16/00501, PI16/00381, PI17/00215, , PI19/01226, P119/00017, PI19/00576 and PI19/01032 Fondo de Investigación para la Salud (FIS)
- - Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S
- Advanced Research Grant 2014-2019; agreement #340918 European Research Council
- 2013ACUP00194 The Recercaixa
- - ICREA under the ICREA Academia programme
- FPU 17/01925 Spanish Ministry of Education, Culture and Sports
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Affiliation(s)
- Josep Basora
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43202 Reus, Spain; (F.V.); (M.P.-M.)
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain; (I.P.-G.); (J.S.-S.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
| | - Felipe Villalobos
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43202 Reus, Spain; (F.V.); (M.P.-M.)
| | - Meritxell Pallejà-Millán
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43202 Reus, Spain; (F.V.); (M.P.-M.)
| | - Nancy Babio
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain; (I.P.-G.); (J.S.-S.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
- Institut d’Investigació Sanitària Pere i Virgili (IISPV), 43204 Reus, Spain
| | - Albert Goday
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Montserrat Fitó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - María Dolores Zomeño
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
- Lipid Unit, Department of Internal Medicine, Bellvitge Biomedical Research Institute (IDIBELL)-Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Emilio Sacanella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
- Department of Internal Medicine, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, 08026 Barcelona, Spain
| | - Indira Paz-Graniel
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain; (I.P.-G.); (J.S.-S.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
- Institut d’Investigació Sanitària Pere i Virgili (IISPV), 43204 Reus, Spain
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain; (I.P.-G.); (J.S.-S.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (A.G.); (O.C.); (M.F.); (M.D.Z.); (X.P.); (E.S.)
- Institut d’Investigació Sanitària Pere i Virgili (IISPV), 43204 Reus, Spain
- Hospital Universitari Sant Joan de Reus (HUSJR), 43204 Reus, Spain
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Torknejad A, Babaei S, Mirmohammadsadeghi M. Effect of an educational intervention based on BASNEF model on treatment adherence after coronary artery bypass surgery: A randomized clinical trial. ARYA ATHEROSCLEROSIS 2020; 16:105-114. [PMID: 33447255 PMCID: PMC7778512 DOI: 10.22122/arya.v16i3.2062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/17/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Coronary artery bypass graft (CABG) surgery is the most effective treatment for cardiovascular disease (CVD). Adherence to treatment after CABG surgery is very important. One of the educational models used in this regard is the BASNEF (Belief, Attitudes, Subjective Norms, and Enabling Factors) model. The present study aimed to assess the effect of an educational intervention based on BASNEF model on adherence to treatment in patients after CABG surgery. METHODS The present study was a randomized clinical trial. In this study, 72 patients who had undergone CABG surgery participated in the two intervention and control groups. Patients in the intervention group took part in 4 40-minute educational sessions based on BASNEF model after discharge. The patients in both groups completed the Modanloo Adherence to Treatment Questionnaire (MATQ) and a researcher-made BASNEF model questionnaire before the intervention, after the educational intervention, and at the 3-month follow-up. Data were analyzed using independent t-test, chi-square test, Man-Whitney test, and repeated measures analysis of variance (ANOVA). Mauchly's sphericity test was used for testing sphericity and the Greenhouse-Geisser correction was used in the case of lack of sphericity. All P-values of less than 0.05 were considered significant. RESULTS The total score of the MATQ and its subscales had significantly improved in the intervention group after the intervention compared with the control group (P < 0.050). In addition, the mean scores of the model constructs (knowledge, attitude, behavior intention, subjective norms, and enabling factors) had significantly improved after the intervention in the intervention group in comparison with the control group (P < 0.050). CONCLUSION The educational intervention based on BASNEF model improved adherence to treatment in patients after CABG surgery. Moreover, the model constructs improved in the intervention group in comparison with the control group after the intervention.
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Affiliation(s)
- Atefeh Torknejad
- MSc Student, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sima Babaei
- Assistant Professor, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Mirmohammadsadeghi
- Associate Professor, Chamran Medical and Research Heart Center AND Department of Cardiac Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
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Aker A, McConnell RER, Loch-Caruso R, Park SK, Mukherjee B, Rosario ZY, Vélez-Vega CM, Huerta-Montanez G, Alshawabkeh AN, Cordero JF, Meeker JD. Interactions between chemicals and non-chemical stressors: The modifying effect of life events on the association between triclocarban, phenols and parabens with gestational length in a Puerto Rican cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 708:134719. [PMID: 31785910 PMCID: PMC6957748 DOI: 10.1016/j.scitotenv.2019.134719] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 04/13/2023]
Abstract
BACKGROUND Phenols and parabens are common additives to consumer products. There is evidence of adverse birth outcomes in association with prenatal exposure to these chemicals, in addition to psychosocial factors. We previously reported an increase in gestational length with bisphenol-A, methylparaben and propylparaben, and a decrease in gestational length with triclocarban. OBJECTIVES We examined the modifying effect of psychosocial stress on the association between chemicals and gestational length in up to 752 women among a pregnancy cohort study. METHODS Urinary biomarkers were measured at up to three time points in pregnancy. Multiple linear regression models were conducted to investigate the association between gestational length and the interaction between average exposure biomarkers and LES. Multiple linear regression models regressing the exposure biomarkers in relation to gestational length were also stratified by LES, Negative LES, and Positive LES, based on the subjective ratings of events. Results were transformed into the change in gestational length for an inter-quartile-range difference in the exposure. RESULTS Of the four psychosocial stress measures, only the life events score (LES) was a significant modifier. Associations between triclocarban, bisphenol-S, methyl- and propylparaben in relation to gestational length were stronger among women with negative Total LES scores. Among women with negative Total LES scores, bisphenol-S and triclocarban were associated with a 3-5 day decrease in gestational length [(-3.15; 95% CI: -6.06, -0.24); (-4.68; 95% CI: -8.47, -0.89)], whereas methylparaben and propylparaben were associated with a 2-3 day increase in gestational length [(2.21; 95% CI: 0.02, 4.40); (2.92; 95% CI: 0.58, 5.26)]. Significant interactions were driven by negative life events, but the association with triclocarban was driven by few positive life events. CONCLUSIONS Associations between exposure biomarkers and gestational length were stronger in the presence of negative life events. This provides evidence that stress makes the body more vulnerable to chemical exposure.
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Affiliation(s)
- Amira Aker
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Rafael E Rios McConnell
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Rita Loch-Caruso
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Sung Kyun Park
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Bhramar Mukherjee
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Zaira Y Rosario
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Carmen M Vélez-Vega
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | | | | | - José F Cordero
- College of Public Health, Athens, University of Georgia, GA, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA.
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Maston G, Gibson AA, Kahlaee HR, Franklin J, Manson E, Sainsbury A, Markovic TP. Effectiveness and Characterization of Severely Energy-Restricted Diets in People with Class III Obesity: Systematic Review and Meta-Analysis. Behav Sci (Basel) 2019; 9:E144. [PMID: 31817943 PMCID: PMC6960910 DOI: 10.3390/bs9120144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/24/2019] [Accepted: 12/03/2019] [Indexed: 12/17/2022] Open
Abstract
Severely energy-restricted diets are used in obesity management, but their efficacy in people with class III obesity (body mass index ≥40 kg/m2) is uncertain. The aims of this systematic review and meta-analysis were to determine the effectiveness and characteristics of severely energy-restricted diets in people with class III obesity. As there was a lack of publications reporting long-term dietary interventions and randomised controlled trial designs, our original publication inclusion criteria were broadened to include uncontrolled study designs and a higher upper limit of energy intake. Eligible publications reported studies including adults with class III obesity and that assessed a diet with daily energy intake ≤5000 kJ for ≥4 weeks. Among 572 unique publications from 4 databases, 11 were eligible and 10 were suitable for meta-analysis. Our original intention was to classify comparison arms into short-term (<6 months) and long-term (>1 year) interventions. Due to the lack of long-term data found, comparison arms were classified according to the commonalities in dietary intervention length among the included publications, namely dietary interventions of 4 weeks' duration and those of ≥6 weeks' duration. After a 4-week severely energy-restricted diet intervention, the pooled average weight loss was 9.81 (95% confidence interval 10.80, 8.83) kg, with a 95% prediction interval of 6.38 to 13.25 kg, representing a loss of approximately 4.1 to 8.6% of initial body weight. Diets ≥6 weeks' duration produced 25.78 (29.42, 22.15) kg pooled average weight loss, with a 95% prediction interval of 13.77 to 37.80 kg, representing approximately 10.2 to 28.0% weight loss. Daily dietary prescriptions ranged from 330 to 5000 kJ (mean ± standard deviation 2260 ± 1400 kJ), and had wide variations in macronutrient composition. The diets were administered mostly via liquid meal replacement products. While the included publications had a moderate risk of bias score, which may inflate reported weight loss outcomes, the published data to date suggest that severely energy-restricted diets, delivered via diets of varying composition, effectively produce clinically relevant weight loss (≥10% of initial body weight) when used for 6 weeks or more in people with class III obesity.
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Affiliation(s)
- Gabrielle Maston
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
| | - Alice A. Gibson
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
| | - H. Reza Kahlaee
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney 2006, Australia;
- School of Life, and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia
| | - Janet Franklin
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
| | - Elisa Manson
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
| | - Amanda Sainsbury
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
| | - Tania P. Markovic
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
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Lovell J, Pham T, Noaman SQ, Davis MC, Johnson M, Ibrahim JE. Self-management of heart failure in dementia and cognitive impairment: a systematic review. BMC Cardiovasc Disord 2019; 19:99. [PMID: 31035921 PMCID: PMC6489234 DOI: 10.1186/s12872-019-1077-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 04/11/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The cornerstone of effective management in heart failure (HF) is the ability to self-care. Aims include i) To determine factors influencing self-care in HF patients with cognitive impairment (CI) and ii) to determine the influence of cognitive domains on self-care in patients with HF and CI. METHODS MEDLINE, CINAHL, EMBASE, EBSCOHost, PsychINFO, ProQuest Research Library, Health Technology Assessment Database, The Cochrane Library, Web of Science and Scopus databases were systematically searched. Original research describing the relationship between cognition and HF self-care in community-dwelling older persons with dementia/CI in English, published in a peer-reviewed journal from 1stJanuary(2000)-22ndMarch(2016) was identified. Study and population characteristics, data sources, self-care processes, methods of cognitive assessment, cognitive domains affected, study outcomes, impact of impairment, and other risk factors of self-care impairment were abstracted by two reviewers. RESULTS Of 10,688 studies identified, 14 met the inclusion criteria. Patients with HF and CI ranged from 14 to 73%. Where reported, self-care maintenance adequacy ranged from 50 to 61%; self-care management adequacy ranged from 14 to 36% and self-care confidence adequacy ranged from 0 to 44% on the Self-care of Heart Failure Index (SCHFI). All but one study predicted poor self-care ability according to poor outcome on cognitive testing. Additionally, specific cognitive domain deficits impaired self-care. Subjects with lower cognitive scores were less likely to seek assistance while subjects with depression had poor self-care abilities. CONCLUSIONS Clinicians must consider the type and severity of impairments in cognitive domains to tailor management. Awareness of depression, self-confidence and support access may modulate self-care ability.
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Affiliation(s)
- Janaka Lovell
- Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia.
| | - Tony Pham
- Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia
| | - Samer Q Noaman
- Department of Cardiology, Alfred Health, Victoria, 3004, Australia
| | | | - Marilyn Johnson
- Institute of Transport Studies, Monash University, Victoria, 3800, Australia
| | - Joseph E Ibrahim
- Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia
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Khanjari S, Tajik Z, Haghani H. The effect of family-centered education on the quality of life of adolescents with spinal cord injuries. J Family Med Prim Care 2019; 8:711-716. [PMID: 30984700 PMCID: PMC6436315 DOI: 10.4103/jfmpc.jfmpc_305_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose: Spinal injury is a destructive complication creating huge changes in the teen health and lifestyle, depending on its extent and severity. Although most of the complications of this disease are treatable, they impose huge costs on the healthcare system, the patient, and his family. The present study was conducted to investigate the effect of family-centered education on the quality of life and self-esteem of adolescents with spinal cord injuries. Method: The present study is a quasi-experimental study. Adolescents (108 old) with spinal cord injuries entered the present study through stratified sampling with appropriate allocation. The participants were compared in two groups of experimental and control. The data was collected using demographic information questionnaire as well as Ferrans and Powers’ quality of life index in spinal cord injury. Four weeks after the intervention, the research questionnaires were completed once more by the adolescents of both groups. Data analysis was conducted by using T-square test, independent t-test, Fisher's exact test, and analysis of variance. Finding: According to results, quality of life mean score of adolescents with spinal cord injuries was 23.05 ± 122.65 before the intervention. It became 22.64 ± 148.15 after the intervention. With respect to importance, quality of life mean score of these adolescents changed from 20.83 ± 164.07 to 21.62 ± 174.99. Conclusion: Given the effect of family-centered education on the quality of life in adolescents with spinal cord injuries, it seems essential to create necessary grounds for training families having adolescents with spinal cord injuries by nurses to improve their quality of life as well as conducting researches on their problems.
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Affiliation(s)
- Sedigheh Khanjari
- Department of Pediatric Nursing, Nursing Care Research Center, Faculty of Nursing and Midwifery, Tehran, Iran
| | - Zahra Tajik
- Department of Pediatric Nursing, School of Management and Medical Informatics, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Haghani
- Department of Biostatistics, School of Management and Medical Informatics, Iran University of Medical Sciences, Tehran, Iran
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The association between psychosocial factors and change in lifestyle behaviour following lifestyle advice and information about cardiovascular disease risk. BMC Public Health 2018; 18:731. [PMID: 29898701 PMCID: PMC6001007 DOI: 10.1186/s12889-018-5655-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/01/2018] [Indexed: 11/12/2022] Open
Abstract
Background Physical activity (PA) and fruit and vegetable intake (FVI) are two key modifiable risk factors for cardiovascular disease (CVD). Achieving change in these behaviours is challenging and affected by many variables including psychosocial factors. We aimed to investigate the association between social support, stress and mood, and change in PA and FVI following provision of CVD risk information and web-based lifestyle advice. Methods Seven hundred sixteen blood donors (56% male; mean age 57 years) from the intervention arms of the Information and Risk Modification (INFORM) trial, a randomised controlled trial to assess the impact of providing CVD risk and web-based lifestyle information, were analysed as a prospective cohort. We used linear and logistic regression analyses to quantify the association between social support, stress and mood at baseline and behaviour change following the intervention. We modelled objective (average acceleration measured by Axivity AX3 wrist-worn accelerometers and plasma carotenoid levels) and subjective (self-reported recreational PA and FVI) outcomes as change between baseline and 12 weeks follow-up. Results There was no clear association between social support and change in objective or subjective PA. Higher levels of stress and, to a lesser extent, depression symptoms were associated with smaller improvement in self-reported PA (β -1.53 h/week vigorous PA, 95% confidence interval (CI) -2.30 to -0.75, p < 0.001 for stress; β -1.64 h/week, 95% CI -3.50 to 0.21, p = 0.082 for little interest). Higher social support was associated with greater odds and higher stress was associated with lower odds of increasing self-reported FVI to five portions per day (odds ratio (OR) 1.33, 95% CI 1.05 to 1.69, p = 0.020 for social support; OR 0.57, 95% CI 0.43 to 0.76, p < 0.001 for stress). The associations between psychosocial factors and objective FVI were not statistically significant. Conclusions High stress and low mood may reduce the likelihood and extent of reported change in PA and FVI following CVD risk information and advice. Greater social support may be associated with increased FVI. The role of psychosocial factors should be considered when developing, tailoring and evaluating future interventions. Trial registration Current Controlled Trials ISRCTN17721237. Registered 12 January 2015. Electronic supplementary material The online version of this article (10.1186/s12889-018-5655-7) contains supplementary material, which is available to authorized users.
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Development and Psychometric Properties of the Family Support Questionnaire for Adherence to Low Fat Diet in Patients with Cardiovascular Disease. HEALTH SCOPE 2018. [DOI: 10.5812/jhealthscope.68261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fitzpatrick SL, Appel LJ, Bray B, Brooks N, Stevens VJ. Predictors of Long-Term Adherence to Multiple Health Behavior Recommendations for Weight Management. HEALTH EDUCATION & BEHAVIOR 2018; 45:997-1007. [PMID: 29478353 DOI: 10.1177/1090198118757823] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND We have demonstrated previously that patterns of behavioral adherence in the first 6 months of behavioral lifestyle interventions were associated with significant weight loss at 18 months. In this article, we extend this work to examine patterns of behavioral adherence over 18 months and to explore baseline demographic and psychosocial predictors. METHOD Latent class analysis was applied separately to the Weight Loss Maintenance and PREMIER trials data to examine patterns of adherence to the following recommendations: (1) consuming ≥9 servings of fruits and vegetables per day, (2) ≤25% of energy from total fat, (3) ≤7% energy from saturated fat, and (4) ≥180 minutes of moderate-to-vigorous physical activity per week. Multinomial logistic regression was used to test demographic and psychosocial predictors of latent class membership. RESULTS Four distinct subgroups with common patterns of behavioral adherence were identified in each trial including, Behavioral Maintainers, who maintained adherence to all behavioral recommendations for 1 year, Nonresponders, who did not adhere to the recommendations at any time point, and latent classes that reflected patterns of adherence to one or two behaviors or behavioral relapse. A significantly higher proportion of Behavioral Maintainers sustained ≥5% weight loss for 1 year compared with Nonresponders. Participants with higher vitality scores at baseline were more likely to belong to a latent class with long-term adherence to one or more recommendations than the Nonresponders class. CONCLUSIONS Regular assessment of health behaviors and psychosocial measures such as vitality may help identify nonresponders and inform treatment tailoring to improve long-term behavioral and weight outcomes.
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Affiliation(s)
| | - Lawrence J Appel
- 2 Johns Hopkins University School of Medicine, Baltimore, MD, USA.,3 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,4 The Welch Center for Prevention, Epidemiology & Clinical Research, Baltimore, MD, USA
| | - Bethany Bray
- 5 Pennsylvania State University, University Park, PA, USA
| | - Neon Brooks
- 1 Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Victor J Stevens
- 1 Kaiser Permanente Center for Health Research, Portland, OR, USA
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Bouldin ED, Trivedi RB, Reiber GE, Rosland AM, Silverman JB, Krieger J, Nelson KM. Associations between having an informal caregiver, social support, and self-care among low-income adults with poorly controlled diabetes. Chronic Illn 2017; 13:239-250. [PMID: 29119864 PMCID: PMC6993051 DOI: 10.1177/1742395317690032] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective To determine whether the presence of an informal caregiver and the patient's level of social support are associated with better diabetes self-care among adults with poorly controlled diabetes. Methods Cross-sectional study using baseline data from 253 adults of age 30-70 with poorly controlled diabetes. Participants who reported receiving assistance with their diabetes from a friend or family member in the past month were classified as having a caregiver. We used multivariate linear and logistic regression models to evaluate the associations between having a caregiver and level of social support with five self-reported diabetes self-care behaviors: diet, foot checks, blood glucose monitoring, medications, and physical activity. Results Compared to participants with no informal caregiver, those with an informal caregiver were significantly more likely to report moderate or high medication adherence (OR = 1.93, 95% CI: 1.07-3.49, p = 0.028). When we included social support in the model, having a caregiver was no longer significantly associated with medication adherence (OR = 1.50, 95% CI: 0.80-2.82), but social support score was (OR = 1.22, 95% CI: 1.03-1.45, p = 0.023). Discussion Among low-income adults with poorly controlled diabetes, having both an informal caregiver and high social support for diabetes may have a beneficial effect on medication adherence, a key self-care target to improve diabetes control.
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Affiliation(s)
- Erin D Bouldin
- 1 Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA.,2 Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Ranak B Trivedi
- 3 Center for Innovation to Implementation, Health Services Research & Development, VA Palo Alto Health Care System, Palo Alto, CA, USA.,4 Department of Psychiatry and Behavioral Sciences, Stanford University, Menlo Park, CA, USA
| | - Gayle E Reiber
- 1 Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA.,2 Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Ann-Marie Rosland
- 5 Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI, USA.,6 Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Julie B Silverman
- 1 Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA.,2 Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.,7 Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - James Krieger
- 2 Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.,8 Action for Healthy Food, Seattle, WA, USA
| | - Karin M Nelson
- 1 Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA.,2 Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.,7 Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
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An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080922. [PMID: 28813030 PMCID: PMC5580624 DOI: 10.3390/ijerph14080922] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/19/2017] [Accepted: 08/08/2017] [Indexed: 12/13/2022]
Abstract
This review aims to provide an overview of the factors associated with adherence reported in existing literature on lifestyle modification programs for weight management among the adult population. An electronic search was performed using PubMed, Medline, PsycINFO and PsycARTICLE to identify studies that examined the factors of adherence to lifestyle modification programs with explicit definition of adherence indicators. We identified 19 studies published between 2004 and 2016. The most commonly used indicator of adherence was attrition, followed by attendance, self-monitoring and dietary adherence. A broad array of factors has been studied but only few studies exploring each factor. Limited evidence suggested older age, higher education, healthier eating and physical activity behaviours, higher stage of change at baseline and higher initial weight loss may predict better adherence. On the other hand, having depression, stress, strong body shape concern, more previous weight loss attempts and being unemployed may predict poor adherence. Inconsistent findings were obtained for self-efficacy, motivation and male gender. This review highlights the need for more rigorous studies to enhance our knowledge on factors related to adherence. Identification of the factors of adherence could provide important implication for program improvement, ultimately improving the effectiveness and the cost-effectiveness of lifestyle modification program.
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Listening to Immokalee moms. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2017. [DOI: 10.1108/ijphm-12-2016-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to present a case study of the research steps taken to identify message directions for a community-wide health communication campaign aimed at supporting healthier eating behaviors among Latino farmworker families in the Immokalee community in Florida. Latino mothers were targeted to understand their beliefs about children’s healthy eating needs and identify communication campaign opportunities that would reinforce choices made in the home, surrounding meal planning, food selection and preparation and portion sizes.
Design/methodology/approach
A sequential mixed-methods approach using focus group, group interview and qualitative message concept testing was used in three distinct stages of research exploration. An independent sample was recruited at each stage through convenience sampling and snowball sampling methods. The stages of change theory provided a framework for research inquiry in the context of healthy eating-at-home practices.
Findings
In general, mothers were aware and participatory in the effort to serve healthy meals for their children at home. The time and money associated with buying nutritious foods and cooking healthy meals daily was stressful, but they were receptive to communication efforts to help them maintain their commitment to give their children healthy foods. These findings provided directional opportunities for the discovery and implementation of health communication strategies. Test results found that the target was most receptive to message strategies that acknowledged the responsibility of both parents to model healthy eating practices to children.
Research limitations/implications
Recruiting resulted in small sample sizes at each stage of the investigation. The reliability of quantitative measurement was a limitation to the research conclusions.
Practical implications
Partnership with the audience from discovery to conceptualization resulted in messages that uniquely resonated with the audience for which they were aimed. Understanding about the target stage of readiness improves message effectiveness to the target group.
Social implications
Health communication campaigns planned and developed with the target audience at its center will generate message strategies that effectively address issues of greatest relevance to those communication agents that seek to change.
Originality/value
The study provides a unique exploration of the steps that health communication agents should pursue to establish a thorough profile of their target audience and the issues that resonate when considering healthy eating behavior at home. The application of the stages of the change model encouraged the discovery of issues surrounding the challenge and highlighted potential obstacles that would mitigate the behavior change efforts.
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Andrade L, Zazpe I, Santiago S, Carlos S, Bes-Rastrollo M, Martínez-González MA. Ten-Year Changes in Healthy Eating Attitudes in the SUN Cohort. J Am Coll Nutr 2017; 36:319-329. [DOI: 10.1080/07315724.2016.1278566] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lucia Andrade
- University of Navarra, Department of Nutrition and Food Sciences and Physiology, Pamplona, Spain
- Centro Nutribalance, Guatemala, Guatemala
| | - Itziar Zazpe
- University of Navarra, Department of Nutrition and Food Sciences and Physiology, Pamplona, Spain
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Susana Santiago
- University of Navarra, Department of Nutrition and Food Sciences and Physiology, Pamplona, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Silvia Carlos
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Maira Bes-Rastrollo
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Miguel-Angel Martínez-González
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
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Nakade M, Tsubota-Utsugi M, Imai E, Tsuboyama-Kasaoka N, Nishi N, Takimoto H. Different Psychosocial Factors Are Associated With Different Intention and Self-Efficacy Toward Eating Breakfast Among Japanese Breakfast Skippers. Asia Pac J Public Health 2017; 29:102-113. [DOI: 10.1177/1010539517691092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A cross-sectional study was conducted among 7593 adults to clarify lifestyle and psychosocial characteristics of breakfast skippers with different intention and self-efficacy toward eating breakfast. Data were obtained from Japan’s national survey in 2009. Multinomial logistic regression analyses were performed to examine the characteristics of each breakfast skipper (having intention and self-efficacy toward eating breakfast [IS], having intention but not self-efficacy [INS], and not having intention to eat breakfast [NI]) compared with breakfast eaters. IS men were less likely to demonstrate understanding of healthy eating. INS and NI men were more likely to eat alone. INS and NI women were less likely to demonstrate understanding of healthy eating. NI men and women were less likely to report weight management behavior. Current smoking and being sleep-deprived were commonly associated with breakfast skipping in both sexes. Our results suggested the need for approaches considering type of breakfast skippers (eg, different intention and self-efficacy).
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Affiliation(s)
| | | | - Eri Imai
- The University of Shiga Prefecture, Hikone-City, Shiga, Japan
| | | | - Nobuo Nishi
- National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan
| | - Hidemi Takimoto
- National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan
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Schumacher TL, Burrows TL, Thompson DI, Callister R, Spratt NJ, Collins CE. The Role of Family in a Dietary Risk Reduction Intervention for Cardiovascular Disease. Healthcare (Basel) 2016; 4:E74. [PMID: 27706027 PMCID: PMC5198116 DOI: 10.3390/healthcare4040074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/13/2016] [Accepted: 09/22/2016] [Indexed: 12/04/2022] Open
Abstract
Diet is an essential strategy for the prevention of primary and secondary cardiovascular disease (CVD) events. The objectives were to examine: how families at increased risk of CVD perceived personal risk, their motivations to make dietary changes, their understanding of diet, and the influence of other family members. Individuals (>18 years) who completed an Australian family-based CVD risk reduction program were invited to a semi-structured telephone interview. Responses were recorded, transcribed verbatim and analysed using a systematic deductive approach with coding derived from key concepts developed as part of the interview structure. Seventeen participants from eight families were interviewed (aged 18-70 years, 47% male, five with CVD diagnosis). Key themes indicated both intrinsic and extrinsic motivations to improve heart health, variations in risk perception, recognition of the role diet plays in heart health, and the extent of family influences on eating patterns. Discrepancies between perceived and actual CVD risk perception impacted on perceived "need" to modify current dietary patterns towards heart health recommendations. Therefore, strategies not reliant on risk perception are needed to engage those with low risk perception. This could involve identifying and accessing the family "ringleader" to influence involvement and capitalising on personal accountability to other family members.
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Affiliation(s)
- Tracy L Schumacher
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Deborah I Thompson
- USDA/ARS Children's Nutrition Research Centre, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Neil J Spratt
- Priority Research Centre for Translational Neuroscience and Mental Health & Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Hunter New England Local Health District & Hunter Medical Research Institute, New Lambton Heights 2305, NSW, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, NSW, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, NSW, Australia.
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40
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Downer MK, Gea A, Stampfer M, Sánchez-Tainta A, Corella D, Salas-Salvadó J, Ros E, Estruch R, Fitó M, Gómez-Gracia E, Arós F, Fiol M, De-la-Corte FJG, Serra-Majem L, Pinto X, Basora J, Sorlí JV, Vinyoles E, Zazpe I, Martínez-González MÁ. Predictors of short- and long-term adherence with a Mediterranean-type diet intervention: the PREDIMED randomized trial. Int J Behav Nutr Phys Act 2016; 13:67. [PMID: 27297426 PMCID: PMC4907003 DOI: 10.1186/s12966-016-0394-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 06/07/2016] [Indexed: 12/25/2022] Open
Abstract
Background Dietary intervention success requires strong participant adherence, but very few studies have examined factors related to both short-term and long-term adherence. A better understanding of predictors of adherence is necessary to improve the design and execution of dietary intervention trials. This study was designed to identify participant characteristics at baseline and study features that predict short-term and long-term adherence with interventions promoting the Mediterranean-type diet (MedDiet) in the PREvención con DIeta MEDiterránea (PREDIMED) randomized trial. Methods Analyses included men and women living in Spain aged 55–80 at high risk for cardiovascular disease. Participants were randomized to the MedDiet supplemented with either complementary extra-virgin olive oil (EVOO) or tree nuts. The control group and participants with insufficient information on adherence were excluded. PREDIMED began in 2003 and ended in 2010. Investigators assessed covariates at baseline and dietary information was updated yearly throughout follow-up. Adherence was measured with a validated 14-point Mediterranean-type diet adherence score. Logistic regression was used to examine associations between baseline characteristics and adherence at one and four years of follow-up. Results Participants were randomized to the MedDiet supplemented with EVOO (n = 2,543; 1,962 after exclusions) or tree nuts (n = 2,454; 2,236 after exclusions). A higher number of cardiovascular risk factors, larger waist circumference, lower physical activity levels, lower total energy intake, poorer baseline adherence to the 14-point adherence score, and allocation to MedDiet + EVOO each independently predicted poorer adherence. Participants from PREDIMED recruiting centers with a higher total workload (measured as total number of persons-years of follow-up) achieved better adherence. No adverse events or side effects were reported. Conclusions To maximize dietary adherence in dietary interventions, additional efforts to promote adherence should be used for participants with lower baseline adherence to the intended diet and poorer health status. The design of multicenter nutrition trials should prioritize few large centers with more participants in each, rather than many small centers. Trial registration This study was registered at controlled-trials.com (http://www.controlled-trials. com/ISRCTN35739639). International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration date: 5 October 2005. Trial design: parallel randomized trial. Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0394-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mary Kathryn Downer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.,Channing Division of Network Medicine, 181 Longwood Avenue, Room 345, Boston, MA, 02115, USA
| | - Alfredo Gea
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.,Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, C/Irunlarrea, No. 1. Research Building, 2nd floor, Local 2520, 31008, Pamplona, Navarra, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.,IdiSNA, Navarra Institute por Health Research, 31008, Barcelona, Navarra, Spain
| | - Meir Stampfer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.,Channing Division of Network Medicine, 181 Longwood Avenue, Room 345, Boston, MA, 02115, USA
| | - Ana Sánchez-Tainta
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, C/Irunlarrea, No. 1. Research Building, 2nd floor, Local 2520, 31008, Pamplona, Navarra, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.,IdiSNA, Navarra Institute por Health Research, 31008, Barcelona, Navarra, Spain
| | - Dolores Corella
- Department of Preventive Medicine, University of Valencia, AVDA,Vicente Blasco Ibanez, 15, 46010, Valencia, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Hospital Universitari de Sant Joan de Reus, Universitat Rovira i Virgili, C/Sant Llorenç, 21, 43201, Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Emilio Ros
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Ramón Estruch
- Department of Internal Medicine, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Montserrat Fitó
- Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Carrer Dr. Aiguader, 88, 08003, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Enrique Gómez-Gracia
- Department of Preventive Medicine, University of Malaga, Campus de Teatinos, 29071, Malaga, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Fernando Arós
- Department of Cardiology, University Hospital of Araba, C/Jose Atxotegi, s/n, 01009, Vitoria-Gasteiz, Araba, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Miquel Fiol
- Palma Institute of Health Research (IdISPa), University of Balearic Islands and Hospital Son Espases, Carretera de Valldemossa, 79, 07120, Palma, Illes Balears, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Francisco Jose Garcia De-la-Corte
- Department of Family Medicine, Research Unit, Distrito Sanitario Atencion Primaria Sevilla, Avda. de Jerez s/n, 41007, Sevilla, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Lluís Serra-Majem
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Juan De Quesada 30, 35001, Las Palmas, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Xavier Pinto
- Head of Lipid and Vascular Risk Unit, Internal Medicine Department, Hospital Universitari de Bellvitge-IDIBELL. Universidad de Barcelona, C/Freixa Larga s/n, 08907 - Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Josep Basora
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV Universitat Rovira i Virgili, C/Sant Llorenç, 21 Planta baja del edificio 4 de la Facultat de Medicina i Ciències de la Salut, 43201, Reus, Tarragona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - José V Sorlí
- Department of Preventive Medicine, University of Valencia, AVDA,Vicente Blasco Ibanez, 15, 46010, Valencia, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Ernest Vinyoles
- Jordi Gol Primary Care Research Institute, Gran Via de les Corts Catalanes 587, àtic, 08007, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Itziar Zazpe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, C/Irunlarrea, No. 1. Research Building, 2nd floor, Local 2520, 31008, Pamplona, Navarra, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.,IdiSNA, Navarra Institute por Health Research, 31008, Barcelona, Navarra, Spain
| | - Miguel-Ángel Martínez-González
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, C/Irunlarrea, No. 1. Research Building, 2nd floor, Local 2520, 31008, Pamplona, Navarra, Spain. .,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain. .,IdiSNA, Navarra Institute por Health Research, 31008, Barcelona, Navarra, Spain.
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Garner MJ, McGregor BA, Murphy KM, Koenig AL, Dolan ED, Albano D. Optimism and depression: a new look at social support as a mediator among women at risk for breast cancer. Psychooncology 2015; 24:1708-13. [PMID: 25782608 DOI: 10.1002/pon.3782] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 01/23/2015] [Accepted: 01/29/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Breast cancer risk is a chronic stressor associated with depression. Optimism is associated with lower levels of depression among breast cancer survivors. However, to our knowledge, no studies have explored the relationship between optimism and depression among women at risk for breast cancer. We hypothesized that women at risk for breast cancer who have higher levels of optimism would report lower levels of depression and that social support would mediate this relationship. METHOD Participants (N = 199) with elevated distress were recruited from the community and completed self-report measures of depression, optimism, and social support. Participants were grouped based on their family history of breast cancer. Path analysis was used to examine the cross-sectional relationship between optimism, social support, and depressive symptoms in each group. RESULTS Results indicated that the variance in depressive symptoms was partially explained through direct paths from optimism and social support among women with a family history of breast cancer. The indirect path from optimism to depressive symptoms via social support was significant (β = -.053; 90% CI = -.099 to -.011, p = .037) in this group. However, among individuals without a family history of breast cancer, the indirect path from optimism to depressive symptoms via social support was not significant. CONCLUSIONS These results suggest that social support partially mediates the relationship between optimism and depression among women at risk for breast cancer. Social support may be an important intervention target to reduce depression among women at risk for breast cancer.
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Affiliation(s)
- Melissa J Garner
- Clinical Psychology, Seattle Pacific University, Seattle, WA, USA.,Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Karly M Murphy
- Clinical Psychology, Seattle Pacific University, Seattle, WA, USA.,Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Alex L Koenig
- Clinical Psychology, Seattle Pacific University, Seattle, WA, USA
| | - Emily D Dolan
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Denise Albano
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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42
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Koniak-Griffin D, Brecht ML, Takayanagi S, Villegas J, Melendrez M, Balcázar H. A community health worker-led lifestyle behavior intervention for Latina (Hispanic) women: feasibility and outcomes of a randomized controlled trial. Int J Nurs Stud 2015; 52:75-87. [PMID: 25307195 PMCID: PMC4277872 DOI: 10.1016/j.ijnurstu.2014.09.005] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 08/07/2014] [Accepted: 09/12/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Low-income Latinas (Hispanics) face risk for cardiovascular disease due to high rates of overweight/obesity, sedentary lifestyle, and other factors. Limited access to health care and language barriers may prevent delivery of health promotion messages. Targeted approaches, including the integration of community health workers, may be required to promote healthy lifestyle and prevent chronic disease in underserved ethnic minority groups. The term commonly used to refer to female community health workers in Latino communities is "promotora(s)." OBJECTIVES This study evaluates the outcomes and feasibility of a promotora-led lifestyle behavior intervention for overweight, immigrant Latinas. METHODS A community prevention model was employed in planning and implementing this study. A randomized controlled trial design was used. A Community Advisory Board provided expertise in evaluating feasibility of study implementation in the community and other important guidance. The sample was comprised of 223 women aged 35-64 years, predominantly with low income and ≤8th grade education. The culturally tailored Lifestyle Behavior Intervention included group education (8 classes based upon Su Corazon, Su Vida), followed by 4 months of individual teaching and coaching (home visits and telephone calls). The control group received a comparable length educational program and follow-up contacts. Evaluations were conducted at baseline and at 6 and 9 months using a dietary habits questionnaire, accelerometer readings of physical activity, and clinical measures (body mass index, weight, waist circumference, blood pressure, lipids, blood glucose). Data were collected between January 2010 and August 2012. RESULTS Women in the intervention group improved significantly in dietary habits, waist circumference, and physical activity in comparison to those in the control group. A treatment dosage effect was observed for weight and waist circumference. Knowledge about heart disease increased. High attendance at classes and participation in the individual teaching and counseling sessions and high retention rates support the feasibility and acceptability of the promotora-led lifestyle behavior intervention. CONCLUSIONS Our findings demonstrate that lifestyle behaviors and other risk factors of overweight Latina women may be improved through a promotora-led lifestyle behavior intervention. Feasibility of implementing this intervention in community settings and engaging promotoras as facilitators is supported.
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Affiliation(s)
- Deborah Koniak-Griffin
- Audrienne H. Moseley Endowed Chair, Women's Health Research, School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mary-Lynn Brecht
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Sumiko Takayanagi
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Juan Villegas
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Marylee Melendrez
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Héctor Balcázar
- Regional Dean, El Paso Regional Campus, and Professor, Division of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health at Houston, El Paso, TX, United States
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Jenkins KR, Fakhoury N, Marzec ML, Harlow-Rosentraub KS. Perceptions of a Culture of Health: Implications for Communications and Programming. Health Promot Pract 2014; 16:796-804. [PMID: 25421566 DOI: 10.1177/1524839914559942] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE This study aims to illustrate the potential utility of open-ended survey data, regarding faculty and staff perceptions of a culture of health (CoH), for targeting communications and programming. Overall, these types of data show how they may be used to assist in implementing, improving, and sustaining a CoH in an organization. Design/method/approach. An anonymous online questionnaire was sent to 10,000 employees. The analysis of open-ended responses was performed using the grounded theory approach. Emerging themes were organized into two major categories: favorable perceptions and unfavorable perceptions regarding the university's CoH. FINDINGS These findings suggest that employees have specific favorable and unfavorable perceptions regarding their university's CoH. Two main favorable perceptions that both faculty and staff commented on were (1) leaders/supervisors showing interest in health and well-being and (2) colleagues participating in healthful behaviors and setting good examples. Examples of unfavorable perceptions include stress not adequately addressed and healthy food options not readily available. Research limitations. The generalizability of the findings may be somewhat challenging given that the analyses are limited to individuals from a large Midwestern university. Also, given that this survey was voluntary, participants in the survey may possess unique characteristics that may have played a role in their likelihood to participate. ORIGINALITY/VALUE There are few studies that address assessing a CoH in a university setting. This study provides examples of (1) topics to consider when evaluating an organization's CoH and (2) actionable intervention and communication strategies that account for the employee's perceptions. Others might use such examples when evaluating or preparing to assess their own organization's CoH.
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Isaksson U, Hajdarevic S, Abramsson M, Stenvall J, Hörnsten Å. Diabetes empowerment and needs for self-management support among people with type 2 diabetes in a rural inland community in northern Sweden. Scand J Caring Sci 2014; 29:521-7. [DOI: 10.1111/scs.12185] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 09/16/2014] [Indexed: 01/10/2023]
Affiliation(s)
- Ulf Isaksson
- Department of Nursing; Umeå University; Umeå Sweden
| | | | | | | | - Åsa Hörnsten
- Department of Nursing; Umeå University; Umeå Sweden
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Risk perception is not associated with attendance at a preventive intervention for type 2 diabetes mellitus among South Asians at risk of diabetes. Public Health Nutr 2014; 18:1109-18. [PMID: 24913375 DOI: 10.1017/s1368980014001086] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the association between risk perception and attendance in a diabetes prevention programme among South Asians with a high risk for diabetes. DESIGN An observational study. We measured risk perception during the baseline interview with causal beliefs, perceived susceptibility and perceived controllability. We used logistic regression to examine the relationship between risk perception and attendance. We adjusted for relevant sociodemographic factors, screening results and psychosocial factors. SETTING The Hague, the Netherlands. SUBJECTS Five hundred and thirty-five Hindustani Surinamese (South Asians) aged 18-60 years from a lifestyle-versus-control intervention for the prevention of diabetes. RESULTS In total, 68·2% attended the lifestyle or control intervention. Participants perceived lifestyle and heredity to increase the risk of diabetes and perceived increasing physical activity to decrease it. Only 44·2% of the participants perceived themselves as susceptible to diabetes and only those who perceived a family history of diabetes as a cause of diabetes appeared to be more inclined to attend. However, after adjustment for confounding, the association was not statistically significant. CONCLUSIONS Risk perception was not significantly associated with attendance. The results suggest that increasing the risk perception alone in this South Asian population is unlikely to increase the attendance at a diabetes prevention programme.
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Avery KNL, Donovan JL, Horwood J, Neal DE, Hamdy FC, Parker C, Wade J, Lane A. The importance of dietary change for men diagnosed with and at risk of prostate cancer: a multi-centre interview study with men, their partners and health professionals. BMC FAMILY PRACTICE 2014; 15:81. [PMID: 24886169 PMCID: PMC4020306 DOI: 10.1186/1471-2296-15-81] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/23/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND The diagnosis of prostate cancer (PC) can provide a trigger for dietary change, and there is evidence that healthier diets may improve quality of life and clinical outcomes. However, men's views about dietary change in PC survivorship are largely unknown. This multi-centre qualitative interview study explored men's views about dietary change in PC survivorship, to better understand motivations for, and barriers to, achieving desired changes. The role of radical and active surveillance treatments on dietary change and the influence of men's partners were examined. Focus groups also evaluated stakeholder opinion, including healthcare professionals, about the provision of dietary advice to PC patients. METHODS A multi-centre interview study explored views about diet and motivations for, and barriers to, dietary change in men at elevated risk or diagnosed with PC following prostate specific antigen (PSA) testing. 58 men and 11 partners were interviewed. Interviews and focus groups were undertaken with 11 healthcare professionals, 5 patients and 4 partners to evaluate stakeholders' opinions about the feasibility and acceptability of providing dietary advice to PC patients. Data were analysed using methods of constant comparison and thematic analysis. RESULTS Over half of diagnosed men reported making dietary changes, primarily to promote general or prostate health or facilitate coping, despite their uncertainty about diet-PC links. Interest in dietary advice was high. Information needs varied depending on treatment received, with men on active surveillance more frequently modifying their diet and regarding this as an adjunct therapy. Men considered their partners integral to implementing changes. Provision of dietary advice to men diagnosed with PC was considered by healthcare professionals and men to be feasible and appropriate in the context of a holistic 'care package'. CONCLUSIONS Many men make positive dietary changes after PC diagnosis, which are perceived by men and their partners to bring psychological and general health benefits and could help future dietary intervention trials. Men and their partners desire more and better dietary information that may support PC survivorship, particularly among those embarking on active surveillance/monitoring programmes. There are opportunities for healthcare professionals to support PC patients both clinically and psychologically by the routine integration of healthy eating advice into survivorship care plans.
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Affiliation(s)
- Kerry NL Avery
- School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
| | - Jeremy Horwood
- School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
| | - David E Neal
- Oncology Centre, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - Chris Parker
- Academic Urology Unit, Royal Marsden NHS Trust, Institute of Cancer Research, Sutton, Surrey, SM2 5PT, UK
| | - Julia Wade
- School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
| | - Athene Lane
- School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Clifton, Bristol BS8 2PS, UK
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Willet MN, Hayes DK, Zaha RL, Fuddy LJ. Social-emotional support, life satisfaction, and mental health on reproductive age women's health utilization, US, 2009. Matern Child Health J 2012; 16 Suppl 2:203-12. [PMID: 22956364 PMCID: PMC4545528 DOI: 10.1007/s10995-012-1096-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
To examine the associations among social-emotional support, life satisfaction, and mental health with not having a routine checkup among women of reproductive age in the US, data from the 2009 Behavioral Risk Factor Surveillance System, a population-based telephone survey of health behaviors, were analyzed among reproductive aged (18-44 years) women in the US. Prevalence estimates were calculated for not having a routine checkup in the past year with measures of social-emotional support, life satisfaction, and mental distress. Independent multivariable logistic regressions for each measure assessed not having a routine checkup within the past year with adjustment for age, race/ethnicity, education level, and health care coverage. Among women of reproductive age, 33.7 % (95 % CI 33.0-34.4) did not have a routine checkup within the past year. Factors associated with not having a routine checkup included: having social-emotional support most of the time (AOR = 1.29, 95 % CI 1.20-1.38) or sometimes or less (AOR = 1.47, 95 % CI 1.34-1.61) compared to those who reported always having the social-emotional support they need; reporting life satisfaction as being satisfied (AOR = 1.27, 95 % CI 1.19-1.36) or dissatisfied (AOR = 1.65, 95 % CI 1.43-1.91) compared to being very satisfied; and frequent mental distress (AOR = 1.19, 95 % CI 1.09-1.30) compared to those without. Women who report lower levels of social-emotional support, less life satisfaction, and frequent mental distress are less likely to see a doctor for a routine checkup. Targeted outreach that provides appropriate support are needed so these women can access clinical services to increase exposure to preventive health opportunities and improve overall health.
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Affiliation(s)
- Michelle N. Willet
- Family Health Services Division, Hawaii State Department of Health, 3652 Kilauea Avenue, Honolulu, HI 96816, USA
| | - Donald K. Hayes
- Family Health Services Division, Hawaii State Department of Health, 3652 Kilauea Avenue, Honolulu, HI 96816, USA,
| | - Rebecca L. Zaha
- Family Health Services Division, Hawaii State Department of Health, 3652 Kilauea Avenue, Honolulu, HI 96816, USA
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Abstract
OBJECTIVE Treatment recommendation and guidelines for patients with heart failure (HF) can be complex, and past work has shown that patients with HF demonstrate low rates of adherence to recommended health behaviors. Although previous work has identified several medical, demographic, and psychosocial predictors of the capacity to adhere to treatment recommendations of persons with HF, little is known about the contribution of cognitive impairment to reported treatment adherence in this population. METHODS A total of 149 persons with HF (mean [standard deviation] = 68.08 [10.74] years) completed a brief fitness assessment and neuropsychological testing. Treatment adherence was assessed using the Heart Failure Compliance Questionnaire, a brief measure that asks participants to report their adherence to a variety of recommended health behaviors (i.e., medication management, diet, and exercise, among others). RESULTS The percentage of participants who reported poor overall adherence was 16.1%, with particularly high rates of nonadherence to dietary and exercise recommendations. Hierarchical regression analyses adjusting for possible confounds revealed that reduced performance on attention (β = .26, p = .01), executive function (β = .18, p = .04), and language (β = .22, p = .01) was associated with poorer overall adherence. Follow-up analyses showed that these cognitive domains were associated with behaviors such as keeping doctor appointments, medication management, and dietary recommendations (p < .05 for all). CONCLUSIONS The current findings demonstrate that cognitive function is an independent contributor to adherence in older adults with HF. Prospective studies that objectively measure treatment adherence are needed to clarify these findings and identify possible strategies to improve outcomes in this population. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00871897.
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49
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Francis SL. Heart disease nutrition education program increases familiarity with heart-healthy lifestyle recommendations. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2012; 44:658-660. [PMID: 23140566 DOI: 10.1016/j.jneb.2012.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Revised: 06/07/2012] [Accepted: 06/18/2012] [Indexed: 06/01/2023]
Affiliation(s)
- Sarah L Francis
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50011, USA.
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50
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Effects of depression and anxiety improvement on adherence to medication and health behaviors in recently hospitalized cardiac patients. Am J Cardiol 2012; 109:1266-71. [PMID: 22325974 DOI: 10.1016/j.amjcard.2011.12.017] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 12/19/2011] [Accepted: 12/19/2011] [Indexed: 11/22/2022]
Abstract
Impaired adherence to medications and health behaviors may mediate the connection between psychiatric symptoms and mortality in cardiac patients. This study assessed the association between improvements in depression/anxiety and self-reported adherence to health behaviors in depressed cardiac patients in the 6 months after cardiac hospitalization. Data were analyzed from depressed patients on inpatient cardiac units who were hospitalized for acute coronary syndrome, heart failure, or arrhythmia and enrolled in a randomized trial of collaborative care depression management (n = 134 in primary analysis). Measurements of depression (Patient Health Questionnaire-9), anxiety (Hospital Anxiety and Depression Scale, Anxiety subscale), and adherence to secondary prevention behaviors (Medical Outcomes Study-Specific Adherence Scale items) were obtained at baseline, 6 weeks 12 weeks, and 6 months. The association between improvement in depression/anxiety and adherence was assessed by linear regression after accounting for the effects of multiple relevant covariates. At all time points improvement in the Patient Health Questionnaire-9 was significantly and independently associated with self-reported adherence to medications and secondary prevention behaviors. In contrast, improvement in the Hospital Anxiety and Depression Scale, Anxiety subscale was associated with improved adherence only at 6 weeks. In conclusion, in a cohort of depressed cardiac patients, improvement in depression was consistently and independently associated with superior self-reported adherence to medications and secondary prevention behaviors across a 6-month span, whereas improvement in anxiety was not.
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