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André N, Grousset M, Audiffren M. A Behavioral Perspective for Improving Exercise Adherence. SPORTS MEDICINE - OPEN 2024; 10:56. [PMID: 38763991 PMCID: PMC11102891 DOI: 10.1186/s40798-024-00714-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/01/2024] [Indexed: 05/21/2024]
Abstract
Adherence to exercise is a crucial aspect of behavioral changes related to exercise. However, current models fail to predict behavioral change, and exercise programs struggle to foster adherence. In this Current Opinion article, we defined adherence as a process linking behavior and attitude. More specifically, exercise adherence is the process by which people's behaviors conform to their attitudes and vice versa. Behavioral change theories should be able to predict changes, transformations, and modifications of behaviors; however, this is not currently the case. Prediction models of behavior are mainly focused on how to predict behavioral changes by affecting attitudes; however, these models have not considered the target behavior as a facilitator of adherence. Herein, a behavioral perspective is considered in three directions: first, exercise is a therapeutic modality that has the potential to improve motivation; second, chronic exercise helps sustain effort over time and increase executive functions and willpower; and third, exercise is an active behavior that has the potential to facilitate attitude change.
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Affiliation(s)
- Nathalie André
- Research Centre on Cognition and Learning, CNRS, University of Poitiers, Poitiers, France.
- Maison des Sciences de l'Homme et de la Société, CNRS, University of Poitiers, Poitiers, France.
| | - Marine Grousset
- Research Centre on Cognition and Learning, CNRS, University of Poitiers, Poitiers, France
- Richelieu Centre, French Red Cross Association, La Rochelle, France
| | - Michel Audiffren
- Research Centre on Cognition and Learning, CNRS, University of Poitiers, Poitiers, France
- Maison des Sciences de l'Homme et de la Société, CNRS, University of Poitiers, Poitiers, France
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2
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Jane B, Downey J. Exercise referral schemes in the UK: mapping provision and aims. J Public Health (Oxf) 2024:fdae057. [PMID: 38702841 DOI: 10.1093/pubmed/fdae057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 02/09/2024] [Accepted: 04/12/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Exercise Referral Schemes (ERS) are designed so health professionals can refer certain patients to a supervised programme of physical activity. However, evaluations have questioned the effectiveness of these schemes/programmes. The aim of this study was to systematically review the provision of ERS in England and analyse related promotional material. METHODS Content analysis methods were used to analyse scheme websites and promotional material. A coding scheme was used to analyse the data, which included information on the programme's aims, inclusion criteria, type of activities, accessibility and cost. RESULTS The study identified 625 sites offering ERS across 168 geographic areas. Findings highlighted a lack of clarity in what constitutes a scheme. Over a third of schemes did not explicitly state their aims, but of those that did, the focus was mainly on notions of physical and mental health benefits. CONCLUSIONS This study is the first to review the scope and offer of ERS in the UK by examining promotional material and highlights issues around the stated aims of ERS. More clarity on aims is needed in the material that promotes the schemes and most likely within the schemes themselves. Such improvements could make a difference when considering engagement with delivery stakeholders and potential participants.
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Affiliation(s)
- Ben Jane
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth PL6 8BH, UK
| | - John Downey
- School of Nursing and Midwifery, University of Plymouth, Plymouth PL4 8AA, UK
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Gómez-Gómez I, Rodero-Cosano ML, Bellón JÁ, Zabaleta-Del-Olmo E, Maderuelo-Fernandez JA, Moreno-Peral P, Magallón-Botaya R, Oliván-Blázquez B, Casajuana-Closas M, López-Jiménez T, Bolíbar B, Llobera J, Clavería A, Sanchez-Perez A, Motrico E. Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study. J Health Psychol 2024:13591053241241015. [PMID: 38605575 DOI: 10.1177/13591053241241015] [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: 04/13/2024] Open
Abstract
This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression (β = - 0 . 076 ; p = 0 . 046 ). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.
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Affiliation(s)
- Irene Gómez-Gómez
- Universidad Loyola Andalucía, Spain
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
| | | | - Juan Á Bellón
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Biomedical Research Institute of Málaga (IBIMA), Spain
- Andalusian Health Service (SAS), Spain
- University of Málaga, Spain
| | - Edurne Zabaleta-Del-Olmo
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Institut Català de la Salut, Spain
- Universitat de Girona, Spain
| | - José A Maderuelo-Fernandez
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Spain
- Instituto de investigación Biomédica de Salamanca (IBSAL), Spain
- Gerencia de Atención Primaria de Salamanca, Spain
- Gerencia Regional de salud de Castilla y León (SACyL), Spain
| | - Patricia Moreno-Peral
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Biomedical Research Institute of Málaga (IBIMA), Spain
| | - Rosa Magallón-Botaya
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Universidad de Zaragoza, Spain
- Institute for Health Research Aragón (IISA), Spain
| | - Bárbara Oliván-Blázquez
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Universidad de Zaragoza, Spain
- Institute for Health Research Aragón (IISA), Spain
| | - Marc Casajuana-Closas
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Tomàs López-Jiménez
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Bonaventura Bolíbar
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Joan Llobera
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Servei de Salut de les Illes Balears, Spain
| | - Ana Clavería
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Área de Vigo, SERGAS, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | - Alvaro Sanchez-Perez
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- BioCruces Bizkaia Health Research Institute, Basque Healthcare Service - Osakidetza, Spain
| | - Emma Motrico
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Instituto de Investigaciones Biomédicas de Sevilla, IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Sevilla, Spain
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Sevilla, Spain
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Costa S, Biscaia JL, Horta MR, Romano S, Guerreiro J, Heudtlass P, Cary M, Romão M, Teixeira Rodrigues A, Miranda A, Martins AP, Bento AS, Pereira J, Mateus C, Helling DK. Real-World Effectiveness in Hypertension and Hyperlipidemia Collaborative Management between Pharmacies and Primary Care in Portugal: A Multicenter Pragmatic Controlled Trial (USFarmácia ®). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6496. [PMID: 37569036 PMCID: PMC10418740 DOI: 10.3390/ijerph20156496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/09/2023] [Accepted: 07/03/2023] [Indexed: 08/13/2023]
Abstract
There is evidence of the efficacy of collaborative health interventions with pharmacies and primary care providers but little of its real-world effectiveness. We aimed to assess the effectiveness and discuss the design and challenges of hypertension and hyperlipidemia management between pharmacies and primary care providers using real-world data exchange between providers and experimental bundled payment. This was a pragmatic, quasi-experimental controlled trial. We collected patient-level data from primary care prescription claims and Electronic Medical Record databases, a pharmacy claims database, and patient telephone surveys at several time points. The primary outcomes were changes in blood pressure and total cholesterol. We used matched controls with difference-in-differences estimators in a Generalized Linear Model (GLM) and controlled interrupted time series (CITS). We collected additional data for economic and qualitative studies. A total of 6 Primary Care Units, 20 pharmacies, and 203 patients entered the study. We were not able to observe significant differences in the effect of intervention vs. control. We experienced challenges that required creative strategies. This real-world trial was not able to show effectiveness, likely due to limitations in the primary care technology which affected the sample size. It offers, however, valuable lessons on methods, strategies, and data sources, paving the way for more real-world effectiveness trials to advance value-based healthcare.
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Affiliation(s)
- Suzete Costa
- NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
- Institute for Evidence-Based Health (ISBE), 1649-028 Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - José Luís Biscaia
- USF São Julião da Figueira, Agrupamento dos Centros de Saúde (ACeS) do Baixo Mondego, 3080-134 Figueira da Foz, Portugal
| | - Maria Rute Horta
- Centre for Medicines Information and Health Interventions (CEDIME), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
| | - Sónia Romano
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
| | - José Guerreiro
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
| | - Peter Heudtlass
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
| | - Maria Cary
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
| | - Mariana Romão
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
| | - António Teixeira Rodrigues
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, 1249-069 Lisboa, Portugal
| | - Ana Miranda
- Registo Oncológico Nacional, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal
| | - Ana Paula Martins
- Institute for Evidence-Based Health (ISBE), 1649-028 Lisboa, Portugal
- Pharmacy, Pharmacology & Health Technologies, Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisboa, Portugal
| | - Ana Sofia Bento
- USF São Julião da Figueira, Agrupamento dos Centros de Saúde (ACeS) do Baixo Mondego, 3080-134 Figueira da Foz, Portugal
| | - João Pereira
- NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
- Public Health Research Centre (PHRC/CISP), Comprehensive Health Research Centre (CHRC), 1600-560 Lisboa, Portugal
| | - Céu Mateus
- Health Economics at Lancaster, Division of Health Research, Lancaster University, Lancaster LA1 4YX, UK
| | - Dennis K. Helling
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Denver, CO 80045, USA
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5
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Savelli E, Murmura F. The intention to consume healthy food among older Gen-Z: Examining antecedents and mediators. Food Qual Prefer 2023. [DOI: 10.1016/j.foodqual.2022.104788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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6
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Recio-Rodriguez JI, Garcia-Ortiz L, Garcia-Yu IA, Lugones-Sanchez C, Olmo EZD, Bolibar B, Casajuana-Closas M, Lopez-Jimenez T, Llobera J, Ramos R, Pombo H, Motrico E, Gil-Girbau M, Lopez-Mendez F, Represas-Carrera F, Maderuelo-Fernandez JA. Effectiveness of a multiple health-behaviour-change intervention in increasing adherence to the Mediterranean Diet in adults (EIRA study): a randomized controlled hybrid trial. BMC Public Health 2022; 22:2127. [PMCID: PMC9675247 DOI: 10.1186/s12889-022-14590-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 11/10/2022] [Indexed: 11/21/2022] Open
Abstract
Background The present study describes the effectiveness of a complex intervention that addresses multiple lifestyles to promote healthy behaviours in increasing adherence to the Mediterranean diet (MD). Methods Cluster-randomised, hybrid clinical trial controlled with two parallel groups. The study was carried out in 26 primary Spanish healthcare centres. People aged 45–75 years who presented at least two of the following criteria were included: smoker, low adherence to the MD or insufficient level of physical activity. The intervention group (IG) had three different levels of action: individual, group, and community, with the aim of acting on the behaviours related to smoking, diet and physical activity at the same time. The individual intervention included personalised recommendations and agreements on the objectives to attain. Group sessions were adapted to the context of each healthcare centre. The community intervention was focused on the social prescription of resources and activities performed in the environment of the community of each healthcare centre. Control group (CG) received brief advice given in the usual visits to the doctor’s office. The primary outcome was the change, after 12 months, in the number of participants in each group with good adherence to the MD pattern. Secondary outcomes included the change in the total score of the MD adherence score (MEDAS) and the change in some cardiovascular risk factors. Results Three thousand sixty-two participants were included (IG = 1,481, CG = 1,581). Low adherence to the MD was present in 1,384 (93.5%) participants, of whom 1,233 initiated the intervention and conducted at least one individual visit with a healthcare professional. A greater increase (13.7%; 95% CI, 9.9–17.5; p < 0.001) was obtained by IG in the number of participants who reached 9 points or more (good adherence) in the MEDAS at the final visit. Moreover, the effect attributable to the intervention obtained a greater increase (0.50 points; 95% CI, 0.35 to 0.66; p < 0.001) in IG. Conclusions A complex intervention modelled and carried out by primary healthcare professionals, within a real clinical healthcare context, achieved a global increase in the adherence to the MD compared to the brief advice. Trial registration ClinicalTrials.gov Identifier: NCT03136211. Retrospectively registered on 02/05/2017 https://clinicaltrials.gov/ct2/show/NCT03136211
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Affiliation(s)
- Jose I. Recio-Rodriguez
- grid.11762.330000 0001 2180 1817Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Red de Investigación en Cronicidad, Atención Primaria Y Promoción de La Salud (RICAPPS) (RD21/0016), Facultad de Enfermería Y Fisioterapia (Universidad de Salamanca), Salamanca, Spain
| | - Luis Garcia-Ortiz
- grid.452531.4Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Departamento de Ciencias Biomédicas Y del Diagnóstico (Universidad de Salamanca), Gerencia Regional de Salud de Castilla Y León (SACyL), 37007 Salamanca, Spain
| | - Irene A. Garcia-Yu
- grid.452531.4Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Cristina Lugones-Sanchez
- grid.452531.4Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla Y León (SACyL), Salamanca, Spain
| | - Edurne Zabaleta-del Olmo
- grid.5841.80000 0004 1937 0247Nursing Department, Nursing Faculty (Universitat de Girona), Fundació Institut Universitari Per a La Recerca a L’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Gerència Territorial de Barcelona (Institut Català de La Salut), UniversitatAutònoma de Barcelona, Barcelona, Spain
| | - Bonaventura Bolibar
- grid.452479.9Fundació Institut Universitari Per a La Recerca a L’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marc Casajuana-Closas
- grid.452479.9Fundació Institut Universitari Per a La Recerca a L’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tomas Lopez-Jimenez
- grid.452479.9Fundació Institut Universitari Per a La Recerca a L’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain
| | - Joan Llobera
- grid.487143.d0000 0004 1807 8885Unitat de Recerca, Atenció Primària de Mallorca. Servei de Salut de Les Illes Balears. IdISBa, Palma, Spain
| | - Rafel Ramos
- grid.429182.4Fundació Institut Universitari Per a La Recerca a L’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Group of Research in Vascular Health, Unitat de Suport a La Recerca de Girona, Girona Biomedical Research Institute (IdibGi), Girona, Spain
| | - Haizea Pombo
- grid.426049.d0000 0004 1793 9479Bizkaia, Deputy Directorate of Healthcare Assistance, Ezkerraldea-Enkarterri-Cruces Integrated Health Organisation-Biocruces Bizkaia Health Research Institute Innovation Unit, Osakidetza-Servicio Vasco de Salud, Araba, Spain
| | - Emma Motrico
- grid.449008.10000 0004 1795 4150Universidad Loyola Andalucía, Seville, Spain
| | - Montserrat Gil-Girbau
- grid.411160.30000 0001 0663 8628Research and Development Unit, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Fatima Lopez-Mendez
- grid.488737.70000000463436020Instituto de Investigación Sanitaria Aragón, Saragossa, Spain
| | - Francisco Represas-Carrera
- grid.420359.90000 0000 9403 4738Atención Primaria, Área Sanitaria de Vigo, Servicio Gallego de Salud (SERGAS), Grupo I-Saúde (Instituto de Investigación Sanitaria Galicia Sur), Galicia, Spain
| | - Jose A. Maderuelo-Fernandez
- grid.452531.4Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla Y León (SACyL), Salamanca, Spain
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Reyes Hernández I, Téllez López AM, López Orozco M, García Pérez ME, López Luna MA, Barajas Esparza L, Bermúdez Camps IB. Pilot study to validate a standard operating procedure for providing health education to diabetic patients. J Taibah Univ Med Sci 2022; 18:470-479. [PMID: 36818172 PMCID: PMC9932454 DOI: 10.1016/j.jtumed.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction The lack of standard operating procedures (SOPs) to provide health education to patients with diabetes means that this service is provided in a heterogeneous, isolated and intermittent manner, thus limiting quality. Objective To validate a SOP to provide health education to diabetic patients using Delphi methodology and determining its efficacy in clinical practice by performing a pilot study. Methods The SOP was designed from a theoretical analysis of the available literature; a participatory brainstorming technique was used to define the processes included in the SOP. The research was carried out at the Comprehensive Pharmaceutical Care Polyclinic of a Mexican Institute of Health Sciences, from August 2017 to March 2020. The pilot test was carried out on 15 outpatients with diabetes type 1 and 2. The validation was carried out by a panel of experts using Delphi methodology, the consensus among the experts was estimated by determining Kendall's coefficient of concordance. The practice clinical efficacy of the SOP was determined by a pilot study in 15 diabetic patients using process indicators. Results The SOP was structured in nine sections with the process approach described in the ISO 9001:2008 standards. The criteria issued by the experts relating to content, records and data extraction tools allowed improvement of the SOP. The pilot test showed that health education, following the SOP, improved metabolic control, level of knowledge, therapeutic adherence and the attitudes of more than 80% of patients. Conclusions The SOP designed and validated by experts was effective in educating patients with diabetes due to the high impact achieved with the intervention and incorporates indicators to guarantee the quality of the health service provided.
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Affiliation(s)
- Ivette Reyes Hernández
- Institute of Health Sciences, Pharmacy Department, Autonomous University of the State of Hidalgo, Pachuca, Hidalgo, Mexico
| | - Ana M. Téllez López
- Institute of Health Sciences, Pharmacy Department, Autonomous University of the State of Hidalgo, Pachuca, Hidalgo, Mexico
| | - Maricela López Orozco
- Institute of Health Sciences, Pharmacy Department, Autonomous University of the State of Hidalgo, Pachuca, Hidalgo, Mexico
| | - Martha E. García Pérez
- Department of Chemical Pharmacobiology, Michoacan University of San Nicolás de Hidalgo, Morelia, Michoacán, México
| | - María A. López Luna
- Academic Unit of Chemical Sciences, Area of Health Sciences, Department of Chemical Sciences, Autonomous University of Zacatecas “Francisco García Salinas”, Zacatecas, México
| | - Liliana Barajas Esparza
- Institute of Health Sciences, Pharmacy Department, Autonomous University of the State of Hidalgo, Pachuca, Hidalgo, Mexico
| | - Isis B. Bermúdez Camps
- Institute of Health Sciences, Pharmacy Department, Autonomous University of the State of Hidalgo, Pachuca, Hidalgo, Mexico,Corresponding address: Pharmacy Department, Institute of Health Sciences, Autonomous University of the State of Hidalgo, Pachuca, Hidalgo 42160 Mexico.
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Park KH, Nam S, Hong I, Park JH. An Investigation of the Psychometric Properties of Lifestyle Profile-BREF. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2138679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Kang-Hyun Park
- Department of Occupational Therapy, Baekseok University, Cheonan, South Korea
| | - Sanghun Nam
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - Ickpyo Hong
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, South Korea; Yonsei New-normal Lifestyle Research Center, Wonju, South Korea
| | - Ji-Hyuk Park
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, South Korea
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Mahadzir MDA, Quek KF, Ramadas A. Comprehending Nutrition and Lifestyle Behaviors of People with Metabolic Syndrome: A Focus Group Study. Healthcare (Basel) 2022; 10:1653. [PMID: 36141266 PMCID: PMC9498472 DOI: 10.3390/healthcare10091653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Demographically and socio-culturally appropriate care is critical for empowering people with metabolic syndrome (MetS) to self-manage their condition. This focus group study aimed to explore the understanding of nutrition and lifestyle behaviors (NLBs) of Malaysians with MetS. Adults with MetS (N = 21) participated in four focus groups at a university's research clinic in Malaysia. A thematic framework analysis approach was applied to the focus group data using an initial coding framework developed from the Health Belief Model. Six main themes were identified on perceived motivations, barriers, and threats toward healthy NLBs. Motivations to adopt healthy NLBs were body image, personal experience of adverse complications, and family and social support. The perception that healthcare is a business model, the idea that changes in NLBs are difficult and expensive, and cultural influence on food intake were identified as barriers to healthy NLBs. Inadequate knowledge of MetS was identified as a subtheme in this study. Health education and health promotion activities that aim to modify the NLBs of people with MetS should consider the community's perception of motivation and barriers to change. Addressing these aspects in the development of programs can potentially increase program adoption and adherence, ensuring the success of community-based lifestyle interventions.
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Affiliation(s)
| | | | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia
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Hooker SA, Sherman MD, Loth KA, Uy MJA, Slattengren AH. Change that Matters: A Health Behavior Change and Behavioral Health Curriculum for Primary Care. J Clin Psychol Med Settings 2022; 29:773-784. [DOI: 10.1007/s10880-021-09836-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 11/28/2022]
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Zabaleta-Del-Olmo E, Casajuana-Closas M, López-Jiménez T, Pombo H, Pons-Vigués M, Pujol-Ribera E, Cabezas-Peña C, Llobera J, Martí-Lluch R, Vicens C, Motrico E, Gómez-Gómez I, Maderuelo-Fernández JÁ, Recio-Rodriguez JI, Masluk B, Contreras-Martos S, Jacques-Aviñó C, Aznar-Lou I, Gil-Girbau M, Clavería A, Magallón-Botaya R, Bellón JÁ, Ramos R, Sanchez-Perez A, Moreno-Peral P, Leiva A, González-Formoso C, Bolíbar B. Multiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial. BMC Public Health 2021; 21:2208. [PMID: 34863136 PMCID: PMC8642878 DOI: 10.1186/s12889-021-11982-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the effectiveness of a) a Multiple Health Behaviour Change (MHBC) intervention on reducing smoking, increasing physical activity and adherence to a Mediterranean dietary pattern in people aged 45-75 years compared to usual care; and b) an implementation strategy. METHODS A cluster randomised effectiveness-implementation hybrid trial-type 2 with two parallel groups was conducted in 25 Spanish Primary Health Care (PHC) centres (3062 participants): 12 centres (1481 participants) were randomised to the intervention and 13 (1581 participants) to the control group (usual care). The intervention was based on the Transtheoretical Model and focused on all target behaviours using individual, group and community approaches. PHC professionals made it during routine care. The implementation strategy was based on the Consolidated Framework for Implementation Research (CFIR). Data were analysed using generalised linear mixed models, accounting for clustering. A mixed-methods data analysis was used to evaluate implementation outcomes (adoption, acceptability, appropriateness, feasibility and fidelity) and determinants of implementation success. RESULTS 14.5% of participants in the intervention group and 8.9% in the usual care group showed a positive change in two or all the target behaviours. Intervention was more effective in promoting dietary behaviour change (31.9% vs 21.4%). The overall adoption rate by professionals was 48.7%. Early and final appropriateness were perceived by professionals as moderate. Early acceptability was high, whereas final acceptability was only moderate. Initial and final acceptability as perceived by the participants was high, and appropriateness moderate. Consent and recruitment rates were 82.0% and 65.5%, respectively, intervention uptake was 89.5% and completion rate 74.7%. The global value of the percentage of approaches with fidelity ≥50% was 16.7%. Eight CFIR constructs distinguished between high and low implementation, five corresponding to the Inner Setting domain. CONCLUSIONS Compared to usual care, the EIRA intervention was more effective in promoting MHBC and dietary behaviour change. Implementation outcomes were satisfactory except for the fidelity to the planned intervention, which was low. The organisational and structural contexts of the centres proved to be significant determinants of implementation effectiveness. TRIAL REGISTRATION ClinicalTrials.gov , NCT03136211 . Registered 2 May 2017, "retrospectively registered".
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Affiliation(s)
- Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, Balmes 22, 08007, Barcelona, Spain
- Nursing Department, Nursing Faculty, Universitat de Girona, Emili Grahit 77, 17003, Girona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
| | - Marc Casajuana-Closas
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
| | - Tomàs López-Jiménez
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
| | - Haizea Pombo
- Ezkerraldea-Enkarterri-Cruces Integrated Health Organisation-Biocruces Bizkaia Health Research Institute Innovation Unit, Plaza de Cruces s/n, 48903, Barakaldo, Bizkaia, Spain
- Deputy Directorate of Healthcare Assistance, Osakidetza-Servicio Vasco de Salud, C/ Araba 45, 01006, Vitoria, Araba, Spain
| | - Mariona Pons-Vigués
- Nursing Department, Nursing Faculty, Universitat de Girona, Emili Grahit 77, 17003, Girona, Spain
- Àrea Assistencial. Servei Català de la Salut (CatSalut), Travessera de les Corts 131-159, Edifici Olímpia, 08228, Barcelona, Spain
| | - Enriqueta Pujol-Ribera
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Nursing Department, Nursing Faculty, Universitat de Girona, Emili Grahit 77, 17003, Girona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
| | - Carmen Cabezas-Peña
- Department of Health, Deputy Directorate of Health Promotion, Public Health Agency, Goverment of Catalonia, Roc Boronat, 81-95 (Edifici Salvany), 08005, Barcelona, Spain
| | - Joan Llobera
- Unitat de Recerca, Atenció Primaria de Mallorca, Servei de Salut de les Illes Balears, C/Escola Graduada 3, 07002, Palma, Spain
- Institut de Investigació Sanitària de les Illes Balears (IdISBa), Carretera de Valldemossa, 79. Hospital Universitari Son Espases, Ed S., 070112, Palma, Spain
| | - Ruth Martí-Lluch
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
- Unitat de suport a la recerca de Girona. Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Carrer Maluquer Salvador 11, 17002, Girona, Spain
- Group of research in Vascular Health, Girona Biomedical Research Institute (IdibGi), Parc Hospitalari Martí Julià - Edifici M2, Carrer del Dr. Castany, s/n, 17190, Salt, Spain
| | - Caterina Vicens
- Institut de Investigació Sanitària de les Illes Balears (IdISBa), Carretera de Valldemossa, 79. Hospital Universitari Son Espases, Ed S., 070112, Palma, Spain
- Centro de Salud Son Serra-La Vileta (Ibsalut), Masanella 22, 07013, Palma, Balearic Islands, Spain
- Facultat de Medicina. Universitat de les Illes Balears, Carretera de Valldemossa, km 7.5, 07122, Palma, Balearic Islands, Spain
| | - Emma Motrico
- Universidad Loyola Andalucía, Avda. de las Universidades, s/n, 41704, Dos Hermanas, Sevilla, Spain
| | - Irene Gómez-Gómez
- Universidad Loyola Andalucía, Avda. de las Universidades, s/n, 41704, Dos Hermanas, Sevilla, Spain
| | - José-Ángel Maderuelo-Fernández
- Institute of Biomedical Research of Salamanca (IBSAL), Edificio Virgen de la Vega, 10.a planta. Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Avda. Portugal 83, 37005, Salamanca, Spain
- Health Service of Castilla y León (SACyL), C/ Arapiles, 25 - 33, 37007, Salamanca, Spain
| | - José I Recio-Rodriguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Avda. Portugal 83, 37005, Salamanca, Spain
- Departamento de Enfermería y Fisioterapia, Universidad de Salamanca, Calle Donantes de Sangre, s/n, 37007, Salamanca, Spain
| | - Barbara Masluk
- Departamento de Psicología y Sociología, Universidad de Zaragoza, C/Pedro Cerbuna 12, 50009, Zaragoza, Spain
- Grupo Aragonés de Investigación en Atención Primaria (GAIAP), Instituto de Investigación Sanitaria, Avda. San Juan Bosco 13, 50009, Zaragoza, Spain
| | - Sara Contreras-Martos
- Unitat de Recerca, Atenció Primaria de Mallorca, Servei de Salut de les Illes Balears, C/Escola Graduada 3, 07002, Palma, Spain
- Institut de Investigació Sanitària de les Illes Balears (IdISBa), Carretera de Valldemossa, 79. Hospital Universitari Son Espases, Ed S., 070112, Palma, Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
| | - Ignacio Aznar-Lou
- Research and Development Unit, Institut de Recerca Sant Joan de Déu, C\ Doctor Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029, Madrid, Spain
| | - Montserrat Gil-Girbau
- Research and Development Unit, Institut de Recerca Sant Joan de Déu, C\ Doctor Antoni Pujadas 42, 08830, Sant Boi de Llobregat, Spain
| | - Ana Clavería
- Área de Xestión Integrada de Vigo, Servizio Galego de Saúde, c/Rosalía Castro 21-23, 36201, Vigo, Spain
- Instituto de Investigación Sanitaria Galicia Sur, Hospital Álvaro Cunqueiro, Bloque Técnico, Planta 2, Carretera Clara Campoamor n° 341, Beade, 36213, Vigo, Spain
| | - Rosa Magallón-Botaya
- Facultad de Medicina, Universidad de Zaragoza, c/ Domingo Miral s/n, 50009, Zaragoza, Spain
- Arrabal Health Centre, Servicio Aragonés de Salud, Andador Aragüés del Puerto 3, 50015, Zaragoza, Spain
- Institute of health research of Aragon (IIS Aragón), Avda. San Juan Bosco, 13, 50009, Zaragoza, Spain
| | - Juan-Ángel Bellón
- Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Civil Pabellón 5. 2a Planta, Plaza del Hospital Civil, s/n, 29009, Málaga, Spain
- El Palo Health Centre', Andalusian Health Service (SAS), Avenida Salvador Allende 159, 29018, Málaga, Spain
- Department of Public Health and Psychiatry, Facultad de Medicina, University of Málaga (UMA), Campus de Teatinos, 29071, Málaga, Spain
| | - Rafel Ramos
- Unitat de suport a la recerca de Girona. Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Carrer Maluquer Salvador 11, 17002, Girona, Spain
- Group of research in Vascular Health, Girona Biomedical Research Institute (IdibGi), Parc Hospitalari Martí Julià - Edifici M2, Carrer del Dr. Castany, s/n, 17190, Salt, Spain
- Department of Medical Sciences, School of Medicine, Campus Salut, Universitat de Girona, Emili Grahit 77, 17003, Girona, Spain
| | - Alvaro Sanchez-Perez
- Primary Care Research Unit, Deputy Directorate of Healthcare Assistance- BioCruces Bizkaia Health Research Institute, Basque Healthcare Service -Osakidetza, Plaza Cruces s/n, E-48903, Barakaldo, Spain
| | - Patricia Moreno-Peral
- Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Civil Pabellón 5. 2a Planta, Plaza del Hospital Civil, s/n, 29009, Málaga, Spain
| | - Alfonso Leiva
- Unitat de Recerca, Atenció Primaria de Mallorca, Servei de Salut de les Illes Balears, C/Escola Graduada 3, 07002, Palma, Spain
- Institut de Investigació Sanitària de les Illes Balears (IdISBa), Carretera de Valldemossa, 79. Hospital Universitari Son Espases, Ed S., 070112, Palma, Spain
| | - Clara González-Formoso
- Instituto de Investigación Sanitaria Galicia Sur, Hospital Álvaro Cunqueiro, Bloque Técnico, Planta 2, Carretera Clara Campoamor n° 341, Beade, 36213, Vigo, Spain
- Unidade de Calidade de Coidados, Área sanitaria de Vigo. Hospital Álvaro Cunqueiro, Estrada Clara Campoamor n° 341, 36312, Vigo, Spain
| | - Bonaventura Bolíbar
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Bellaterra, Spain
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Murakami M, Aoki T, Sugiyama Y, Takeuchi M, Yui T, Koyama M, Ichikawa Y, Yanagisawa K, Furuhata S, Ikezoe M, Ota T, Matsushima M. Association between the transtheoretical model approach and sustained intradialytic pedaling exercise: A retrospective cohort study. Medicine (Baltimore) 2021; 100:e27406. [PMID: 34678867 PMCID: PMC8542113 DOI: 10.1097/md.0000000000027406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/17/2021] [Indexed: 11/26/2022] Open
Abstract
The transtheoretical model (TTM) is a promising approach to the promotion of behavior change, but it remains to be established whether there is an association between the TTM approach and intradialytic exercise among patients on hemodialysis (HD) with low motivation to exercise in a real-world setting.This retrospective cohort study, conducted in a regional hospital in Japan, included adult outpatients receiving HD 3 times per week who had never participated in intradialytic pedaling exercise despite the encouragement of the HD personnel. Patients were divided into 2 groups according to HD weekday. Patients undergoing HD on Tuesday, Thursday, and Saturday were encouraged by the HD unit team to exercise during HD based on the TTM (exposure group) and those receiving HD on Monday, Wednesday, and Friday were encouraged to exercise as usual (control group). The primary outcome was sustained intradialytic exercise using a leg ergometer, defined as a total of 72 sessions of 30-minute pedaling exercise (duration of at least 6 months).Overall, 85 patients were included in the analysis (mean age: 67.1 ± 11.9 years, 22% female). Of 33 patients in the exposure group, 10 (30%) maintained intradialytic exercise, compared with 2 of 52 patients (4%) in the control group. Log-binomial regression models with stabilized inverse probability of treatment weighting showed a significant association between the TTM approach and sustained intradialytic exercise (adjusted risk ratio 9.23 [95% confidence interval 2.13-40.00]). There were no exercise-related cardiovascular events.Among patients with low motivation to exercise during HD, use of the TTM approach in clinical practice was associated with sustained intradialytic exercise compared with usual care.
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Affiliation(s)
- Minoru Murakami
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
- Department of Nephrology, Saku Central Hospital, Nagano, Japan
| | - Takuya Aoki
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshifumi Sugiyama
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
- Division of Community Health and Primary Care, Center for Medical Education, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Tomoko Yui
- Dialysis Unit, Saku Central Hospital, Nagano, Japan
| | - Miyuki Koyama
- Department of Nursing, Saku Central Hospital, Nagano, Japan
| | - Yuhei Ichikawa
- Department of Pharmacy, Saku Central Hospital, Nagano, Japan
| | - Kazuki Yanagisawa
- Department of Clinical Engineering, Saku Central Hospital, Nagano, Japan
| | | | - Masaya Ikezoe
- Department of Nephrology, Saku Central Hospital, Nagano, Japan
| | - Tadashi Ota
- Division of Rehabilitation Medicine, Saku Central Hospital, Nagano, Japan
| | - Masato Matsushima
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
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Han X, Li P, Yang Y, Liu X, Xia J, Wu W. An Exploration of the Application of Step Counter-Based Physical Activity Promotion Programs in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review. Front Public Health 2021; 9:691554. [PMID: 34631641 PMCID: PMC8495070 DOI: 10.3389/fpubh.2021.691554] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This paper aimed to systematically review the application methods and components of step counter-based physical activity (PA) promotion programs in patients with chronic obstructive pulmonary disease (COPD). The effects of longer-duration (≥12 weeks) programs on PA, exercise capacity, quality of life, and dyspnea were discussed. Methods: This review was performed in accordance with the preferred reporting items for systematic reviews and meta-analysis. Online data resources PubMed, Web of Science, Embase, and EBSCO were searched. The publication year was limited between January 2000 to August 2020. All randomized controlled trials with ≥12-week duration of step counter-based PA promotion programs of COPD were included. Two researchers independently assessed the quality of the included studies and extracted their characteristics. Results: Nine studies involving 1,450 participants were included. Step counters, counseling, exercise goals, diaries, and tele-communicational approaches were common components of these programs. The PA feedback tools were mostly pedometers (n = 8), whereas accelerometers were often used as assessment tools of PA (n = 5). All studies implemented counseling: five applied behavioral change theories, and three reported motivational interview techniques simultaneously. Six studies reported detailed exercise goals. The usual exercise goal was to reach a total of 8,000–10,000 steps/day. Three research studies used diaries, and five applied tele-communication approaches to deliver interventions. The programs could be implemented alone (n = 4), in combination with exercise training (n = 2), or with pulmonary rehabilitation (n = 2). All studies showed a significant increase in the PA (≥793 steps/day). Three studies observed a significant improvement in exercise capacity (≥13.4 m), and two reported a significant increase in the quality of life (p < 0.05). No study showed significant between-group differences in dyspnea. Conclusion: There are a few studies assessing the impact of long-duration (≥12 weeks) step counter-based interventions in COPD, with different methodologies, although all studies included counseling and exercise goal setting. These interventions seem to have a positive effect on PA. A few studies also showed benefit on exercise capacity and quality of life.
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Affiliation(s)
- Xiaoyu Han
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Peijun Li
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yahui Yang
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xiaodan Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jun Xia
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Weibing Wu
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
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Implementation of the EIRA 3 Intervention by Targeting Primary Health Care Practitioners: Effectiveness in Increasing Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910537. [PMID: 34639836 PMCID: PMC8507856 DOI: 10.3390/ijerph181910537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/29/2021] [Accepted: 10/02/2021] [Indexed: 11/17/2022]
Abstract
The World Health Organization (WHO) estimated that physical inactivity (PI) is responsible for 20 to 30% of all non-communicable diseases. We aimed to analyze the effectiveness of a multiple health behavior change (MHBC) intervention to increase physical activity (PA) in patients 45 to 75 years old who had at least 2 of 3 unhealthy behaviors (tobacco use, reduced fruit and vegetable consumption, and insufficient PA). The MHBC intervention is based on the Transtheoretical Model and the conceptual framework of the "5 A's" and includes an individually tailored intervention, group sessions, and the use of community resources. We included 3062 participants, 1481 in the intervention group and 1581 in the control group. After 12 months, there were no differences in PA intensity measured by metabolic_equivalent_of_task_minutes/week (adjusted mean difference: 284.093, 95% CI: -298.24, 866.42) nor in the proportion of participants who increased PA levels to moderate or high (OR: 1.02, 95% CI: 0.85, 1.23; p = 0.822), and no differences in blood pressure, weight loss, or waist circumference. We found an increased proportion of patients in the intervention group who followed the WHO recommendations for PA (OR: 1.29; 95% CI: 1.04, 1.60; p = 0.02). We concluded that the intervention did not lead to a significant increase in PA.
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"My Patients Asked Me If I Owned a Fruit Stand in Town or Something." Barriers and Facilitators of Personalized Dietary Advice Implemented in a Primary Care Setting. J Pers Med 2021; 11:jpm11080747. [PMID: 34442392 PMCID: PMC8399817 DOI: 10.3390/jpm11080747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 12/16/2022] Open
Abstract
Primary care is especially well positioned to address prevention of non-communicable diseases. However, implementation of health promotion activities such as personalized dietary advice is challenging. The study aim was to understand barriers and facilitators of the personalized dietary advice component of a lifestyle intervention in primary care, as perceived by health center professionals and program participants. Thirteen focus groups were conducted with 49 professionals and 47 participants. Audio recordings were transcribed. Professional group text was coded using the Consolidated Framework for Implementation Research (CFIR). Participant group text was coded via an inductive approach with thematic analysis. Across most CFIR domains, both barriers and facilitators were equally present, except for ‘characteristics of individuals’, which were primarily facilitators. Intervention characteristics was the most important domain, with barriers in design and packaging (e.g., the ICT tool) and complexity. Facilitators included high evidence strength and quality, adaptability, and relative advantage. Participants described the importance of more personalized advice, the value of follow-up with feedback, and the need to see outcomes. Both professionals and patients stated that primary care was the place for personalized dietary advice intervention, but that lack of time, workload, and training were barriers to effective implementation. Implementation strategies targeting these modifiable barriers could potentially increase intervention adoption and intervention effectiveness.
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Aznar-Lou I, Zabaleta-Del-Olmo E, Casajuana-Closas M, Sánchez-Viñas A, Parody-Rúa E, Bolíbar B, Iracheta-Todó M, Bulilete O, López-Jiménez T, Pombo-Ramos H, Martín Miguel MV, Magallón-Botaya R, Maderuelo-Fernández JÁ, Motrico E, Bellón J, Martí-Lluch R, Rubio-Valera M, Serrano-Blanco A. Cost-effectiveness analysis of a multiple health behaviour change intervention in people aged between 45 and 75 years: a cluster randomized controlled trial in primary care (EIRA study). Int J Behav Nutr Phys Act 2021; 18:88. [PMID: 34215275 PMCID: PMC8254273 DOI: 10.1186/s12966-021-01144-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/27/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Multiple health behaviour change (MHBC) interventions that promote healthy lifestyles may be an efficient approach in the prevention or treatment of chronic diseases in primary care. This study aims to evaluate the cost-utility and cost-effectiveness of the health promotion EIRA intervention in terms of MHBC and cardiovascular reduction. METHODS An economic evaluation alongside a 12-month cluster-randomised (1:1) controlled trial conducted between 2017 and 2018 in 25 primary healthcare centres from seven Spanish regions. The study took societal and healthcare provider perspectives. Patients included were between 45 and 75 years old and had any two of these three behaviours: smoking, insufficient physical activity or low adherence to Mediterranean dietary pattern. Intervention duration was 12 months and combined three action levels (individual, group and community). MHBC, defined as a change in at least two health risk behaviours, and cardiovascular risk (expressed in % points) were the outcomes used to calculate incremental cost-effectiveness ratios (ICER). Quality-adjusted life-years (QALYs) were estimated and used to calculate incremental cost-utility ratios (ICUR). Missing data was imputed and bootstrapping with 1000 replications was used to handle uncertainty in the modelling results. RESULTS The study included 3062 participants. Intervention costs were €295 higher than usual care costs. Five per-cent additional patients in the intervention group did a MHBC compared to usual care patients. Differences in QALYS or cardiovascular risk between-group were close to 0 (- 0.01 and 0.04 respectively). The ICER was €5598 per extra health behaviour change in one patient and €6926 per one-point reduction in cardiovascular risk from a societal perspective. The cost-utility analysis showed that the intervention increased costs and has no effect, in terms of QALYs, compared to usual care from a societal perspective. Cost-utility planes showed high uncertainty surrounding the ICUR. Sensitivity analysis showed results in line with the main analysis. CONCLUSION The efficiency of EIRA intervention cannot be fully established and its recommendation should be conditioned by results on medium-long term effects. TRIAL REGISTRATION Clinicaltrials.gov NCT03136211 . Registered 02 May 2017 - Retrospectively registered.
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Affiliation(s)
- Ignacio Aznar-Lou
- Research and development Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Dr. Antoni Pujades 42, 08830, Sant Boi de Llobregat, Barcelona, Catalonia, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
| | - Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain
- Departament d'Infermeria, Facultat d'Infermeria, Universitat de Girona, Girona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Marc Casajuana-Closas
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Primary Care Prevention and Health Promotion Network (redIAPP), Palma de Mallorca, Spain
| | - Alba Sánchez-Viñas
- Research and development Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Dr. Antoni Pujades 42, 08830, Sant Boi de Llobregat, Barcelona, Catalonia, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Elizabeth Parody-Rúa
- Research and development Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Dr. Antoni Pujades 42, 08830, Sant Boi de Llobregat, Barcelona, Catalonia, Spain
| | - Bonaventura Bolíbar
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Primary Care Prevention and Health Promotion Network (redIAPP), Palma de Mallorca, Spain
| | - Montserrat Iracheta-Todó
- Research and development Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Dr. Antoni Pujades 42, 08830, Sant Boi de Llobregat, Barcelona, Catalonia, Spain
- Primary Care Prevention and Health Promotion Network (redIAPP), Palma de Mallorca, Spain
| | - Oana Bulilete
- Primary Care Research Unit, Mallorca, Balearic Public Health Service, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Tomàs López-Jiménez
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Haizea Pombo-Ramos
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | | | - Rosa Magallón-Botaya
- IIS-Aragón Grupo b21-17R, Universidad de Zaragoza, Zaragoza, Spain
- CS Arrabal.Servicio Aragonés de Salud, Zaragoza, Spain
| | - Jose Ángel Maderuelo-Fernández
- Primary Health Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Emma Motrico
- Primary Care Prevention and Health Promotion Network (redIAPP), Palma de Mallorca, Spain
- Universidad Loyola Andalucía, Sevilla, Spain
| | - Juan Bellón
- Primary Care Prevention and Health Promotion Network (redIAPP), Palma de Mallorca, Spain
- Centro de Salud El Palo, Málaga, Spain
- Department of Preventive Medicine, University of Málaga, Málaga, Spain
- Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Ruth Martí-Lluch
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- ISV Research Group, Research Unit in Primary Care, Primary Care Services, Girona, Catalan Institute of Health (ICS), Girona, Catalonia, Spain
- Biomedical Research Institute, Girona (IdIBGi), ICS, Girona, Catalonia, Spain
| | - Maria Rubio-Valera
- Research and development Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Dr. Antoni Pujades 42, 08830, Sant Boi de Llobregat, Barcelona, Catalonia, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Antoni Serrano-Blanco
- Research and development Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Dr. Antoni Pujades 42, 08830, Sant Boi de Llobregat, Barcelona, Catalonia, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
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The Mediating Role of Self-Regulation and Self-Efficacy on Physical Activity Change in Community-Dwelling Older Adults (≥65 Years): An Experimental Cross-Lagged Analysis Using Data From SITLESS. J Aging Phys Act 2021; 29:931-940. [PMID: 34135127 DOI: 10.1123/japa.2020-0322] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/22/2020] [Accepted: 12/08/2020] [Indexed: 11/18/2022]
Abstract
Improving the capacity for physical activity interventions to maintain behavior change is a key public health concern and an important strategy for the health and independence of older adults. Ways of ensuring effective maintenance of physical activity levels in older adults are unclear. This study includes the objective measure of moderate-to-vigorous physical activity (MVPA); self-reported self-efficacy; and self-regulation at four timepoints (baseline, intervention completion at 4 months, 12-, and 18-month follow-up) from the SITLESS study, a clinical trial conducted with a cohort of community-dwelling older adults (≥65 years) from Denmark, Germany, Spain, and the United Kingdom. A cross-lagged analysis found that self-regulation and self-efficacy may be key determinants of MVPA behavior in community-dwelling older adults. More specifically, the use of behavioral support strategies represents an important correlate of MVPA behavior, and its association with MVPA may be mediated by self-regulation and self-efficacy in older adults in the short and long term.
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Andrade AQ, Beleigoli A, Diniz MDF, Ribeiro AL. Influence of Baseline User Characteristics and Early Use Patterns (24-Hour) on Long-Term Adherence and Effectiveness of a Web-Based Weight Loss Randomized Controlled Trial: Latent Profile Analysis. J Med Internet Res 2021; 23:e26421. [PMID: 34081012 PMCID: PMC8212621 DOI: 10.2196/26421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/22/2021] [Accepted: 05/06/2021] [Indexed: 01/20/2023] Open
Abstract
Background Low adherence to real-world online weight loss interventions reduces long-term efficacy. Baseline characteristics and use patterns are determinants of long-term adherence, but we lack cohesive models to guide how to adapt interventions to users’ needs. We also lack information whether very early use patterns (24 hours) help describe users and predict interventions they would benefit from. Objective We aim to understand the impact of users’ baseline characteristics and early (initial 24 hours) use patterns of a web platform for weight loss on user adherence and weight loss in the long term (24 weeks). Methods We analyzed data from the POEmaS randomized controlled trial, a study that compared the effectiveness of a weight loss platform with or without coaching and a control approach. Data included baseline behavior and use logs from the initial 24 hours after platform access. Latent profile analysis (LPA) was used to identify classes, and Kruskal-Wallis was used to test whether class membership was associated with long-term (24 weeks) adherence and weight loss. Results Among 828 participants assigned to intervention arms, 3 classes were identified through LPA: class 1 (better baseline health habits and high 24-hour platform use); class 2 (better than average health habits, but low 24-hour platform use); class 3 (worse baseline health habits and low 24-hour platform use). Class membership was associated with long-term adherence (P<.001), and class 3 members had the lowest adherence. Weight loss was not associated with class membership (P=.49), regardless of the intervention arm (platform only or platform + coach). However, class 2 users assigned to platform + coach lost more weight than those assigned to platform only (P=.02). Conclusions Baseline questionnaires and use data from the first 24 hours after log-in allowed distinguishing classes, which were associated with long-term adherence. This suggests that this classification might be a useful guide to improve adherence and assign interventions to individual users. Trial Registration ClinicalTrials.gov NCT03435445; https://clinicaltrials.gov/ct2/show/NCT03435445 International Registered Report Identifier (IRRID) RR2-10.1186/s12889-018-5882-y
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Affiliation(s)
- Andre Q Andrade
- Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, Australia
| | - Alline Beleigoli
- Flinders Digital Health Research Centre, Flinders University, Adelaide, Australia.,Caring Futures Institute, Flinders University, Adelaide, Australia.,Adult Health Sciences Post Graduation Course, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria De Fatima Diniz
- Adult Health Sciences Post Graduation Course, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Antonio Luiz Ribeiro
- Centre of Telehealth of the Hospital das Clinicas da UFMG, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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19
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Martín-Payo R, Papín-Cano C, Fernández-Raigada RI, Santos-Granda MI, Cuesta M, González-Méndez X. Motiva.DM2 project. A pilot behavioral intervention on diet and exercise for individuals with type 2 diabetes mellitus. Diabetes Res Clin Pract 2021; 171:108579. [PMID: 33307132 DOI: 10.1016/j.diabres.2020.108579] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/28/2020] [Accepted: 11/20/2020] [Indexed: 02/08/2023]
Abstract
AIM The purpose of this study was to assess the efficacy of an educational intervention based on the Behavior Change Wheel (BCW) framework for individuals with type 2 diabetes mellitus (DM2) on dietary and exercise behavior in a Spanish region. METHODS A two-arm pilot research was developed. The intervention consisted of a 6-month period with guidelines and 4 in-person interventions. The outcome was changes in behaviors, motivation, competence, autonomy, social support to implement the recommendations, HbA1c, and body composition. RESULTS n = 111 patients were recruited. Individuals in the intervention experienced a significative improvement on adherence to dietary recommendations (+1.23; p = 0.026), exercise (+0.86; p = 0.001), and a decrease in HbA1c levels (-0.6%; p = 0.002) and BMI (-0.73; p < 0.001). CONCLUSION The intervention for DM2 individuals, based on the BCW framework, developed, and implemented by primary care nurses has been effective in improving the adherence to healthy eating, exercise, HbA1c levels, and body composition.
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Affiliation(s)
- R Martín-Payo
- Faculty of Medicine and Health Sciences, University of Oviedo, Spain; PRECAM Research Team, Health Research Institute of the Principality of Asturias, Spain.
| | - C Papín-Cano
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Spain; Health Service of the Principality of Asturias (Area 3), Spain
| | | | | | - M Cuesta
- Faculty of Psychology, University of Oviedo, Spain
| | - X González-Méndez
- Faculty of Medicine and Health Sciences, University of Oviedo, Spain; PRECAM Research Team, Health Research Institute of the Principality of Asturias, Spain; Health Service of the Principality of Asturias (Area 3), Spain
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21
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Calonge-Pascual S, Fuentes-Jiménez F, Casajús Mallén JA, González-Gross M. Design and Validity of a Choice-Modeling Questionnaire to Analyze the Feasibility of Implementing Physical Activity on Prescription at Primary Health-Care Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6627. [PMID: 32932923 PMCID: PMC7559833 DOI: 10.3390/ijerph17186627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/27/2020] [Accepted: 09/03/2020] [Indexed: 11/17/2022]
Abstract
Worldwide health policies are trying to implement physical activity on prescription (PAP) at healthcare settings. However, there is not a proper methodology to analyze PHC organizational staff factors. This study aims to validate two questionnaires to assess the self-perception of nurses and general practitioners to implement PAP at primary healthcare (PHC) settings. The designed choice-modeling Google-form questionnaire was sent to 11 expert nurses and 11 expert sports medicine physicians. Experts evaluated each question on a 1-5 points Likert-type scale according to their expertise. Aiken's V coefficient values ≥0.75 were used to validate separately each question using the Visual Basic-6.0 software. A total of 10 sports medicine physicians and 10 nurses with 28.4 ± 5.1 y and 16.3 ± 11.8 y of PAP experience, respectively, validated the questionnaire. One expert in each group was not considered for offering 3 ± SD answers in ≥2 questions respect to the mean of the rest of experts. Final Aiken's V coefficient values were 0.89 (0.77-1.00) for the nurses' questionnaire and 0.84 (0.77-0.95) for the physicians' one. The questionnaires designed to assess the PAP self-perception of PHC nurses and physicians were validated. This methodology could be used to analyze PHC organizational staff factors in order to achieve an efficient PAP implementation in other PHC contexts.
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Affiliation(s)
- Sergio Calonge-Pascual
- ImFINE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, C/Martín Fierro 7, 28040 Madrid, Spain; (S.C.-P.); (F.F.-J.)
| | - Francisco Fuentes-Jiménez
- ImFINE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, C/Martín Fierro 7, 28040 Madrid, Spain; (S.C.-P.); (F.F.-J.)
| | - José A. Casajús Mallén
- GENUD Research Group, Faculty of Health Sciences, University of Zaragoza, Pedro Miral s/n, 50008 Zaragoza, Spain;
- Biomedical Research Center of Physiopathology of Obesity and Nutrition, CIBERobn, (CB12/03/30038), Carlos III Health Institute, Avenida de Monforte de Lemos 5, 28029 Madrid, Spain
| | - Marcela González-Gross
- ImFINE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, C/Martín Fierro 7, 28040 Madrid, Spain; (S.C.-P.); (F.F.-J.)
- Biomedical Research Center of Physiopathology of Obesity and Nutrition, CIBERobn, (CB12/03/30038), Carlos III Health Institute, Avenida de Monforte de Lemos 5, 28029 Madrid, Spain
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22
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Sherman MD, Hooker SA. Family medicine physicians' confidence and perceived effectiveness in delivering health behaviour change interventions. Fam Pract 2020; 37:493-498. [PMID: 31967296 DOI: 10.1093/fampra/cmaa001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Approximately 40% of deaths in the USA are attributable to modifiable health behaviours. Despite clear recommendations and practice guidelines, primary care physicians (PCPs) generally do not dedicate much time to addressing health behaviours, thereby missing opportunities to improve patient well-being. OBJECTIVE(S) To examine what health behaviour change techniques PCPs use with their patients, including frequency of use, confidence in and perceived effectiveness of those interventions. METHODS Using a cross-sectional study design, family medicine resident and faculty physicians (n = 68) from three residency training programs completed an anonymous online survey. Questions explored their use of, confidence in and perceived effectiveness of health behaviour change interventions for six domains: physical activity, healthy eating, medication adherence, smoking cessation, sleep and alcohol reduction. Qualitative responses to open-ended questions were double coded by two independent raters. PCPs' open-ended responses to questions regarding specific intervention techniques were coded using an evidence-based behaviour change taxonomy. RESULTS Although PCPs indicated that they address health behaviour topics quite frequently with their patients, they reported only moderate confidence and low-to-moderate perceived effectiveness with their interventions. The most frequently cited technique was providing instruction (telling patients what to do). PCPs reported lowest frequency of addressing, lowest confidence and lowest effectiveness regarding helping patients decrease their use of alcohol. Insufficient time and perceived low patient motivation were commonly cited barriers. CONCLUSION These findings highlight the need for the development and evaluation of educational curricula to teach physicians brief, evidence-based approaches to helping patients make these changes in their health-related behaviours.
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Affiliation(s)
- Michelle D Sherman
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Stephanie A Hooker
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Joachim-Célestin M, Gamboa-Maldonado T, Dos Santos H, Montgomery SB. A Qualitative Study on the Perspectives of Latinas Enrolled in a Diabetes Prevention Program: Is the Cost of Prevention Too High? J Prim Care Community Health 2020; 11:2150132720945423. [PMID: 32755275 PMCID: PMC7543125 DOI: 10.1177/2150132720945423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Latinas are among the groups most affected by diabetes health disparities, yet they often benefit less from diabetes interventions even when these are culturally adapted. The purpose of this qualitative study was to explore readiness of Latinas enrolled in a diabetes prevention program to adopt recommended preventive behaviors, and to identify factors associated with the adoption and maintenance of these recommended lifestyle changes. Insights gained will be used to inform future efforts at reducing diabetes disparities and the burden of chronic diseases among Latinas. Methods: Nine focus group discussions (FGDs) and 3 key informant interviews (KIIs) were conducted after the completion of a culturally adapted diabetes prevention program led by Latino community health workers. A grounded theory approach by Charmaz informed by the transtheoretical model guided the questions. Discussions and interviews were audio-taped with participants’ permission, transcribed, coded, and themed. Results: Forty low-income Latinas contributed to FGDs and KIIs. Baseline readiness to engage in new behaviors varied. Negative personal and family health events and physician referral impacted most readiness to enroll and to adopt preventive behaviors. Built environment, financial constraints, and threat of social alienation constituted major barriers to behavior adoption and maintenance, while physician involvement, awareness of diabetes complications, and social support partially mitigated these impediments. Conclusions: Our results suggest that timing of enrollment, physician-patient dynamics, and the emotional personal/family cost of behavior modification should all be considered when planning diabetes prevention programs for low-income Latinas. Besides appropriately timing referrals to accessible culturally informed prevention programs, health educators and health care providers should be aware of the potentially negative impact of behavior modification on family dynamics and be prepared to address resulting repercussions. Future research on Latinas should also include and report data on physician involvement, family context, and social determinants of health for more consistent program comparisons.
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Abstract
The importance and value of behavioral sciences in dentistry have long been recognized, and their contribution to dental education, research, clinical practice, and oral health policy has been significant over the past half century. Over time behavioral sciences have expanded our understanding of oral health beyond "disease" to a broader biopsychosocial concept of oral health. This in turn has led dentistry away from a focus of "treatment" to oral health "care," notably in the new millennium. Key oral health behaviors have been identified for more than half a century: the importance of diet, oral hygiene, dental services, and other factors. Various behavioral models and theories have been proposed, particularly since the 1970s, providing useful frameworks with sound psychological basis to help understand the paths of oral health behaviors. These models draw on theories of self-efficacy, motivation, counseling, and "behavior change." Since the 1980s, there has been a greater understanding that these behaviors often share a common pathway with the etiology of other diseases (common risk factors). Furthermore, the relationship between individual factors and the broader environmental factors has been increasingly emphasized since the 1990s, leading to a united call for action in addressing oral health inequalities. Within the past decade, there are useful examples of models, frameworks, and techniques of behavior change with respect to oral health, involving planning, prompting, encouraging, goal setting, and/or motivating. In particular, there is a growing interest and use of motivational interviewing. Likewise, behavioral therapies, such as cognitive behavioral therapy, are increasingly being employed in dental practice in the management of dental anxiety, pain, and psychosomatic dental and oral problems, with promising results. Recommendations are outlined for future directions for behavioral sciences in the promotion of oral health.
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Affiliation(s)
- C McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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25
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Albert FA, Crowe MJ, Malau-Aduli AEO, Malau-Aduli BS. Functionality of Physical Activity Referral Schemes (PARS): A Systematic Review. Front Public Health 2020; 8:257. [PMID: 32671011 PMCID: PMC7329989 DOI: 10.3389/fpubh.2020.00257] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/21/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Physical activity (PA) is vital to maintaining good health. However, WHO estimates that 60% of the world's population are inadequately active. To enhance PA, Physical Activity Referral Schemes (PARS) have been established by some countries. Objective: This study examined the functionality of the PARS process across different countries. Methods: This systematic review was performed and reported in accordance with the PRISMA guidelines. Sixteen electronic databases were searched from January 1990 to May 2020. PARS studies, published in English language and in peer-reviewed journals, that reported adherence, outcomes, disease conditions, interventions, facilitators and barriers, were included in this review. Results: Twenty-seven studies conducted across eight countries met the inclusion criteria. Most patients were referred for sedentary/inactivity reasons and supervised group-based activities was the most used intervention. Participants' average adherence rate was 77.5%. Adherence was either facilitated or hindered by type of support provided during and after intervention period. Inclusion of PA allied health specialist in the intervention enhanced positive health outcomes. Conclusion: PARS is a key driver and motivator for individuals to undertake and adhere to PA interventions. Utilization of guidelines on evidence-based interventional PA for different types of diseases, effective use of common group supervised activities and the involvement of PA specialists may aid PA adherence and foster positive health outcomes.
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Affiliation(s)
- Francis Ali Albert
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
| | - Melissa J Crowe
- Division of Tropical Health and Medicine, James Cook University, Douglas, QLD, Australia
| | - Aduli E O Malau-Aduli
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, QLD, Australia
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
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Differences in Lifestyle Behaviours of Students between Inner Urban and Peri-urban High Schools: A Cross-Sectional Study in Chongqing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072282. [PMID: 32231112 PMCID: PMC7177544 DOI: 10.3390/ijerph17072282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/15/2022]
Abstract
Background: Lifestyle behaviours of students from schools in different socioeconomic areas may be different. Few studies have investigated such topics in China. This study aimed to explore the differences in lifestyle behaviours between inner urban high school students (IUHSSs) and peri-urban high school students (PUHSSs). Methods: A cross-sectional survey based on a self-report questionnaire was administered among 1560 high school students (726 from inner urban high schools and 834 from peri-urban high schools) in Chongqing, China. Physical activity, sleep time, screen time and dietary behaviours were assessed according to a series of recommendations of Chinese guidelines. Results: No significant difference was found in meeting the recommendation for daily physical activity between IUHSSs and PUHSSs (7.6% vs. 6.8%, p > 0.05). PUHSSs were more likely to meet the recommendations of weekdays’ sleep time (14.9% vs. 5.4%, p < 0.001), weekdays’ and weekends’ screen time (85.4% vs. 76.7%, p < 0.001; 21.1% vs. 14.3%, p < 0.001), and had higher proportion of high-score group of dietary behaviours (58.6% vs. 36.4%, p < 0.001) than those of IUHSSs. IUHSSs were more likely to meet the recommendation of weekends’ sleep time (75.6% vs. 67.9%, p < 0.001) than that of PUHSSs. Conclusions: A low proportion met the recommendations of physical activity, weekdays’ sleep time and weekends’ screen time among high school students in Chongqing, China. Lifestyle behaviours may differ between inner urban and peri-urban high school students. Additional support or targeted health education should be provided by high schools to improve the lifestyle behaviours of students, especially in inner urban districts.
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Al Rawahi SH, Asimakopoulou K, Masood M, Al Bulushi NM, Al Yaqoobi KH, Newton JT. The Psychological Models of Health-related Behavior in Understanding Sugars Intake in Adults: A Review. Oman Med J 2020; 35:e114. [PMID: 32308991 PMCID: PMC7151060 DOI: 10.5001/omj.2020.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/30/2019] [Indexed: 12/19/2022] Open
Abstract
Free sugars intake plays a major role in dental caries formation and other general health issues such as obesity. Therefore, interventions, which assist individuals or populations in the control of their free sugars intake, are of central importance in caries prevention strategies. There is good evidence that behavioral interventions benefit from a foundation in conceptual theories of behavior change founded on empirical data. In this review, we discuss the future application of seven theories, including six common psychological theories in predicting and developing interventions to reduce free sugars intake related to dental caries among adults. For each model, we summarize its key features and the data derived from its application in general and oral health settings and make recommendations for future research. We searched Medline, PsycINFO, Global Health, PubMed, and Embase databases to identify items dealing with dental caries, adults, sugars intake, and six psychological theories. These included the Transtheoretical Model of Change, Theory of Planned Behavior, Social Cognitive Theory, Information-Motivation-Behavioral Skills model, PRIME Theory, and Behavior Change Wheel theories. We searched literature published in the last 10 years, and priority was given to systematic reviews and randomized control trials. Although there is extensive literature on the application of the six psychological theories, there is a gap in knowledge about their effectiveness in reducing free sugars intake related to dental caries among adults. There is a need for better-designed trials of interventions based on the clear operationalization of psychological constructs to reduce sugars intake among the adult population.
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Affiliation(s)
| | - Koula Asimakopoulou
- Department of Population and Patient Health, Dental Institute, King’s College London, London, UK
| | - Mohd Masood
- Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Melbourne, Australia
| | | | | | - Jonathon Timothy Newton
- Department of Population and Patient Health, Dental Institute, King’s College London, London, UK
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Esteban-Vasallo MD, García-Riolobos C, Domínguez-Berjón MF, Zoni AC. Lifestyle interventions for cancer prevention in primary care: Differences between family physicians and nursing professionals. J Eval Clin Pract 2020; 26:326-334. [PMID: 31197908 DOI: 10.1111/jep.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Prevention offers the most cost-effective long-term strategy for cancer control. The objective of this study was to ascertain opinions, attitudes, and professional practices towards cancer prevention among primary care professionals and to assess differences between family physicians (FP) and nursing professionals (NP). METHOD A cross-sectional study was performed in 2012 in the Community of Madrid. A random sample of 3586 professionals received an online questionnaire about opinions/attitudes, training, and interventions in cancer prevention. The chi-square test was used to analyse the association of the profession with all the variables. Factors associated with the usual practice of individual, group, and community interventions were analysed using multivariate logistic regression, with separate models for FP and NP. RESULTS The response rate was 39.4% (N = 1413). Approximately 90% of the participants attributed "sufficient/high" utility to individualized counselling. NP attributed higher utility to group and community interventions than FP (70.1% vs 60.1% and 64.9% vs 57.7%, respectively, P-value < 0.01). The usual practice of group and community interventions was more frequent among NP. The practice of group and community interventions was associated with knowledge of resources for prevention, specific training in group interventions, and the utility attributed to these methods. Among FP, the ability to dispense effective health advice and the utility attributed to this advice were associated with the usual practice of the three interventions. CONCLUSIONS Group and community interventions are rarely practised, especially among FP. Actions targeting improved ability and knowledge could lead to higher involvement in the promotion of health. It would also be necessary to intervene in the examination of the utility of such interventions.
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Affiliation(s)
| | | | | | - Ana Clara Zoni
- Madrid Regional Health Authority, Public Health Directorate, Madrid, Spain
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Freyer-Adam J, Noetzel F, Baumann S, Aghdassi AA, Siewert-Markus U, Gaertner B, John U. Behavioral health risk factor profiles in general hospital patients: identifying the need for screening and brief intervention. BMC Public Health 2019; 19:1594. [PMID: 31783832 PMCID: PMC6884835 DOI: 10.1186/s12889-019-7931-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 11/08/2019] [Indexed: 11/30/2022] Open
Abstract
Background Little is known about the clustering of behavioral health risk factors (HRFs), namely the occurrence of 16 specific combinations of tobacco smoking, at-risk alcohol use, overweight and physical inactivity in general hospital patients. Furthermore, social inequalities in HRFs, health and life expectancy are a major concern in public health. In order to establish the need for screening and intervention in general hospital care, the study aimed to determine the co-occurrence of HRFs in patients in four medical departments, and to investigate differences by gender, age and socio-economic characteristics. Methods Over 17 months, a systematic multiple HRF screening was conducted at one general hospital in northeastern Germany. In total, 6251 18–64 year old patients (92% of eligibles) participated. Proportions and confidence intervals were calculated for all 16 HRF profiles stratified by department, gender, age group, school education, and employment status. Results In total, 92.2% of the participants (58.6% male) reported ≥1 HRF, and 65.7% ≥2 HRFs. Men (71.2%), patients aged 35–49 (67.9%) and 50–64 years (69.5%), lower educated (79.0%), and unemployed (77.8%) patients had larger proportions of ≥2 HRFs than their counterparts. In all departments, the most common HRF profiles included overweight. HRF profiles that included alcohol and/ or smoking were more common in ear-nose-throat and trauma surgery than in internal medicine and general surgery patients. Men had higher rates concerning almost all HRF profiles including ≥2 HRFs and alcohol; women concerning profiles that included ≤2 HRFs and inactivity. In older patients, profiles with ≥2 HRFs including overweight; and in younger patients, profiles with smoking and/or alcohol were more common. In lower educated patients, profiles with ≥2 HRFs including inactivity; and in higher educated patients profiles with ≤2 HRFs including alcohol were more common. Compared to others, unemployed patients had higher rates of profiles with ≥3 HRFs including smoking. Conclusions Two in three patients require interventions targeting two or more HRFs. The findings help to develop screening and brief intervention for patients with specific health risk profiles, that can reach most patients, including those most in need and those most hard to reach, with socio-economically disadvantaged people in particular. Registry clinicaltrials.gov: NCT01291693.
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Affiliation(s)
- Jennis Freyer-Adam
- Institute for Medical Psychology, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany. .,German Center for Cardiovascular Research, Site Greifswald, Fleischmannstr. 42-44, 17475, Greifswald, Germany.
| | - Florian Noetzel
- Clinic and Policlinic of Urology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Sophie Baumann
- German Center for Cardiovascular Research, Site Greifswald, Fleischmannstr. 42-44, 17475, Greifswald, Germany.,Institute of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.,Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Ali Alexander Aghdassi
- Department of Internal Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Ulrike Siewert-Markus
- Institute for Medical Psychology, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.,German Center for Cardiovascular Research, Site Greifswald, Fleischmannstr. 42-44, 17475, Greifswald, Germany
| | - Beate Gaertner
- Department of Epidemiology and Health Monitoring, Robert Koch Institute Berlin, General-Pape-Str. 62-66, 12101, Berlin, Germany
| | - Ulrich John
- German Center for Cardiovascular Research, Site Greifswald, Fleischmannstr. 42-44, 17475, Greifswald, Germany.,Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Gil-Girbau M, Pons-Vigués M, Rubio-Valera M, Murrugarra G, Masluk B, Rodríguez-Martín B, García Pineda A, Vidal Thomás C, Conejo-Cerón S, Recio JI, Martínez C, Pujol-Ribera E, Berenguera A. Modelos teóricos de promoción de la salud en la práctica habitual en atención primaria de salud. GACETA SANITARIA 2019; 35:48-59. [PMID: 31753510 DOI: 10.1016/j.gaceta.2019.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/30/2019] [Accepted: 06/09/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Montse Gil-Girbau
- Research and Development Unit, Institut de Recerca Sant Joan de Déu, Barcelona, España; Primary Care Prevention and Health Promotion Research Network, Barcelona, España
| | - Mariona Pons-Vigués
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès, Barcelona), España; Universitat de Girona, Girona, España
| | - Maria Rubio-Valera
- Research and Development Unit, Institut de Recerca Sant Joan de Déu, Barcelona, España; Primary Care Prevention and Health Promotion Research Network, Barcelona, España; CIBER en Epidemiología y Salud Pública (CIBERESP), España; Facultad de Farmacia, Universidad de Barcelona, Barcelona, España
| | - Gabriela Murrugarra
- Research and Development Unit, Institut de Recerca Sant Joan de Déu, Barcelona, España
| | - Barbara Masluk
- Departmento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, España
| | | | | | - Clara Vidal Thomás
- Gabinete Técnico de la Gerencia de Atención Primaria de Mallorca, Servicio de Salud Illes Balears, Instituto de Investigación Sanitaria de les Illes Balears, España
| | - Sonia Conejo-Cerón
- Instituto de Investigación Biomédica de Málaga, Unidad de Investigación, Distrito de Atención Primaria Málaga-Guadalhorce, Málaga, España
| | - José Ignacio Recio
- Institute of Biomedical Research of Salamanca, Primary Health Care Research Unit, La Alamedilla (Salamanca), España
| | - Catalina Martínez
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Bilbao, España
| | - Enriqueta Pujol-Ribera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès, Barcelona), España; Universitat de Girona, Girona, España
| | - Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès, Barcelona), España.
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Joseph-Shehu EM, Ncama BP, Mooi N, Mashamba-Thompson TP. The use of information and communication technologies to promote healthy lifestyle behaviour: a systematic scoping review. BMJ Open 2019; 9:e029872. [PMID: 31662364 PMCID: PMC6830587 DOI: 10.1136/bmjopen-2019-029872] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Health-promoting lifestyle behaviours are part of the activities of daily living that influence individual happiness, values and well-being. They play a crucial role in prevention and control of non-communicable diseases (NCDs) among all age groups. Current statistics on mortality, disability and morbidity associated with NCDs are alarming globally. The use of information and communication technology (ICT) for a health-promoting lifestyle behaviour programme enhances health behaviours that are important in the prevention and control of both communicable and non-communicable diseases. Our study aimed to map evidence on the use of ICT in comprehensive health-promoting lifestyle behaviour among healthy adults. METHODS Eleven electronic databases were searched for the study. We included studies published in English between January 2007 and December 2018 reporting on healthy adults, ICT and any subscales of the health-promoting lifestyle profile (HPLP). Studies focusing on diseases or disease management and studies that combine monitoring tools in the form of hardware (accelerometer or pedometer) with ICT or computer games were excluded. Data were summarised numerically and thematically. RESULTS All the studies reviewed were conducted in developed countries. Most of the studies reported on physical activity, and findings of one study covered all the subscales of HPLP. The use of ICT for health-promoting lifestyle behaviours was reported to be effective in ensuring health behaviours that can improve physical and mental health. CONCLUSION Our findings showed that there is a dearth of knowledge on comprehensive health-promoting lifestyle behaviour that can be beneficial for the control and prevention of NCDs. There is a need to carry out primary studies on the use of ICT and comprehensive health-promoting lifestyle, especially among adults in low-income and middle-income countries where there are alarming statistics for mortality and disability associated with NCDs. PROSPERO REGISTRATION NUMBER CRD42016042568.
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Affiliation(s)
- Elizabeth Musili Joseph-Shehu
- Nursing, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
- Nursing Science, National Open University of Nigeria, Jabi, Abuja, Nigeria
| | - Busisiwe Purity Ncama
- Nursing, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
| | - Nomaxabiso Mooi
- Nursing, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
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Panagiotakos DB, Kouvari M. Behavioral healthy nutrition and physical activity counseling in cardiovascular disease prevention: where we are now? Hepatobiliary Surg Nutr 2019; 8:534-536. [PMID: 31673549 DOI: 10.21037/hbsn.2018.11.16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Department of Kinesiology and Health, School of Arts and Sciences, Rutgers University, New Brunswick, NJ, USA.,Faculty of Health, University of Canberra, Canberra, Australia.,School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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Katz DL, Karlsen MC, Chung M, Shams-White MM, Green LW, Fielding J, Saito A, Willett W. Hierarchies of evidence applied to lifestyle Medicine (HEALM): introduction of a strength-of-evidence approach based on a methodological systematic review. BMC Med Res Methodol 2019; 19:178. [PMID: 31429718 PMCID: PMC6701153 DOI: 10.1186/s12874-019-0811-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/25/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Current methods for assessing strength of evidence prioritize the contributions of randomized controlled trials (RCTs). The objective of this study was to characterize strength of evidence (SOE) tools in recent use, identify their application to lifestyle interventions for improved longevity, vitality, or successful aging, and to assess implications of the findings. METHODS The search strategy was created in PubMed and modified as needed for four additional databases: Embase, AnthropologyPlus, PsycINFO, and Ageline, supplemented by manual searching. Systematic reviews and meta-analyses of intervention trials or observational studies relevant to lifestyle intervention were included if they used a specified SOE tool. Data was collected for each SOE tool. Conditions necessary for assigning the highest SOE grading and treatment of prospective cohort studies within each SOE rating framework were summarized. The expert panel convened to discuss the implications of findings for assessing evidence in the domain of lifestyle medicine. RESULTS AND CONCLUSIONS A total of 15 unique tools were identified. Ten were tools developed and used by governmental agencies or other equivalent professional bodies and were applicable in a variety of settings. Of these 10, four require consistent results from RCTs of high quality to award the highest rating of evidence. Most SOE tools include prospective cohort studies only to note their secondary contribution to overall SOE as compared to RCTs. We developed a new construct, Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM), to illustrate the feasibility of a tool based on the specific contributions of diverse research methods to understanding lifetime effects of health behaviors. Assessment of evidence relevant to lifestyle medicine requires a potential adaptation of SOE approaches when outcomes and/or exposures obviate exclusive or preferential reliance on RCTs. This systematic review was registered with the International Prospective Register of Systematic Reviews, PROSPERO [CRD42018082148].
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Affiliation(s)
- D. L. Katz
- American College of Lifestyle Medicine, PO Box 6432, Chesterfield, MO 63006 USA
- The True Health Initiative, Derby, CT USA
- Yale Griffith Prevention Research Center, 130 Division St, Derby, CT 06418 USA
| | - M. C. Karlsen
- American College of Lifestyle Medicine, PO Box 6432, Chesterfield, MO 63006 USA
- Applied Clinical Nutrition and Global Public Health Programs, University of New England, 11 Hills Beach Rd, Biddeford, ME 04005 USA
| | - M. Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111 USA
| | - M. M. Shams-White
- Risk Factor Assessment Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, 4E204, Bethesda, MD 20850 USA
| | - L. W. Green
- Department of Epidemiology and Biostatistics, University of California at San Francisco School of Medicine, 550 16th Street, Second Floor, San Francisco, CA 94158 USA
| | - J. Fielding
- University of California Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA 90095 USA
| | - A. Saito
- Brown University School of Public Health, 121 S Main St, Providence, RI 02903 USA
| | - W. Willett
- Harvard University T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115 USA
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
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Takada T, Fukuma S, Yamamoto Y, Shimizu S, Nihata K, Miyashita J, Azuma T, Hayashi M, Fukuhara S. Determinants of incentive preferences for health behavior change in Japan. Health Promot Int 2019; 34:760-769. [PMID: 29788091 DOI: 10.1093/heapro/day031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Interest in the use of incentives to promote health behavior change has been growing worldwide. However, to develop an effective incentive program, accurate information regarding individual preferences is essential. Therefore, the aim of this study was to clarify determinants of incentive preferences for health behavior change. A self-completed questionnaire survey regarding incentives for health behavior change was conducted in a Japanese village in 2015. The outcome measures were individual preferences for features of incentives, including item, frequency, type and value. The types of incentives were defined as follows: assured-type (given for participation); effort-type (given if participants make some kind of effort); and outcome-type (given if participants make achievements decided a priori). The associations with respondents' sex, age, presence of lifestyle-related disease and stage in the transtheoretical model of health behavior change were investigated using multivariate analysis. A total of 1469 residents responded to the survey. Significant associations with preference for different incentive features were found as follows: for monetary items, female and elderly; for high frequency, female and maintenance stage; for effort-type, male, action stage and contemplation stage; and for outcome-type, maintenance stage and action stage. Our results appeared to identify determinants of incentive preferences for health behavior change. These findings are expected to promote the development of an incentive program more in tune with individual preferences.
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Affiliation(s)
- Toshihiko Takada
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima, Japan.,Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Shingo Fukuma
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima, Japan.,Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.,Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan.,Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.,Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, Japan
| | - Sayaka Shimizu
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Kakuya Nihata
- Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - Jun Miyashita
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima, Japan.,Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Teruhisa Azuma
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima, Japan
| | - Michio Hayashi
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima, Japan
| | - Shunichi Fukuhara
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima, Japan.,Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.,Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
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Sustainable effect of individualised sun protection advice on sun protection behaviour: a 10-year follow-up of a randomised controlled study in primary care. BJGP Open 2019; 3:bjgpopen19X101653. [PMID: 31344682 PMCID: PMC6970591 DOI: 10.3399/bjgpopen19x101653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/01/2019] [Indexed: 12/24/2022] Open
Abstract
Background In the light of increasing skin cancer incidences worldwide, preventive measures to promote sun protection in individuals with risky sun habits have continued relevance and importance. Aim To report the long-term effect of individualised sun protection advice given in primary health care (PHC), on sun habits and sun protection behaviour. Design & setting In 2005, 309 PHC patients were enrolled in a randomised controlled study performed in a Swedish PHC setting. Method At baseline, the study participants completed a Likert scale-based questionnaire, mapping sun habits, propensity to increase sun protection, and attitudes towards sun exposure, followed by randomisation into three intervention groups, all receiving individualised sun protection advice: in Group 1 (n = 116) by means of a letter, and in Group 2 (n = 97) and 3 (n = 96) communicated personally by a GP. In Group 3, participants also underwent a skin ultraviolet-sensitivity phototest, with adjusted sun protection advice based on the result. A repeated questionnaire was administered after 3 and 10 years. Results Statistically significant declines were observed in all groups for sun exposure mean scores over time. When using a cumulative score, according to the Sun Exposure and Protection Index (SEPI), significantly greater decrease in SEPI mean score was observed in Groups 2 and 3 (GP), compared to Group 1 (letter); P<0.01. The addition of a phototest did not enhance the effect of the intervention. Conclusion Individualised sun protection advice mediated verbally by the GP can lead to sustained improvement of sun protective behaviour.
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Santos MDDV, Santos SV, Caccia-Bava MDCGG. [The prevalence of strategies for cessation of tobacco use in primary health care: an integrative review]. CIENCIA & SAUDE COLETIVA 2019; 24:563-572. [PMID: 30726388 DOI: 10.1590/1413-81232018242.27712016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 03/23/2017] [Indexed: 11/22/2022] Open
Abstract
The habit of tobacco use/smoking, which is a major concern of Primary Health Care (PHC), is a serious public health problem and the main avoidable cause of death in the world. The relevance of actions, whose focus is to facilitate the cessation of this habit, motivates the discussion of studies that have different approaches to tackle this issue by seeking to train PHC professionals accordingly. A search was conducted in the Lilacs, MEDLINE and Web of Science databases for recent scientific publications (2010-2015). The key words were combined with Boolean operators and, after analysis of the articles found, 75 are discussed in this article since they have strategies with a higher prevalence in PHC. The conclusion drawn is that the brief or intense individual approach using the 5A method (Transtheoretical Model) is the most widely adopted, as well as bupropion and nicotine replacement patches. The increasing use of hard technology requires new studies that examine their impact on the treatment of smokers. It was clearly revealed that there is a need for health professionals to be better prepared to address the issue with the users, in addition to a lack of stimulus and proper conditions to work in the PHC team directly reflecting scientific advances in clinical practice.
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Affiliation(s)
- Meire de Deus Vieira Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900, Monte Alegre. 14048-900 Ribeirão Preto SP Brasil.
| | - Stella Vieira Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900, Monte Alegre. 14048-900 Ribeirão Preto SP Brasil.
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Pardavila-Belio MI, Canga-Armayor A, Duaso MJ, Pueyo-Garrigues S, Pueyo-Garrigues M, Canga-Armayor N. Understanding how a smoking cessation intervention changes beliefs, self-efficacy, and intention to quit: a secondary analysis of a pragmatic randomized controlled trial. Transl Behav Med 2019; 9:58-66. [PMID: 30590861 DOI: 10.1093/tbm/ibx070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although beliefs, self-efficacy, and intention to quit have been identified as proximal predictors of initiation or quitting in young adults, few studies have studied how these variables change after a smoking cessation intervention. To evaluate the changes in the beliefs, self-efficacy, and intention to avoid smoking and determine if these are potential mediators in quitting, following a smoking cessation intervention, aimed at tobacco-dependent college students. Single-blind, pragmatic randomized controlled trial with a 6-month follow-up. A total of 255 smoker students were recruited from September 2013 to February 2014. Participants were randomly assigned to intervention group (n = 133) or to control group (n = 122). The students in the intervention group received a multicomponent intervention based on the Theory of Triadic Influence (TTI). The strategies of this program consisted of a 50 min motivational interview conducted by a nurse and online self-help material. The follow-up included a reinforcing e-mail and group therapy. The smoking-related self-efficacy, belief, and intention scale was used to assess outcomes. Intention to quit smoking is partial moderator explaining 36.2% of the total effects in smoking cessation incidence. At 6 month follow-up, the differences in the mean scores of self-efficacy and intention related to stopping smoking were significantly higher in the intervention than in the control group. A multicomponent intervention based on the TTI, tailored to college students, positively increased the self-efficacy to avoid smoking and the intention to quit, suggesting intention as potential mediator of quitting.
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Affiliation(s)
- Miren I Pardavila-Belio
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
| | - Ana Canga-Armayor
- IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain.,Department of Nursing Care of the Adult Person, University of Navarra, Pamplona, Navarra, Spain
| | - María J Duaso
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - Sara Pueyo-Garrigues
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain
| | - María Pueyo-Garrigues
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain
| | - Navidad Canga-Armayor
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
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Eynon M, Foad J, Downey J, Bowmer Y, Mills H. Assessing the psychosocial factors associated with adherence to exercise referral schemes: A systematic review. Scand J Med Sci Sports 2019; 29:638-650. [PMID: 30742334 DOI: 10.1111/sms.13403] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/04/2018] [Accepted: 02/05/2019] [Indexed: 12/30/2022]
Abstract
This paper aimed to systematically review the evidence base to uncover the key psychosocial factors that underpin adherence to an exercise referral scheme (ERS). Databases PsycINFO, MEDLINE, SPORTDiscus, Web of Science, PubMed, PsycARTICLES, Open Grey, and PsycEXTRA were systematically searched. A parallel results-based convergent synthesis was performed by identifying key themes from quantitative and qualitative studies separately. After applying inclusion and exclusion criteria, the review included 24 eligible studies. Key findings showed intrinsic motivation, psychological need satisfaction, social support, and self-efficacy to be the prominent psychosocial factors associated with ERS adherence. In addition, lower expectations for change when entering the scheme was associated with ERS adherence. This review should serve as a catalyst to provide evidence-based ERS and as such ERS providers should seek to place an emphasis on participants' expectations and beliefs when entering the scheme. Moreover, targeting the key factors of intrinsic motivation, psychological need satisfaction, social support, and self-efficacy throughout the duration of an ERS should serve to facilitate adherence.
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Affiliation(s)
- Michael Eynon
- Faculty of Sport, Health & Applied Science, St Mary's University, Twickenham, London, UK
| | - Jessica Foad
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, UK
| | - John Downey
- Faculty of Sport, Health & Applied Science, St Mary's University, Twickenham, London, UK
| | - Yasmin Bowmer
- Faculty of Sport, Health & Applied Science, St Mary's University, Twickenham, London, UK
| | - Hayley Mills
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, UK
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Parappilly BP, Mortenson WB, Field TS, Eng JJ. Exploring perceptions of stroke survivors and caregivers about secondary prevention: a longitudinal qualitative study. Disabil Rehabil 2019; 42:2020-2026. [DOI: 10.1080/09638288.2018.1544296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Beena P. Parappilly
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
- Stroke Unit, Medicine Program, St. Paul's Hospital, Providence Health Care, Vancouver, BC, Canada
| | - William B. Mortenson
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - Thalia S. Field
- Vancouver Stroke Program, Division of Neurology Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Janice J. Eng
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
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Hall N, Mooney JD, Sattar Z, Ling J. Extending alcohol brief advice into non-clinical community settings: a qualitative study of experiences and perceptions of delivery staff. BMC Health Serv Res 2019; 19:11. [PMID: 30616659 PMCID: PMC6323768 DOI: 10.1186/s12913-018-3796-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 12/05/2018] [Indexed: 11/25/2022] Open
Abstract
Background At a population level, the majority of alcohol-related harm is attributable to drinkers whose consumption exceeds recommended drinking levels, rather than those with severe alcohol dependency. Identification and Brief Advice (IBA) interventions offer a cost-effective approach for reducing this harm. Traditionally, IBA interventions have been delivered in healthcare settings and therefore contextual influences on their use in non-clinical settings are not well understood. Methods Qualitative face-to-face and telephone interviews with staff responsible for delivering a pilot IBA intervention across community settings in the UK. Interviews were recorded and transcribed verbatim. Inductive thematic analysis was used to identify key issues and the constant comparison method was employed to compare barriers and facilitators to implementation across and within settings. Results A number of facilitators and barriers to delivery and implementation was identified across settings. These included familiarity with the customer base, working within public spaces, and assimilation of the intervention within existing role boundaries. Despite underlying concerns relating to the sensitive nature of the topic, most delivery staff felt their respective settings were appropriate for the delivery of the intervention and had proactively engaged members of the public with varying levels of risky drinking and readiness for behaviour change. Perceptions of actual or potential intervention success were conceptualised in relation to existing day-to-day role boundaries and responsibilities and the contexts in which they took place. Conclusions Findings support the potential value of multi-setting community approaches to facilitate more inclusive engagement with IBA. By comparing experiences and views from staff responsible for delivering the intervention across different community settings, our findings provide insight into how intervention acceptability and success are framed across settings, and how the intervention is assimilated within everyday practice and role boundaries. This study also highlights key areas to be addressed when implementing IBAs in non-clinical community settings by staff with diverse levels of health-related knowledge, skills and support needs. Although essential, the need for adaptable training and delivery approaches across different setting types is likely to result in methodological challenges that need to be addressed when evaluating future interventions and setting-specific influences on behaviour change and health outcomes.
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Affiliation(s)
- Nicola Hall
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England.
| | - John D Mooney
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England
| | - Zeibeda Sattar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England.,Faculty of Health and Life Sciences, Northumbria University, Newcastle, NE1 8ST, UK, England
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England
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Bouma AJ, van Wilgen P, Lemmink KAPM, Stewart R, Dijkstra A, Diercks RL. Barrier-belief lifestyle counseling in primary care: A randomized controlled trial of efficacy. PATIENT EDUCATION AND COUNSELING 2018; 101:2134-2144. [PMID: 30072044 DOI: 10.1016/j.pec.2018.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 07/14/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Intervening on barrier beliefs (BBs) may inhibit the role of barriers as mediating factors in lifestyle behavior. The aim of this study was to analyze the effects of a barrier-belief counseling intervention (BBCI) on physical activity (PA) and healthy food intake. METHODS An RCT was conducted in a primary care setting among adults (aged 18-70), with two interventions: a BBCI (n = 123) and a standardized lifestyle group intervention (SLI) (n = 122). A non-treated hanging control group (n = 36) received no intervention. Outcomes on PA (accelerometer and SQUASH) and fruit and vegetable intake (self-report) were measured with follow-ups at 6, 12 and 18 months, and analyzed using multiple regression. RESULTS The BBCI was more effective on PA compared with the SLI (p < .01): in the short term all PA outcomes improved (p < .05), in the long term moderate-to-vigorous PA outcomes improved (p < .05), all with small effect sizes. No differences between interventions were found on fruit and vegetable intake. None of the outcomes in the control group changed over time. CONCLUSIONS BBCI in primary care improves PA compared with SLI. PRACTICE IMPLICATIONS The customized BB approach seems promising for implementation in healthcare practice to stimulate PA.
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Affiliation(s)
- Adrie J Bouma
- Hanze University of Applied Sciences Groningen, Institute of Sports Studies, Zernikeplein 17, 9766 AS Groningen, The Netherlands.
| | - Paul van Wilgen
- Transcare, Transdisciplinary Pain Management Centre, Barkmolenstraat 196, 9723 DM Groningen, The Netherlands.
| | - Koen A P M Lemmink
- Center for Human Movement Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - Roy Stewart
- Faculty of Medical Sciences, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - Arie Dijkstra
- Faculty of Behavioral and Society Sciences, Grote Kruisstraat 2/1, 9712 TS, University of Groningen, Groningen, The Netherlands.
| | - Ron L Diercks
- Department of Sports Medicine and Orthopedic Surgery, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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Symons M, Pedruzzi RA, Bruce K, Milne E. A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities. BMC Public Health 2018; 18:1227. [PMID: 30390661 PMCID: PMC6215602 DOI: 10.1186/s12889-018-6139-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/22/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work. METHOD The MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO, SocINDEX, and Informit databases were searched from inception to 22/08/2017 for all prevention and intervention papers published in peer-reviewed scientific journals, with results, targeting prenatal alcohol exposure and FASD in Indigenous populations. This review was limited to studies published in English and excluded interventions focusing on the workforce. All steps were completed independently by two reviewers with discrepancies resolved via consensus with the senior author. RESULTS There was significant heterogeneity in the ten included studies. Populations targeted included non-pregnant women of child-bearing age, pregnant women, school children and the general public. Study designs included one randomised controlled trial, five cohort studies with pre-post design, one cross-sectional study with different pre- and post-intervention groups, and four studies collected post-intervention data. Studies assessed changes in knowledge, and/or changes in risk for prenatal alcohol exposure including self-reported alcohol consumption, use of birth control or a combination of both. One study was conducted in Australia and nine in the US. The methodological quality of all studies was rated as 'Poor' using the systematic review assessment tools developed by The National Heart, Lung and Blood Institute. Studies were subject to substantial bias due to issues such as high loss to follow-up, lack of control groups and the reliance on self-report measures to assess the main outcome. CONCLUSION Overall, there is little evidence that previous interventions aiming to reduce the risk of prenatal alcohol exposure or FASD in Indigenous populations have been effective. Future intervention studies should address the cultural factors and historical context that are fundamental to successful work with Indigenous populations, and be designed, implemented and evaluated using rigorous methods. This systematic review was registered with PROSPERO, CRD42018086212.
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Affiliation(s)
- Martyn Symons
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, Perth, Australia
| | - Rebecca Anne Pedruzzi
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Kaashifah Bruce
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
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44
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Wändell PE, de Waard AKM, Holzmann MJ, Gornitzki C, Lionis C, de Wit N, Søndergaard J, Sønderlund AL, Kral N, Seifert B, Korevaar JC, Schellevis FG, Carlsson AC. Barriers and facilitators among health professionals in primary care to prevention of cardiometabolic diseases: A systematic review. Fam Pract 2018; 35:383-398. [PMID: 29385438 DOI: 10.1093/fampra/cmx137] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study is to identify potential facilitators and barriers for health care professionals to undertake selective prevention of cardiometabolic diseases (CMD) in primary health care. We developed a search string for Medline, Embase, Cinahl and PubMed. We also screened reference lists of relevant articles to retain barriers and facilitators for prevention of CMD. We found 19 qualitative studies, 7 quantitative studies and 2 mixed qualitative and quantitative studies. In terms of five overarching categories, the most frequently reported barriers and facilitators were as follows: Structural (barriers: time restraints, ineffective counselling and interventions, insufficient reimbursement and problems with guidelines; facilitators: feasible and effective counselling and interventions, sufficient assistance and support, adequate referral, and identification of obstacles), Organizational (barriers: general organizational problems, role of practice, insufficient IT support, communication problems within health teams and lack of support services, role of staff, lack of suitable appointment times; facilitators: structured practice, IT support, flexibility of counselling, sufficient logistic/practical support and cooperation with allied health staff/community resources, responsibility to offer and importance of prevention), Professional (barriers: insufficient counselling skills, lack of knowledge and of experience; facilitators: sufficient training, effective in motivating patients), Patient-related factors (barriers: low adherence, causes problems for patients; facilitators: strong GP-patient relationship, appreciation from patients), and Attitudinal (barriers: negative attitudes to prevention; facilitators: positive attitudes of importance of prevention). We identified several frequently reported barriers and facilitators for prevention of CMD, which may be used in designing future implementation and intervention studies.
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Affiliation(s)
- Per E Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden
| | - Anne-Karien M de Waard
- Julius Center for Health Sciences and Primary Care, University medical Center, Utrecht, The Netherlands
| | - Martin J Holzmann
- Functional Area of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carl Gornitzki
- University Library, Karolinska Institutet, Stockholm, Sweden
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece
| | - Niek de Wit
- Julius Center for Health Sciences and Primary Care, University medical Center, Utrecht, The Netherlands
| | - Jens Søndergaard
- Research Unit for General Practice, Institute of Public Health, University of Southern, Odense, Denmark
| | - Anders L Sønderlund
- Research Unit for General Practice, Institute of Public Health, University of Southern, Odense, Denmark
| | - Norbert Kral
- Department of General Practice, Charles University, First Faculty of Medicine, Prague, Czech Republic
| | - Bohumil Seifert
- Department of General Practice, Charles University, First Faculty of Medicine, Prague, Czech Republic
| | - Joke C Korevaar
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - François G Schellevis
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.,Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Axel C Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden.,Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
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Mouodi S, Hosseini SR, Ghadimi R, Bijani A, Cumming RG, Amiri HA, Bayani F, Sum S. The First Step of Health Policy-Making for Lifestyle Modifications at Middle Age: Problem Identification in 40- to 60-Year-Old Population, Northern Iran. J Obes 2018; 2018:9895346. [PMID: 30123584 PMCID: PMC6079593 DOI: 10.1155/2018/9895346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 06/08/2018] [Accepted: 06/17/2018] [Indexed: 11/17/2022] Open
Abstract
Background The purpose of this study was to determine the current situation of lifestyle behaviors and related outcomes, as the first step to make proper local health policies for improvement of health lifestyle behaviors. Materials and Methods This analytic research has been conducted as a cross-sectional study on the middle-aged (40-60 years old) population of Amirkola, Northern Iran. The Persian translation of the Health-Promoting Lifestyle Profile II questionnaire and the International Physical Activity Questionnaire were used for data collection. Also, anthropometric variables, blood pressure, fasting blood sugar, and serum lipids profile were examined. Results Three hundred one individuals have been enrolled in the study. Results showed that 10.6% of the participants had unhealthy lifestyle behaviors in the subdomain of spiritual growth; 46.8% in the subdomain of health responsibility; and 48.2% in the subdomains of stress management, physical activity, and nutrition; men had more physical activity than women (p < 0.001). Totally, 189 persons (63.9%) had serum cholesterol greater than or equal to 200 mg/dL; seventy-five individuals (25%) had high blood pressure. One hundred twenty-six persons (81.8%) of women and 103 (70.1%) of men were overweight or obese. Conclusions Health lifestyle behaviors in 40- to 60-year-old population need a proper intervention to improve the current situation.
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Affiliation(s)
- Simin Mouodi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Reza Ghadimi
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Hassan Ashrafian Amiri
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Bayani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shima Sum
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Zabaleta-del-Olmo E, Pombo H, Pons-Vigués M, Casajuana-Closas M, Pujol-Ribera E, López-Jiménez T, Cabezas-Peña C, Martín-Borràs C, Serrano-Blanco A, Rubio-Valera M, Llobera J, Leiva A, Vidal C, Campiñez M, Martín-Álvarez R, Maderuelo JÁ, Recio JI, García-Ortiz L, Motrico E, Bellón JÁ, Moreno-Peral P, Martín-Cantera C, Clavería A, Aldecoa-Landesa S, Magallón-Botaya R, Bolíbar B. Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial. BMC Public Health 2018; 18:874. [PMID: 30005705 PMCID: PMC6045838 DOI: 10.1186/s12889-018-5805-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/05/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Health promotion is a key process of current health systems. Primary Health Care (PHC) is the ideal setting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority of the adult population engages two or more risk behaviours, that is why a multiple intervention might be more effective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness and an implementation strategy of a complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in PHC. METHODS This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing a complex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. The study focuses on people between 45 and 75 years who carry out two or more of the following unhealthy behaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level. The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in the routine care of PHC practices according to the conceptual framework of the "5A's". It will have a maximum duration of 12 months and it will be carried out to three different levels (individual, group and community). Incremental cost per quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. The implementation strategy is based on the "Consolidated Framework for Implementation Research", a set of discrete implementation strategies and an evaluation framework. DISCUSSION EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple risk intervention and will provide a better understanding of implementation processes of health promotion interventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriers that affect implementation of these interventions and to quantify the contextual factors that moderate the effectiveness of implementation. TRIAL REGISTRATION ClinicalTrials.gov , NCT03136211 .Retrospectively registered on May 2, 2017.
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Affiliation(s)
- Edurne Zabaleta-del-Olmo
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Haizea Pombo
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Luis Power Kalea 18, 48014 Bilbao, Spain
| | - Mariona Pons-Vigués
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Marc Casajuana-Closas
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Tomás López-Jiménez
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Carmen Cabezas-Peña
- Deputy Directorate of Health Promotion, Public Health Agency, Department of Health, Goverment of Catalonia, Roc Boronat, 81-95 (Edifici Salvany), 08005 Barcelona, Spain
| | - Carme Martín-Borràs
- Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, C/Císter 34, 08022 Barcelona, Spain
- Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull Univesity, C/Padilla 326-332, 08025 Barcelona, Spain
| | - Antoni Serrano-Blanco
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Rubio-Valera
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Llobera
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Alfonso Leiva
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Clara Vidal
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Manuel Campiñez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023 Barcelona, Spain
| | - Remedios Martín-Álvarez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023 Barcelona, Spain
| | - José-Ángel Maderuelo
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
| | - José-Ignacio Recio
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucía, c/Energía Solar 1, Sevilla, Spain
| | - Juan-Ángel Bellón
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla 23, Málaga, Spain
- Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla 23, Málaga, Spain
- El Palo Health Center, Andalusian Health Service (SAS), Av. Salvador Allende 159, 29018 Málaga, Spain
- Department of Public Health and Psychiatry, University of Malaga, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - Patricia Moreno-Peral
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla 23, Málaga, Spain
- Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla 23, Málaga, Spain
| | - Carlos Martín-Cantera
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Ana Clavería
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201 Vigo, Spain
| | - Susana Aldecoa-Landesa
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201 Vigo, Spain
- Primary Health Centre Beiramar, Xerencia de Xestión Integrada Vigo, Servizo Galego de Saúde (SERGAS), Avda Rosalía Castro 21, 36201 Vigo, Spain
| | - Rosa Magallón-Botaya
- Instituto de Investigación Sanitaria Aragón, Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
| | - Bonaventura Bolíbar
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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de Almeida ML, Casemiro FG, Baba CT, Monteiro D, Fornazieri M, Cerri N, Fernandes DFM, de Oliveira Gomes GA. Studies About Physical Activity Interventions Including Follow-Up Analysis: A Systematic Review. J Phys Act Health 2018; 15:462-467. [PMID: 29542365 DOI: 10.1123/jpah.2016-0580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Some studies have used the follow-up method to analyze real behavioral changes in research involving physical activity (PA) interventions. This has great scientific value; however, it is hard to apply without satisfactory resources and research funding. Little is known about how many studies have used this method to analyze PA interventions in low-income and middle-income countries, especially Brazil. PURPOSE To describe Brazilian studies using follow-up analysis after PA interventions. METHODS A systematic review was performed including Brazilian studies with follow-up analysis after PA interventions; the analyzed papers were from the previous 10 years. The search was carried out in Portuguese, English, and Spanish in the following databases: SciELO, Latin American and Caribbean Health Science Literature, PubMed, and Scopus. The Preferred Reporting Items for Systematic Review and Meta-Analysis method was used. RESULTS In total, 6 of the 7 studies analyzed were from the southeast region, with the intervention time ranging from 2 to 12 months, carrying out follow-up every 5.3 months with 2.2 observations on average. The interventions had a behavioral approach and were generally carried out in universities, hospitals, and ambulatory care. CONCLUSION Studies on PA interventions using follow-up analysis are scarce. Considering the relevance of follow-up studies to measure behavior changes, the results suggest that more studies about this topic are essential in Brazil.
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A randomized controlled trial of orthodontist-based brief advice to prevent child obesity. Contemp Clin Trials 2018; 70:53-61. [PMID: 29747047 DOI: 10.1016/j.cct.2018.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/23/2018] [Accepted: 05/02/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We conducted a randomized controlled trial to test whether brief exercise and diet advice provided during child patient visits to their orthodontic office could improve diet, physical activity, and age-and-gender-adjusted BMI. METHODS We enrolled orthodontic offices in Southern California and Tijuana, Mexico, and recruited their patients aged 8-16 to participate in a two-year study. At each office visit, staff provided the children with "prescriptions" for improving diet and exercise behaviors. Multilevel models, which adjusted for clustering, determined differential group effects on health outcomes, and moderation of effects. RESULTS We found differential change in BMI favoring the intervention group, but only among male participants (p < 0.001; Cohen's d = 0.085). Of four dietary variables, only junk food consumption changed differentially, in favor of the intervention group (p = 0.020; d = 0.122); the effect was significant among overweight/obese (p = 0.001; d = 0.335) but not normal weight participants. Physical activity declined non-differentially in both groups and both genders. CONCLUSION The intervention, based on the Geoffrey Rose strategy, had limited success in achieving its aims. IMPLICATIONS Orthodontists can deliver non-dental prevention advice to complement other health-practitioner-delivered advice. Higher fidelity to trial design is needed to adequately test the efficacy of clinician-based brief advice on preventing child obesity and/or reversing obesity.
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Motivational Benefits of Social Support and Behavioural Interventions for Smoking Cessation. J Smok Cessat 2018; 13:216-226. [PMID: 30984294 DOI: 10.1017/jsc.2017.26] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This study examined the role of social support and behavioral interventions used during the last unsuccessful quit attempt for smokers' intentions to quit smoking within the next 6 months, and identified smokers' attributes associated with use of social support and behavioral interventions. The analytic sample included 7,195 adult daily smokers who responded to the 2010-2011 Tobacco Use Supplement to the Current Population Survey, conducted in the US, and indicated having a serious quit attempt in the past 12 months. Smokers who relied on social support from friends and family had higher odds of intending to quit than those who did not (OR= 1.39, 95% CI= 1.22:1.58), and smokers who used interventions had higher odds of intending to quit than those who did not (OR= 1.36, 95% CI= 1.07:1.74). These associations were similar for both sexes, all age groups, and nicotine dependence levels. Both, relying on social support and use of behavioral interventions were more common among smokers who were female, higher educated, residing in the Western US region, and those who used pharmacological aids for smoking cessation. Social support and behavioral interventions are associated with higher intentions to quit among attempters who relapsed and thus, may aid future smoking cessation.
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50
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James EL, Ewald BD, Johnson NA, Stacey FG, Brown WJ, Holliday EG, Jones M, Yang F, Hespe C, Plotnikoff RC. Referral for Expert Physical Activity Counseling: A Pragmatic RCT. Am J Prev Med 2017; 53:490-499. [PMID: 28818417 DOI: 10.1016/j.amepre.2017.06.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 05/16/2017] [Accepted: 06/21/2017] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Primary care physicians are well placed to offer physical activity counseling, but insufficient time is a barrier. Referral to an exercise specialist is an alternative. In Australia, exercise specialists are publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. This trial aimed to (1) determine the efficacy of primary care physicians' referral of insufficiently active patients for counseling to increase physical activity, compared with usual care, and (2) compare the efficacy of face-to-face counseling with counseling predominantly via telephone. STUDY DESIGN Three-arm pragmatic RCT. SETTING/PARTICIPANTS Two hundred three insufficiently active (<7,000 steps/day) primary care practice patients (mean age 57 years; 70% female) recruited in New South Wales, Australia, in 2011-2014. INTERVENTION (1) Five face-to-face counseling sessions by an exercise specialist, (2) one face-to-face counseling session followed by four telephone calls by an exercise specialist, or (3) a generic mailed physical activity brochure (usual care). The counseling sessions operationalized social cognitive theory via a behavior change counseling framework. MAIN OUTCOME MEASURES Change in average daily step counts between baseline and 12 months. Data were analyzed in 2016. RESULTS Forty (20%) participants formally withdrew; completion rates at 3 and 6 months were 64% and 58%, respectively. Intervention attendance was high (75% received five sessions). The estimated mean difference between usual care and the combined intervention groups at 12 months was 1,002 steps/day (95% CI=244, 1,759, p=0.01). When comparing face-to-face with predominantly telephone counseling, the telephone group had a non-significant higher mean daily step count (by 619 steps) at 12 months. CONCLUSIONS Provision of expert physical activity counseling to insufficiently active primary care patients resulted in a significant increase in physical activity (approximately 70 minutes of walking per week) at 12 months. Face-to-face only and counseling conducted predominantly via telephone were both effective. This trial provides evidence to expand public funding for expert physical activity counseling and for delivery via telephone in addition to face-to-face consultations. TRIAL REGISTRATION This trial is registered at www.anzctr.org.au/ ACTRN12611000884909.
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Affiliation(s)
- Erica L James
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Ben D Ewald
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Natalie A Johnson
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Fiona G Stacey
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Wendy J Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Elizabeth G Holliday
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Clinical Research Design, IT and Statistical Support, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Mark Jones
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Clinical Research Design, IT and Statistical Support, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Fan Yang
- Central and Eastern Sydney Primary Health Network, Ashfield, New South Wales, Australia
| | - Charlotte Hespe
- General Practice and Primary Care Research, School of Medicine, Sydney, University of Notre Dame, Darlinghurst, New South Wales, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
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