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Cruz-Piedrahita C, Roscoe CJ, Howe C, Fecht D, de Nazelle A. Holistic approach to assess the association between the synergistic effect of physical activity, exposure to greenspace, and fruits and vegetable intake on health and wellbeing: Cross-sectional analysis of UK Biobank. Front Public Health 2022; 10:886608. [PMID: 36249200 PMCID: PMC9561552 DOI: 10.3389/fpubh.2022.886608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/30/2022] [Indexed: 01/21/2023] Open
Abstract
Background Urban agriculture has been shown to contribute to healthy lifestyle behaviors, such as increased fruit and vegetable intake and greater exposure to greenspaces and there is plenty of evidence linking these lifestyle behaviors to better health and wellbeing. However, most evidence relates to assessing one behavior at a time despite available epidemiological research showing how the combined effects of multiple behaviors are associated with health and wellbeing. This research aims to examine the association of the interactions between various lifestyle behaviors and exposures related to urban agriculture and health and wellbeing. Methods We used data from the UK Biobank baseline questionnaire (N~500, 000) to assess the association of two lifestyle behaviors (fruit and vegetable intake and physical activity) and greenspace exposure, with four health and wellbeing markers (blood pressure, BMI, self-health assessment, and self-reported loneliness) independently, and in combination. Associations between lifestyle behaviors, greenspace exposure, and the possible interactions with health and wellbeing were explored using general linear models (GLMs), adjusted for socio-demographic confounders including age, sex, educational qualifications, index of multiple deprivation, and ethnicity, and a lifestyle confounder: smoking status. Results After removing missing data, as well as participants who did not meet the inclusion criteria, the final study sample was n = 204,478. The results indicate that meeting recommended levels of the World Health Organization (WHO) for fruits and vegetable intake, and the advice from the UK Chief Medical Officer for physical activity, is linked to better health and wellbeing markers. We found that UK Biobank participants who lived in greener areas and were physically active were more likely to feel alone and think their health was poor. Participants who were physically active and met the recommended intake of fruits and vegetables were more likely to have healthy blood pressure, feel less lonely, and rate their health as good. Evidence of three-way interactions was weak, and mostly was not associated with the health and wellbeing markers assessed here. Conclusion Taken in combination, healthy diets, physical activity and exposure to greenspaces are associated with health and wellbeing. In some cases, these effects are synergistic, indicating associations above and beyond the mere additive effect of the behaviors considered independently. Promoting such behaviors together, for example, through urban agriculture, is therefore more likely to generate greater public health changes than if they are promoted through independent policies and programs. Inter-relationships between these pathways and different health and wellbeing markers, however, are complex, and require further investigation to understand optimal environments and conditions for urban health promotion.
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Affiliation(s)
| | - Charlotte J. Roscoe
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Caroline Howe
- Centre for Environmental Policy, Imperial College London, London, United Kingdom
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Audrey de Nazelle
- Centre for Environmental Policy, Imperial College London, London, United Kingdom
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Zhao Y, Ma Y, Zhao C, Lu J, Jiang H, Cao Y, Xu Y. The effect of integrated health care in patients with hypertension and diabetes: a systematic review and meta-analysis. BMC Health Serv Res 2022; 22:603. [PMID: 35513809 PMCID: PMC9074341 DOI: 10.1186/s12913-022-07838-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background A growing number of studies show that integrated health care provides comprehensive and continuous care to patients with hypertension or diabetes. However, there is still no consensus about the effect of integrated health care on patients with hypertension or diabetes. The objective of this study was to verify the effectiveness of integrated health care for patients with hypertension or diabetes by using a systematic review and meta-analysis. Methods The study searched multiple English and Chinese electronic databases. The search period was from database inception to 31 October 2020. Systematic reviews and meta-analyses were conducted after assessing the risk of bias of each study. Results Sixteen studies that involved 5231 patients were included in this study. The results of the systematic review revealed that systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI) and glycosylated haemoglobin (HbA1c) are commonly used indicators for patients with hypertension or diabetes. Individual models and group- and disease-specific models are the most commonly used models of integrated health care. All the studies were from high-income and middle-income countries. Meta-analysis showed that integrated health care significantly improved SBP, DBP and HbA1c but not BMI. A comparison of interventions lasting 6 and 12 months for diabetes was conducted, and HbA1c was decreased after 12 months. The changes in SBP and DBP were statistically significant after using group- and disease-specific model but not individual models. HbA1c was significantly improved after using group- and disease-specific models and individual models. Conclusion Integrated health care is a useful tool for disease management, and individual models and group- and disease-specific models are the most commonly used models in integrated health care. Group- and disease-specific models are more effective than individual models in the disease management of hypertension patients. The duration of intervention should be considered in the disease management of patients with diabetes, and interventions longer than 12 months are recommended. The income level may affect the model of integrated health care in selecting which disease to intervene, but this point still needs support from more studies.
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Affiliation(s)
- Yan Zhao
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Yue Ma
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Chongbo Zhao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiahong Lu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Jiang
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China
| | - Yanpei Cao
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China.
| | - Yafang Xu
- Department of Nursing, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, China. .,School of Nursing, Fudan University, Shanghai, China.
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Almomani MH, Akhu-Zaheya L, Alsayyed M, Alloubani A. Public's Knowledge of Hypertension and its Associated Factors: A Cross-Sectional Study. Open Nurs J 2022. [DOI: 10.2174/18744346-v16-e2201060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Hypertension is a significant challenge for healthcare systems globally. It is estimated to cause 7.5 million deaths worldwide annually. Knowledge of hypertension plays a crucial role in behavioral changes required to prevent and manage the condition. This study aimed to assess the public's knowledge of hypertension’s risk factors, symptoms, complications, and treatment.
Methods:
This cross-sectional, descriptive, and exploratory study included a convenience sample of 723 Jordanian adults. The Hypertension Knowledge Test was used to measure the participants' knowledge of hypertension’s risk factors, symptoms, complications, and treatment.
Results:
The participants' mean score of total hypertension knowledge was 11.5 ±3.82 (52.2%), with 85.9% (n=621) having inadequate knowledge. Their mean scores for hypertension’s risk factors, symptoms, complications, and treatment were 7.45 ±2.35 (62.1%), 2.29 ±1.21 (45.8%), 1.38 ± 0.943 (46%), and 0.391 ± 0.603 (19.6%), respectively. Four factors were found to be significant predictors of participants' knowledge, such as age (p=0.002), education level (p<0.001), family history (p<0.001), and receiving hypertension-related information (p<0.001).
Conclusion:
The participants had inadequate knowledge regarding hypertension’s complications, risk factors, symptoms, and treatment. Public health education programs that focus on hypertension knowledge are required. Nurses and other healthcare providers should take the initiative in hypertension education. Strategic planning and designing of hypertension programs are required to fit the needs of the Jordanian public to enhance their knowledge of hypertension and related preventive and control measures.
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Estrada D, Sierra C, Soriano RM, Jordán AI, Plaza N, Fernández C. Grado de conocimiento de la hipertensión en pacientes hipertensos. ENFERMERIA CLINICA 2020; 30:99-107. [DOI: 10.1016/j.enfcli.2018.11.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 11/28/2018] [Indexed: 01/07/2023]
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Edwards LA, Taylor DJ, Campbell P, Shah R, Edgar DF, Crabb DP. Feeling the pressure: a cross-sectional study exploring feasibility of a healthcare Pop-Up for intraocular pressure measurements in shopping centres in England. BMJ Open 2019; 9:e030523. [PMID: 31748291 PMCID: PMC6887061 DOI: 10.1136/bmjopen-2019-030523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To test the hypothesis that a shopping centre Pop-Up health check combining an intraocular pressure (IOP) check with a general health check (blood pressure (BP)) is more readily accepted by the general public than an IOP check only. We investigate public awareness of IOP compared with BP and the feasibility of measuring IOP in large numbers in a Pop-Up. DESIGN A cross-sectional study using a tailor-made healthcare Pop-Up. SETTING The 'Feeling the Pressure' Pop-Up was sited in eight regionally-different shopping centres in England. PARTICIPANTS Adult members of the public in shopping centres. METHODS On one day we measured IOP only and on another measured BP and IOP. IOP was measured by Icare IC100 tonometer (Helsinki, Finland). Potential participants were asked about their awareness of IOP and BP and when they last visited their optometrist. RESULTS More people attended the combined BP + IOP days (461; 60%; 95% CI 56% to 64%) than IOP-only days (307; 40%, 95% CI 37% to 43%) over 16 days of testing. We recorded IOP in 652 participants (median (IQR) age and IOP of 54 (42 to 68) years and 13 (11 to 15) mm Hg, respectively). Fewer people reported awareness about IOP (19%, 95% CI 16% to 23%) compared with BP (71%, 95% CI 66% to 75%). Of 768 participants, 60 (8%) reported no previous optometric eye examination and 185 (24%) reported >2 years since their most recent examination. CONCLUSIONS Measuring IOP in large numbers of the public via a shopping centre Pop-Up is feasible. Public engagement was greater when a BP check was offered alongside an IOP check, suggesting unfamiliar health checks can be promoted by aligning them with a more familiar check. Our findings hint at strategies for public health schemes that engage the public with their eye health.
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Affiliation(s)
- Laura A Edwards
- Division of Optometry and Visual Science, School of Health Sciences, City University London, London, UK
| | - Deanna J Taylor
- Division of Optometry and Visual Science, School of Health Sciences, City University London, London, UK
| | - Peter Campbell
- Division of Optometry and Visual Science, School of Health Sciences, City University London, London, UK
| | - Rakhee Shah
- Division of Optometry and Visual Science, School of Health Sciences, City University London, London, UK
| | - David F Edgar
- Division of Optometry and Visual Science, School of Health Sciences, City University London, London, UK
| | - David P Crabb
- Division of Optometry and Visual Science, School of Health Sciences, City University London, London, UK
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Busingye D, Arabshahi S, Evans RG, Riddell MA, Srikanth VK, Kartik K, Kalyanram K, Zhu X, Suresh O, Howard G, Thrift AG. Knowledge of risk factors for hypertension in a rural Indian population. HEART ASIA 2019; 11:e011136. [PMID: 31031832 DOI: 10.1136/heartasia-2018-011136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/22/2019] [Accepted: 02/04/2019] [Indexed: 11/04/2022]
Abstract
Objective To study knowledge of risk factors and consequences of hypertension in a rural population in South India. Methods This is a community-based study conducted among adults of a rural population in the Rishi Valley, India. Residents of randomised rural villages were invited to participate in a study of hypertension. We obtained measures of blood pressure, height, weight, waist and hip circumferences and questionnaire-based information on knowledge about hypertension, sociodemographic characteristics and health behaviours. Multivariable logistic regression analyses were conducted to determine the factors associated with knowledge of risk factors for hypertension (knowledge of ≥2 risk factors). Results The study comprised 641 adults; 132 aware and 218 unaware of their hypertension, and 291 with normal blood pressure. Only 31% of participants knew that hypertension adversely affects an individual's health and 7% knew the benefits of treating hypertension. Almost a third (30%) of those aware of their hypertensive status, and 48% overall, did not know any of the risk factors for hypertension. Being aware of one's hypertensive status (OR 2.51, 95% CI 1.44 to 4.39), being treated for hypertension, male sex, younger age, having some schooling, abdominal obesity and physical inactivity were associated with better knowledge of risk factors for hypertension. Conclusion Knowledge of risk factors and consequences of hypertension in this disadvantaged population was poor. There was better knowledge of risk factors in some, but not all, people who were aware of having hypertension. Screening and targeted educational programmes are warranted in this population to improve health behaviours and reduce the consequences of hypertension.
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Affiliation(s)
| | | | - Roger G Evans
- Physiology, Monash University, Clayton, Victoria, Australia
| | | | | | - Kamakshi Kartik
- Rishi Valley Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - Kartik Kalyanram
- Rishi Valley Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - Xuan Zhu
- School of Earth, Atmosphere and Environment, Monash University, Clayton, Victoria, Australia
| | - Oduru Suresh
- Rishi Valley Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - George Howard
- Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Hypertension Status and Associations with Self-Rated Health and General Practitioner Health Seeking in a Rural Australian Cohort. J Cardiovasc Dev Dis 2018; 5:jcdd5040053. [PMID: 30404200 PMCID: PMC6306829 DOI: 10.3390/jcdd5040053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 12/18/2022] Open
Abstract
Hypertension is the most frequently managed condition by Australian general practitioners (GP). Knowledge of hypertension and blood pressure (BP) values may motivate individuals to seek GP management. Our study aims to determine the associations of knowledge of BP values, BP perception, GP health seeking, and self-rated health (SRH) in a rural population. Two-hundred and seventy-eight (278) residents responded to the health survey on socio-demographic profile, medical history, BP knowledge and perception, SRH, and GP visit frequency. Associations were evaluated using Chi-squared test and multivariate logistic regression. Cohort mean age was 63.6 (12.4) years with 63.3% females. Hypertension (37.8%) was the most common condition. GP visits were made at least once every month (19.1%), every 2–6 months (35.6%), >6 months (11.5%), or only when needed (29.5%). Univariate analyses showed age, education, alcohol consumption, comorbidities, hypertension status, and SRH were significantly associated with visit frequency. After adjustments, hypertension status (OR = 3.6, 95% CI [1.7, 7.9]) and poor SRH (OR = 3.1, 95% CI [1.4, 7.0]) were significantly associated with frequent monthly visits. Our cohort demonstrated that having hypertension and poor self-rated health were associated with frequent monthly GP visits. The perception of high blood pressure does not drive seeking additional GP input.
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Benítez Camps M, Egocheaga Cabello MI, Dalfó Baqué A, Bajo García J, Vara González L, Sanchis Doménech C, Martín Rioboo E, Ureña Fernández T, Domínguez Sardiña M, Bonet Pla A. Estudio Conocimiento: grado de conocimiento sobre hipertensión arterial de nuestros pacientes. Relación con el nivel de control de la misma. HIPERTENSION Y RIESGO VASCULAR 2015; 32:12-20. [DOI: 10.1016/j.hipert.2014.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 06/22/2014] [Accepted: 06/26/2014] [Indexed: 11/28/2022]
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