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Anokye R, Jackson B, Dimmock J, Dickson JM, Blekkenhorst LC, Hodgson JM, Lewis JR, Stanley M. Psychological distress and quality of life in asymptomatic adults following provision of imaging results for prevention of cardiovascular disease events: a scoping review. Eur J Cardiovasc Nurs 2023; 22:13-22. [PMID: 35709338 DOI: 10.1093/eurjcn/zvac047] [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: 03/11/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 01/14/2023]
Abstract
AIMS Psychological distress and changes in health-related quality of life (HRQoL) may occur after screening for disease. Reporting outcomes related to potential benefits and harms of screening is a key recommendation in the guidelines for reporting high-quality trials or interventions. However, no reviews have directly investigated outcomes related to psychological distress and/or changes in HRQoL following imaging assessment of cardiovascular risk and communication of cardiovascular findings to asymptomatic adults. A scoping review was conducted to map research on psychological distress and/or HRQoL following screening. METHODS AND RESULTS Six electronic databases (MEDLINE, PsychINFO, Social Work Abstracts, Psychology and Behavioural Sciences Collection, CINAHL, and EMBASE) were searched for articles that assessed psychological distress and/or HRQoL following screening. Two investigators independently screened titles and abstracts for all records retrieved using predefined criteria. Studies were conducted among active smokers, military personnel, athletes, post-menopausal women, and high-risk individuals. Seven constructs related to psychological distress and HRQoL appeared across 11 articles (randomized controlled trials, n = 4 and non-randomized studies, n = 7). Worry, depression, perceived stress, anxiety, and quality of life were most prominent. Multiple-item measures of psychological distress (e.g. Taylor Anxiety Score and Beck Depression Inventory) were used in 5/9 (56%) studies. Key findings on psychological distress and/or changes in HRQoL following screening were mixed. CONCLUSIONS Findings support the need for multiple-item measures with better psychometric properties to examine the psychological responses to screening results in future studies. Strategies to support individuals during and following vascular screening to maximise potential benefits of screening and minimize harms are discussed.
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Affiliation(s)
- Reindolf Anokye
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Royal Perth Hospital Research Foundation, Perth, WA, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - James Dimmock
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia.,Department of Psychology, College of Healthcare Sciences, James Cook University, Queensland, Australia
| | - Joanne M Dickson
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Royal Perth Hospital Research Foundation, Perth, WA, Australia.,School of Arts and Humanities (Psychology Discipline), Edith Cowan University, Joondalup, WA, Australia.,Department of Psychological Science, University of Liverpool, Liverpool, UK
| | - Lauren C Blekkenhorst
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Royal Perth Hospital Research Foundation, Perth, WA, Australia.,Medical School, The University of Western Australia, Perth, Australia
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Royal Perth Hospital Research Foundation, Perth, WA, Australia.,Medical School, The University of Western Australia, Perth, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Royal Perth Hospital Research Foundation, Perth, WA, Australia.,Medical School, The University of Western Australia, Perth, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Mandy Stanley
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Lv N, Azar KMJ, Rosas LG, Wulfovich S, Xiao L, Ma J. Behavioral lifestyle interventions for moderate and severe obesity: A systematic review. Prev Med 2017; 100:180-193. [PMID: 28450123 PMCID: PMC5503454 DOI: 10.1016/j.ypmed.2017.04.022] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 04/13/2017] [Accepted: 04/22/2017] [Indexed: 12/29/2022]
Abstract
Moderate and severe obesity (BMI ≥35 kg/m2) affect 15% of US adults, with a projected increase over the next two decades. This study reviews evidence of behavioral lifestyle interventions for weight loss in this population. We searched PubMed, PsychInfo, CINAHL®, and Scopus through February 2016 for experimental and quasi-experimental studies that tested a dietary and/or physical activity intervention with a behavioral modification component versus a comparator; and had ≥six-month follow-up and a weight-related primary outcome. Twelve studies representing 1862 participants (mean BMI 37.5-48.3, mean age 30-54 years) were included. Nine studies compared different behavioral interventions and three tested behavioral intervention(s) versus pharmacological or surgical treatments. Among the 25 behavioral interventions in the 12 studies, 18 reported percent of participants achieving clinically significant weight loss up to 12months (32-97% achieving 5% or 3-70% achieving 10%). Three studies measured other cardiometabolic risk factors, but showed no significant risk reduction. Seven interventions with greater effectiveness (i.e., at least 31% achieving ≥10% or 62% achieving ≥5% weight loss up to one year) included multiple components (diet, physical activity, and behavioral strategies), long duration (e.g., one year), and/or intensive contacts (e.g., inpatient stays for clinic-based interventions, weekly contacts for community-based ones). Evidence for the effectiveness of behavioral interventions versus pharmacological or surgical treatment was limited. Comprehensive and intensive behavioral interventions can result in clinically significant, albeit modest, weight loss in this obese subpopulation but may not result significant improvements in other cardiometabolic risk factors. More research on scalable and sustainable interventions is needed.
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Affiliation(s)
- Nan Lv
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA 94301, USA
| | - Kristen M J Azar
- Sutter Health Research, Development and Dissemination, Walnut Creek, CA 94596, USA
| | - Lisa Goldman Rosas
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA 94301, USA; Department of Medicine, Stanford University School of Medicine, Stanford, CA 94301, USA
| | - Sharon Wulfovich
- Department of Human Biology, Stanford University, Stanford, CA 94301, USA
| | - Lan Xiao
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA 94301, USA
| | - Jun Ma
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA 94301, USA; Health Policy and Administration, School of Public Health Academic Internal Medicine and Geriatric, College of Medicine, University of Illinois at Chicago, Chicago, IL 60608, USA.
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Campos-Uscanga Y, Gutiérrez-Ospina G, Morales-Romero J, Romo-González T. Self-regulation of eating and physical activity is lower in obese female college students as compared to their normal weight counterparts. Eat Weight Disord 2017; 22:311-319. [PMID: 27796845 DOI: 10.1007/s40519-016-0338-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 10/20/2016] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE Obesity is characterized, among other features, by overeating, reduced physical activity and an abnormal accumulation of body fat. These features are thought to result, at least in part, from the individual's inability to self-regulate their eating and physical activity behaviors (E&PaB). Self-regulation of the E&PaB is a three-step sequential process: self-observation, self-evaluation and self-reaction. However, it is yet unclear whether deficient self-regulation of E&PaB could predispose, facilitate and/or consolidate obesity. Unraveling this issue is fundamental in order to more precisely define the role of self-regulation of E&PaB in the management of obesity. METHODS This research was focused on the question of whether or not self-regulation of E&PaB is related to obesity in female undergraduate students. This population segment seems especially vulnerable to developing obesity since they undergo a significant shift of their E&PaB upon their university enrollment. To address this question, a cross-sectional study with 108 female undergraduate students with normal weight (n = 80) or obesity (n = 28) was performed, in which self-regulation of eating habits and physical activity was measured by two validated scales and a personal data questionnaire. RESULTS Female undergraduate students displaying lower E&PaB self-reactions were consistently overweight or obese. In addition, a multivariate analysis identified high levels of self-reaction towards eating habits related to a minor presence of overweight issues or obesity. CONCLUSION Self-regulation should be an essential component in the strategies for obesity prevention as an integral approach that must include orientation about healthy eating and physical activity behaviors. In addition, further studies on the effect of self-regulation in the treatment of the obesity are needed.
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Affiliation(s)
- Yolanda Campos-Uscanga
- Instituto de Salud Pública, Universidad Veracruzana, Luis Castelazo Ayala s/n, Col. Industrial Ánimas, 91190, Xalapa, Veracruz, Mexico
| | - Gabriel Gutiérrez-Ospina
- Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas; Coordinación de Psicobiología, Facultad de Psicología, Universidad Nacional Autónoma de México, Avenida Universidad # 3000, Distrito Federal, 04510, Mexico
| | - Jaime Morales-Romero
- Instituto de Salud Pública, Universidad Veracruzana, Luis Castelazo Ayala s/n, Col. Industrial Ánimas, 91190, Xalapa, Veracruz, Mexico
| | - Tania Romo-González
- Área de Biología y Salud Integral, Instituto de Investigaciones Biológicas, Universidad Veracruzana, Luis Castelazo Ayala s/n, Col. Industrial Ánimas, 91190, Xalapa, Veracruz, Mexico.
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Annesi JJ, Johnson PH, Tennant GA, Porter KJ, Mcewen KL. Weight Loss and the Prevention of Weight Regain: Evaluation of a Treatment Model of Exercise Self-Regulation Generalizing to Controlled Eating. Perm J 2016; 20:15-146. [PMID: 26901268 DOI: 10.7812/tpp/15-146] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
CONTEXT For decades, behavioral weight-loss treatments have been unsuccessful beyond the short term. Development and testing of innovative, theoretically based methods that depart from current failed practices is a priority for behavioral medicine. OBJECTIVE To evaluate a new, theory-based protocol in which exercise support methods are employed to facilitate improvements in psychosocial predictors of controlled eating and sustained weight loss. METHODS Women with obesity were randomized into either a comparison treatment that incorporated a print manual plus telephone follow-ups (n = 55) or an experimental treatment of The Coach Approach exercise-support protocol followed after 2 months by group nutrition sessions focused on generalizing self-regulatory skills from an exercise support to a controlled eating context (n = 55). Repeated-measures analysis of variance contrasted group changes in weight, physical activity, fruit and vegetable intake, mood, and exercise- and eating-related self-regulation and self-efficacy over 24 months. Regression analyses determined salient interrelations of change scores over both the weight-loss phase (baseline-month 6) and weight-loss maintenance phase (month 6-month 24). RESULTS Improvements in all psychological measures, physical activity, and fruit and vegetable intake were significantly greater in the experimental group where a mean weight loss of 5.7 kg (6.1% of initial body weight) occurred at month 6, and was largely maintained at a loss of 5.1 kg (5.4%) through the full 24 months of the study. After establishing temporal intervals for changes in self-regulation, self-efficacy, and mood that best predicted improvements in physical activity and eating, a consolidated multiple mediation model suggested that change in self-regulation best predicted weight loss, whereas change in self-efficacy best predicted maintenance of lost weight. CONCLUSIONS Because for most participants loss of weight remained greater than that required for health benefits, and costs for treatment administration were comparatively low, the experimental protocol was considered successful. After sufficient replication, physician referral and applications within health promotion and wellness settings should be considered.
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Affiliation(s)
- James J Annesi
- Director of Wellness Advancement, YMCA of Metropolitan Atlanta, and Professor in the Department of Health Promotion and Physical Education at Kennesaw State University in GA.
| | - Ping H Johnson
- Professor in the Department of Health Promotion and Physical Education at Kennesaw State University in GA.
| | | | - Kandice J Porter
- Associate Professor in the Department of Health Promotion and Physical Education at Kennesaw State University in GA.
| | - Kristin L Mcewen
- Empower Healthy Living Lead at the YMCA of Metropolitan Atlanta in GA.
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