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Wiese LK, Williams IC, Holt JK, Williams CL, Lingler J, Galvin JE, Schoenberg NE. Testing the 'Faith Moves Mountains model' to increase Alzheimer's disease awareness, detection, and diagnosis among rural, racially, and ethnically diverse older adults. Aging Ment Health 2024; 28:943-956. [PMID: 38127408 PMCID: PMC11144567 DOI: 10.1080/13607863.2023.2294062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Racially and ethnically diverse populations have recently contributed to the majority of rural and small-town growth. Consequently, the disproportionately high risk and prevalence of Alzheimer's disease and related dementias (ADRD) among rural and minoritized older residents will likely increase. To address this threat, we tested the hypotheses that (1) a faith-based, resident-led approach would increase basic ADRD knowledge and diagnosis, and (2) older age, female gender, lower educational levels, and more years lived rural would predict number of referrals, new dementia diagnoses, and treatment. METHODS An adaptation of Schoenberg's Faith Moves Mountains model, previously successful in detection and management of other chronic illnesses in rural settings, guided this community-based participatory research. Local faith community members were trained as research assistants to recruit, administer surveys, conduct brief memory assessments, teach brain health strategies, and follow-up with residents. Outreaches were offered virtually during the pandemic, then in-person monthly at rotating church sites, and repeated ∼1 year later. RESULTS This rural sample was racially and ethnically diverse (74.5% non-White), with 28% reporting eight or less years of formal education. Findings included that referrals and years lived rural were significant and positive predictors of new ADRD treatments [(b = 3.74, χ2(1, n = 235) = 13.01, p < 0.001); (b = 0.02, χ2(1, n = 235 = 3.93, p = 0.048)], respectively, regardless of participant characteristics. CONCLUSION Resident-led action research in rural, diverse, faith communities is a successful approach to increasing ADRD disease knowledge, detection, diagnosis, and treatment.
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Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Ishan C Williams
- University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Janet K Holt
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
- Southern Illinois University, Edwardsville, IL, USA
| | | | - Jennifer Lingler
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, FL, USA
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Ritchie ND, Turk MT. Enhancing access and impact of the Medicare Diabetes Prevention Program using telehealth: a narrative review. Mhealth 2023; 10:10. [PMID: 38323146 PMCID: PMC10839516 DOI: 10.21037/mhealth-23-37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/16/2023] [Indexed: 02/08/2024] Open
Abstract
Background and Objective Over 26 million older adults in the United States (US) have prediabetes, which is often a precursor to type 2 diabetes. The Medicare Diabetes Prevention Program (MDPP) is an evidence-based, lifestyle program for older-adult Medicare beneficiaries to prevent progression to diabetes. However, the MDPP has been drastically underutilized. Telehealth delivery may be a promising strategy to increase the reach and impact of the MDPP, including for underserved populations. The objective of this narrative review is to explore the role of telehealth on the accessibility and effectiveness of diabetes prevention programs (DPPs) for older adults. Methods We searched the online databases of MEDLINE, APA PsycInfo, CINAHL, and Academic Search Elite for studies that used telehealth to deliver DPPs to older adults through distance learning, i.e., live program delivery where participants join via phone- or video-conferencing. Relevant information from policy documents and related publications was also included. Key Content and Findings Three themes emerged from the literature on telehealth delivery of DPPs for older adults (I) clinical effectiveness for weight loss, (II) feasibility and acceptability of this format; and (III) policy considerations to support greater public health impact. There is a growing body of recent evidence to suggest that older adults achieve a clinically meaningful amount of weight loss from participation in telehealth DPPs. The literature suggests that telehealth program delivery is feasible, and older adults find it acceptable, with some specific accommodations. Effectiveness and acceptability of telehealth interventions were also noted for older adults from rural, ethnically-diverse, and low-income groups. Policy considerations include adjustments in rulemaking by the Centers for Medicare and Medicaid Services (CMS) to allow MDPP delivery via telehealth using distance learning, along with sufficient reimbursement rates. Conclusions The evidence indicates that delivery of the MDPP via telehealth is beneficial for increasing program reach and impact, including among underserved groups, as well as providing social support for older participants. Scalable delivery of the MDPP via telehealth is essential to make a national, population-level impact for older adults with prediabetes who receive Medicare benefits.
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Affiliation(s)
- Natalie D. Ritchie
- Office of Research, Denver Health and Hospital Authority, Denver, CO, USA
- Department of Psychiatry, University of Colorado School of Medicine, Denver, CO, USA
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Firdaus MKZH, Jittanoon P, Boonyasopun U, Che Hasan MK. The effect of mHealth program on behavior modification and health outcomes among patients with diabetes: A randomized controlled trial study. BELITUNG NURSING JOURNAL 2023; 9:437-447. [PMID: 37901368 PMCID: PMC10600709 DOI: 10.33546/bnj.2664] [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: 04/12/2023] [Revised: 04/26/2023] [Accepted: 09/23/2023] [Indexed: 10/31/2023] Open
Abstract
Background Mobile health presents a promising alternative in the digital era. Mobile health apps (mHealth), when combined with the concept of self-management, are considered one of the methods for incorporating technology-based interventions into the healthcare system. Objective This study aimed to determine the effect of mHealth (specifically, the Diabetic Care App) on foot care behavior, dietary behavior, foot condition, and fasting blood glucose levels among patients with uncontrolled diabetes mellitus. Methods A single randomized controlled trial was conducted at a government-run primary clinic in Northern Malaysia, involving 58 patients with uncontrolled diabetes who were assigned to two groups. The intervention group received the Diabetic Care App, attended a 2-hour face-to-face session, and was included in a WhatsApp group, while the control group received standard care. Relevant assessments were conducted for both groups in Week 1 and Week 5. The study was conducted from February 2020 to November 2020, and parametric and non-parametric statistics were used for data analysis. Results Pretest-posttest comparisons in both groups revealed significant findings for foot care behavior (p <0.01), dietary behavior (p <0.01), and foot condition (p <0.01), except for fasting blood glucose levels. In inter-group comparisons, a significant difference was observed only in foot care behavior (p <0.01) and dietary behavior (p <0.01). Conclusion The results indicate that technology-based interventions are beneficial for modifying behavior, specifically in terms of foot care and dietary behavior, in this study. The study highlights the applicability of mHealth for nurses in patient education and self-management of chronic conditions. Future research should explore app utilization among patients with chronic conditions. Clinical trial registration number NCT04260100 (registered at https://clinicaltrials.gov/ct2/show/NCT04260100).
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Affiliation(s)
- Mohd Khairul Zul Hasymi Firdaus
- Department of Medical Surgical Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Malaysia
- Faculty of Nursing, Prince of Songkla University, Thailand
| | | | | | - Muhammad Kamil Che Hasan
- Department of Medical Surgical Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Malaysia
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Herbert J, Schumacher T, Brown LJ, Clarke ED, Collins CE. Delivery of telehealth nutrition and physical activity interventions to adults living in rural areas: a scoping review. Int J Behav Nutr Phys Act 2023; 20:110. [PMID: 37715234 PMCID: PMC10504780 DOI: 10.1186/s12966-023-01505-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/20/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Lifestyle behaviours related to smoking, alcohol, nutrition, and physical activity are leading risk factors for the development of chronic disease. For people in rural areas, access to individualised lifestyle services targeting behaviour change may be improved by using telehealth. However, the scope of literature investigating telehealth lifestyle behaviour change interventions for rural populations is unknown, making it difficult to ascertain whether telehealth interventions require adaptation for rural context via a systematic review. This scoping review aimed to address this gap, by mapping existing literature describing telehealth lifestyle interventions delivered to rural populations to determine if there is scope for systematic review of intervention effectiveness in this research topic. METHODS The PRISMA extension for scoping review checklist guided the processes of this scoping review. A search of eight electronic databases reported in English language until June 2023 was conducted. Eligible studies included adults (18 years and over), who lived in rural areas of high-income countries and undertook at least one synchronous (video or phone consultation) telehealth intervention that addressed either addictive (smoking or alcohol), or non-addictive lifestyle behaviours (nutrition or physical activity). Studies targeting addictive and non-addictive behaviours were separated after full text screening to account for the involvement of addictive substances in smoking and alcohol studies that may impact behaviour change interventions described. Studies targeting nutrition and/or physical activity interventions are presented here. RESULTS The search strategy identified 17179 citations across eight databases, with 7440 unique citations once duplicates were removed. Full texts for 492 citations were retrieved and screened for inclusion with 85 publications reporting on 73 studies eligible for data extraction and analysis. Of this, addictive behaviours were comprised of 15 publications from 13 studies. Non-addictive behaviours included 70 publications from 58 studies and are reported here. Most interventions were delivered within the United States of America (n = 43, 74.1%). The most common study design reported was Randomised Control Trial (n = 27, 46.6%). Included studies involved synchronous telehealth interventions targeting nutrition (11, 18.9%), physical activity (5, 8.6%) or nutrition and physical activity (41, 70.7%) and were delivered predominately via videoconference (n = 17, 29.3%). CONCLUSIONS Despite differences in intervention characteristics, the number of randomised control trials published suggests sufficient scope for future systematic reviews to determine intervention effectiveness related to nutrition and physical activity telehealth interventions for rural populations. TRIAL REGISTRATION The scoping review protocol was not pre-registered.
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Affiliation(s)
- Jaimee Herbert
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Tracy Schumacher
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Leanne J Brown
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Erin D Clarke
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, ATC 205, ATC Building, University Drive Callaghan, Newcastle, NSW, 2308, Australia
| | - Clare E Collins
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, ATC 310, ATC Building, University Drive Callaghan, Newcastle, NSW, 2308, Australia.
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Ritchie ND, Gurfinkel D, Sajatovic M, Carter M, Glasgow RE, Holtrop JS, Waxmonsky JA, Kwan BM. A Multi-Method Study of Patient Reach and Attendance in a Pragmatic Trial of Diabetes Shared Medical Appointments. Clin Diabetes 2023; 41:526-538. [PMID: 37849523 PMCID: PMC10577507 DOI: 10.2337/cd23-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Shared medical appointments (SMAs) are an evidence-based approach to diabetes care in primary care settings, yet practices can struggle to ensure participation, especially among racial and ethnic minority and low-income patients. We conducted a multimethod evaluation of reach and attendance in the Invested in Diabetes study of the comparative effectiveness of two SMA delivery models (standardized and patient-driven) in two practice settings (federally qualified health centers [FQHCs] and clinics serving more commercially insured patients). Through this study, 22 practices reached 6.2% of patients with diabetes through SMAs over 3 years, with good attendance for both practice types and both SMA delivery models. FQHCs were especially successful at enrolling underserved populations and improved attendance with virtual SMAs.
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Affiliation(s)
- Natalie D. Ritchie
- Center for Health Systems Research, Denver Health & Hospital Authority, Denver, CO
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Dennis Gurfinkel
- Adult & Child Center for Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Martha Sajatovic
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Madelaine Carter
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Russell E. Glasgow
- Adult & Child Center for Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO
- Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jodi Summers Holtrop
- Adult & Child Center for Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jeanette A. Waxmonsky
- Adult & Child Center for Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Bethany M. Kwan
- Adult & Child Center for Outcomes Research & Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
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Graham SA, Auster-Gussman LA, Lockwood KG, Branch OH. Weight Loss in a Digital Diabetes Prevention Program for People in Health Professional Shortage and Rural Areas. Popul Health Manag 2023. [PMID: 37115532 DOI: 10.1089/pop.2022.0278] [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: 04/29/2023] Open
Abstract
Individuals with prediabetes living in hard-to-reach and underserved areas experience barriers to accessing traditional in-person preventive health services. The National Diabetes Prevention Program (DPP) is a preventive health care program designed to reduce the risk of developing type 2 diabetes. Although there have been increasing numbers of remote DPPs accessible, there are little data on the clinical outcomes of digital DPPs for members living in hard-to-reach and underserved areas. This study assessed whether living in a designated Health Professional Shortage Area (HPSA) and a rural versus urban area impacted the weight loss of N = 7266 members of a fully digital program called Lark DPP. Secondary analyses included between-group comparisons of program retention and member characteristics, demographics, and socioeconomics. Percent weight loss did not differ by HPSA (P = 0.16) or rural/urban status (P = 0.15), despite greater potential barriers for members residing in HPSAs (eg, highest starting body mass index, lowest income, lowest education). Mean percent weight loss for members residing in an HPSA and rural area was mean (M) = 4.75%, standard error (SE) = 0.09; for members in a non-HPSA, rural area M = 4.96%, SE = 0.16; for members in an HPSA, urban area M = 4.55%, SE = 0.13; and for members in a non-HPSA, urban area M = 4.77%, SE = 0.13. Members of a fully digital DPP achieved weight loss that did not differ by HPSA or urban/rural designation. Fully digital programs offer a solution to reduce the risk of type 2 diabetes in areas where residents may not otherwise have access to diabetes prevention services.
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Qiao K, Liu H, Li X, Jin Q, Wang Y, Gu M, Bai X, Qin T, Yang Y. An intervention study on a hospital-community integrated management model of tobacco dependence based on a community intervention trial. Front Psychiatry 2023; 14:1029640. [PMID: 36960455 PMCID: PMC10027698 DOI: 10.3389/fpsyt.2023.1029640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Objective To assess the effect of the hospital-community integrated management model of tobacco dependence on smoking cessation among community residents compared with a brief smoking cessation intervention. Methods Our study recruited 651 smokers who were willing to quit in 19 communities in Beijing and conducted a 6-month smoking cessation intervention. The control group receiving a brief smoking cessation intervention and the pilot group receiving an integrated smoking cessation intervention. Intention-to-treat analysis (ITT) and generalized estimating equations were used to assess the effects of the integrated intervention and smoking cessation medication on average number of cigarettes smoked per day (ACSD) and smoking cessation rate. Results Simple effects analysis showed that smokers taking medication had significantly lower ACSD than those not taking medication at follow-up, the control group reduced smoking by 3.270, 4.830, and 4.760 cigarettes in the first, third and sixth months, respectively, while the pilot group reduced by 6.230, 5.820, and 4.100 cigarettes. The integrated intervention significantly reduced ACSD among medication-taking smokers at 1st month (reduced by 3.420, P < 0.05) and 3rd month (reduced by 2.050, P < 0.05), but had no significant effect among non-medication taking smokers. The 3rd month smoking cessation rate among medication-taking smokers was 27.0%, which was significantly higher than the smokers with brief smoking cessation intervention. Conclusion The integrated hospital-community intervention can significantly promote smoking cessation among smokers taking medication, but the issue of payment for medication and additional labor compensation for medical staff should be addressed before its popularization.
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Affiliation(s)
- Kun Qiao
- School of Public Health, Capital Medical University, Beijing, China
| | - Han Liu
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xingming Li
- School of Public Health, Capital Medical University, Beijing, China
- *Correspondence: Xingming Li,
| | - Qianying Jin
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yao Wang
- School of Public Health, Capital Medical University, Beijing, China
| | - Mingyu Gu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xinyuan Bai
- School of Public Health, Capital Medical University, Beijing, China
| | - Tingting Qin
- School of Public Health, Capital Medical University, Beijing, China
| | - Yutong Yang
- School of Public Health, Capital Medical University, Beijing, China
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Firdaus MKZH, Jittanoon P, Boonyasopun U. Developing, validating, and pre-testing of a diabetic care self-management mobile health application: A technology-based intervention for patients with diabetes in Malaysia. BELITUNG NURSING JOURNAL 2022; 8:365-371. [PMID: 37546497 PMCID: PMC10401381 DOI: 10.33546/bnj.2127] [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: 04/21/2022] [Revised: 05/22/2022] [Accepted: 07/05/2022] [Indexed: 08/08/2023] Open
Abstract
Background Technology-based intervention showed a promising approach to health promotion strategies. There had been limited knowledge of the existing program for technology-based intervention in promoting foot care and dietary behavior modification. Thus, a mobile app was developed as an alternative strategy for promoting foot care and dietary behavior modification. Objective This paper aims to elaborate on the process of developing, validating, and examining the Diabetic Care Self-Management Mobile Health Application (Diabetic Care). Methods There are two phases conducted. The first phase is the process of developing and validating Diabetic Care. Intervention Mapping (IM) Framework was used to guide the process of developing Diabetic Care, while in assessing validity, guidance from Kassam-Adams et al. was used. A team of experts was appointed to validate the mobile app developed. Next, the usability of Diabetic Care was conducted among ten conveniently chosen patients with diabetes in a governmental primary care clinic. Results The process of developing Diabetic Care was clearly explained. The Diabetic Care app showed a good I-CVI score (1.00) and general CVI score (1.00) after the expert team assessed. During the trial, two drawbacks were identified and explored to find solutions. Conclusion The Diabetic Care app is proven appropriate to be employed in the study. Even though there were two drawbacks encountered, however, possible solutions were able to be explored in addressing the issues. Further research should be conducted to examine the effectiveness of this mobile app in modifying foot care behavior and dietary behavior. Hence, it will assist in the translation of advanced technology in nursing care.
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Affiliation(s)
- Mohd Khairul Zul Hasymi Firdaus
- Kulliyyah of Nursing, International Islamic University Malaysia, Malaysia
- Faculty of Nursing, Prince of Songkla University, Thailand
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Dugani SB, Mielke MM, Vella A. Burden and management of type 2 diabetes in rural United States. Diabetes Metab Res Rev 2021; 37:e3410. [PMID: 33021052 PMCID: PMC7990742 DOI: 10.1002/dmrr.3410] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/10/2020] [Accepted: 08/23/2020] [Indexed: 12/31/2022]
Abstract
In the United States, rural areas have a higher burden of type 2 diabetes (T2DM) compared to urban areas. However, there is limited information on risk factors and interventions that improve the primary prevention and management of T2DM in rural areas. To synthesize current knowledge on T2DM in rural areas and to guide healthcare providers and policy makers, we reviewed five scientific databases and the grey literature over the last decade (2010-2020). We described classification systems for rurality and the T2DM burden based on rurality and region (West, South, Midwest, and Northeast). We highlighted risk factors for T2DM in rural compared to urban areas, and summarized interventions to screen and manage T2DM based on opportunistic screening, T2DM self-management, community-based initiatives, as well as interventions targeting comorbidities and T2DM. Several studies identified the co-existence of T2DM and depression/psychological symptoms, which could reduce adherence to non-pharmacologic and pharmacologic management of T2DM. We highlighted the role of technology in education and counselling of patients with geographic and financial barriers to accessing care, which is exacerbated by the SARS-CoV-2 coronavirus disease-19 pandemic. We identified knowledge gaps and next steps in improving T2DM care in rural areas. There is an urgent need for interventions tailored to rural areas given that rural Americans currently experience a disproportionate burden of T2DM and are encumbered by its associated morbidity, mortality, and loss in economic productivity.
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Affiliation(s)
| | | | - Adrian Vella
- Division of Endocrinology, Mayo Clinic, Rochester, MN
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Reed M, Wilbur J, Tangney CC, Miller AM, Schoeny ME, Webber-Ritchey KJ. Development and Feasibility of an Obesity Prevention Intervention for Black Adolescent Daughters and Their Mothers. JOURNAL OF HEALTHY EATING AND ACTIVE LIVING 2021; 1:94-107. [PMID: 37789909 PMCID: PMC10544921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Black female adolescents and women have disproportionately higher rates of obesity than their racial/ethnic counterparts. There is an urgent need to address obesity prevention in Black adolescent females through interventions that enhance lifestyle physical activity and improve dietary behaviors. Middle adolescence presents an important opportunity to strengthen the daughter-mother bond and improve healthy behaviors such as physical activity and dietary intake. Because of the intersection of adolescent development, culture and structural racism, it is essential to include mothers; however, this approach is understudied in the literature. This pre-pilot proof of concept study, Black Girls Move, was conducted using a 12-week pre-post within-subjects design to assess feasibility of conducting and delivering the BGM intervention, program satisfaction, and ability to obtain outcome measures in Black ninth and tenth grade daughters and their mothers. Twenty-two dyads were recruited and 14 dyads completed baseline assessments; however, only eight daughters and their mothers attended the first session and remained for the entire study. All dyads had valid objective and self-reported physical activity data. However, two of eight daughters and one mother provided self-reported dietary data that were considered invalid. All individual sessions were rated highly. Excellent attendance, retention, and satisfaction among participants suggest that we succeeded in developing an accepted, culturally relevant intervention. This lifestyle intervention would be strengthened by modifications to recruitment and retention, as well as incorporation of a computerized dietary assessment tool, a tailored dietary app for self-monitoring, and increased photo-based and group homework activities.
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Gershkowitz BD, Hillert CJ, Crotty BH. Digital Coaching Strategies to Facilitate Behavioral Change in Type 2 Diabetes: A Systematic Review. J Clin Endocrinol Metab 2021; 106:e1513-e1520. [PMID: 33206975 DOI: 10.1210/clinem/dgaa850] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Indexed: 01/18/2023]
Abstract
CONTEXT In this systematic review, we focus on the clinical impact of digital tools for providing health coaching, education, and facilitating behavior in patients with prediabetes or type 2 diabetes. Our approach was designed to provide insights for clinicians and health care systems that are considering adopting such digital tools. EVIDENCE ACQUISITION We searched the CINAHL, Scopus, and Ovid/MEDLINE databases using PRISMA guidelines for studies that reported digital coaching strategies for management and prevention of type 2 diabetes published from January 2014 to June 2019. Articles were reviewed by 2 independent blinded reviewers. Twenty-one articles met inclusion criteria. EVIDENCE SYNTHESIS We found that 20 of 21 studies in our analysis showed statistically significant improvements in at least one measure of diabetes control including HbA1c, weight loss, fasting blood glucose, and BMI. Studies that reported weight loss percentage from baseline at 1 year reported values ranging from -3.04% to -8.98%, similar to outcomes with traditional coaching in the Diabetes Prevention Program (N = 4). Additionally, all studies that included a comparison group of in-person or telephone-based coaching showed statistically better or similar outcomes in the digital coaching group (N = 5). CONCLUSIONS The evidence reported in this systematic review suggests that digital health coaching offers a promising strategy for long-term management and prevention of type 2 diabetes in diverse populations with similar benefits to in-person or telephone-based health coaching. We argue that, with the potential to treat large numbers of individuals in diverse geographic locations, digital coaching offers a promising solution to the rapid increase in diabetes prevalence.
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Beks H, King O, Clapham R, Alston L, Glenister K, McKinstry C, Quilliam C, Wellwood I, Williams C, Wong Shee A. Community health programs delivered through information and communications technology in high-income countries: a scoping review (Preprint). J Med Internet Res 2020; 24:e26515. [PMID: 35262498 PMCID: PMC8943572 DOI: 10.2196/26515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/15/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background The COVID-19 pandemic has required widespread and rapid adoption of information and communications technology (ICT) platforms by health professionals. Transitioning health programs from face-to-face to remote delivery using ICT platforms has introduced new challenges. Objective The objective of this review is to scope for ICT-delivered health programs implemented within the community health setting in high-income countries and rapidly disseminate findings to health professionals. Methods The Joanna Briggs Institute’s scoping review methodology guided the review of the literature. Results The search retrieved 7110 unique citations. Each title and abstract was screened by at least two reviewers, resulting in 399 citations for full-text review. Of these 399 citations, 72 (18%) were included. An additional 27 citations were identified through reviewing the reference lists of the included studies, resulting in 99 citations. Citations examined 83 ICT-delivered programs from 19 high-income countries. Variations in program design, ICT platforms, research design, and outcomes were evident. Conclusions Included programs and research were heterogeneous, addressing prevalent chronic diseases. Evidence was retrieved for the effectiveness of nurse and allied health ICT-delivered programs. Findings indicated that outcomes for participants receiving ICT-delivered programs, when compared with participants receiving in-person programs, were either equivalent or better. Gaps included a paucity of co-designed programs, qualitative research around group programs, programs for patients and carers, and evaluation of cost-effectiveness. During COVID-19 and beyond, health professionals in the community health setting are encouraged to build on existing knowledge and address evidence gaps by developing and evaluating innovative ICT-delivered programs in collaboration with consumers and carers.
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Affiliation(s)
- Hannah Beks
- School of Medicine, Deakin University, Geelong, Australia
| | | | - Renee Clapham
- St Vincents Health Australia, Melbourne, Australia
- Ballarat Health Services, Ballarat, Australia
| | - Laura Alston
- School of Medicine, Deakin University, Geelong, Australia
- Colac Area Health, Colac, Australia
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Kristen Glenister
- Department of Rural Health, University of Melbourne, Wangaratta, Australia
- Department of Rural Health, University of Melbourne, Shepparton, Australia
| | - Carol McKinstry
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Claire Quilliam
- Department of Rural Health, University of Melbourne, Wangaratta, Australia
| | - Ian Wellwood
- Faculty of Health Sciences, Australian Catholic University, Ballarat, Australia
| | | | - Anna Wong Shee
- School of Medicine, Deakin University, Geelong, Australia
- Ballarat Health Services, Ballarat, Australia
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13
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Affiliation(s)
- Maria T Vamvini
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Joanne R Dushay
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Martin J Abrahamson
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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14
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The Effect of Remote Patient Monitoring on Patients with Spinal Cord Injury: A Mini-Review. ARCHIVES OF NEUROSCIENCE 2019. [DOI: 10.5812/ans.85491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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