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Robinson KM, Robinson KA, Scherer AM, Mackin ML. Patient Perceptions of Weight Stigma Experiences in Healthcare: A Qualitative Analysis. Health Expect 2024; 27:e70013. [PMID: 39223786 PMCID: PMC11369018 DOI: 10.1111/hex.70013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 08/05/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Weight stigma is the social devaluation and denigration of individuals because of their excess body weight, resulting in poorer physical and mental health and healthcare avoidance. Attribution Theory and Goffman's theory of spoiled identity provided a general overarching framework for understanding weight stigma experiences. OBJECTIVE Our purpose was to explore weight stigma experiences from a broad range of perspectives emphasizing identities typically excluded in the weight stigma literature. DESIGN We conducted a qualitative descriptive study with data drawn from 73 substantive narrative comments from participants who responded to a larger survey. RESULTS Analysis developed five themes: Working on weight, Not being overweight, Lack of help and empathy, Exposure and embarrassment and Positive experiences. Individuals who would be clinically assessed as overweight, especially men, often did not identify with having a weight problem and found the framing of personal responsibility for weight empowering. Participants with larger body sizes more often attributed embarrassment and shame about weight to treatment in the clinical setting. Older participants were more likely to have positive experiences. CONCLUSIONS The findings suggest ongoing tension between the framing of weight as a personal responsibility as opposed to a multifactorial condition with many uncontrollable aspects. Gender, age and body size shaped respondent perspectives, with some young male respondents finding empowerment through perceived personal control of weight. The healthcare system perpetuates weight stigma through lack of adequate equipment and excessively weight-centric medical counselling. Recommending a healthy lifestyle to patients without support or personalized medical assessment may perpetuate weight stigma and associated detrimental health outcomes. PATIENT OR PUBLIC CONTRIBUTION Patients with obesity and overweight were integral to this study, providing comments for our qualitative analyses.
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Affiliation(s)
- Kathleen M. Robinson
- Department of Internal MedicineUniversity of Iowa Hospitals and ClinicsIowa CityIowaUSA
- Division of EndocrinologyUniversity of Iowa Hospitals and ClinicsIowa CityIowaUSA
| | | | - Aaron M. Scherer
- Department of Internal MedicineUniversity of Iowa Hospitals and ClinicsIowa CityIowaUSA
| | - Melissa Lehan Mackin
- Health Science Campus, College of NursingUniversity of New Mexico College of NursingAlbuquerqueNew MexicoUSA
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Crane NT, Miller NA, Arigo D, Butryn ML. Understanding the selection of support partners in a behavioral weight loss program. Psychol Health 2024:1-18. [PMID: 39028224 DOI: 10.1080/08870446.2024.2381238] [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: 09/29/2023] [Accepted: 07/10/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE Engaging a support partner during behavioral weight loss (BWL) programs can improve outcomes. However, little information is available about those selected as support partners. The study aimed to (1) characterize support partners and qualities of the relationship, (2) assess differences in relationship dynamics across relationship types, and (3) assess differences in supportive relationships by participant gender. METHODS AND MEASURES Upon entering a 24-month BWL program, participants (N = 323) nominated a support person from their existing social networks. Participants completed self-report measures at baseline, including the Working Alliance Inventory and study-specific measures assessing characteristics of the support person and comfort in communicating with them. RESULTS Spouse/partners were chosen by 43.3% of all participants. Among married participants, 80.9% of men and 53.8% of women chose their spouse/partner. Working alliance was lower when the support partner was a spouse/partner versus a friend (p < 0.05, r = -0.19). Comfort talking about exercise with a support partner was higher than talking about eating or weight (p < 0.001, η2p= 0.05). CONCLUSION A variety of friends and family can be selected as support partners during BWL. Programs should attend to the unique needs of men versus women when identifying sources of support.
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Affiliation(s)
- Nicole T Crane
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Nicole A Miller
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, New Jersey, USA
- Department of Family Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
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Nguyen D, Liu Y, Kavanagh SA, Archibald D. Gender-sensitive community weight-loss programmes to address overweight and obesity in men: a scoping review. BMJ Open 2024; 14:e083646. [PMID: 38991680 PMCID: PMC11243212 DOI: 10.1136/bmjopen-2023-083646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
OBJECTIVES To examine how gender-sensitive community weight-loss programmes have been used to address overweight and obesity in men and to identify what can be learnt from this rapidly evolving field. DESIGN Scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review checklist for reporting. DATA SOURCES A database search was conducted using EBSCOhost (Academic Search Complete, CINAHL Complete, Global Health, Health Source: Consumer Edition, Health Source: Nursing/Academic Edition and Medline Complete), Google, Google Scholar, Open Access Theses and Dissertations platform and Scopus. ELIGIBILITY CRITERIA All weight-loss programmes using a gender-sensitive approach to address men's overweight and obesity in community settings. DATA EXTRACTION AND SYNTHESIS Narrative synthesis was conducted based on the research questions and objectives. Primary outcomes include operationalisation, context and concept of the gender-sensitive approach. Information was reviewed and extracted to Microsoft Excel by two reviewers. RESULTS A total of 40 studies (28 quantitative, eight mixed methods and four qualitative) were identified from 4617 records. Gender-sensitive approaches were undertaken in a range of settings and contexts including professional sports clubs (n=21), non-professional sporting clubs (n=16), workplace-based (n=2) and commercial organisation-based (n=1). The most common analysis approaches were evaluating the effect of the programmes (n=31) where positive impact was predominantly shown (eg, up to 3.9 kg weight reduction at 3-month follow-up). Programmes (ie, Football Fans in Training) were short-term cost-effective (eg, the cost was £862-£2228 per 5% weight reduction at 12-month follow-up). Qualitative evidence highlights factors that influenced men's participation (eg, camaraderie) and identifies areas for improvement. CONCLUSION The findings demonstrate that gender-sensitive programmes for men's weight loss have been effectively applied using a range of different approaches and in a range of different contexts. Further evidence is needed to confirm the effectiveness of the programmes across diverse groups of men.
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Affiliation(s)
- Dieu Nguyen
- Deakin University, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia
| | - Yutong Liu
- Deakin University, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia
| | - Shane A Kavanagh
- Deakin University, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia
| | - Daryll Archibald
- La Trobe University, Olga Tennison Autism Research Centre, Bundoora, Victoria, Australia
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Forman EM, Butryn ML, Chwyl C, Crane MM, Dart H, Hagerman CJ, Manasse SM, Onu M, Sun J, Veling H, Zhang F. Gamification and neurotraining to engage men in behavioral weight loss: Protocol for a factorial randomized controlled trial. Contemp Clin Trials 2023; 124:107010. [PMID: 36396065 PMCID: PMC9839628 DOI: 10.1016/j.cct.2022.107010] [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: 09/19/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
Over 70% of men are overweight, and most desire weight loss; however, men are profoundly underrepresented in weight loss programs. Gamification represents a novel approach to engaging men and may enhance efficacy through two means: (1) game-based elements (e.g., streaks, badges, team-based competition) to motivate weight control behaviors and (2) arcade-style "neurotraining" to enhance neurocognitive capacities to resist the temptation of unhealthy foods and more automatically select healthy foods. This study will use a 2 × 2 factorial design to examine the independent and combinatory efficacy of gamification and inhibitory control training (ICT). Men with overweight/obesity (N = 228) will receive a 12-month mobile weight loss program that incorporates behavioral weight loss strategies (e.g., self-monitoring, goal setting, stimulus control). Men will be randomly assigned to a non-gamified or gamified version, and an active or sham ICT. A game design company will create the program, with input from a male advisory panel. Aims of the project are to test whether a gamified (versus non-gamified) weight loss program and/or ICT (versus sham) promotes greater improvements in weight, diet, and physical activity; whether these treatment factors have combinatory or synergistic effects; to test whether postulated mechanisms of action (increased engagement, for gamification, and inhibitory control, for ICT) mediate treatment effects; and whether baseline gameplay frequency and implicit preferences for ICT-targeted foods moderate effects. It is hoped this study will contribute to improved mHealth programs for men and enhance our understanding of the impact of gamified elements and neurocognitive training on weight control.
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Affiliation(s)
- Evan M Forman
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA.
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Christina Chwyl
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Melissa M Crane
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, USA
| | - Hannah Dart
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Charlotte J Hagerman
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Stephanie M Manasse
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Michael Onu
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Jasmine Sun
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Harm Veling
- Consumption and Healthy Lifestyles, Wageningen University and Research, the Netherlands
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
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Macaulay L, O'Dolan C, Avenell A, Carroll P, Cotton S, Dombrowski S, Elders A, Goulao B, Gray C, Harris FM, Hunt K, Kee F, MacLennan G, McDonald MD, McKinley M, Skinner R, Torrens C, Tod M, Turner K, van der Pol M, Hoddinott P. Effectiveness and cost-effectiveness of text messages with or without endowment incentives for weight management in men with obesity (Game of Stones): study protocol for a randomised controlled trial. Trials 2022; 23:582. [PMID: 35869503 PMCID: PMC9306253 DOI: 10.1186/s13063-022-06504-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity increases the risk of type 2 diabetes, heart disease, stroke, mobility problems and some cancers, and its prevalence is rising. Men engage less than women in existing weight loss interventions. Game of Stones builds on a successful feasibility study and aims to find out if automated text messages with or without endowment incentives are effective and cost-effective for weight loss at 12 months compared to a waiting list comparator arm in men with obesity. METHODS A 3-arm, parallel group, assessor-blind superiority randomised controlled trial with process evaluation will recruit 585 adult men with body mass index of 30 kg/m2 or more living in and around three UK centres (Belfast, Bristol, Glasgow), purposively targeting disadvantaged areas. Intervention groups: (i) automated, theory-informed text messages daily for 12 months plus endowment incentives linked to verified weight loss targets at 3, 6 and 12 months; (ii) the same text messages and weight loss assessment protocol; (iii) comparator group: 12 month waiting list, then text messages for 3 months. The primary outcome is percentage weight change at 12 months from baseline. Secondary outcomes at 12 months are as follows: quality of life, wellbeing, mental health, weight stigma, behaviours, satisfaction and confidence. Follow-up includes weight at 24 months. A health economic evaluation will measure cost-effectiveness over the trial and over modelled lifetime: including health service resource-use and quality-adjusted life years. The cost-utility analysis will report incremental cost per quality-adjusted life years gained. Participant and service provider perspectives will be explored via telephone interviews, and exploratory mixed methods process evaluation analyses will focus on mental health, multiple long-term conditions, health inequalities and implementation strategies. DISCUSSION The trial will report whether text messages (with and without cash incentives) can help men to lose weight over 1 year and maintain this for another year compared to a comparator group; the costs and benefits to the health service; and men's experiences of the interventions. Process analyses with public involvement and service commissioner input will ensure that this open-source digital self-care intervention could be sustainable and scalable by a range of NHS or public services. TRIAL REGISTRATION ISRCTN 91974895 . Registered on 14/04/2021.
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Affiliation(s)
- Lisa Macaulay
- NMAHP Research Unit, Stirling University, Pathfoot Building, Stirling, FK9 4LA, UK.
| | - Catriona O'Dolan
- NMAHP Research Unit, Stirling University, Pathfoot Building, Stirling, FK9 4LA, UK
| | - Alison Avenell
- Health Services Research Unit, 3Rd Floor Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Paula Carroll
- Department Sport & Exercise Science, Waterford Institute of Technology, Main Campus Cork RoadCo. Waterford, Waterford City, Ireland
| | - Seonaidh Cotton
- CHaRT, HRSU, 3Rd Floor Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Stephan Dombrowski
- Faculty of Kinesiology, University of New Brunswick, 3 Bailey Drive, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada
| | - Andrew Elders
- NMAHP Research Unit, Glasgow Caledonian University, Govan Mbeki Building, Cowcaddens Road, G4 0BA, Glasgow, UK
| | - Beatriz Goulao
- CHaRT, HRSU, 3Rd Floor Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Cindy Gray
- School of Social and Political Sciences, University of Glasgow, 25-29 Bute Gardens, Glasgow, G12 8RS, UK
| | - Fiona M Harris
- School of Health & Life Sciences, University of the West of Scotland, High Street, Paisley, Renfrewshire, PA1 2BE, UK
| | - Kate Hunt
- Institute for Social Marketing and Health, Pathfoot Building, University of Stirling, Stirling, FK9 4LA, UK
| | - Frank Kee
- Centre for Public Health, UKCRC Centre of Excellence for Public Health Research (NI), Institute Clinical Sciences A, Grosvenor Road, Belfast, BT12 6BJ, Northern Ireland
| | - Graeme MacLennan
- CHaRT, HRSU, 3Rd Floor Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | | | - Michelle McKinley
- Queen's University Belfast, University Road, Belfast, BT7 1NN, Northern Ireland
| | | | - Claire Torrens
- NMAHP Research Unit, Stirling University, Pathfoot Building, Stirling, FK9 4LA, UK
| | - Martin Tod
- Men's Health Forum, 49-51 East Rd, Hoxton, London, N1 6AH, UK
| | - Katrina Turner
- Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Marjon van der Pol
- Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Pat Hoddinott
- NMAHP Research Unit, Stirling University, Pathfoot Building, Stirling, FK9 4LA, UK
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6
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Kwasnicka D, Donnachie C, Thøgersen-Ntoumani C, Hunt K, Gray CM, Ntoumanis N, McBride H, McDonald MD, Newton RU, Gucciardi DF, Olson JL, Wyke S, Morgan PJ, Kerr DA, Robinson S, Quested E. The Aussie-FIT process evaluation: feasibility and acceptability of a weight loss intervention for men, delivered in Australian Football League settings. Psychol Health 2022; 37:470-489. [PMID: 33719789 DOI: 10.1080/08870446.2021.1890730] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This process evaluation aimed to evaluate the feasibility and acceptability of Aussie-FIT, a group-based weight loss intervention for men with overweight and obesity in Australia. DESIGN Process data and data collected from: (1) six-participant focus groups (n= 24), (2) coach interviews (n = 4), (3) audio recordings of Aussie-FIT sessions and (4) post-program participant surveys (n= 93) were analysed. MAIN OUTCOME MEASURES We explored the feasibility and acceptability of program setting and context, recruitment strategies, factors impacting implementation and mechanisms of impact. RESULTS Recruitment via Australian Football League (AFL) clubs was highly effective; 426 men expressed interest within 3 days of advertising, 130 men took part. Program attendance was not consistently recorded by coaches. Coach interviews indicated a 'core group of men' participated in each session (typically 10-12 of 15 men). Program delivery proved feasible in the AFL context. Program acceptability and satisfaction were high. Internalisation of autonomous motives was identified as driving behaviour change. Behaviour change to support maintained weight loss was facilitated through habit formation, goal setting and effective management of multiple goals. CONCLUSION Aussie-FIT sets a blueprint for future weight loss interventions that utilise behaviour change strategies and principles of self-determined motivation to support men to lose weight. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12617000515392. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
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Affiliation(s)
- Dominika Kwasnicka
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia.,Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Craig Donnachie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cecilie Thøgersen-Ntoumani
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Kate Hunt
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nikos Ntoumanis
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Hannah McBride
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Matthew D McDonald
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
| | - Daniel F Gucciardi
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Jenny L Olson
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Sally Wyke
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, Australia
| | - Deborah A Kerr
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Suzanne Robinson
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Eleanor Quested
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
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7
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Valli C, Suñol R, Orrego C, Niño de Guzmán E, Strammiello V, Adrion N, Immonen K, Ninov L, van der Gaag M, Ballester M, Alonso‐Coello P. The development of a core outcomes set for self-management interventions for patients living with obesity. Clin Obes 2022; 12:e12489. [PMID: 34617681 PMCID: PMC9285702 DOI: 10.1111/cob.12489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 07/05/2021] [Accepted: 09/08/2021] [Indexed: 11/28/2022]
Abstract
Self-management interventions (SMIs) can improve the life of patients living with obesity. However, there is variability in the outcomes used to assess the effectiveness of SMIs and these are often not relevant for patients. In the context of COMPAR-EU, our aim was to develop a core outcome set (COS) for the evaluation of SMIs for patients with obesity. We followed a four steps multimethod approach: (1) the development of the initial catalogue of outcomes; (2) a scoping review of reviews on patients' values and preferences on outcomes of self-management (SM); (3) a Delphi survey including patients and patient representatives to rate the importance of outcomes; and (4) a 2-day consensus workshop with patients, patient representatives, healthcare professionals and researchers. The initial catalogue included 82 outcomes. Ten patients and patient's representatives participated in the Delphi survey. We identified 16 themes through the thematic synthesis of the scoping review that informed 37.80% of the outcomes on initial catalogue. Five patients, five healthcare professionals, and four researchers participated in the consensus workshop. After the consensus process, 15 outcomes were selected to be part of the final COS, and five supplementary outcomes were also provided. We developed a COS for the evaluation of SMIs in obesity with a significant involvement of patients and other key stakeholders. This COS will help improving data synthesis and increasing the value of SM research data in healthcare decision making.
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Affiliation(s)
- Claudia Valli
- Iberoamerican Cochrane Centre Barcelona—Department of Clinical Epidemiology and Public HealthBiomedical Research Institute Sant Pau (IIB Sant Pau)BarcelonaSpain
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive MedicineUniversidad Autónoma de BarcelonaBarcelonaSpain
| | - Rosa Suñol
- Universitat Autònoma de BarcelonaBarcelonaSpain
- Avedis Donabedian Research Institute (FAD)Spain
- Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC)BarcelonaSpain
| | - Carola Orrego
- Universitat Autònoma de BarcelonaBarcelonaSpain
- Avedis Donabedian Research Institute (FAD)Spain
- Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC)BarcelonaSpain
| | - Ena Niño de Guzmán
- Iberoamerican Cochrane Centre Barcelona—Department of Clinical Epidemiology and Public HealthBiomedical Research Institute Sant Pau (IIB Sant Pau)BarcelonaSpain
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive MedicineUniversidad Autónoma de BarcelonaBarcelonaSpain
- Cancer Prevention and Control ProgrammeCatalan Institute of Oncology, IDIBELL, Hospitalet de LlobregatBarcelonaSpain
| | | | | | | | | | | | - Marta Ballester
- Universitat Autònoma de BarcelonaBarcelonaSpain
- Avedis Donabedian Research Institute (FAD)Spain
- Cancer Prevention and Control ProgrammeCatalan Institute of Oncology, IDIBELL, Hospitalet de LlobregatBarcelonaSpain
| | - Pablo Alonso‐Coello
- Iberoamerican Cochrane Centre Barcelona—Department of Clinical Epidemiology and Public HealthBiomedical Research Institute Sant Pau (IIB Sant Pau)BarcelonaSpain
- CIBER de Epidemiología y Salud Pública (CIBERESP), MadridSpain
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8
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Niño de Guzmán Quispe E, Martínez García L, Orrego Villagrán C, Heijmans M, Sunol R, Fraile-Navarro D, Pérez-Bracchiglione J, Ninov L, Salas-Gama K, Viteri García A, Alonso-Coello P. The Perspectives of Patients with Chronic Diseases and Their Caregivers on Self-Management Interventions: A Scoping Review of Reviews. THE PATIENT 2021; 14:719-740. [PMID: 33871808 PMCID: PMC8563562 DOI: 10.1007/s40271-021-00514-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Self-management (SM) interventions are supportive interventions systematically provided by healthcare professionals, peers, or laypersons to increase the skills and confidence of patients in their ability to manage chronic diseases. We had two objectives: (1) to summarise the preferences and experiences of patients and their caregivers (informal caregivers and healthcare professionals) with SM in four chronic diseases and (2) to identify and describe the relevant outcomes for SM interventions from these perspectives. METHODS We conducted a mixed-methods scoping review of reviews. We searched three databases until December 2020 for quantitative, qualitative, or mixed-methods reviews exploring patients' and caregivers' preferences or experiences with SM in type 2 diabetes mellitus (T2DM), obesity, chronic obstructive pulmonary disease (COPD), and heart failure (HF). Quantitative data were narratively synthesised, and qualitative data followed a three-step descriptive thematic synthesis. Identified themes were categorised into outcomes or modifiable factors of SM interventions. RESULTS We included 148 reviews covering T2DM (n = 53 [35.8%]), obesity (n = 20 [13.5%]), COPD (n = 32 [21.6%]), HF (n = 38 [25.7%]), and those with more than one disease (n = 5 [3.4%]). We identified 12 main themes. Eight described the process of SM (disease progression, SM behaviours, social support, interaction with healthcare professionals, access to healthcare, costs for patients, culturally defined roles and perceptions, and health knowledge), and four described their experiences with SM interventions (the perceived benefit of the intervention, individualised care, sense of community with peers, and usability of equipment). Most themes and subthemes were categorised as outcomes of SM interventions. CONCLUSION The process of SM shaped the perspectives of patients and their caregivers on SM interventions. Their perspectives were influenced by the perceived benefit of the intervention, the sense of community with peers, the intervention's usability, and the level of individualised care. Our findings can inform the selection of patient-important outcomes, decision-making processes, including the formulation of recommendations, and the design and implementation of SM interventions.
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Affiliation(s)
- Ena Niño de Guzmán Quispe
- Iberoamerican Cochrane Centre (IbCC)-Sant Pau Biomedical Research Institute (IIB-Sant Pau), C/ Sant Antoni Maria Claret 167. Pabellón 18, Planta 0, 08025, Barcelona, Spain.
| | - Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC)-Sant Pau Biomedical Research Institute (IIB-Sant Pau), C/ Sant Antoni Maria Claret 167. Pabellón 18, Planta 0, 08025, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carola Orrego Villagrán
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Monique Heijmans
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | - Rosa Sunol
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David Fraile-Navarro
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- Madrid Primary Health Care Service, Madrid, Spain
| | | | | | - Karla Salas-Gama
- Health Services Research Group, Institut de Recerca Vall d'Hebron Hospital, Barcelona, Spain
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - Andrés Viteri García
- Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC), Universidad UTE, Quito, Ecuador
- Centro Asociado Cochrane de Ecuador, Universidad UTE, Quito, Ecuador
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC)-Sant Pau Biomedical Research Institute (IIB-Sant Pau), C/ Sant Antoni Maria Claret 167. Pabellón 18, Planta 0, 08025, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Pringle A, Zwolinsky S, Lozano-Sufrategui L. Investigating the delivery of health improvement interventions through professional football club community trusts-strengths and challenges. PUBLIC HEALTH IN PRACTICE 2021; 2:100104. [PMID: 36101611 PMCID: PMC9461585 DOI: 10.1016/j.puhip.2021.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives This study audits health improvement provision delivered in/by English professional Football Club Community Trusts and reports the strengths and challenges around the implementation of interventions. Study design Multi-methods design: Data were collected through (i) a review of trust websites (n = 72), (ii) an online survey (n = 34/47.2%) and (iii) semi-structured interviews (n = 11/32.3%) with a sub-sample of trust managers. Results The review of websites confirms all trusts provided physical activity-led interventions. The online survey showed most managers were male (n = 23/67.7%) and white British (n = 30/88.2%). Two thirds held management roles, (n = 23/67.6%) and represented Championship (n = 12/35.2%), League 1 (n = 13/38.2%) and League 2 clubs (n = 9/26.5%). Trusts provided physical activity and most provided diet (n = 31/91.2%) as well as smoking (n = 20/58.8%) and alcohol (n = 19/55.9%) interventions. Weight management, (n = 25/73.5%), mental health interventions (n = 28/82.4%) were offered. Trusts provided male-specific (n = 20/58.8%), with fewer providing female-specific interventions (n = 15/44.1%). Most trusts (n = 30/88.2%) evaluated interventions. 80.8% (n = 21/26) used public health guidance for programme design, 69.2% (n = 18/26) delivery, 57.7% (n = 15/26) needs assessment and 50% (n = 13/26) evaluation. Interviews and qualitative reports identified strengths including, using football, the 'club brand', 'meeting health needs' and 'working as a strategic collaboration with partners'. Challenges included 'short-term funding staffing, mainstreaming, and evaluating interventions'. Conclusion Football Community Trusts deliver interventions, but challenges were encountered when implementing these programmes.
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Affiliation(s)
- A.R. Pringle
- Sport, Outdoor and Exercise Sciences, College of Science and Engineering, University of Derby, Kedleston Road, Derby, DE22 1GB, UK
| | - S. Zwolinsky
- West Yorkshire and Harrogate Cancer Alliance, White Rose House, West Parade, Wakefield, WF1 1LT, UK
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10
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Spreckley M, Seidell J, Halberstadt J. Perspectives into the experience of successful, substantial long-term weight-loss maintenance: a systematic review. Int J Qual Stud Health Well-being 2021; 16:1862481. [PMID: 33455563 PMCID: PMC7833027 DOI: 10.1080/17482631.2020.1862481] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose: In light of the increasing prevalence of overweight and obesity, understanding the experiences, strategies and challenges encountered when trying to achieve substantial, sustainable weight loss is an important area to investigate. We systematically evaluated qualitative studies focusing on the accounts of individuals who have achieved sustained weight loss to create a comprehensive picture of the experience of sustainable weight loss. Methods: Included studies were peer-reviewed studies that qualitatively assessed the views and experiences of adults who previously had or currently have overweight or obesity who successfully lost weight and who subsequently maintained or regained weight. The evidence was systematically synthesized, which enabled the formulation of clear themes and recommendations. Results: The 15 chosen studies included the accounts of 294 individuals. We found that continuous monitoring and goal setting, driven by sustained motivation and encouraging experiences, while resisting ever present challenges and enduring discouraging experience encapsulates the experience of sustained, substantial weight loss. Conclusions: This review aims to provide a comprehensive understanding of the experiences, strategies and challenges encountered when trying to achieve substantial, sustained weight loss. Additional research taking into account findings from this review and others of its kind will enhance the formulation of treatment protocols.
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Affiliation(s)
- Marie Spreckley
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
| | - Jaap Seidell
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
| | - Jutka Halberstadt
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
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11
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Tudor K, Tearne S, Jebb SA, Lewis A, Adab P, Begh R, Jolly K, Daley A, Farley A, Lycett D, Nickless A, Aveyard P. Gender differences in response to an opportunistic brief intervention for obesity in primary care: Data from the BWeL trial. Clin Obes 2021; 11:e12418. [PMID: 33026192 DOI: 10.1111/cob.12418] [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: 06/10/2020] [Revised: 08/11/2020] [Accepted: 09/02/2020] [Indexed: 11/30/2022]
Abstract
Weight loss programmes appeal mainly to women, prompting calls for gender-specific programmes. In the United Kingdom, general practitioners (GPs) refer nine times as many women as men to community weight loss programmes. GPs endorsement and offering programmes systematically could reduce this imbalance. In this trial, consecutively attending patients in primary care with obesity were invited and 1882 were enrolled and randomized to one of two opportunistic 30-second interventions to support weight loss given by GPs in consultations unrelated to weight. In the support arm, clinicians endorsed and offered referral to a weight loss programme and, in the advice arm, advised that weight loss would improve health. Generalized linear mixed effects models examined whether gender moderated the intervention. Men took effective weight loss action less often in both arms (support: 41.6% vs 60.7%; advice: 12.1% vs 18.3%; odds ratio (OR) = 0.38, 95% confidence interval (CI), 0.27, 0.52, P < .001) but there was no evidence that the relative effect differed by gender (interaction P = .32). In the support arm, men accepted referral and attended referral less often, 69.3% vs 82.4%; OR = 0.48, 95% CI, 0.35, 0.66, P < .001 and 30.4% vs 47.6%; OR = 0.48, 95% CI, 0.36, 0.63, P < .001, respectively. Nevertheless, the gender balance in attending weight loss programmes closed to 1.6:1. Men and women attended the same number of sessions (9.7 vs 9.1 sessions, P = .16) and there was no evidence weight loss differed by gender (6.05 kg men vs 4.37 kg women, P = .39). Clinician-delivered opportunistic 30-second interventions benefits men and women equally and reduce most of the gender imbalance in attending weight loss programmes.
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Affiliation(s)
- Kate Tudor
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, Oxford, UK
| | - Sarah Tearne
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, Oxford, UK
| | - Amanda Lewis
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rachna Begh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Amanda Daley
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Amanda Farley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Deborah Lycett
- Faculty Research Centre for Advances in Behavioural Science, Coventry University, Coventry, UK
| | | | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, Oxford, UK
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12
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Punt SE, Kurz DL, Befort CA. Recruitment of Men Into a Pragmatic Rural Primary Care Weight Loss Trial. Am J Mens Health 2020; 14:1557988320971917. [PMID: 33174488 PMCID: PMC7673057 DOI: 10.1177/1557988320971917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Men remain underrepresented in behavioral weight loss trials and are more difficult to recruit compared to women. We describe recruitment response of men and women into a mixed-gender behavioral weight loss trial conducted within 36 rural primary care clinics. Participants were recruited through primary care clinics via direct mailings (n = 15,076) and in-clinic referrals by their primary care provider (PCP). Gender differences were examined in response rate to direct mailings, study referral source, and rates of proceeding to study screening, being eligible, and enrolling. Men had a lower response rate to direct mailings than women (7.8% vs. 17.7%, p < .001). Men (vs. women) responding to the mailing were more likely to respond by opt-in postcard (64.6% vs. 56.8%) and less likely to respond by phone (33.9% vs. 39.6%), p = .002. Among potential participants contacting the study (n = 2413), men were less likely to report being referred by PCPs (15.2% vs. 21.6%; p < .001), but were just as likely to proceed to screening, be eligible, and enroll. Men and women were more likely to proceed to screening when referred by PCPs (93.3% vs. 95.4%) compared to direct mailings (74.2% vs. 73.9%). Enrolled men were older (p < .001), more likely to be married (p = .04), and had higher levels of education (p = .01). Men were less likely than women to respond to direct mailings and to be referred by their PCP, but after contacting the study, had similar screening, eligibility, and enrollment rates. Encouraging and training providers to refer men during clinic visits may help recruit more men into primary care-based weight loss trials.
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Affiliation(s)
- Stephanie E Punt
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Daniel L Kurz
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christie A Befort
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
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13
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McDonald MD, Dombrowski SU, Skinner R, Calveley E, Carroll P, Elders A, Gray CM, Grindle M, Harris FM, Jones C, Hoddinott P. Recruiting men from across the socioeconomic spectrum via GP registers and community outreach to a weight management feasibility randomised controlled trial. BMC Med Res Methodol 2020; 20:249. [PMID: 33023501 PMCID: PMC7542377 DOI: 10.1186/s12874-020-01136-2] [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: 05/21/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background Men, particularly those living in disadvantaged areas, are less likely to participate in weight management programmes than women despite similar levels of excess weight. Little is known about how best to recruit men to weight management interventions. This paper describes patient and public involvement in pre-trial decisions relevant to recruitment and aims to report on recruitment to the subsequent men-only weight management feasibility trial, including the: i) acceptability and feasibility of recruitment; and ii) baseline sample characteristics by recruitment strategy. Methods Men with BMI ≥30 kg/m2 and/or waist circumference ≥ 40 in. were recruited to the feasibility trial via two strategies; community outreach (venue information stands and word of mouth) and GP letters, targeting disadvantaged areas. Recruitment activities (e.g. letters sent, researcher venue hours) were recorded systematically, and baseline characteristics questionnaire data collated. Qualitative interviews (n = 50) were conducted three months post-recruitment. Analyses and reporting followed a complementary mixed methods approach. Results 105 men were recruited within four months (community n = 60, GP letter n = 45). Community outreach took 2.3 recruiter hours per participant and GP letters had an opt-in rate of 10.2% (n = 90/879). More men were interested than could be accommodated. Most participants (60%) lived in more disadvantaged areas. Compared to community outreach, men recruited via GP letters were older (mean = 57 vs 48 years); more likely to report an obesity-related co-morbidity (87% vs 44%); and less educated (no formal qualifications, 32% vs 10%, degree educated 11% vs 41%). Recruitment strategies were acceptable, a sensitive approach and trusting relationships with recruiters valued, and the ‘catchy’ study name drew attention. Conclusions Targeted community outreach and GP letters were acceptable strategies that successfully recruited participants to a men-only weight management feasibility trial. Both strategies engaged men from disadvantaged areas, a typically underserved population. Using two recruitment strategies produced samples with different health risk profiles, which could add value to research where either primary or secondary prevention is of interest. Further work is required to examine how these strategies could be implemented and sustained in practice. Trial registration ClinicalTrials.gov: NCT03040518, 2nd February 2017.
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Affiliation(s)
- Matthew D McDonald
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK. .,Physical Activity and Wellbeing Research Group, Curtin University, Perth, Australia. .,School of Psychology, Curtin University, Perth, Australia.
| | - Stephan U Dombrowski
- Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada.,Division of Psychology, University of Stirling, Stirling, UK
| | - Rebecca Skinner
- Division of Psychology, University of Stirling, Stirling, UK
| | - Eileen Calveley
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | | | - Andrew Elders
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Cindy M Gray
- School of Social and Political Sciences, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Mark Grindle
- Institute for Health Research and Innovation, University of the Highlands and Islands, Inverness, UK
| | - Fiona M Harris
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
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14
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Caperchione CM, Bottorff JL, Stolp S, Sharp P, Johnson ST, Oliffe JL, Hunt K. Positive Lifestyle Behavior Changes Among Canadian Men: Findings From the HAT TRICK Program. Am J Health Promot 2020; 35:193-201. [PMID: 32935549 DOI: 10.1177/0890117120957176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To estimate program effectiveness regarding physical activity (PA), diet, and social connectedness as part of a feasibility study. DESIGN Pre-post quasi-experimental. SETTING HAT TRICK was delivered in collaboration with a Canadian semi-professional ice hockey team and offered at the arena where they trained and played games. PARTICIPANTS Participants (N = 62) at baseline were overweight (BMI >25kg/m2) and inactive (<150 minutes of MVPA/week) men age 35+ years. INTERVENTION Gender-sensitized 12-week intervention for men targeting PA, healthy eating and social connectedness. METHOD Baseline, post-intervention (12 weeks) and 9-month follow-up self-report and accelerometer data were collected. Multi-level modeling assessed growth trajectories of outcome measures across time. RESULTS Accelerometer measured weekly/min. of moderate PA showed significant linear trends (95%CI: 42.9 - 175.3) from baseline (147.0 ± 104.6), 12-week (237.7 ± 135.5) and 9-month follow-up (204.89 ± 137.7) qualified with a quadratic trend. Self-reported weekly/min of moderate and vigorous PA showed significant linear trends (95%CI: 94.1, 264.1; 95%CI: 35.1, 109.6) from baseline (52.6 ± 83.8, 22.42 ± 44.9), 12 week (160.1 ± 157.4, 66.6 ± 74.4) and 9-month follow-up (118.6 ± 104.6, 52.2 ± 59.2) qualified with quadratic trends. DINE measured fat score rating showed linear trends over time (95%CI -14.24, -6.8), qualified with a quadratic trend. DINE fibre score and social connectedness showed no trends. CONCLUSION Findings yield valuable information about the implementation of gender-sensitized lifestyle interventions for men and demonstrate the importance of male-specific strategies for reaching and engaging overweight, physically inactive men.
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Affiliation(s)
- Cristina M Caperchione
- Human Performance Research Centre, 1994University of Technology Sydney, New South Wales, Australia.,School of Health and Exercise Science, 8166University of British Columbia, Kelowna, British Columbia, Canada
| | - Joan L Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, 8166University of British Columbia, Kelowna, British Columbia, Canada.,School of Nursing, 8166University of British Columbia, Kelowna, British Columbia, Canada
| | - Sean Stolp
- Human Performance Research Centre, 1994University of Technology Sydney, New South Wales, Australia
| | - Paul Sharp
- Human Performance Research Centre, 1994University of Technology Sydney, New South Wales, Australia
| | - Steven T Johnson
- Faculty of Health Disciplines, 70418Athabasca University, Edmonton, Alberta, Canada
| | - John L Oliffe
- School of Nursing, 8166University of British Columbia, Vancouver, British Columbia, Canada
| | - Kate Hunt
- 150980Institute of Social Marketing, University of Stirling, United Kingdom
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15
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Dombrowski SU, McDonald M, van der Pol M, Grindle M, Avenell A, Carroll P, Calveley E, Elders A, Glennie N, Gray CM, Harris FM, Hapca A, Jones C, Kee F, McKinley MC, Skinner R, Tod M, Hoddinott P. Text messaging and financial incentives to encourage weight loss in men with obesity: the Game of Stones feasibility RCT. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background
In 2016, 26% of UK men were estimated to be obese. Systematic reviews suggest that few men engage in formal weight loss interventions that support weight reduction and improve health.
Objective
To co-produce, with patient and public involvement, an acceptable and feasible randomised controlled trial design to test a men-only weight management intervention.
Design
This was a two-phase feasibility study. Phase 1 was the development of intervention components, study procedures and materials including a discrete choice experiment with survey questions. Phase 2 was an individually randomised three-arm feasibility trial over 12 months. Qualitative interviews were conducted at 3 and 12 months.
Setting
The setting was two sites in Scotland that had disadvantaged urban and rural areas and differed in employment levels and ethnic groups.
Participants
In phase 1, 1045 men with obesity were recruited by Ipsos MORI (London, UK; www.ipsos.com/ipsos-mori/en-uk) to represent the UK population. In phase 2, 105 men with obesity were recruited in the community or through general practice obesity registers. Qualitative interviews were conducted with 50 men at 3 months and with 33 men at 12 months.
Interventions
The trial arms were narrative short message service (SMS) for 12 months (SMS only), financial endowment incentive informed by loss aversion and linked to achievement of weight loss targets plus narrative SMS for 12 months (SMS + I), and waiting list control group for 12 months followed by 3 months of an alternative SMS style developed based on feedback from men who had received the narrative SMS (control).
Main outcome measures
The main outcome measures were acceptability and feasibility of recruitment, retention, engagement, intervention components and trial procedures. Outcomes were assessed by examining procedural, quantitative and qualitative data at 3, 6 and 12 months.
Results
The most acceptable incentive strategy, based on the discrete choice experiment results, was to verify weight loss of 5% at 3 months, verify weight loss of 10% at 6 months and maintain weight loss of 10% at 12 months. Overall, 105 men with obesity from across the socioeconomic spectrum were successfully recruited to target, 59% of whom lived in more disadvantaged areas. Retention at 12 months was acceptable (74%) and was higher among individuals from disadvantaged areas. Narrative SMS were acceptable to many men, with a minority reporting negative reactions. Incentives were acceptable but were not the primary motivation for behaviour change. Twelve men in the incentive arm (33%) secured at least some money and three (8%) secured the full amount. Both intervention arms lost some weight, with greater weight loss in the arm that received SMS and incentives. The alternative SMS based on men’s feedback received no strong negative reactions.
Limitations
Fewer participants from the SMS + I arm (64%) completed the study at 12 months than did those in the SMS-only (79%) and control (83%) arms. The reasons for this difference were complex.
Conclusions
The men-only weight management intervention consisting of narrative SMS and financial incentives was acceptable and feasible, meeting the progression criteria for a full trial. Tailoring of SMS may improve acceptability and retention.
Future work
Minor refinements to the intervention components based on the study findings will be made prior to testing in a multisite definitive randomised controlled trial.
Trial registration
ClinicalTrials.gov NCT03040518.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 11. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Stephan U Dombrowski
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK
| | - Matthew McDonald
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | | | - Mark Grindle
- Division of Rural Health and Wellbeing, University of the Highlands and Islands, Inverness, UK
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Eileen Calveley
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Andrew Elders
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Nicola Glennie
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Cindy M Gray
- Institute of Health & Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Fiona M Harris
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Adrian Hapca
- Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - Frank Kee
- Centre for Public Health, Institute of Clinical Sciences, Queen’s University Belfast, Belfast, UK
| | | | - Rebecca Skinner
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK
| | | | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
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Seymour-Smith S, Gough B, Matthews CR, Rutherford Z. Food assessment: a discursive analysis of diet talk in interviews with older men who are obese. Psychol Health 2020; 35:946-967. [PMID: 32148091 DOI: 10.1080/08870446.2019.1701673] [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: 10/24/2022]
Abstract
Objective: Obesity rates are increasing faster in men than in women, with particular concerns raised regarding older men. However, men are less likely than women to engage in weight-loss activities such as dieting, typically constructed as a feminine practice. Previous research has argued that men's food consumption is notably different and unhealthier than women's. The novel contribution of this article is an analysis of food assessments in order to explore how older men (mostly) undergoing weight management programmes make sense of changes in their nutritional intake. Design: Semi-structured interviews were conducted with 30 men who were obese, 27 of whom were engaged in weight loss programmes. Discursive psychology was employed to analyse the data. Results: In contrast to other research, participants constructed nutritional advice as enlightening. Participants worked up 'ownership' and pleasure assessments to certain food choices which they contrasted with new, less calorific, eating practices. Moreover, new diets were constructed as acceptable. Conclusion: Our study contributes new insights about how nutritional advice impacts upon preconceived (mis)understandings of healthy eating practices. During the interviews, men positioned themselves as educators - health promoters might usefully develop nutritional advice in collaboration with men who have successfully changed their diets for optimum effect.
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Affiliation(s)
- Sarah Seymour-Smith
- Psychology Division, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Brendan Gough
- Calverly Building, School of Social Sciences, Leeds Beckett University, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - Christopher R Matthews
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Zoe Rutherford
- Centre for Active Lifestyles, Leeds Beckett University, Leeds, United Kingdom of Great Britain and Northern Ireland
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17
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Dombrowski SU, McDonald M, van der Pol M, Grindle M, Avenell A, Carroll P, Calveley E, Elders A, Glennie N, Gray CM, Harris FM, Hapca A, Jones C, Kee F, McKinley MC, Skinner R, Tod M, Hoddinott P. Game of Stones: feasibility randomised controlled trial of how to engage men with obesity in text message and incentive interventions for weight loss. BMJ Open 2020; 10:e032653. [PMID: 32102807 PMCID: PMC7045214 DOI: 10.1136/bmjopen-2019-032653] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/06/2019] [Accepted: 01/08/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To examine the acceptability and feasibility of narrative text messages with or without financial incentives to support weight loss for men. DESIGN Individually randomised three-arm feasibility trial with 12 months' follow-up. SETTING Two sites in Scotland with high levels of disadvantage according to Scottish Index for Multiple Deprivation (SIMD). PARTICIPANTS Men with obesity (n=105) recruited through community outreach and general practitioner registers. INTERVENTIONS Participants randomised to: (A) narrative text messages plus financial incentive for 12 months (short message service (SMS)+I), (B) narrative text messages for 12 months (SMS only), or (C) waiting list control. OUTCOMES Acceptability and feasibility of recruitment, retention, intervention components and trial procedures assessed by analysing quantitative and qualitative data at 3, 6 and 12 months. RESULTS 105 men were recruited, 60% from more disadvantaged areas (SIMD quintiles 1 or 2). Retention at 12 months was 74%. Fewer SMS+I participants (64%) completed 12-month assessments compared with SMS only (79%) and control (83%). Narrative texts were acceptable to many men, but some reported negative reactions. No evidence emerged that level of disadvantage was related to acceptability of narrative texts. Eleven SMS+I participants (31%) successfully met or partially met weight loss targets. The cost of the incentive per participant was £81.94 (95% CI £34.59 to £129.30). Incentives were acceptable, but improving health was reported as the key motivator for weight loss. All groups lost weight (SMS+I: -2.51 kg (SD=4.94); SMS only: -1.29 kg (SD=5.03); control: -0.86 kg (SD=5.64) at 12 months). CONCLUSIONS This three-arm weight management feasibility trial recruited and retained men from across the socioeconomic spectrum, with the majority from areas of disadvantage, was broadly acceptable to most participants and feasible to deliver. TRIAL REGISTRATION NUMBER NCT03040518.
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Affiliation(s)
- Stephan U Dombrowski
- Department of Kinesiology, University of New Brunswick Fredericton, Fredericton, New Brunswick, Canada
- Division of Psychology, University of Stirling, Stirling, UK
| | - Matthew McDonald
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
| | | | - Mark Grindle
- Institute for Health Research and Innovation, University of the Highlands and Islands, Inverness, Highland, UK
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Eileen Calveley
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
| | - Andrew Elders
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Nicola Glennie
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fiona M Harris
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
| | - Adrian Hapca
- Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Rebecca Skinner
- Division of Psychology, University of Stirling, Stirling, UK
| | | | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
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Elliott M, Gillison F, Barnett J. Exploring the influences on men's engagement with weight loss services: a qualitative study. BMC Public Health 2020; 20:249. [PMID: 32093707 PMCID: PMC7041184 DOI: 10.1186/s12889-020-8252-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/21/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Engagement of men with commercial and UK National Health Service (NHS) weight loss services is low, and few studies report on why this may be. However, evidence shows that men who do participate in weight loss programmes tend to lose as much, or more weight than women. The present study aimed to explore men's experiences and expectations of mainstream weight loss services in the UK, following referral from a medical professional, particular in relation to barriers and motivators. METHODS Semi-structured interviews were conducted with 18 men with a BMI over 25 kg/m2 including those who had, and had not, attended group-based or one-to-one weight loss services. Interviews were analysed using thematic analysis. RESULTS Two themes were identified; 'Fear as a motivation for change' (1) and 'Attitudes towards existing weight loss services' (2). Within theme two, two subthemes were identified; 'Female dominated services' and 'Incompatibility of existing services for men'. The findings suggest that fear, as a result of a medical diagnosis or referral is a mechanism for motivating men to engage with weight loss services. This was often augmented by awareness of other people's experiences of poor health due to their weight. The gender imbalance and attitudes towards existing weight loss services deterred men from engaging with or continuously attending sessions. This imbalance resulted in feelings of self-consciousness, shame and a perceived stigma for men using weight loss services. These experiences highlighted the importance of providing services which align with men's preferences to promote engagement. CONCLUSIONS A medical diagnosis or referral serves as a strong motivator for men to engage with weight loss services by invoking fear of negative consequences of not losing weight. Men perceived weight loss services to be feminised spaces, in which they felt self-conscious and out of place. As a result, men were deterred from engaging and considered their options were limited. Implications for service design and commissioning are discussed. Involving men in research, service design and evaluation is key to improving their engagement and weight loss.
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Affiliation(s)
- Megan Elliott
- Faculty of Life Sciences and Education, University of South Wales, Lower Glyntaff Campus, Pontypridd, CF37 1DL, UK.
| | - Fiona Gillison
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Julie Barnett
- Department of Psychology, University of Bath, Bath, BA2 7AY, UK
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Sharp P, Spence JC, Bottorff JL, Oliffe JL, Hunt K, Vis-Dunbar M, Caperchione CM. One small step for man, one giant leap for men's health: a meta-analysis of behaviour change interventions to increase men's physical activity. Br J Sports Med 2020; 54:1208-1216. [PMID: 32024644 DOI: 10.1136/bjsports-2019-100912] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine the effects of behaviour change interventions on men's physical activity (postintervention), sustained change in physical activity behaviour (≥12 months postintervention) and to identify variations in effects due to potential moderating variables (eg, theoretical underpinning, gender-tailored, contact frequency). DESIGN Systematic review with meta-analysis. Pooled effect size (Cohen's d) was calculated assuming a random-effects model. Homogeneity and subsequent exploratory moderator analyses were assessed using Q, T2 and I2. DATA SOURCES Medline, EMBASE, CINAHL, SportDiscus and Web of Science to April 2019. ELIGIBILITY CRITERIA FOR SELECTED STUDIES Randomised control trials of behaviour change interventions in men (≥18 years) where physical activity was an outcome and data were from men-only studies or disaggregated by sex. RESULTS Twenty-six articles described 24 eligible studies. The overall mean intervention effect on men's physical activity was 0.35 (SE=0.05; 95% CI 0.26 to 0.45; p<0.001). This effect size is consistent with an increase of approximately 97 min of total physical activity per week or 980 steps per day. Intervention moderators associated with greater increases in physical activity included objective physical activity outcome measures, a gender-tailored design, use of a theoretical framework, shorter length programmes (≤12 weeks), using four or more types of behaviour change techniques and frequent contact with participants (≥1 contact per week). 12 studies included additional follow-up assessments (≥12 months postintervention) and the overall mean effect was 0.32 (SE=0.09; 95% CI 0.15 to 0.48; p<0.001) for that sustained increase in physical activity. SUMMARY Behaviour change interventions targeting men's physical activity can be effective. Moderator analyses are preliminary and suggest research directions.
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Affiliation(s)
- Paul Sharp
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - John C Spence
- Sedentary Living Lab, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Joan L Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, British Columbia, Canada.,School of Nursing, University of British Columbia, Kelowna, British Columbia, Canada
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kate Hunt
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Mathew Vis-Dunbar
- Library, University of British Columbia, Kelowna, British Columbia, Canada
| | - Cristina M Caperchione
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.,Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, British Columbia, Canada
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20
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O'Brien L. Carrying out Physical Activity as Part of the Active Forests Programme in England: What Encourages, Supports and Sustains Activity?-A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245118. [PMID: 31847396 PMCID: PMC6950703 DOI: 10.3390/ijerph16245118] [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] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 11/16/2022]
Abstract
The Active Forests programme was developed through a partnership between Forestry England and Sport England. A three-year pilot programme focused on five forest sites ran from 2014. It was mainstreamed in April 2017 and is now running on eighteen forest sites in England in 2019. The aim of the programme is to encourage a physical activity habit, and participants can get involved in a wide range of activities from Nordic walking to mountain biking, Pilates, running, and Bootcamp in different scenic forests. The aim of the research was to identify the motivations, benefits and the overall experience participants had from their forest physical activity. As part of the programme, qualitative data was gathered through in-situ participant observation, and interviews or focus groups. One hundred and twenty people were involved in the research. The findings identify some of the key elements of the programme that encourage, support and in some instances help to sustain or change physical activity. These include participants gaining a wide range of wellbeing benefits; appropriate targeted activities; opportunities for progression; social connections; providing challenge; and a supportive atmosphere. There is evidence of participants sustaining and changing physical activity practices, however attribution of this to the Active Forests programme is not straightforward. The programme is also explored through the lens of social practice theory and its concepts of materials, competence, and meanings. The research highlights how a targeted physical activity programme can reach and involve a broad range of people from the already physically active to those who are less active.
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Affiliation(s)
- Liz O'Brien
- Forest Research, Social and Economic Research Group, Farnham GU10 4LH, UK
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21
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Chauvet-Gelinier JC, Roussot A, Cottenet J, Brindisi MC, Petit JM, Bonin B, Vergès B, Quantin C. Depression and obesity, data from a national administrative database study: Geographic evidence for an epidemiological overlap. PLoS One 2019; 14:e0210507. [PMID: 30620759 PMCID: PMC6324832 DOI: 10.1371/journal.pone.0210507] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/24/2018] [Indexed: 01/05/2023] Open
Abstract
Background Depression and obesity are two major conditions with both psychological and somatic burdens. Some data suggest strong connections between depression and obesity and more particularly associated prevalence of both disorders. However, little is known about the geographical distribution of these two diseases. This study aimed to determine if there is spatial overlap between obesity and depression using data from the entire French territory. Methods Data for 5,627 geographic codes for metropolitan France were collected from the two national hospital databases (PMSI-MCO and RIM-P) for the year 2016. We identified people who were depressed, obese or both registered in the two public medico-administrative databases, and we assessed their location. In addition, a multivariable analysis was performed in order to determine geographic interactions between obesity and depression after controlling for age, sex, environmental and socio-economic factors (social/material deprivation, urbanicity/rurality). Results 1,045,682 people aged 18 years and older were identified. The mapping analysis showed several cold and hot regional clusters of coinciding obesity and depression. The multivariable analysis demonstrated significant geographic interactions, with an increasing probability of finding a high prevalence of obesity in regions with major depression (OR 1.29 95% CI 1.13–1.49, p = 0.0002) and an increased probability of finding a high prevalence of depression in regions with a high ration of obesity (OR 1.32, 95% CI 1.15–1.52, p<0.0001). Conclusion Our study confirms the significant bidirectional relationships between obesity and depression at a group level. French geographic patterns reveal a partial overlap between obesity and depression, suggesting these two diseases can be included in a common approach. Further studies should be done to increase the understanding of this complex comorbidity.
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Affiliation(s)
- Jean-Christophe Chauvet-Gelinier
- Psychiatry Unit, Department of Neurosciences, Dijon University Hospital, France
- INSERM Research Center 866, Dijon, France
- * E-mail:
| | - Adrien Roussot
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, University of Burgundy-Franche-Comté, Dijon, France
| | - Jonathan Cottenet
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, University of Burgundy-Franche-Comté, Dijon, France
- Inserm, CIC 1432, Dijon, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/ Clinical Trials Unit, Dijon, France
| | - Marie-Claude Brindisi
- INSERM Research Center 866, Dijon, France
- Department of Endocrinology and Metabolic Diseases, Dijon University Hospital, Dijon, France
| | - Jean-Michel Petit
- INSERM Research Center 866, Dijon, France
- Department of Endocrinology and Metabolic Diseases, Dijon University Hospital, Dijon, France
| | - Bernard Bonin
- Psy-DREPI Laboratory, EA7458, University of Burgundy-Franche-Comté, Dijon, France
| | - Bruno Vergès
- INSERM Research Center 866, Dijon, France
- Department of Endocrinology and Metabolic Diseases, Dijon University Hospital, Dijon, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, University of Burgundy-Franche-Comté, Dijon, France
- Inserm, CIC 1432, Dijon, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/ Clinical Trials Unit, Dijon, France
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
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22
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Harper C, Maher J, Grunseit A, Seimon RV, Sainsbury A. Experiences of using very low energy diets for weight loss by people with overweight or obesity: a review of qualitative research. Obes Rev 2018; 19:1412-1423. [PMID: 30144269 DOI: 10.1111/obr.12715] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 04/18/2018] [Accepted: 04/30/2018] [Indexed: 12/13/2022]
Abstract
Although very low energy diets (VLEDs) are the most successful non-surgical, non-pharmacological treatment for obesity, they are underutilized, and little is known about experiences of people using VLEDs for weight loss. This systematic review synthesizes qualitative studies investigating participants' experiences of undertaking a VLED composed of total meal replacement products to lose weight. Of the 4,911 articles screened, three studies met criteria for inclusion. Thematic synthesis was used to analyse the study findings. Health and appearance were the main motivators to use a VLED for weight loss. Adherence was facilitated by group support meetings, rapid weight loss and ease of use of the diet. Being part of a clinical trial gave a sense of accountability and further reason to adhere to a VLED, and the VLED itself was well accepted by users. Barriers to adherence, such as temptations and social occasions, were overcome by avoidance and distraction strategies. In conclusion, this qualitative synthesis of users' experiences of VLEDs shows that VLEDs are well accepted and positively viewed by users. More in-depth research could facilitate understanding of how this weight loss strategy influences the weight maintenance period, in order to facilitate better long-term results.
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Affiliation(s)
- C Harper
- Faculty of Medicine and Health, The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, The University of Sydney, Charles Perkins Centre, Sydney, NSW, Australia
| | - J Maher
- Faculty of Science, Health, Education and Engineering, School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - A Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Charles Perkins Centre, Sydney, NSW, Australia
| | - R V Seimon
- Faculty of Medicine and Health, The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, The University of Sydney, Charles Perkins Centre, Sydney, NSW, Australia
| | - A Sainsbury
- Faculty of Medicine and Health, The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, The University of Sydney, Charles Perkins Centre, Sydney, NSW, Australia
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23
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Kime NH, Pringle A, Rivett MJ, Robinson PM. Physical activity and exercise in adults with type 1 diabetes: understanding their needs using a person-centered approach. HEALTH EDUCATION RESEARCH 2018; 33:375-388. [PMID: 30184073 DOI: 10.1093/her/cyy028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 08/09/2018] [Indexed: 06/08/2023]
Abstract
Physical activity is a key component in the management of diabetes, but most people do not engage in recommended levels of physical activity. A recent consensus statement on exercise management in type 1 diabetes (T1D) fails to mention behavioral change and the specific determinants impacting on exercise management. The aim of this study is to investigate the needs of adults with T1D around physical activity and the challenges they face. Using a person-centered approach, focus groups and individual semi-structured interviews recorded the perspectives of 67 adults aged ≥18 with diabetes. Four global themes were identified: (i) it's a balancing act, (ii) winging it, (iii) engagement and (iv) encouraging uptake. These findings suggest that adults with T1D find it difficult to manage their diabetes and physical activity and decision-making is based on trial and error with minimal input from healthcare professionals. Participants want more information to enable them to manage their diabetes and physical activity effectively. Adults with T1D face unique challenges in relation to physical activity. Participants reported key determinants for being active. Research is needed to understand how physical activity promotion is best developed for those with T1D and the preparedness of healthcare professionals for delivering guidance to adults with T1D.
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Affiliation(s)
- N H Kime
- Research Centre for Active Lifestyles, School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| | - A Pringle
- Research Centre for Active Lifestyles, School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| | - M J Rivett
- Research Centre for Active Lifestyles, School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| | - P M Robinson
- Research Centre for Active Lifestyles, School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
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24
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Hartmann-Boyce J, Boylan AM, Jebb SA, Fletcher B, Aveyard P. Cognitive and behavioural strategies for self-directed weight loss: systematic review of qualitative studies. Obes Rev 2017; 18:335-349. [PMID: 28117945 PMCID: PMC5408390 DOI: 10.1111/obr.12500] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 12/06/2016] [Indexed: 12/23/2022]
Abstract
AIM We conducted a systematic review of qualitative studies to examine the strategies people employ as part of self-directed weight loss attempts, map these to an existing behaviour change taxonomy and explore attitudes and beliefs surrounding these strategies. METHODS Seven electronic databases were searched in December 2015 for qualitative studies in overweight and obese adults attempting to lose weight through behaviour change. We were interested in strategies used by participants in self-directed efforts to lose weight. Two reviewers extracted data from included studies. Thematic and narrative synthesis techniques were used. RESULTS Thirty one studies, representing over 1,000 participants, were included. Quality of the included studies was mixed. The most commonly covered types of strategies were restrictions, self-monitoring, scheduling, professional support and weight management aids. With the exception of scheduling, for which participant experiences were predominantly positive, participants' attitudes and beliefs surrounding implementation of these groups of strategies were mixed. Two new groups of strategies were added to the existing taxonomy: reframing and self-experimentation. CONCLUSIONS This review demonstrates that at present, interventions targeting individuals engaged in self-management of weight do not necessarily reflect lived experiences of self-directed weight loss.
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Affiliation(s)
- J Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - A-M Boylan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - S A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - B Fletcher
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - P Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Crane MM, Jeffery RW, Sherwood NE. Exploring Gender Differences in a Randomized Trial of Weight Loss Maintenance. Am J Mens Health 2016; 11:369-375. [PMID: 27923968 PMCID: PMC5313337 DOI: 10.1177/1557988316681221] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study is to explore gender differences in reasons for losing weight, weight loss methods, and weight loss behaviors prior to and during a weight loss maintenance trial. This is a secondary analysis of data from a 24-month randomized controlled trial comparing Self-Directed or Guided phone-based weight loss maintenance interventions among adults who had intentionally lost ≥10% of their body weight in the year prior to enrollment. Participants reported their weight loss methods and reasons for recently losing weight at baseline. Dietary intake, physical activity, and dietary patterns were assessed at baseline, 12, and 24 months. Participants included 419 adults (18.4% men, age 47.0 ± 10.8, BMI 28.4 ± 5.0). Women were more likely than men to report having used an organized weight loss program during their weight loss (55.9% vs. 24.7%, p < .001) and to report improving personal esteem as a motivator (51.2% vs. 35.1%, p = .01). Men were more likely than women to report eating food from convenience stores at baseline (22.1% vs. 13.2%, p = .05) and throughout the study but otherwise reported similar meal patterns (ps > .05). Men reported higher energy intake than women while physical activity was similar. Although more men self-directed their initial weight loss and more women utilized organized weight loss programs, behaviors reported during weight loss maintenance were similar. Futures studies are needed to understand if these results generalize to other men who have successfully lost weight and are participants in other weight loss maintenance interventions.
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Abstract
There is little research involving the US male population regarding weight control and behavior that may affect weight status. Gender-specific weight-control programs for men aren't the standard. Our study objectives were to survey dieting and health habits of an adult male employee population and to determine if the population would be interested in gender-specific programming. Demographics, weight-control practices and interest in gender-specific weight-control programs were examined cross sectionally. A 50-question web-based survey was posted via email from October 2-30, 2014 to male employees at a Mid-Atlantic university. Statistical analyses included frequencies, means and percentages. Chi square and t tests were conducted. The 254 participants were ages 18-65+ years, predominantly white, college educated with annual incomes above $50,000. Sources of nutrition knowledge ranged from a high of web sites (65 %) to a low of registered dietitians (9 %). Macronutrient restrictions reported for dieting were carbohydrates 77 %, fats 40 % and protein 19 %. The >30 age group was more likely to have: decreased amount of food intake P = .001), reducing overall calories (P = .047), skipping meals (P = .006) or trying commercial programs (P = .011). There was nothing of significance for those <30. Among all respondents, interest in gender-specific programs was compared with these variables: current weight satisfaction (P = .032), education (P = .008), income (P = . 006) and BMI (P = .004). Men who were dissatisfied with their weight were most likely to be interested in a gender-specific weight control program, especially those over age 30 years. Further research should address whether offering male-specific diet programs would offer incentive and motivation for males to lose and maintain weight loss.
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Affiliation(s)
- Virginia L Vining
- Department of Behavioral Health and Nutrition, University of Delaware, 339 McDowell Hall, Newark, DE, 19716, USA
| | - Nancy Cotugna
- Department of Behavioral Health and Nutrition, University of Delaware, 339 McDowell Hall, Newark, DE, 19716, USA.
| | - Chengshun Fang
- Department of Behavioral Health and Nutrition, University of Delaware, 339 McDowell Hall, Newark, DE, 19716, USA
| | - O Sue Snider
- Department of Animal and Food Sciences, University of Delaware, Newark, DE, USA
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