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Mena-Jiménez AV, Rodríguez-Suárez CA, González-de la Torre H. Return to Physical Activity in Individuals with Surgical Stomas: A Scoping Review. Sports (Basel) 2024; 12:273. [PMID: 39453239 PMCID: PMC11511191 DOI: 10.3390/sports12100273] [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: 08/02/2024] [Revised: 10/03/2024] [Accepted: 10/10/2024] [Indexed: 10/26/2024] Open
Abstract
In surgically treated individuals with surgical stomas, the return to physical activity is an indicator of quality of life that reflects their well-being. With the aim of synthesizing the available evidence regarding the return to physical activity in individuals with surgical stomas, a scoping review was developed following the methodological approach of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews criteria. Searches were conducted in Medline (PubMed), Scopus, Web of Science, Cinahl, and Lilacs, as well as the meta-search engines TripDatabase and Epistemonikos, using MeSH terms. Included studies were written in Spanish, English, Portuguese, and German, without any limitation on the year of publication. A total of n = 15 studies was included (n = 2 qualitative; n = 2 case reports; n = 1 case series; n = 1 cohort; n = 8 cross-sectional; and n = 1 randomized clinical trial), which showed variability in the quality of the designs. The qualitative studies explored themes such as motivation, beliefs about physical activity, and other lifestyle factors. The case reports described physiological, psychological, and functional implications of returning to physical activity for specific individuals after ostomy surgery. Quantitative studies evaluated the effects of different types of physical activity on quality of life and tolerance to physical activity in these individuals, employing various measurement instruments. In conclusion, the evidence on returning to sports and physical activity after stoma surgery is limited and varied. While studies highlight the importance of social support and self-confidence, they generally lack rigor and primarily focus on adults and oncology patients. There is a need for more research to establish clear guidelines on physical activity type, frequency, and intensity to ensure safe and beneficial outcomes for individuals with stomas.
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Affiliation(s)
- Andrea-Victoria Mena-Jiménez
- Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain;
- Nursing Department, Faculty of Healthcare Science, University of Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain;
| | - Claudio-Alberto Rodríguez-Suárez
- Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain;
- Nursing Department, Faculty of Healthcare Science, University of Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain;
| | - Héctor González-de la Torre
- Nursing Department, Faculty of Healthcare Science, University of Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain;
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Uthman OA, Al-Khudairy L, Nduka C, Court R, Enderby J, Anjorin S, Mistry H, Melendez-Torres GJ, Taylor-Phillips S, Clarke A. Interventions for primary prevention of cardiovascular disease: umbrella review of systematic reviews. Health Technol Assess 2024:1-26. [PMID: 38970453 DOI: 10.3310/gjtr5006] [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: 07/08/2024] Open
Abstract
Background Cardiovascular diseases are the leading cause of death globally. The aim of this overview of systematic reviews was to compare the effectiveness of different pharmacological and non-pharmacological interventions for the primary prevention of cardiovascular disease. Methods A structured search of the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE and the Database of Abstracts of Reviews of Effects archive was conducted to find systematic reviews that reported the effect of various pharmacological and non-pharmacological interventions for the primary prevention of cardiovascular disease from inception to March 2021. References of included studies were also checked. The included systematic reviews' methodological quality was assessed using the Assessment of Multiple Systematic Reviews 2 instrument (range, 0-16). The outcomes of each included review's meta-analysis were extracted and described narratively. Results This study analysed 95 systematic reviews, including 41 on non-pharmacological interventions and 54 on pharmacological interventions for cardiovascular health. The majority of the reviews focused on lipid-lowering interventions (n = 25) and antiplatelet medications (n = 21), followed by nutritional supplements, dietary interventions, physical activity, health promotion and other interventions. Only 1 of the 10 reviews addressing cardiovascular mortality showed a potential benefit, while the others found no effect. Antiplatelets were found to have a beneficial effect on all-cause mortality in 2 out of 12 meta-analyses and on major cardiovascular disease events in 8 out of 17 reviews. Lipid-lowering interventions showed beneficial effects on cardiovascular disease mortality, all-cause mortality and major cardiovascular disease events in varying numbers of the reviews. Glucose-lowering medications demonstrated significant benefits for major cardiovascular events, coronary heart disease events and mortality. However, the combination of dietary interventions, physical activities, nutritional supplements and polypills showed little or no significant benefit for major cardiovascular outcomes or mortality. Future work and limitations More research is needed to determine whether the effect of treatment varies depending on population characteristics. The findings of this review should be interpreted with caution because the majority of studies of non-pharmacological interventions compare primary prevention with usual care, which may include recommended pharmacological treatment in higher-risk patients (e.g. statins and/or antihypertensive medications, etc.). In addition, randomised controlled trial evidence may be better suited to the study of pharmacological interventions than dietary and lifestyle interventions. Conclusions This umbrella review captured the variability in different interventions on randomised controlled trial evidence on interventions for primary prevention of cardiovascular disease and identified areas that may benefit from further research. Specifically, this review focused on randomised controlled trial evidence on interventions for primary prevention of cardiovascular disease. Researchers may use these findings as a resource to direct new intervention studies and network meta-analyses to compare the efficacy of various interventions based on these findings. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment (HTA) programme as award number 17/148/05.
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Affiliation(s)
| | | | - Chidozie Nduka
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Rachel Court
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Jodie Enderby
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Seun Anjorin
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Hema Mistry
- Warwick Medical School, University of Warwick, Coventry, UK
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group (PenTAG), College of Medicine and Health, University of Exeter, Exeter, UK
| | | | - Aileen Clarke
- Warwick Medical School, University of Warwick, Coventry, UK
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Buffey AJ, Langley CK, Carson BP, Donnelly AE, Salsberg J. Participatory Approaches in the Context of Research Into Workplace Health Promotion to Improve Physical Activity Levels and Reduce Sedentary Behavior Among Office-Based Workers: Scoping Review. JMIR Public Health Surveill 2024; 10:e50195. [PMID: 38896458 PMCID: PMC11222769 DOI: 10.2196/50195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/06/2023] [Accepted: 02/15/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Participatory research (PR) involves engaging in cocreation with end users and relevant stakeholders throughout the research process, aiming to distribute power equitably between the end users and research team. Engagement and adherence in previous workplace health promotion (WHP) studies have been shown to be lacking. By implementing a PR approach, the insights of end users and stakeholders are sought in the co-design of feasible and acceptable intervention strategies, thereby increasing the relevance of the research. OBJECTIVE This scoping review aims to explore, identify, and map PR techniques and their impact when used in office-based WHP interventions designed to improve physical activity (PA) or reduce sedentary behavior (SB). METHODS The reporting of this scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). A systematic literature search of 5 electronic databases-Web of Science, PubMed, Scopus, Google Scholar, and OpenGrey-was conducted, searching from January 1, 1995, to February 8, 2023. In total, 2 independent reviewers first screened the retrieved articles by title and abstract, and then assessed the full texts based on the inclusion and exclusion criteria. The search strategy and eligibility criteria were developed and guided by an a priori population (office-based working adults), intervention (a PA WHP intervention that took a PR approach), comparison (no comparison required), and outcome (PA or SB) framework. Data were charted and discussed via a narrative synthesis, and a thematic analysis was conducted. The included studies were evaluated regarding the degree of end user engagement throughout the research process and power shared by the researchers, using Arnstein's ladder of citizen participation. RESULTS The search retrieved 376 records, of which 8 (2.1%) met the inclusion criteria. Four key strategies were identified: (1) end user focus groups, (2) management involvement, (3) researcher facilitators, and (4) workplace champions. The degree of engagement and power shared was relatively low, with 25% (2/8) of the studies determined to be nonparticipation studies, 25% (2/8) determined to be tokenistic, and 50% (4/8) determined to provide citizen power. CONCLUSIONS This review provides a foundation of evidence on the current practices when taking a PR approach, highlighting that previous office-based PA WHP studies have been largely tokenistic or nonparticipative, and identified that the end user is only engaged with in the conception and implementation of the WHP studies. However, a positive improvement in PA and reduction in SB were observed in the included studies, which were largely attributed to implementing a PR approach and including the end user in the design of the WHP intervention. Future studies should aim to collaborate with workplaces, building capacity and empowering the workforce by providing citizen control and letting the end users "own" the research for a sustainable WHP intervention. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2021-054402.
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Affiliation(s)
- Aidan John Buffey
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | | | - Brian P Carson
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Alan E Donnelly
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Jon Salsberg
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland
- Public and Patient Involvement Research Unit, Health Research Institute, University of Limerick, Limerick, Ireland
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Makarem N, German CA, Zhang Z, Diaz KM, Palta P, Duncan DT, Castro‐Diehl C, Shechter A. Rest-Activity Rhythms Are Associated With Prevalent Cardiovascular Disease, Hypertension, Obesity, and Central Adiposity in a Nationally Representative Sample of US Adults. J Am Heart Assoc 2024; 13:e032073. [PMID: 38156474 PMCID: PMC10863829 DOI: 10.1161/jaha.122.032073] [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: 08/21/2023] [Accepted: 10/27/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Rest-activity rhythms (RARs), a measure of circadian rhythmicity in the free-living setting, are related to mortality risk, but evidence is limited on associations with cardiovascular disease (CVD) and its risk factors. METHODS AND RESULTS Participants included 4521 adults from the 2013 to 2014 National Health and Nutrition Examination Survey physical activity monitoring examination. Wrist-worn ActiGraph GT3X+ data were used to estimate RARs. Multivariable logistic models evaluated associations of RARs with prevalent CVD, hypertension, obesity, and central adiposity. Participants (mean age, 49 years) in the highest versus lowest tertile of relative amplitude (greater circadian rhythmicity) had 39% to 62% lower odds of prevalent CVD, hypertension, obesity, and central adiposity. A more active wake period was associated with 19% to 72% lower CVD, hypertension, obesity, and central adiposity odds. Higher interdaily stability (regular sleep-wake and rest-activity patterns) was related to 52% and 23% lower CVD and obesity odds, respectively. In contrast, participants in the highest versus lowest tertile of intradaily variability (fragmented RAR and inefficient sleep) had >3-fold and 24% higher CVD and obesity odds, respectively. A later and less restful sleep period was associated with 36% to 2-fold higher CVD, hypertension, obesity, and central adiposity odds. A statistically significant linear trend was observed for all associations (P-trend<0.05). CONCLUSIONS A robust, stable, and less fragmented RAR, an active wake period, and an earlier and more restful sleep period are associated with lower prevalent CVD, hypertension, obesity, and central adiposity, with evidence of a dose-response relationship. The magnitude, timing, and regularity of sleep-wake and rest-activity patterns may be important targets for reducing cardiovascular risk.
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Affiliation(s)
- Nour Makarem
- Department of Epidemiology, Mailman School of Public HealthColumbia University Irving Medical CenterNew YorkNY
| | - Charles A. German
- Section of Cardiology, Department of MedicineUniversity of ChicagoChicagoIL
| | - Zhanhao Zhang
- Department of StatisticsColumbia UniversityNew YorkNY
| | - Keith M. Diaz
- Department of MedicineColumbia University Irving Medical CenterNew YorkNY
- Center for Behavioral Cardiovascular HealthColumbia University Irving Medical CenterNew YorkNY
| | - Priya Palta
- Department of MedicineColumbia University Irving Medical CenterNew YorkNY
- Department of NeurologyUniversity of North Carolina at Chapel Hill School of MedicineChapel HillNC
| | - Dustin T. Duncan
- Department of Epidemiology, Mailman School of Public HealthColumbia University Irving Medical CenterNew YorkNY
| | | | - Ari Shechter
- Department of MedicineColumbia University Irving Medical CenterNew YorkNY
- Center for Behavioral Cardiovascular HealthColumbia University Irving Medical CenterNew YorkNY
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Aziz S, Meier B, Wuensch K, Dolbier C. Take a break! Leisure participation moderates the workaholism-work stress relationship. THE CAREER DEVELOPMENT QUARTERLY 2023; 71:315-329. [PMID: 38390370 PMCID: PMC10883458 DOI: 10.1002/cdq.12336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 10/09/2023] [Indexed: 02/24/2024]
Abstract
Our primary aim was to gain a better understanding of how leisure activities (i.e., physical activity, mindfulness, and vacation) may beneficially relate to workaholism and work stress. Secondary aims included exploring motivations for participating in the three types of leisure activities. The job demands-resources theory; conservation of resources theory; and detachment-recovery, autonomy, mastery, meaning, and affiliation model provided context for hypothesized relationships among the variables. Full-time employees in the United States (N = 367) were recruited via Amazon's Mechanical Turk community, and they completed an online survey. Leisure participation significantly moderated the relationship between workaholism and work stress (weakening it). The majority of motivations for mindfulness and vacation were related to mental/emotional health, with a more even split between mental/emotional health and physical health/appearance motivations for physical activities. Several policy and practice-based recommendations for prioritizing leisure engagement are provided.
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Affiliation(s)
- Shahnaz Aziz
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA
| | - Brittany Meier
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA
| | - Karl Wuensch
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA
| | - Christyn Dolbier
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA
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Ma T, Jennings L, Sirard JR, Xie YJ, Lee CD. Association of the time of day of peak physical activity with cardiovascular mortality: Findings from the UK Biobank study. Chronobiol Int 2023; 40:324-334. [PMID: 36691906 PMCID: PMC10192159 DOI: 10.1080/07420528.2023.2170240] [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: 08/29/2022] [Revised: 12/20/2022] [Accepted: 01/14/2023] [Indexed: 01/25/2023]
Abstract
Cardiovascular physiology and pathophysiology display pronounced circadian rhythms. The study is designed to examine whether the time of day of physical activity is associated with cardiovascular mortality. We analyzed 94,489 UK Biobank adults with objectively measured physical activity, including 53,328 morning-type participants and 30,962 evening-type participants based on self-reported chronotypes. The time of day of peak physical activity was categorized using a machine learning algorithm: early morning (n = 18,477), late morning (n = 25,700), midday (reference) (n = 27,803), and night (n = 22,509). Hazard ratios of cardiovascular mortality were examined using the Cox proportional hazards model. During a median follow-up of 6.9 years (interquartile range, 6.3-7.4 years), we identified 629 cardiovascular deaths. The hazard of cardiovascular mortality was elevated in the early morning group (hazard ratio = 1.56, 95% Confidence Interval [1.23-1.98]) and night group (1.49, [1.18-1.88]) but not in the late morning group (1.21, [0.98-1.47]) compared to the referent midday group. In the chronotype-stratified analysis, the increased cardiovascular mortality in the morning group was only observed in the evening-type participants, while the increased cardiovascular mortality in the night group was only observed in the morning-type participants. In conclusion, optimizing the timing of peak physical activity according to cardiovascular circadian rhythms and individual chronotypes could be a potential therapeutic target that brings additional health benefits.
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Affiliation(s)
- Tongyu Ma
- Health Sciences Department, Franklin Pierce University, Rindge, NH, USA
| | - Lydia Jennings
- Health Sciences Department, Franklin Pierce University, Rindge, NH, USA
| | - John R Sirard
- Department of Kinesiology, University of Massachusetts, Amherst, MA, USA
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chong-Do Lee
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
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Scharf C, Tilp M. Twelve Weeks of Web-Based Low to Moderate Physical Activity Breaks with Coordinative Exercises at the Workplace Increase Motor Skills but Not Motor Abilities in Office Workers-A Randomised Controlled Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2193. [PMID: 36767561 PMCID: PMC9915999 DOI: 10.3390/ijerph20032193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
Integrating physical activity interventions at the workplace can have positive effects on the employees' health. This study aimed to evaluate a physical activity break with coordinative exercises (PAB) including juggling and balance tasks and to assess its effects on motor abilities. Thirty-two university employees were randomly allocated to an intervention (IG:20) or a control (CG:12) group. The IG participated two times per week for 12 weeks in a PAB with a duration of 15 to 20 min. We measured the unimanual, bimanual finger, and hand dexterity with the Purdue Pegboard Test, the reaction time with the Fall Stick Test, and the dynamic balance with the Y Balance Test. Juggling performance was assessed by measuring the time(s) of performing a three-ball-cascade. Furthermore, an evaluation of the PAB was executed. Participants in the IG improved their juggling performance after six and twelve weeks. These increases were significantly different compared to the CG. However, no other parameters changed significantly. The evaluation showed that the PAB was enjoyable and led to subjective improvements in the participants health and working routine. To conclude, PAB can lead to improvements in juggling performance, subjective health, and the working routine.
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Berninger NM, Plasqui G, Crutzen R, Ruiter RAC, Kok G, Ten Hoor GA. The Effects of UPcomplish on Office Workers' Sedentary Behaviour, Quality of Life and Psychosocial Determinants: A Stepped-Wedge Design. Int J Behav Med 2022; 29:728-742. [PMID: 35099779 PMCID: PMC9684295 DOI: 10.1007/s12529-022-10054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sedentary behaviour (SB) affects cardiometabolic health and quality of life (QoL). We examine the effects of UPcomplish, a 12-week data-driven intervention, on SB, QoL and psychosocial determinants among office workers. METHODS Participants were recruited via judgement sampling. Five groups starting with time-lags of 7 weeks (n = 142, 96 females) received 14 feedback messages (FBMs) which were tailored to SB patterns, goals and hurdles. Participants received questionnaires at the beginning, middle and end of the intervention and wore an accelerometer measuring SB, operationalized as proportions (compositional data approach, CoDA) and summed squared sitting bouts (SSSB). We used linear mixed-effects models with random intercepts for weeks (between-subjects) and individuals (within-subjects). RESULTS UPcomplish did not reduce SB. Within-subjects compared to baseline, FBM #3 (βCoDA = 0.24, p < .001, 95% CI [0.15, 0.33]; βSSSB = 20.83, p < .001, 95% CI [13.90, 27.28]) and #4 (βCoDA = 0.20, p < .001, 95% CI [0.11, 0.29]; βSSSB = 24.80, p < .001, 95% CI [15.84, 33.76]) increased SB. QoL was unaffected. Perceived susceptibility was lower after FBMs #6 to #8 (βbetween = - 0.66, p = .04, 95% CI [- 1.03, - 0.30]; βwithin = - 0.75, p = .02, 95% CI [- 1.18, - 0.32]). Within-subjects, intentions to sit less were higher after FBMs #1 to #5 (1.14, p = .02, 95% CI [0.61, 1.66]). Improvements in determinants and in SB were not associated, nor were improvements in SB and in QoL. CONCLUSIONS Compared to VitaBit only, UPcomplish was not beneficial. Environmental restructuring might be superior, but detailed analyses of moderators of effectiveness are needed.
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Affiliation(s)
- Nathalie M. Berninger
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Guy Plasqui
- Department of Human Biology and Movement Sciences, Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Rik Crutzen
- Department of Health Promotion, CAPHRI, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Robert A. C. Ruiter
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Gerjo Kok
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Gill A. Ten Hoor
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Factors Influencing Long-Term Care Workers' Self-Efficacy for Encouraging Residents to Engage in Physical Activity. J Aging Phys Act 2022; 30:987-994. [PMID: 35303711 DOI: 10.1123/japa.2021-0299] [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: 08/06/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/18/2022]
Abstract
We aimed to assess work-related factors and their association with long-term care workers' self-efficacy for encouraging and engaging residents in physical activity. Baseline data from a worksite wellness study with 98 workers were used. We used a linear regression model, to assess if job satisfaction, work ability, and social support for staff health behaviors from coworkers and supervisors were associated with staffs' self-efficacy for Function-Focused Care (FFC) and Staffs' Outcome Expectations for FFC. Staffs' social support for healthy behaviors from coworkers was the only factor that was significantly associated with Staffs' Outcome Expectations for FFC and staffs' self-efficacy-FFC, respectively explaining 19% and 14% of the variance. Our findings show that staffs' social support from coworkers is associated with higher self-efficacy for encouraging and engaging residents in physical activity suggests future worksite wellness studies with long-term care workers may wish to consider assessing program impacts on residents' physical activity levels.
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Brunet J, Black M, Tulloch HE, Pipe AL, Reid RD, Reed JL. Work-related factors predict changes in physical activity among nurses participating in a web-based worksite intervention: A randomized controlled trial. BMC Nurs 2021; 20:224. [PMID: 34749710 PMCID: PMC8576966 DOI: 10.1186/s12912-021-00739-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 10/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background Despite the numerous benefits associated with physical activity (PA), most nurses are not active enough and few interventions have been developed to promote PA among nurses. A secondary analysis of raw data from a single-centre, three-arm parallel-group randomized controlled trial was conducted to assess whether work-related characteristics and general mood states predict changes in total weekly moderate-to-vigorous intensity PA (MVPA) and average daily step-count among nurses participating in a 6-week web-based worksite intervention. Methods Seventy nurses (meanage: 46.1 ± 11.2 years) were randomized to an individual-, friend-, or team-based PA challenge. Participants completed questionnaires pre- and post-intervention assessing work-related characteristics (i.e., shift schedule and length, number of hours worked per week, work role) and general mood states (i.e., tension, depression, anger, confusion, fatigue, vigour). Participants received a PA monitor to wear before and during the 6-week PA challenge, which was used to assess total weekly MVPA minutes and average daily step-count. Data were analyzed descriptively and using multilevel modeling for repeated measures. Results Change in total weekly MVPA minutes, but not change in average daily step-count, was predicted by shift schedule (rotating vs. fixed) by time (estimate = − 17.43, SE = 6.18, p = .006), and work role (clinical-only vs. other) by time (estimate = 18.98, SE = 6.51, p = .005). General mood states did not predict change in MVPA or change in average daily step-count. Conclusions Given that nurses who work rotating shifts and perform clinical work showed smaller improvements in MVPA, it may be necessary to consider work-related factors/barriers (e.g., time constraints, fatigue) and collaborate with nurses when designing and implementing MVPA interventions in the workplace. Trial registration ClinicalTrials.gov: NCT04524572. August 24, 2020. This trial was registered retrospectively. This study adheres to the CONSORT 2010 statement guidelines. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00739-4.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada. .,Institut du savoir de l'Hôpital Montfort (ISM), Hôpital Montfort, 713 Montreal Road, Ottawa, Ontario, Canada. .,Cancer Therapeutic Program, Ottawa Hospital Research Institute (OHRI), 725 Parkdale Avenue, Ottawa, Ontario, Canada.
| | - Melissa Black
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada
| | - Heather E Tulloch
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada.,Faculty of Medicine, University of Ottawa, 451 Smyth Road, Roger Guidon Hall, Ottawa, Ontario, Canada
| | - Andrew L Pipe
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada.,Faculty of Medicine, University of Ottawa, 451 Smyth Road, Roger Guidon Hall, Ottawa, Ontario, Canada
| | - Robert D Reid
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada.,Faculty of Medicine, University of Ottawa, 451 Smyth Road, Roger Guidon Hall, Ottawa, Ontario, Canada
| | - Jennifer L Reed
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada.,Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada.,Faculty of Medicine, University of Ottawa, 451 Smyth Road, Roger Guidon Hall, Ottawa, Ontario, Canada
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Olapeju B, Hong X, Wang G, Summers A, Burd I, Cheng TL, Wang X. Birth outcomes across the spectrum of maternal age: dissecting aging effect versus confounding by social and medical determinants. BMC Pregnancy Childbirth 2021; 21:594. [PMID: 34470614 PMCID: PMC8411515 DOI: 10.1186/s12884-021-04077-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 08/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the trend of increasing maternal age and associated adverse reproductive outcomes in the US, this study aimed to assess whether this association is due to an independent aging or confounded by sociodemographic, biomedical, or behavioral determinants in a predominantly Black US population. METHODS Data was from 8509 women enrolled in the Boston Birth Cohort. Adverse reproductive outcomes included spontaneous preterm delivery, cesarean delivery, and low birth weight. Covariates included sociodemographic (parity, race/ethnicity, education, marital status, income, receipt of public assistance, nativity); biomedical (obesity, hypertensive disorders, diabetes mellitus); and behavioral (consistent intake of multivitamin supplements, support from father of baby, support from family, major stress in pregnancy, cigarette smoking, alcohol intake). Analysis included Lowess and marginal probability plots, crude and adjusted sequential logistic regression models to examine age-outcome associations and to what degree the association can be explained by the above covariables. RESULT Overall, the study sample had high levels of spontaneous preterm birth (18%), cesarean delivery (33%) and low birth weight (26%). Unadjusted models showed no significant difference odds of spontaneous preterm birth by maternal age but higher odds of cesarean section (aOR: 1.77, 95% CI: 1.60, 1.95) and low birth weight (aOR: 1.15, 95% CI: 1.04, 1.28) among women 30 years or older. Adjustment for sociodemographic factors, biomedical conditions and behavioral factors revealed higher odds of spontaneous preterm birth: (aOR: 1.30, 95% CI: 1.14, 1.49), cesarean section deliveries (aOR: 1.68, 95% CI: 1.51, 1.87) and low birth weight (aOR: 1.36, 95% CI: 1.21, 1.53). Across all ages, optimal BMI status and consistent multivitamin supplement intake were protective of spontaneous preterm birth and low birth weight. CONCLUSION In this high-risk minority population, we demonstrated that the association between increasing maternal age and adverse pregnancy outcomes was due to an independent aging effect and the presence of confounding by sociodemographic, biomedical, and behavioral factors. Some modifiable risk factors to counteract aging effect, include optimizing BMI and consistent intake of multivitamin supplement. A fundamental change in how care is provided to women, particularly low income Black women, is needed with emphasis on the protective role of optimal nutritional status. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03228875.
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Affiliation(s)
- Bolanle Olapeju
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
- Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xiumei Hong
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
| | - Amber Summers
- Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Irina Burd
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tina L Cheng
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA.
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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12
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Using Focus Groups and Interviews to Inform the Design of a Workplace Exercise Programme: An Example From a High-Intensity Interval Training Intervention. J Occup Environ Med 2021; 63:e63-e74. [PMID: 33234874 DOI: 10.1097/jom.0000000000002092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Using a formative evaluation of a high-intensity interval training (HIIT) intervention, we illustrate how qualitative data can inform the development of workplace exercise interventions. METHOD Eight focus groups and four interviews were conducted with employees (n = 38) and management (n = 4) from six office-based organisations before intervention implementation. RESULTS Some participants thought workplace-based HIIT would be practical, given the limited time required. Others perceived it may not be acceptable for all individuals, given the exercise intensity. With consideration of identified barriers (workload/family commitments effecting time availability) and facilitators (flexible working conditions) participants' perspectives were incorporated into the intervention protocol. A short-term group-based intervention was preferred, with a choice of exercise modes (based on stair climbing, stepping or boxing). CONCLUSION This study provides a framework to incorporate stakeholders' perspectives into the development of workplace exercise interventions.
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13
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Physical activity outcomes from a randomized trial of a theory- and technology-enhanced intervention for Latinas: the Seamos Activas II study. J Behav Med 2021; 45:1-13. [PMID: 34379236 DOI: 10.1007/s10865-021-00246-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
Latina women report disproportionately high and increasing prevalence of chronic health conditions (obesity, diabetes) related to low physical activity levels. Efforts to date at addressing high rates of physical inactivity in this at-risk population have shown modest success. The original Seamos Saludables (sample size N = 266) was a culturally and linguistically adapted, print-based physical activity intervention that showed significant increases in moderate to vigorous physical activity (MVPA) from baseline to 6 months. However, only 11% of intervention participants reached the national PA guidelines of ≥ 150 min/week of aerobic MVPA. The current study tests the original Seamos Saludables intervention (Original Intervention) against an enhanced iteration Seamos Activas II (Enhanced Intervention). Study aims and intervention refinements focus on increasing the percentage of Latinas meeting national aerobic PA guidelines. For the current study (Seamos Activas II), a randomized controlled trial with (N = 199 participants) of two PA interventions (original intervention, N = 102; vs. enhanced intervention, N = 97) was conducted. Intervention refinements involved further targeting key constructs of the Social Cognitive Theory and incorporating text-message-based strategies for self-monitoring, in response to participant feedback for greater interactivity and accountability. PA assessments were conducted at baseline and 6 months. The sample was predominantly Mexican American (89%) with average age of 43.8 years (SD = 10.11) and mean BMI at baseline was 30.6 (SD = 7.56). There were significant within group increases in MVPA from baseline to 6 months (p < .05) in both Original and Enhanced Intervention arms. However, quantile regression models did not indicate significant differences in 6-month outcomes between conditions controlling for baseline, p = 0.73. There were significant differences between conditions with respect to meeting national guidelines for aerobic MVPA at 6 months, with 57% of Enhanced Intervention participants meeting guidelines compared to 44% of Original Intervention participants, OR = 1.66, 95% CI: 1.09 -2.89. Models suggest trends favoring the enhanced condition for improvements in biomarkers over 6 months. Findings indicate that the intervention enhancements likely helped more Latinas achieve nationally recommended, health enhancing PA levels than the original intervention and showed promise for improving physiological response to exercise.Trial Registration ClinicalTrials.Gov; NCT02630953. Registered 14 December 2015. https://clinicaltrials.gov/ct2/show/NCT02630953 .
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14
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García Pérez de Sevilla G, Barceló Guido O, De la Cruz MDLP, Blanco Fernández A, Alejo LB, Montero Martínez M, Pérez-Ruiz M. Adherence to a Lifestyle Exercise and Nutrition Intervention in University Employees during the COVID-19 Pandemic: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147510. [PMID: 34299960 PMCID: PMC8305330 DOI: 10.3390/ijerph18147510] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/28/2021] [Accepted: 07/06/2021] [Indexed: 01/09/2023]
Abstract
Healthy lifestyles should be encouraged in the workplace through the occupational health teams of the companies. The objective of the present study was to evaluate the adherence to a lifestyle intervention carried out in university employees during the COVID-19 pandemic and its impact on health-related quality of life (HrQoL). A randomized controlled trial following the CONSORT guidelines was performed, consisting of three supervised interventions lasting for 18 weeks: an educational intervention on healthy habits, a nutritional intervention, and a telematic aerobic and strength exercise intervention. Lifestyle and HrQoL were analyzed six months post-intervention to assess adherence. Twenty-three middle-aged participants completed the study. The intervention group significantly improved their lifestyle according to the Health Promoting Lifestyle Profile II questionnaire, especially in the categories of Health Responsibility, Physical Activity, and Nutrition, with a large effect size. Sitting time was reduced by 2.5 h per day, with a moderate effect size. Regarding HrQoL, the intervention group showed a clinically significant improvement in the Physical Component Summary. Despite the lockdown and the mobility restrictions caused by the COVID-19 pandemic, this intervention performed on university employees achieved adherence to a healthier lifestyle and improved their HrQoL, which is of great clinical relevance.
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Affiliation(s)
- Guillermo García Pérez de Sevilla
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Correspondence: ; Tel.: +34-62920-7357
| | - Olga Barceló Guido
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (O.B.G.); (L.B.A.); (M.P.-R.)
| | | | - Ascensión Blanco Fernández
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.B.F.); (M.M.M.)
| | - Lidia B. Alejo
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (O.B.G.); (L.B.A.); (M.P.-R.)
| | - María Montero Martínez
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.B.F.); (M.M.M.)
| | - Margarita Pérez-Ruiz
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (O.B.G.); (L.B.A.); (M.P.-R.)
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15
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Burn NL, Weston M, Atkinson G, Graham M, Weston KL. Brief Exercise at Work (BE@Work): A Mixed-Methods Pilot Trial of a Workplace High-Intensity Interval Training Intervention. Front Sports Act Living 2021; 3:699608. [PMID: 34278300 PMCID: PMC8282817 DOI: 10.3389/fspor.2021.699608] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The efficacy of high-intensity interval training (HIIT) for improving markers of physical fitness and cardiometabolic health is promising. The workplace is one non-laboratory setting where the effectiveness of HIIT could be explored. The aim of this study was to undertake a mixed-methods exploratory pilot trial of a workplace HIIT intervention named Brief Exercise at Work (BE@Work). Methods: Fifty-four healthy employees (mean ± standard deviation [SD] age 46 ± 10 years) from two workplaces in Northeast England were allocated to 8 weeks of thrice-weekly workplace HIIT based on boxing, stair climbing and stepping, comprising 4-7 60 s high-intensity intervals interspersed with 75 s rest (n = 30), or a no-intervention control (n = 24). The primary outcome was the change SD of predicted maximal oxygen consumption (VO2max). Markers of physical fitness, cardiometabolic health and mental well-being were also measured at baseline and follow-up. Participant perceptions of the intervention were explored in post-intervention focus groups (n = 9). Results: Mean (±SD) session attendance was 82% (±15%). Mean peak heart rate across the intervention was 87% of age-predicted maximal heart rate with a within- and between-subject SD of 5.5% and 3.7%, respectively. The SD of changes in predicted VO2max was 6.6 mL·kg-1·min-1 across both groups, which can be used to inform sample size estimations for a future full trial. The control-adjusted mean increase (95% confidence interval) in predicted VO2max was 3.9 (-0.2 to 8.1) mL·kg-1·min-1, corresponding to a Cohen's D of 0.47. We also observed preliminary evidence of small to moderate effects in favour of the intervention group for non-dominant leg extensor muscle power, markers of health-related quality of life, well-being and perceived stress and small to moderate effects in favour of the controls in perceived pain, physical activity and high-density lipoprotein cholesterol. During HIIT, focus group participants reported physiological responses they perceived as unpleasant or tiring (e.g., breathlessness, local muscular fatigue), but also that they felt alert and energised afterwards. Conclusion: The findings of this exploratory pilot trial support the implementation of a definitive randomised controlled trial to quantify the effectiveness of a workplace HIIT intervention.
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Affiliation(s)
- Naomi L Burn
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Matthew Weston
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Greg Atkinson
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Michael Graham
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Kathryn L Weston
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
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16
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Targeting Diet Quality at the Workplace: Influence on Cardiometabolic Risk. Nutrients 2021; 13:nu13072283. [PMID: 34209458 PMCID: PMC8308315 DOI: 10.3390/nu13072283] [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: 05/28/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 11/24/2022] Open
Abstract
The American Heart Association criteria for cardiovascular health include overall diet quality (DQ). The present study evaluated the effect of a workplace health promotion program targeting DQ and physical activity on features of cardiometabolic risk (CMR). Before and after the 3-month intervention, 2260 employees (1462 men and 798 women) completed a health and fitness evaluation including assessment of DQ using a validated food-based questionnaire. After the 3-month lifestyle modification program, DQ increased significantly in both sexes (p < 0.0001) as well as physical activity level (p < 0.0001). A reduction in waist circumference (p < 0.0001) and improved lipid levels were also observed. Significant associations were found between changes in DQ index and changes in CMR variables in both men (standardized regression coefficients ranged from −0.19 (95% confidence interval: −0.26 to −0.12) to −0.29 (95% confidence interval: −0.34 to −0.25)) and women (standardized regression coefficients ranged from −0.18 (95% confidence interval: −0.25 to −0.11) to −0.27 (95% confidence interval: −0.41 to −0.13)). Multiple linear regression analyses showed a significant contribution of changes in the DQ index to the variation in some CMR variables, independent from changes in physical activity level and cardiorespiratory fitness. This study provides evidence that targeting DQ at the workplace is relevant to improve cardiometabolic health.
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17
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Dieterich AV, Müller AM, Akksilp K, K C S, Dabak SV, Rouyard T. Reducing sedentary behaviour and physical inactivity in the workplace: protocol for a review of systematic reviews. BMJ Open Sport Exerc Med 2020; 6:e000909. [PMID: 33324487 PMCID: PMC7722375 DOI: 10.1136/bmjsem-2020-000909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Increasing rates of urbanisation have been accompanied by higher levels of sedentary behaviour (SB) and reduced physical activity (PA) worldwide. While physical inactivity has long been identified as a major risk factor for morbidity and mortality, increased concerns about the detrimental associations between SB and health has led to the development of many interventions aimed at reducing SB and/or promoting PA. Due to the prominence of sedentary time spent at work, the workplace has been identified as a key setting to implement such interventions. Building an evidence base of effective strategies to reduce SB and/or promote PA at work is needed to help reduce the health risks faced by many employees. METHODS AND ANALYSIS We aim to conduct a review of reviews (RoR) to identify, evaluate and synthesise all systematic reviews (SRs) of workplace interventions aimed at reducing SB and/or promoting PA among adults. Systematic searches for relevant SRs will be conducted in six databases: Cochrane Systematic Review Database, Cumulative Index to Nursing & Allied Health Literature through EBSCOhost, EMBASE, PubMed including MEDLINE, Scopus and Web of Science. Selection for final inclusion and data extraction will be performed by two independent reviewers. SRs will be included if they assessed interventions aimed at reducing SB or promoting PA in the workplace, and if they report on changes in the respective behavioural outcomes in the occupational domain. DISCUSSION This RoR will be valuable to policy-makers and employers who are looking for strategies to promote health at work. This will also allow potential research gaps to be identified, so that the design of future studies can be better informed. TRIAL REGISTERATION This study has been registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42020171774).
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Affiliation(s)
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Centre for Sport & Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Katika Akksilp
- Health Intervention and Technology Assessment Program, Mueang Nonthaburi, Thailand
| | - Sarin K C
- Health Intervention and Technology Assessment Program, Mueang Nonthaburi, Thailand
| | | | - Thomas Rouyard
- Research Center for Health Policy and Economics, Hitotsubashi University, Kunitachi, Japan
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18
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Jiménez-Mérida MR, Romero-Saldaña M, Molina-Luque R, Molina-Recio G, Meneses-Monroy A, De Diego-Cordero R, Vaquero-Abellán M. Women-centred workplace health promotion interventions: a systematic review. Int Nurs Rev 2020; 68:90-98. [PMID: 33140478 DOI: 10.1111/inr.12637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/18/2020] [Accepted: 09/15/2020] [Indexed: 11/29/2022]
Abstract
AIM To analyse workplace health promotion interventions implemented exclusively for the female population. BACKGROUND The differences in biological, psychological and social characteristics, as well as the type of work carried out by men and women, make it necessary for workplace health promotion to be specific for each group. This study focussed on working women. INTRODUCTION Workplace health promotion interventions are centred on increasing the well-being and health of the employees. Occupational health nurses play an essential role in the implementation of these interventions. METHODS A systematic review was carried out using the MEDLINE and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. RESULTS Twelve articles met the inclusion criteria. Two lines of interventions were found: (1) promotion of breastfeeding (16.6%) and (2) promotion of physical activity and other healthy lifestyles (83.4%). The interventions studied underlined promoting breastfeeding, preventing a sedentary lifestyle, improving body composition, reducing cardiovascular risk, relieving premenstrual symptoms, time of breastfeeding after returning to work, and showing favourable results. DISCUSSION The lack of studies on the subject and the medium-to-low quality of the articles included in the review have made it difficult to analyse workplace health promotion interventions, making it necessary to continue research in this area. CONCLUSION There are very few occupational health promotion interventions targeting women (1.9%), and the majority of them focus on promoting physical activity. It is worrying that specific aspects of women's health are poorly addressed. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY The work of the occupational nurse essentially is to guarantee the health of women in the workplace, being the key figure in the research and development of gender-related policies in the field of public health.
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Affiliation(s)
- M R Jiménez-Mérida
- Nursing, Pharmacology and Physiotherapy Department, Faculty of Medicine, and Nursing, University of Cordoba, Cordoba, Spain
| | - M Romero-Saldaña
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, University Complutense of Madrid, Madrid, Spain
| | - R Molina-Luque
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, University Complutense of Madrid, Madrid, Spain
| | - G Molina-Recio
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, University Complutense of Madrid, Madrid, Spain
| | - A Meneses-Monroy
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, University Complutense of Madrid, Madrid, Spain
| | - R De Diego-Cordero
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, University of Sevilla, Sevilla, Spain
| | - M Vaquero-Abellán
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, University Complutense of Madrid, Madrid, Spain
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19
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Madden SK, Cordon EL, Bailey C, Skouteris H, Ahuja K, Hills AP, Hill B. The effect of workplace lifestyle programmes on diet, physical activity, and weight-related outcomes for working women: A systematic review using the TIDieR checklist. Obes Rev 2020; 21:e13027. [PMID: 32803854 DOI: 10.1111/obr.13027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 12/20/2022]
Abstract
Physical activity and healthy diets are essential for the prevention of obesity and chronic disease that disparately impact women compared with men. Given the number of women engaged in the workforce, workplace interventions could improve lifestyle behaviours and health outcomes for women. This systematic review aimed to identify intervention characteristics of lifestyle programmes or organizational policy changes in the workplace associated with improved diet, physical activity, or weight-related outcomes for working women using the template for intervention description and replication (TIDieR) checklist. Seven databases were searched for controlled studies published up to March 2019 that included a workplace diet and/or physical activity intervention. From 5,318 identified records, 20 studies (23 articles and 26 intervention arms) were included. Data were extracted on diet, physical activity, weight-related outcomes, and TIDieR components. Findings indicated that group delivery may improve physical activity outcomes, and a high number of sessions may benefit weight-related outcomes for physical activity interventions. Mixed interventions that included tailoring and input from non-healthcare professionals may also enhance physical activity. In contrast, the role of mixed interventions in improving diet and weight-related outcomes was less clear. Overall, workplace health programmes were effective at improving lifestyle behaviours for working women.
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Affiliation(s)
- Seonad K Madden
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Emma L Cordon
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Kiran Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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20
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Freak-Poli RLA, Cumpston M, Albarqouni L, Clemes SA, Peeters A. Workplace pedometer interventions for increasing physical activity. Cochrane Database Syst Rev 2020; 7:CD009209. [PMID: 32700325 PMCID: PMC7389933 DOI: 10.1002/14651858.cd009209.pub3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends undertaking 150 minutes of moderate-intensity physical activity per week, but most people do not. Workplaces present opportunities to influence behaviour and encourage physical activity, as well as other aspects of a healthy lifestyle. A pedometer is an inexpensive device that encourages physical activity by providing feedback on daily steps, although pedometers are now being largely replaced by more sophisticated devices such as accelerometers and Smartphone apps. For this reason, this is the final update of this review. OBJECTIVES To assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving long-term health outcomes. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Occupational Safety and Health (OSH) UPDATE, Web of Science, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform from the earliest record to December 2016. We also consulted the reference lists of included studies and contacted study authors to identify additional records. We updated this search in May 2019, but these results have not yet been incorporated. One more study, previously identified as an ongoing study, was placed in 'Studies awaiting classification'. SELECTION CRITERIA We included randomised controlled trials (RCTs) of workplace interventions with a pedometer component for employed adults, compared to no or minimal interventions, or to alternative physical activity interventions. We excluded athletes and interventions using accelerometers. The primary outcome was physical activity. Studies were excluded if physical activity was not measured. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. When studies presented more than one physical activity measure, we used a pre-specified list of preferred measures to select one measure and up to three time points for analysis. When possible, follow-up measures were taken after completion of the intervention to identify lasting effects once the intervention had ceased. Given the diversity of measures found, we used ratios of means (RoMs) as standardised effect measures for physical activity. MAIN RESULTS We included 14 studies, recruiting a total of 4762 participants. These studies were conducted in various high-income countries and in diverse workplaces (from offices to physical workplaces). Participants included both healthy populations and those at risk of chronic disease (e.g. through inactivity or overweight), with a mean age of 41 years. All studies used multi-component health promotion interventions. Eleven studies used minimal intervention controls, and four used alternative physical activity interventions. Intervention duration ranged from one week to two years, and follow-up after completion of the intervention ranged from three to ten months. Most studies and outcomes were rated at overall unclear or high risk of bias, and only one study was rated at low risk of bias. The most frequent concerns were absence of blinding and high rates of attrition. When pedometer interventions are compared to minimal interventions at follow-up points at least one month after completion of the intervention, pedometers may have no effect on physical activity (6 studies; very low-certainty evidence; no meta-analysis due to very high heterogeneity), but the effect is very uncertain. Pedometers may have effects on sedentary behaviour and on quality of life (mental health component), but these effects were very uncertain (1 study; very low-certainty evidence). Pedometer interventions may slightly reduce anthropometry (body mass index (BMI) -0.64, 95% confidence interval (CI) -1.45 to 0.18; 3 studies; low-certainty evidence). Pedometer interventions probably had little to no effect on blood pressure (systolic: -0.08 mmHg, 95% CI -3.26 to 3.11; 2 studies; moderate-certainty evidence) and may have reduced adverse effects (such as injuries; from 24 to 10 per 100 people in populations experiencing relatively frequent events; odds ratio (OR) 0.50, 95% CI 0.30 to 0.84; low-certainty evidence). No studies compared biochemical measures or disease risk scores at follow-up after completion of the intervention versus a minimal intervention. Comparison of pedometer interventions to alternative physical activity interventions at follow-up points at least one month after completion of the intervention revealed that pedometers may have an effect on physical activity, but the effect is very uncertain (1 study; very low-certainty evidence). Sedentary behaviour, anthropometry (BMI or waist circumference), blood pressure (systolic or diastolic), biochemistry (low-density lipoprotein (LDL) cholesterol, total cholesterol, or triglycerides), disease risk scores, quality of life (mental or physical health components), and adverse effects at follow-up after completion of the intervention were not compared to an alternative physical activity intervention. Some positive effects were observed immediately at completion of the intervention periods, but these effects were not consistent, and overall certainty of evidence was insufficient to assess the effectiveness of workplace pedometer interventions. AUTHORS' CONCLUSIONS Exercise interventions can have positive effects on employee physical activity and health, although current evidence is insufficient to suggest that a pedometer-based intervention would be more effective than other options. It is important to note that over the past decade, technological advancement in accelerometers as commercial products, often freely available in Smartphones, has in many ways rendered the use of pedometers outdated. Future studies aiming to test the impact of either pedometers or accelerometers would likely find any control arm highly contaminated. Decision-makers considering allocating resources to large-scale programmes of this kind should be cautious about the expected benefits of incorporating a pedometer and should note that these effects may not be sustained over the longer term. Future studies should be designed to identify the effective components of multi-component interventions, although pedometers may not be given the highest priority (especially considering the increased availability of accelerometers). Approaches to increase the sustainability of intervention effects and behaviours over a longer term should be considered, as should more consistent measures of physical activity and health outcomes.
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Affiliation(s)
- Rosanne LA Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Miranda Cumpston
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Loai Albarqouni
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Stacy A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Anna Peeters
- Institute for Health Transformation, Deakin University, Geelong, Australia
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21
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Burn NL, Weston M, Maguire N, Atkinson G, Weston KL. Effects of Workplace-Based Physical Activity Interventions on Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis of Controlled Trials. Sports Med 2020; 49:1255-1274. [PMID: 31115827 DOI: 10.1007/s40279-019-01125-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cardiorespiratory fitness is a strong predictor of all-cause mortality. Physical activity of at least moderate intensity can improve cardiorespiratory fitness. Workplaces may provide a relatively controlled setting in which to improve cardiorespiratory fitness through physical activity. Limited work has been conducted to quantify the impact of delivering physical activity in the workplace on cardiorespiratory fitness. OBJECTIVE The objective of this systematic review was to quantify the effects of workplace physical activity interventions on peak oxygen consumption (VO2peak) and explore study and participant characteristics as putative moderators. METHODS Seven databases were searched up to September 2018. Search terms included "workplace", "physical activity" and "intervention". Inclusion criteria were controlled trials where physical activity of at least moderate intensity was delivered in the workplace and compared to controls or non-active comparators; and cardiorespiratory fitness measured by actual or predicted VO2peak. Risk of bias was assessed using the PEDro scale. A random-effects meta-analysis was conducted with between-study variation quantified and then explored for putative predictors with a meta-regression. Pooled estimate uncertainty was expressed as 90% confidence intervals (CIs) and assessed against our threshold value for clinical relevance of 1 mL·kg-1·min-1. RESULTS The final dataset consisted of 25 estimates of VO2peak from 12 trials. The pooled mean differences between intervention and control arms was a beneficial improvement of 2.7 mL·kg-1·min-1 (90% CI 1.6-3.8). The 95% prediction interval ranged from a reduction in VO2peak of - 1.1 to an improvement of 6.5 mL·kg-1·min-1. Between-study heterogeneity (τau) was ± 1.6 mL·kg-1·min-1. The meta-regression showed longer interventions (3.2 mL·kg-1·min-1; 90% CI 1.6-3.8) to have an additive effect and studies with a low risk of bias (- 2.5 mL·kg-1·min-1; 90% CI - 4.0 to - 1.0), and participants of greater baseline VO2peak (- 1.6 mL·kg-1·min-1; 90% CI - 3.6 to 0.4), and age (- 1.4 mL·kg-1·min-1; 90% CI - 3.2 to 0.3) having a lesser effect. Participant sex (percentage female) had an additive effect on VO2peak (0.4 mL·kg-1·min-1; 90% CI - 1.6 to 2.4). CONCLUSIONS Workplace-based physical activity interventions consisting of at least moderate-intensity activity improve cardiorespiratory fitness. At the present time, we surmise that no single group of employees (e.g. older employees or less fit individuals) can be definitively identified as standing to benefit more from workplace physical activity interventions than others. This demonstrates the potential utility of workplace physical activity interventions for improving cardiorespiratory fitness in a broad range of healthy employees. Protocol registration: PROSPERO (registration number: 42017057498).
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Affiliation(s)
- Naomi L Burn
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK. .,Teesside University, Southfield Rd, Middlesbrough, TS1 3BX, UK.
| | - Matthew Weston
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - Neil Maguire
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - Greg Atkinson
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - Kathryn L Weston
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
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Miranda Bispo LG, Norte da Silva JM, Bolis I, Karla Dos Santos Leite W, Marama de Araujo Vieira E, Colaço GA, Lopes de Souza E, Gontijo LA, Bueno da Silva L. Effects of a worksite physical activities program among men and women: An interventional study in a footwear industry. APPLIED ERGONOMICS 2020; 84:103005. [PMID: 31765918 DOI: 10.1016/j.apergo.2019.103005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 06/10/2023]
Abstract
The study aims to assess the association between various levels of engagement in a worksite physical activities program and variables related to musculoskeletal symptoms, psychophysiological well-being, difficulty to perform tasks, willingness to work, and interpersonal relationships, among men and women in a footwear industry. This program involved 1113 workers. Data were analysed using an ordinal logistic regression model. In women, an increase in the frequency of participation in the worksite physical activities program was associated with less musculoskeletal pain (OR = 3.12; 2.07-4.71), better relationships among colleagues (OR = 2.83; 1.67-4.81), and a higher level of psychophysiological well-being (OR = 1.98; 1.06-3.70). In men, an increase in the frequency participation in the worksite physical activities program was associated with less difficulty in performing occupational tasks (OR = 0.49; 0.27-0.87). Thus, the association between occupational exercises and studied variables differed between genders.
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Affiliation(s)
- Lucas Gomes Miranda Bispo
- Department of Industrial Engineering, Federal University of Alagoas, Delmiro Gouveia, Alagoas, Brazil
| | | | - Ivan Bolis
- Department of Psychology, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
| | | | | | - Geraldo Alves Colaço
- Department of Industrial Engineering, Estácio de Sá School, Salvador, Bahia, Brazil
| | - Erivaldo Lopes de Souza
- Department of Industrial Engineering, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - Leila Amaral Gontijo
- Department of Industrial Engineering, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Luiz Bueno da Silva
- Department of Industrial Engineering, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
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23
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Lam C, Milne-Ives M, Van Velthoven MH, Meinert E. Internet of Things-Enabled Technologies for Weight Management in Children and Adolescents: Protocol for a Systematic Review. JMIR Res Protoc 2020; 9:e16930. [PMID: 32229473 PMCID: PMC7157501 DOI: 10.2196/16930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/04/2019] [Accepted: 12/11/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Childhood obesity is a serious global issue, leading to increased medical spending on obesity-related diseases such as cardiovascular diseases and diabetes. There is a need for health care services that link health behavior to risk factors, such as diet and physical activity, and that provide better advice and feedback to users, which Internet of Things-enabled technologies could facilitate. OBJECTIVE The objective of the systematic review will be to identify available Internet of Things-enabled technologies for weight management of children and adolescents (users younger than 18 years). It will also aim to understand the use, effectiveness, and feasibility of these technologies. METHODS We will search the Medline, PubMed, Web of Science, Scopus, ProQuest Central, and IEEE Xplore Digital Library databases for studies published after 2010, using a combination of keywords and subject headings related to health activity tracking, youth, and Internet of Things. In addition, a Google search to identify grey literature will be conducted. Two authors will independently screen the titles and abstracts identified from the search and accept or reject the studies according to the study inclusion criteria. Any discrepancies will then be discussed and resolved. The quality of the included studies will be assessed using the Critical Appraisal Skills Programme (CASP) checklists. Data from included studies will be extracted into a predesigned form to identify the types of devices or apps, Internet of Things applications, and health outcomes related to weight management. RESULTS A preliminary search on Medline returned 484 results. The publication of the final systematic review is expected in mid-2020. CONCLUSIONS The effectiveness and feasibility of physical activity trackers and consumer wearables for different patient groups have been well reviewed, but there are currently no published reviews that look into these technologies in the wider Internet of Things context. This review aims to address this gap by examining Internet of Things-enabled technologies that are designed for youth weight management and thus inform further research and clinical studies to reduce childhood obesity. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/16930.
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Affiliation(s)
- Ching Lam
- Digitally Enabled Population Health Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Madison Milne-Ives
- Digitally Enabled Population Health Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Michelle Helena Van Velthoven
- Digitally Enabled Population Health Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Edward Meinert
- Digitally Enabled Population Health Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- Department of Primary Care and Public Health, Imperial College London, United Kingdom
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24
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Podrekar N, Kozinc Ž, Šarabon N. The effects of cycle and treadmill desks on work performance and cognitive function in sedentary workers: A review and meta-analysis. Work 2020; 65:537-545. [DOI: 10.3233/wor-203108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Nastja Podrekar
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia
- InnoRennew CoE, Izola, Slovenia
| | - Žiga Kozinc
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia
- University of Primorska, Andrej Marušič Institute, Koper, Slovenia
| | - Nejc Šarabon
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia
- InnoRennew CoE, Izola, Slovenia
- S2P, Science to Practice Ltd., Ljubljana, Slovenia
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25
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Vidal-Almela S, Czajkowski B, Prince SA, Chirico D, Way KL, Pipe AL, Reed JL. Lessons learned from community- and home-based physical activity programs: A narrative review of factors influencing women's participation in cardiac rehabilitation. Eur J Prev Cardiol 2020; 28:761-778. [PMID: 33611528 DOI: 10.1177/2047487320907748] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/30/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiovascular disease remains a leading cause of death in women. Despite the well-known benefits of cardiac rehabilitation, it remains underutilized, especially among women. Physical activity programs in the community, however, attract a large female population, suggesting that they overcome barriers to physical activity encountered by women. The characteristics of interventions that extend beyond the traditional cardiac rehabilitation model and promote physical activity merit examination. OBJECTIVES This narrative review aimed to: (a) summarize women's barriers to attend cardiac rehabilitation; (b) examine the characteristics of community- and home-based physical activity or lifestyle coaching interventions; and (c) discuss which barriers may be addressed by these alternative programs. METHODS Studies were included if they: (a) were published within the past 10 years; (b) included ≥70% women with a mean age ≥45 years; (c) implemented a community- or home-based physical activity intervention or a lifestyle education/behavioral coaching program; and (d) aimed to improve physical activity levels or physical function. RESULTS Most interventions reported high (≥70%) participation rates and significant increases in physical activity levels at follow-up; some improved physical function and/or cardiovascular disease risk factors. Community- and home-based interventions address women's cardiac rehabilitation barriers by: implementing appealing modes of physical activity (e.g. dancing, group-walking, technology-based balance exercises); adapting the program to meet participants' needs; offering flexible options regarding timing and setting (e.g. closer to home, the workplace or faith-based institutions); and promoting social interactions. CONCLUSION Cardiac rehabilitation can be enhanced by understanding the specific needs of women; novel elements such as program offerings, convenient settings and opportunities for socialization should be considered when designing cardiac rehabilitation programs.
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Affiliation(s)
- Sol Vidal-Almela
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada
- Institut du savoir Montfort, l'Hôpital Montfort, Canada
| | - Brenna Czajkowski
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Stephanie A Prince
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Daniele Chirico
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Kimberley L Way
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Andrew L Pipe
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
- Faculty of Medicine, University of Ottawa, Canada
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Canada
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26
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Thøgersen-Ntoumani C, Quested E, Smith BS, Nicholas J, McVeigh J, Fenton SAM, Stamatakis E, Parker S, Pereira G, Gucciardi DF, Ntoumanis N. Feasibility and preliminary effects of a peer-led motivationally-embellished workplace walking intervention: A pilot cluster randomized trial (the START trial). Contemp Clin Trials 2020; 91:105969. [PMID: 32114186 DOI: 10.1016/j.cct.2020.105969] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/19/2020] [Accepted: 02/22/2020] [Indexed: 11/18/2022]
Abstract
Walking interventions can be effective in increasing physical activity amongst physically inactive employees. However, despite their promising potential regarding sustainability and scalability, peer-led workplace walking interventions have not been tested. We evaluated a peer-led workplace group walking intervention designed to engage physically inactive employees. A 16-week pilot cluster randomized controlled trial consisted of enhanced (5 worksites; n = 50 participants) and minimal treatment (3 worksites; n = 47) conditions. All participants were provided with a Fitbit Zip and information on health benefits of walking. Enhanced treatment participants had access to a mobile phone app incorporating behavior change techniques, were trained on principles of autonomous motivation, and had a peer leader trained in a motivationally supportive communication style. Feasibility assessments included recruitment and drop-out rates, assessment completion rates, training acceptability (walkers and peer leaders), and intervention acceptability (walkers only). Outcomes assessed included movement-related behaviors (assessed via activPAL devices), cardio-metabolic risk factors, motivation to walk, and well-being, and these measures were taken at baseline and post-intervention. The results supported intervention feasibility. Preliminary efficacy evidence was mixed. Markers of cardio-metabolic risk improved in the enhanced treatment only. Autonomous motivation increased in both conditions. There were no changes in step counts, standing, and sitting time, or well-being. Further fine tuning is needed before a definitive RCT. Australian and New Zealand Clinical Trials Registry: ACTRN12618000807257.
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Affiliation(s)
- C Thøgersen-Ntoumani
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia.
| | - E Quested
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
| | - B S Smith
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
| | - J Nicholas
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
| | - J McVeigh
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - S A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, England
| | - E Stamatakis
- Charles Perkins Centre, School of Public Health, University of Sydney, Sydney, Australia
| | - S Parker
- Centre for Transformative Work Design, Future of Work Institute, Curtin University, Perth, Australia
| | - G Pereira
- School of Public Health, Curtin University, Perth, Australia
| | - D F Gucciardi
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - N Ntoumanis
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
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Mulchandani R, Chandrasekaran AM, Shivashankar R, Kondal D, Agrawal A, Panniyammakal J, Tandon N, Prabhakaran D, Sharma M, Goenka S. Effect of workplace physical activity interventions on the cardio-metabolic health of working adults: systematic review and meta-analysis. Int J Behav Nutr Phys Act 2019; 16:134. [PMID: 31856826 PMCID: PMC6923867 DOI: 10.1186/s12966-019-0896-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 12/04/2019] [Indexed: 02/02/2023] Open
Abstract
Background Adults in urban areas spend almost 77% of their waking time being inactive at workplaces, which leaves little time for physical activity. The aim of this systematic review and meta-analysis was to synthesize evidence for the effect of workplace physical activity interventions on the cardio-metabolic health markers (body weight, waist circumference, body mass index (BMI), blood pressure, lipids and blood glucose) among working adults. Methods All experimental studies up to March 2018, reporting cardio-metabolic worksite intervention outcomes among adult employees were identified from PUBMED, EMBASE, COCHRANE CENTRAL, CINAHL and PsycINFO. The Cochrane Risk of Bias tool was used to assess bias in studies. All studies were assessed qualitatively and meta-analysis was done where possible. Forest plots were generated for pooled estimates of each study outcome. Results A total of 33 studies met the eligibility criteria and 24 were included in the meta-analysis. Multi-component workplace interventions significantly reduced body weight (16 studies; mean diff: − 2.61 kg, 95% CI: − 3.89 to − 1.33) BMI (19 studies, mean diff: − 0.42 kg/m2, 95% CI: − 0.69 to − 0.15) and waist circumference (13 studies; mean diff: − 1.92 cm, 95% CI: − 3.25 to − 0.60). Reduction in blood pressure, lipids and blood glucose was not statistically significant. Conclusions Workplace interventions significantly reduced body weight, BMI and waist circumference. Non-significant results for biochemical markers could be due to them being secondary outcomes in most studies. Intervention acceptability and adherence, follow-up duration and exploring non-RCT designs are factors that need attention in future research. Prospero registration number: CRD42018094436.
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Affiliation(s)
- Rubina Mulchandani
- Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, India
| | | | | | - Dimple Kondal
- Centre for Chronic Disease Control, New Delhi, India
| | - Anurag Agrawal
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | - Jeemon Panniyammakal
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Government Medical College, Thiruvananthapuram, Kerala, India.,Public Health Foundation of India, Gurgaon, India
| | - Nikhil Tandon
- All India Institute of Medical Sciences, Delhi, India
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India.,Public Health Foundation of India, Gurgaon, India
| | | | - Shifalika Goenka
- Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, India. .,Centre for Chronic Disease Control, New Delhi, India.
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28
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Zhang KM, Tulloch HE, Brunet J, Pipe AL, Reid RD, Prince SA, Reed JL. What Motivates Nurses to Exercise? Determinants of Physical Activity Among Canadian Nurses Using Self-Determination Theory. Ann Behav Med 2019; 54:381-390. [DOI: 10.1093/abm/kaz055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AbstractBackgroundNurses’ suboptimal physical activity (PA) levels place them at high risk for cardiovascular diseases. Little is known about the motivational factors that influence their PA behavior.PurposeThis study drew on the Self-Determination Theory (SDT) to investigate whether associations between nurses’ levels of mood disturbance, psychological need satisfaction (competence, autonomy, and relatedness), and self-determined motivation predict levels of objectively assessed PA.MethodsA total of 363 nurses recruited from 14 hospitals in the Champlain region of Ontario, Canada, wore ActiGraph GT3X accelerometers and completed standardized questionnaires assessing sociodemographic and work characteristics, mood disturbance, and SDT variables. Levels of moderate-to-vigorous intensity PA (MVPA) were measured in minutes/week in bouts ≥10 min. Data were analyzed using path analysis and multiple mediational model.ResultsThe model predicting MVPA showed good fit to the data, χ 2 (4, n = 363) = 7.82, p = .10; comparative fit index = .991; Tucker–Lewis Index = .967; root mean square error of approximation = .051. Higher mood disturbance was associated with lower perceived competence (β = −.29, p = .002), autonomy (β = −.29, p = .002), and relatedness (β = −.19, p = .002). Lower perceived competence (β = .46, p = .003) and autonomy (β = .14, p = .011), as well as higher mood disturbance (β = −.16, p = .016), were associated with less self-determined motivation for PA. Lower self-determined motivation was associated with lower levels of MVPA among nurses.ConclusionsInterventions targeting low mood, as well as perceived competence and autonomy in exercise, may promote MVPA among nurses and reduce cardiac risk.
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Affiliation(s)
- Karen M Zhang
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
- Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Canada
| | - Heather E Tulloch
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Andrew L Pipe
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Robert D Reid
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Stephanie A Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Jennifer L Reed
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
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Timpel P, Harst L, Reifegerste D, Weihrauch-Blüher S, Schwarz PEH. What should governments be doing to prevent diabetes throughout the life course? Diabetologia 2019; 62:1842-1853. [PMID: 31451873 DOI: 10.1007/s00125-019-4941-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 06/05/2019] [Indexed: 11/25/2022]
Abstract
Health systems and governments are increasingly required to implement measures that target at-risk populations to prevent noncommunicable diseases. In this review we lay out what governments should be doing to prevent diabetes throughout the life course. The following four target groups were used to structure the specific recommendations: (1) pregnant women and young families, (2) children and adolescents, (3) working age population, and (4) the elderly. The evidence to date supports the effectiveness of some known government policy measures, such as sugar taxes and regulatory measures in the (pre-)school setting for children and adolescents. Many of these appear to be more effective if they are part of a bundle of strategies and if they are supplemented by communication strategies. Although there is a current focus on strategies that target the individual, governments can make use of evidence-based population-level prevention strategies. More research and continuous evaluation of the overall and subgroup-specific effectiveness of policy strategies using high-quality longitudinal studies are needed.
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Affiliation(s)
- Patrick Timpel
- Department for Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Lorenz Harst
- Research Association Public Health Saxony/Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Doreen Reifegerste
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Susann Weihrauch-Blüher
- Department of Pediatrics I, Pediatric Endocrinology and Diabetology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Peter E H Schwarz
- Department for Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- German Center for Diabetes Research (DZD), Munich, Neuherberg, Germany
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Schwarz PEH, Timpel P, Harst L, Greaves CJ, Ali MK, Lambert J, Weber MB, Almedawar MM, Morawietz H. Reprint of: Blood Sugar Regulation for Cardiovascular Health Promotion and Disease Prevention: JACC Health Promotion Series. J Am Coll Cardiol 2019; 72:3071-3086. [PMID: 30522637 DOI: 10.1016/j.jacc.2018.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 07/27/2018] [Accepted: 07/30/2018] [Indexed: 02/08/2023]
Abstract
The primary objective of this study was to analyze the most up-to-date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review. Three separate, systematic literature searches identified 2,343 papers in total. Overall, 44 studies were included for data extraction and analysis. The included systematic reviews and meta-analyses published between January 1, 2016, and December 31, 2017, were of good to very good quality (median Overview Quality Assessment Questionnaire score = 17). Identified evidence suggests that cardiovascular disease (CVD) prevention services should consider regulation of blood glucose as a key target for intervention. Furthermore, the recommendations for effective intervention and service development/training described here for prevention of CVD should be adopted into evidence-based practice guidelines. Multidisciplinary teams should be formed to deliver multicomponent interventions in community-based settings. There may be substantial opportunities for integrating CVD and diabetes prevention services.
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Affiliation(s)
- Peter E H Schwarz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Lorenz Harst
- Research Association Public Health Saxony/Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Colin J Greaves
- School for Sport, Exercise and Rehabilitation, University of Birmingham, Birmingham, United Kingdom
| | - Mohammed K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jeffrey Lambert
- The Institute of Health Research, Primary Care, University of Exeter Medical School, Exeter, United Kingdom
| | - Mary Beth Weber
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Mohamad M Almedawar
- Dresden International Graduate School for Biomedicine and Bioengineering, Technische Universität Dresden, Dresden, Germany; Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Henning Morawietz
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Schwarz PEH, Timpel P, Harst L, Greaves CJ, Ali MK, Lambert J, Weber MB, Almedawar MM, Morawietz H. Blood Sugar Regulation for Cardiovascular Health Promotion and Disease Prevention: JACC Health Promotion Series. J Am Coll Cardiol 2019; 72:1829-1844. [PMID: 30286928 DOI: 10.1016/j.jacc.2018.07.081] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 07/27/2018] [Accepted: 07/30/2018] [Indexed: 02/06/2023]
Abstract
The primary objective of this study was to analyze the most up-to-date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review. Three separate, systematic literature searches identified 2,343 papers in total. Overall, 44 studies were included for data extraction and analysis. The included systematic reviews and meta-analyses published between January 1, 2016, and December 31, 2017, were of good to very good quality (median Overview Quality Assessment Questionnaire score = 17). Identified evidence suggests that cardiovascular disease (CVD) prevention services should consider regulation of blood glucose as a key target for intervention. Furthermore, the recommendations for effective intervention and service development/training described here for prevention of CVD should be adopted into evidence-based practice guidelines. Multidisciplinary teams should be formed to deliver multicomponent interventions in community-based settings. There may be substantial opportunities for integrating CVD and diabetes prevention services.
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Affiliation(s)
- Peter E H Schwarz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Lorenz Harst
- Research Association Public Health Saxony/Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Colin J Greaves
- School for Sport, Exercise and Rehabilitation, University of Birmingham, Birmingham, United Kingdom
| | - Mohammed K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jeffrey Lambert
- The Institute of Health Research, Primary Care, University of Exeter Medical School, Exeter, United Kingdom
| | - Mary Beth Weber
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Mohamad M Almedawar
- Dresden International Graduate School for Biomedicine and Bioengineering, Technische Universität Dresden, Dresden, Germany; Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Henning Morawietz
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Abstract
PURPOSE OF REVIEW This review focuses on recent literature examining and targeting the physical activity and sedentary behaviour of nurses. The role of physical activity and sedentary behaviour in preventing and managing cardiovascular disease (CVD) in women is also discussed. RECENT FINDINGS Nurses (most of whom are women) represent the largest professional group within the health care workforce and many present with risk factors for CVD (e.g. physical inactivity, sedentary behaviour, overweight/obesity, hypertension, dyslipidemia, diabetes, smoking, depression, anxiety). Several studies have measured the physical activity and sedentary behaviour of nurses and found low levels of physical activity (i.e. most do not meet physical activity guidelines) and high levels of sedentary behaviour (50-60% of the day). Nurses working rotating shifts, 12-h shifts and/or working full-time or part-time (vs. casual) may be at greater risk of physical inactivity; however, the opposite has been observed for sedentary behaviour. Few interventions targeting nurses' physical activity levels have shown promise, but those that have used activity monitors with behavioural strategies; no studies, to date, have evaluated the impact of sedentary behaviour interventions in nurses. SUMMARY Improving the physical activity levels and reducing the sedentary behaviour of nurses is important for nurses' cardiovascular health. There is a need for interventions to address low physical activity and high sedentary behaviour among nurses.
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Huang CH, Talley PC, Lin CW, Huang RY, Liu IT, Chiang IH, Lu IC, Lai YC, Kuo KM. Factors associated with low health literacy among community-dwelling women in Taiwan. Women Health 2019; 60:487-501. [PMID: 31488046 DOI: 10.1080/03630242.2019.1662872] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The present study investigated factors associated with health literacy in community-dwelling Taiwanese women, particularly focusing on those associated with prevalent unhealthy behaviors. This cross-sectional study recruited 353 community-dwelling women aged 39-89 years from February to October 2015 in urban, suburban, and rural areas. Variables investigated included physical activity, community activity, tobacco usage, alcohol consumption, and betel-nut chewing. Degree of health literacy was evaluated using the Chinese-language version of the European Health Literacy Survey Questionnaire. Most respondents had inadequate (17.6%), or problematic (49.3%), general health literacy. Multiple logistic regression analyses showed that low educational attainment was closely associated with inadequate or problematic general health literacy. Women who did not engage in regular physical activity or direct community activity were more likely to have inadequate and problematic general health literacy, respectively. Selected unhealthy behaviors (tobacco usage, alcohol consumption, betel-nut chewing) were not associated with health literacy. Low health literacy was prevalent among participants. Lower educational attainment and a lack of physical or community activity were associated with low health literacy. Health literacy should be considered during the process of delivering health information, and health education programs must enhance health literacy tailored to address individuals' lifestyles.
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Affiliation(s)
- Chi-Hsien Huang
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,Center for Evidence-based Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China.,Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Paul C Talley
- Department of Applied English, I-Shou University, Kaohsiung City, Taiwan, Republic of China
| | - Chi-Wei Lin
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China
| | - Ru-Yi Huang
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China.,Center for International Medical Education, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China
| | - I-Ting Liu
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China.,Institute of Gerontology, National Cheng Kung University, Tainan City, Tainan City, Republic of China
| | - I-Hui Chiang
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China
| | - I-Cheng Lu
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China
| | - Yu-Cheng Lai
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China
| | - Kuang-Ming Kuo
- Department of Healthcare Administration, I-Shou University, Kaohsiung City, Taiwan, Republic of China
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Salinas JJ, Parra-Medina D. Physical activity change after a promotora-led intervention in low-income Mexican American women residing in South Texas. BMC Public Health 2019; 19:782. [PMID: 31221117 PMCID: PMC6585106 DOI: 10.1186/s12889-019-7105-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 06/05/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine physical activity (PA) preferences associated with increases in moderate-to-vigorous physical activity (MVPA) and decrease in sedentary time in Mexican American (MA) women participating in a Promotora (community health worker)-led intervention on the U.S.-Mexico border. METHODS Enlace ('to link' in Spanish) was a randomized clinical trial to increase PA in low-income, MA women living in South Texas on the U.S.-Mexico border. A total of 620 participants were recruited into the study. The primary outcome was increase in moderate to vigorous physical activity (MVPA) using the Actigraph GT3X 16 Mb accelerometer. A modified version of the Community Health Activities Model Program for Seniors Physical Activity (CHAMPS) instrument was used to predict MVPA. Adjusted and unadjusted logistic regression models predicted change in MVPA by change in CHAMPS activities. ANOVA analysis determined the variance explained in change in MVPA by change in time engaged in activity. Individual effect sizes were then calculated for significant activity type change on MVPA increase. RESULTS There were significant increases in all CHAMPS activities except aerobic machines and errand walking. An increase in leisure walking (O.R. = 2.76, p = .046), errand (O.R. = 3.53, p = .051), and brisk walking (O.R. = 4.74, p = .011), dance (O.R. = 8.22, p = .003), aerobics class (O.R. = 32.7, p = .001), and light housework (O.R. = 6.75, p = .000), were associated with a decrease in sedentary time. Significant effect sizes for MVPA were observed for jogging (1.2, p = .050), general exercise (1.6, p = .024), and other exercise not specified (2.6, p = .003). Significant effect sizes for sedentary time were detected for leisure time (.031, p = .036), errands (.017, p = .022), brisk walking (.022, p = .003), dance (.042, p = .005), and aerobics class (.013, p = .009). DISCUSSION Participants who engaged in walking and aerobic activities through this intervention significantly increased their engagement in MVPA and decreased their sedentary time. These findings are novel, since preferences have not been examined in relation to MVPA or sedentary time in MA women. CONCLUSION PA preferences need to be considered when aiming to promote activities that reduce sedentary time and increase PA participation among marginalized groups, such as MA women. TRIAL REGISTRATION NCT02046343 .
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Affiliation(s)
- Jennifer J. Salinas
- Department of Family Medicine, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, Center of Emphasis in Cancer Research, 9849 Kenworthy St, El Paso, TX 79924 USA
| | - Deborah Parra-Medina
- Latino Research Initiative, The University of Texas at Austin, 210 W. 24th Street, Mailcode F9200, GWB 2.102, Austin, Texas 78712 USA
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Prince SA, Elliott CG, Scott K, Visintini S, Reed JL. Device-measured physical activity, sedentary behaviour and cardiometabolic health and fitness across occupational groups: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2019; 16:30. [PMID: 30940176 PMCID: PMC6444868 DOI: 10.1186/s12966-019-0790-9] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/08/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND With approximately 8 hours of one's waking day spent at work, occupational tasks and environments are important influencers on an individual's physical activity (PA) and sedentary behaviours. Little research has compared device-measured physical activity, sedentary behaviour and cardiometabolic outcomes between occupational groups. OBJECTIVE To compare device-measured movement (sedentary time [ST], light intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA], and steps) across occupations. The secondary objective was to examine whether cardiometabolic and fitness outcomes differed by occupation. METHODS Five bibliographic databases were searched to identify all studies which included working age, employed adults from high-income countries, and reported on device-measured movement within occupations. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses and narrative syntheses. RESULTS The review includes 132 unique studies with data from 15,619 participants. Working adults spent ~ 60% of their working and waking time engaged in sedentary behaviour; a very small proportion (~ 4%) of the day included MVPA. On average, workers accumulated 8124 steps/day. Office and call center workers' steps/day were among the lowest, while those of postal delivery workers were highest. Office workers had the greatest ST and the lowest time in LPA both at work and during wakeful time. However, office workers had the greatest minutes sent in MVPA during wakeful hours. Laborers had the lowest ST and spent a significantly greater proportion of their work time in LPA and MVPA. Healthcare and protective services workers had higher levels of LPA at work compared to other occupations. Workers in driving-based occupations tended to have a higher body mass index and blood pressure. CONCLUSION This review identifies that occupational and wakeful time PA and ST differed between occupations. Future studies are needed to assess whether patterns differ by age and sex, describe leisure-time movement and movement patterns, and the relationship with cardiometabolic health. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017070448 .
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Affiliation(s)
- Stephanie A. Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - Cara G. Elliott
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
| | - Kyle Scott
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Canada
| | - Jennifer L. Reed
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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Podrekar N, Kozinc Ž, Šarabon N. Effects of cycle and treadmill desks on energy expenditure and cardiometabolic parameters in sedentary workers: review and meta-analysis. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2019; 27:728-736. [PMID: 30595127 DOI: 10.1080/10803548.2018.1562688] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Purpose. The aim of this article was to evaluate the effects of cycle and treadmill desks on energy expenditure and cardiovascular and biochemical indicators in sedentary workers. Materials and methods. In February 2018, six databases were searched. Both parallel and crossover design studies evaluating workplace cycle and treadmill desks compared to a conventional seated condition were included. Results. Twenty-two studies met the inclusion criteria. Cycle and treadmill desks significantly increased energy expenditure (standard mean difference [SMD] = 3.84, p < 0.001, I2 = 95%) and the heart rate (SMD = 1.68, p < 0.001, I2 = 91%), and lowered blood glucose and insulin levels (SMD = -0.54, p < 0.001, I2 = 0% and SMD = -3.13, p < 0.001, I2 = 76%, respectively). The interventions had no effect on blood pressure and other biochemical indicators. Conclusion. Cycle and treadmill desks may positively influence energy expenditure in sedentary workers and could be effective for reducing negative effects of workplace-related sedentary behaviour. However, considerable heterogeneity is present in the measuring protocols for energy expenditure.
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Affiliation(s)
- Nastja Podrekar
- Faculty of Health Sciences, University of Primorska, Slovenia.,InnoRenew CoE, Human Health in the Built Environment, Slovenia
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Slovenia.,Andrej Marusic Institute, University of Primorska, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Slovenia.,Laboratory for Motor Control and Motor Behavior, S2P, Science to Practice, Ltd., Slovenia
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Cotie LM, Prince SA, Elliott CG, Ziss MC, McDonnell LA, Mullen KA, Hiremath S, Pipe AL, Reid RD, Reed JL. The effectiveness of eHealth interventions on physical activity and measures of obesity among working-age women: a systematic review and meta-analysis. Obes Rev 2018; 19:1340-1358. [PMID: 30156044 DOI: 10.1111/obr.12700] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 03/28/2018] [Accepted: 03/28/2018] [Indexed: 12/25/2022]
Abstract
Physical inactivity and obesity are modifiable risk factors for cardiovascular disease, particularly in women. eHealth interventions may increase physical activity and improve obesity-related outcomes among women. The objective of this study was to review the evidence of the effectiveness of eHealth interventions to increase moderate-to-vigorous physical activity among working-age women. The secondary objective was to examine their effectiveness on improving obesity-related outcomes. A comprehensive search strategy was developed for eight electronic databases; through July 2016. All studies consisting of >80% women of working-age (18-65 years) in high income countries were included. Multiple unblinded reviewers determined study eligibility and extracted data. Risk of bias was evaluated using the Cochrane Risk of Bias Tool and data quality using the Grading of Recommendations Assessment, Development and Evaluation approach. Data were pooled using a random-effects model. Sixty studies were included in the review of which 20 were in the meta-analysis. The meta-analysis demonstrated eHealth interventions improved moderate-to-vigorous physical activity (standard mean difference = 1.13, 95% confidence interval: 0.58, 1.68, P < 0.0001); an increase of ~25 min week-1 . No changes were observed in obesity-related outcomes; waist circumference (P = 0.06), body mass (P = 0.05) and body mass index (P = 0.35). eHealth interventions are effective at increasing min week-1 of moderate-to-vigorous physical activity among working-age women from high income countries.
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Affiliation(s)
- L M Cotie
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - S A Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.,Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - C G Elliott
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - M C Ziss
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - L A McDonnell
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - K A Mullen
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - S Hiremath
- Faculty of Medicine, Roger Guindon Hall, University of Ottawa, Ottawa, Canada.,Clinical Epidemiology Program, Division of Nephrology, Ottawa Hospital Research Institute, the Ottawa Hospital, Ottawa, Canada
| | - A L Pipe
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.,Faculty of Medicine, Roger Guindon Hall, University of Ottawa, Ottawa, Canada
| | - R D Reid
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.,Faculty of Medicine, Roger Guindon Hall, University of Ottawa, Ottawa, Canada
| | - J L Reed
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Johnson S, Regnaux JP, Marck A, Berthelot G, Ungureanu J, Toussaint JF. Understanding how outcomes are measured in workplace physical activity interventions: a scoping review. BMC Public Health 2018; 18:1064. [PMID: 30144823 PMCID: PMC6109358 DOI: 10.1186/s12889-018-5980-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/20/2018] [Indexed: 11/17/2022] Open
Abstract
Background An inverse relationship exists between physical activity and many non-communicable diseases, such as obesity. Given the daily time spent, a logical domain to reach an adult population for intervention is within and around the workplace. Many government bodies, including the World Health Organization (WHO), include worksite health promotions (WHPs) targeted at increasing physical activity as a public health intervention. The aim of this scoping review was to determine what was measured (outcomes) and how they were measured (evaluation tools) during workplace physical activity interventions in order to identify gaps and implications for policies and practice. Methods A scoping review was executed in April 2017 via PubMed, SPORTDiscus, EBSCOhost and the Cochrane Library. This search included articles published between January 2008 to February 2017 in order to coincide with the WHO’s Global Plan of Action on Worker’s Health. Extracted information was arranged into data collection grids. Cross-analysis of measured outcomes with their corresponding evaluation tools was completed. A quality assessment based on study design was executed. Results Identification of 732 records was made and ultimately 20 studies and reviews that met criteria were selected. Researchers themed 9 primary measured outcomes. Studies utilized various forms of both objective and subjective evaluation methods. Three primary evaluation methods were categorized: biologic, electronic and declarative tools. The researchers discovered 92 unique tools: 27 objective and 65 subjective, within these parameters. Conclusion Study quality, measurement tools and data collection were heterogeneous making analysis of effect comparisons problematic and unreliable. Much of the published research does not employ robust statistical analysis making effects difficult to ascertain. Considering the variety of both measured outcomes and evaluation tools, only educated inferences can be made as to the effectiveness and efficiency of WHPs. More standardized measurement practices are therefore suggested for assessment efficiency. Electronic supplementary material The online version of this article (10.1186/s12889-018-5980-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stacey Johnson
- Institut de Recherche bio-Médicale et d'Épidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), 11 avenue du Tremblay, 75012, Paris, France. .,École des hautes études en santé publique (EHESP), Université Sorbonne Paris Cité, Rennes, France.
| | - Jean-Philippe Regnaux
- École des hautes études en santé publique (EHESP), Université Sorbonne Paris Cité, Rennes, France.,Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), METHODS Team, INSERM U1153, Université Sorbonne Paris Cité, Paris, France.,Centre d'Investigations en Médecine du Sport (CIMS), Hôtel-Dieu, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Adrien Marck
- Institut de Recherche bio-Médicale et d'Épidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), 11 avenue du Tremblay, 75012, Paris, France.,Université Paris Descartes, EA 7329, Sorbonne Paris Cité, Paris, France
| | - Geoffroy Berthelot
- Institut de Recherche bio-Médicale et d'Épidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), 11 avenue du Tremblay, 75012, Paris, France.,Université Paris Descartes, EA 7329, Sorbonne Paris Cité, Paris, France.,Research LAboratory for Interdisciplinary Studies (RELAIS), Paris, France
| | - Joana Ungureanu
- Institut de Recherche bio-Médicale et d'Épidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), 11 avenue du Tremblay, 75012, Paris, France.,École des hautes études en santé publique (EHESP), Université Sorbonne Paris Cité, Rennes, France
| | - Jean-François Toussaint
- Institut de Recherche bio-Médicale et d'Épidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), 11 avenue du Tremblay, 75012, Paris, France.,Université Paris Descartes, EA 7329, Sorbonne Paris Cité, Paris, France.,Centre d'Investigations en Médecine du Sport (CIMS), Hôtel-Dieu, Assistance Publique - Hôpitaux de Paris, Paris, France
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The Acute Physical and Cognitive Effects of a Classical Workplace Physical Activity Program Versus a Motor-Cognitive Coordination Workplace Program: A Randomized Crossover Trial. J Occup Environ Med 2018; 60:936-942. [PMID: 29905646 DOI: 10.1097/jom.0000000000001378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To compare the exercise loads and cognitive effects of a classical workplace program from that for a motor-cognitive coordination workplace intervention. METHODS Twenty-eight (28) employed adults (women 19, men 9) participated in a motor-cognitive coordination and a classical workplace health promotion exercise intervention. Effects on attention and cognition (trail making test [TMT]) as well as exercise load (heart rate and rates of perceived exhaustion [RPE]) were assessed. RESULTS The motor-cognitive intervention does not improve cognitive abilities (TMT-A: -4.6 ± 2.2 seconds; TMT-B: -8.5 ± 3.2 seconds) to a greater extent than the classical workplace health enhancement training (TMT-A: -4.6 ± 3.1 seconds; TMT-B: -7.4 ± 3.9 seconds) (P < 0.05). The exercise load was not different between the two interventions (maximal heart rate: 107 ± 8 vs 111 ± 6 bpm; RPE: 11.8 ± 1.7 vs 11.9 ± 1.2 points). CONCLUSIONS The motor-cognitive workplace intervention may be adopted as an additional/alternate enhancement in terms of varied activity, and not as a compensation intervention for workplace health. More research is needed to proof this assumption.
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Influence of the workplace on physical activity and cardiometabolic health: Results of the multi-centre cross-sectional Champlain Nurses’ study. Int J Nurs Stud 2018; 81:49-60. [DOI: 10.1016/j.ijnurstu.2018.02.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 11/19/2022]
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Leonardi M, Guido D, Quintas R, Silvaggi F, Guastafierro E, Martinuzzi A, Chatterji S, Koskinen S, Tobiasz-Adamczyk B, Haro JM, Cabello M, Raggi A. Factors Related to Unemployment in Europe. A Cross-Sectional Study from the COURAGE Survey in Finland, Poland and Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040722. [PMID: 29641485 PMCID: PMC5923764 DOI: 10.3390/ijerph15040722] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/05/2018] [Accepted: 04/08/2018] [Indexed: 01/08/2023]
Abstract
Background: Research addressing the impact of a large number of factors on unemployment is scarce. We aimed to comprehensively identify factors related to unemployment in a sample of persons aged 18-64 from Finland, Poland and Spain. Methods: In this cross-sectional study, factors from different areas were considered: socio-demographic indicators, health habits, chronic conditions, health state markers, vision and hearing indicators, and social networks and built environment scores. Results: Complete data were available for 5003 participants, mean age 48.1 (SD 11.5), 45.4% males. The most important factors connected to unemployment were health status indicators such as physical disability (OR = 2.944), self-rated health (OR = 2.629), inpatient care (OR = 1.980), and difficulties with getting to the toilet (OR = 2.040), while the most relevant factor related to employment were moderate alcohol consumption (OR = 0.732 for non-heavy drinkers; OR = 0.573 for infrequent heavy drinkers), and being married (OR = 0.734), or having been married (OR = 0.584). Other factors that played a significant role included presence of depression (OR = 1.384) and difficulties with near vision (OR = 1.584) and conversation hearing (OR = 1.597). Conclusions: Our results highlight the importance of selected factors related to unemployment, and suggest public health indications that could support concrete actions on modifiable factors, such as those aimed to promote physical activity and healthy behaviors, tackling depression or promoting education, in particular for the younger.
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Affiliation(s)
- Matilde Leonardi
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
| | - Davide Guido
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
| | - Rui Quintas
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
- Neurological Institute C. Besta IRCCS Foundation, Clinical and Experimental Epileptology Unit, 20133 Milan, Italy.
| | - Fabiola Silvaggi
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
| | - Erika Guastafierro
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
| | - Andrea Martinuzzi
- E. Medea Scientific Institute, Conegliano-Pieve di Soligo Research Centre, 31015 Conegliano Veneto, Italy.
| | - Somnath Chatterji
- Information, Evidence and Research Unit, World Health Organization, 1211 Geneva, Switzerland.
| | - Seppo Koskinen
- Ageing, Disability and Functioning Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland.
| | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Jagiellonian University Medical College, 31-034 Krakow, Poland.
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, University of Barcelona, CIBERSAM, 08830 Barcelona, Spain.
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain.
| | - Maria Cabello
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain.
- Department of Psychiatry, Universidad Autonoma de Madrid, 28029 Madrid, Spain.
| | - Alberto Raggi
- Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, 20133 Milan, Italy.
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42
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Affiliation(s)
- Elizabeth A Jackson
- From the Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (E.A.J.); VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI (B.K.N.); and Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.).
| | - Brahmajee K Nallamothu
- From the Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (E.A.J.); VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI (B.K.N.); and Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.)
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