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Alessy SA, Malkin JD, Finkelstein EA, AlAhmed R, Baattaiah BA, Evenson KR, Rakic S, Cetinkaya V, Herbst CH, Al-Hazzaa HM, Alqahtani SA. Effectiveness of Interventions Promoting Physical Activity and Reducing Sedentary Behavior in Community-Dwelling Older Adults: An Umbrella Review With Application to Saudi Arabia. J Epidemiol Glob Health 2023; 13:361-373. [PMID: 37199911 PMCID: PMC10193325 DOI: 10.1007/s44197-023-00111-6] [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: 12/14/2022] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND As Saudi Arabia is expected to face population aging in the future, the burden of diseases arising from inadequate physical activity (PA) and excess sedentary behavior (SB) may subsequently increase without successful interventions. The present study critically reviews the global literature on the effectiveness of PA interventions targeting community-dwelling older adults to draw on lessons and applications for future interventions in Saudi Arabia. METHODS This umbrella review of systematic reviews included interventions designed to increase PA and/or reduce SB in community-dwelling older adults. We conducted searches in July 2022 in two electronic databases-PubMed and Embase-and identified relevant peer-reviewed systematic reviews in English. RESULTS Fifteen systematic reviews focusing on community-dwelling older adults were included. Several reviews reported that PA- or SB-based interventions, including eHealth interventions (such as automated advice, tele-counseling, digital PA coaching, automated PA tracking and feedback, online resources, online social support, and video demonstrations), mHealth interventions, and non-eHealth interventions (such as goal setting, individualized feedback, motivational sessions, phone calls, face-to-face education, counseling, supervised exercise sessions, sending educational materials to participants' homes, music, and social marketing programs), were effective in the short term (e.g., ≤ 3 months) but with wide heterogeneity in findings and methodologies. There were limited studies on PA- and SB-based interventions that could be effective for one year or more after the intervention. Most reviews were heavily skewed toward studies carried out in Western communities, limiting their generalizability to Saudi Arabia and other parts of the world. CONCLUSION There is evidence that some PA and SB interventions may be effective in the short term, but high-quality evidence regarding long-term effects is lacking. The cultural, climate, and environmental barriers related to PA and SB in Saudi Arabia require an innovative approach and research to evaluate such interventions in older individuals in the long term.
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Affiliation(s)
- Saleh A. Alessy
- Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
- Centre for Cancer, Society and Public Health, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | | | - Eric A. Finkelstein
- Duke-NUS Medical School, Health Services and System Research Program, Singapore, Singapore
| | - Reem AlAhmed
- King Faisal Specialist Hospital & Research Center, Liver Transplant Center, Riyadh, Saudi Arabia
| | - Baian A. Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina USA
| | | | | | | | - Hazzaa M. Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Saleh A. Alqahtani
- King Faisal Specialist Hospital & Research Center, Liver Transplant Center, Riyadh, Saudi Arabia
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD USA
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Influential social marketing interventions in physical activity promotion. HEALTH EDUCATION 2021. [DOI: 10.1108/he-04-2021-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to identify and rank the influential social marketing factors for physical activity promotion.Design/methodology/approachA descriptive-survey approach is used in this study. First, the influential social marketing factors for physical activity promotion were determined through the review of theoretical foundations and literature. The factors with a >0.7 content validity index (CVI) value, based on the experts' opinion, were selected. A total of 23 individuals participated in the study, including sports marketing experts and members of physical activity committees of Iranian sports federations, and they were selected purposively. The study data were collected using a pairwise comparison questionnaire and analyzed using the DEMATEL-based analytic network process (DANP) method.FindingsIn this study, a total of 17 influential social marketing factors were identified and categorized in 5 dimensions: product, price, place, promotion and partnership. Based on DEMATEL-based analytic network process (DANP) results, the “promotion” with the weight of 0.212 was the most important dimension and “providing inexpensive sports services” with the weight of 0.096 was the most important social marketing factor influencing the promotion of the physical activity.Originality/valueThe results highlight the importance of sport for all services expenses and costs in promoting physical activity. Thus, the results can be the basis for policies regarding social marketing to promote physical activity.
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Goethals L, Barth N, Hupin D, Mulvey MS, Roche F, Gallopel-Morvan K, Bongue B. Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature. BMC Public Health 2020; 20:1312. [PMID: 32859180 PMCID: PMC7456007 DOI: 10.1186/s12889-020-09386-x] [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: 12/06/2019] [Accepted: 08/13/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Falls are a significant source of morbidity in people aged 65 and over, affecting one in three people in this age group. The scientific evidence indicates that physical activity is the most effective method for preventing falls among seniors. Although public health professionals often use social marketing to design and plan successful interventions, its use to promote physical activity and prevent falls among older people remains low. This article aims to provide a new systematic literature review of social marketing interventions promoting physical activity and targeting people aged 60 and over. METHODS Following CRD's guidance and PRISMA guidelines, we searched between January 2008 and July 2019 for relevant articles in five primary databases using predefined search and inclusion criteria. Two independent reviewers analysed the selected articles to identify evidence of the seven social marketing benchmark criteria, defined by experts in the field as the common elements that contribute to social marketing success. RESULTS The final review included nine studies. Of the studies selected, three specifically targeted over 60-year-olds, whereas the others segmented the population into several age-based subcategories, including over 60-year-olds. Eight studies highlighted positive results for the participants with an increase in participation or an increase in physical activity level. None of the nine studies selected for this systematic review implemented the entire social marketing approach. CONCLUSION Few published interventions use the seven social marketing criteria. Further research is required to encourage uptake and inclusion in successful social marketing interventions to increase program effectiveness in this target population.
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Affiliation(s)
- Luc Goethals
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France.
| | - Nathalie Barth
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France.,Gerontopole AURA, Saint-Etienne, France
| | - David Hupin
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France.,Service de physiologie, Clinique et de l'exercice, CHU de Saint-Etienne, Saint-Etienne, France
| | - Michael S Mulvey
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Frederic Roche
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France
| | | | - Bienvenu Bongue
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France.,Centre Technique d'Appui et de Formation (CETAF), Saint-Étienne, France
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Abstract
Purpose
A significant proportion of the world’s adult population is insufficiently active. One approach used to overcome barriers and facilitate participation in physical activity is social marketing. The purpose of this paper are twofold: first, this review seeks to provide a contemporary review of social marketing’s effectiveness in changing physical activity for the better; and second, it seeks to ascertain the extent that Andreasen’s (2002) six social marketing benchmark criteria have been applied in social marketing interventions targeting physical activity.
Design/methodology/approach
In total, 94 articles covering 26 social marketing interventions were identified following systematic literature review procedures.
Findings
None of the interventions gave evidence that they addressed all six social marketing benchmark criteria, and only four interventions addressed five criteria. The results indicate that three of the benchmark criteria, namely, behavioural objectives, formative research, and marketing mix are well utilised in social marketing interventions. Inclusion of market segmentation, exchange and competition offers potential to extend further on social marketing’s effectiveness in increasing physical activity.
Originality/value
The results of the current study indicate that increasing the number of benchmark criteria used in an intervention to at least four increases the chances of achieving positive behavioural outcomes.
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Cassimatis M, Kavanagh DJ, Hills AP, Smith AC, Scuffham PA, Edge S, Gibson J, Gericke C. Development of the OnTrack Diabetes Program. JMIR Res Protoc 2015; 4:e24. [PMID: 26013840 PMCID: PMC4461785 DOI: 10.2196/resprot.2823] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 04/01/2014] [Accepted: 07/28/2014] [Indexed: 01/15/2023] Open
Abstract
Background Type 2 diabetes affects an estimated 347 million people worldwide and often leads to serious complications including blindness, kidney disease, and limb amputation. Comorbid dysphoria is common and is an independent risk factor for poor glycaemic control. Professional support for diabetes self-management and dysphoria has limited availability and involves high costs, especially after regular hours, and in rural and remote areas. Web-based cognitive behavior therapy offers highly accessible, acceptable, and cost-effective support for people with diabetes. This paper describes the development of OnTrack Diabetes, a self-guided, Web-based program to promote improved physical and emotional self-management in people with Type 2 diabetes. Objective The objective of the study is to describe the development of the OnTrack Diabetes program, which is a self-guided, Web-based program aimed to promote euthymia and improved disease self-management in people with Type 2 diabetes. Methods Semistructured interviews with 12 general practitioners and 13 patients with Type 2 diabetes identified enablers of and barriers to effective diabetes self-management, requirements for additional support, and potential program elements. Existing resources and research data informed the development of content, and consultants from relevant disciplines provided feedback on draft segments and reviewed the program before release. Using a self-guided delivery format contained costs, in addition to adapting program features and modules from an existing OnTrack program. Results A separate paper describes the protocol for a randomized controlled trial to provide this required evaluation. Conclusions Development of the OnTrack Diabetes program demonstrates strategies that help ensure that a program is acceptable to users. The next stages involve testing users’ experiences and examining the program’s effectiveness and cost-effectiveness in randomized controlled trials. Trial Registration The Australian New Zealand Clinical Trials Registry (ACTRN): 12614001126606;
https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614001126606 (Archived by WebCite at
http://www.webcitation.org/6U0Fh3vOj).
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Affiliation(s)
- Mandy Cassimatis
- Queensland University of Technology, Institute of Health and Biomedical Innovation, Brisbane, Australia.
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Can physical activity interventions for adults with type 2 diabetes be translated into practice settings? A systematic review using the RE-AIM framework. Transl Behav Med 2014; 4:60-78. [PMID: 24653777 DOI: 10.1007/s13142-013-0235-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Despite the strong evidence base for the efficacy of physical activity in the management of type 2 diabetes, a limited number of physical activity interventions have been translated and evaluated in everyday practice. This systematic review aimed to report the findings of studies in which an intervention, containing physical activity promotion as a component, has been delivered within routine diabetes care. A comprehensive search was conducted for articles reporting process data relating to components of the RE-AIM (Reach, Effectiveness, Adoption, Implementation and/or Maintenance) framework. Twelve studies met the selection criteria. Of the nine studies which measured physical activity as an outcome, eight reported an increase in physical activity levels, five of which were significant. Tailoring recruitment, resources and intervention delivery to the target population played a positive role, in addition to the use of external organisations and staff training. Many interventions were of short duration and lacked long-term follow-up data. Findings revealed limited and inconsistent reporting of useful process data.
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Nies MA, Troutman-Jordan M, Branche D, Moore-Harrison T, Hohensee C. Physical activity preferences for low-income sedentary urban African American older adults. J Gerontol Nurs 2013; 39:20-9; quiz 30-1. [PMID: 23590243 DOI: 10.3928/00989134-20130408-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 01/09/2013] [Indexed: 11/20/2022]
Abstract
The objective of this study was to determine (a) activity preferences for low-income sedentary urban African American older adults and (b) information needed to deliver a lay physical activity intervention in the community for this population. This descriptive qualitative study used six focus groups. Participants were African American, 55 and older, had low incomes, and had sedentary behavior. Physical activity themes included excitement/emotion for physical activity, group physical activity, and location of physical activity. Themes regarding aspects of being a lay community health worker included beneficial service, uncertainty, logistics concerns, and delivery method preferences. The findings from this study will provide the basis for an intervention for low-income sedentary African American older adults. Preferences for physical activity, concerns about and supports needed for individuals to serve as lay community health workers, various types of training materials, and preferred technology for physical activity participation are identified and discussed.
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Affiliation(s)
- Mary A Nies
- School of Nursing, Idaho State University, Pocatello, ID, USA.
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Aoun S, Shahid S, Le L, Holloway K. Champions in a lifestyle risk-modification program: reflections on their training and experiences. Health Promot J Austr 2013; 24:7-12. [DOI: 10.1071/he12904] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 09/19/2012] [Indexed: 11/23/2022] Open
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Luca NR, Suggs LS. Theory and model use in social marketing health interventions. JOURNAL OF HEALTH COMMUNICATION 2012; 18:20-40. [PMID: 22934539 DOI: 10.1080/10810730.2012.688243] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The existing literature suggests that theories and models can serve as valuable frameworks for the design and evaluation of health interventions. However, evidence on the use of theories and models in social marketing interventions is sparse. The purpose of this systematic review is to identify to what extent papers about social marketing health interventions report using theory, which theories are most commonly used, and how theory was used. A systematic search was conducted for articles that reported social marketing interventions for the prevention or management of cancer, diabetes, heart disease, HIV, STDs, and tobacco use, and behaviors related to reproductive health, physical activity, nutrition, and smoking cessation. Articles were published in English, after 1990, reported an evaluation, and met the 6 social marketing benchmarks criteria (behavior change, consumer research, segmentation and targeting, exchange, competition and marketing mix). Twenty-four articles, describing 17 interventions, met the inclusion criteria. Of these 17 interventions, 8 reported using theory and 7 stated how it was used. The transtheoretical model/stages of change was used more often than other theories. Findings highlight an ongoing lack of use or underreporting of the use of theory in social marketing campaigns and reinforce the call to action for applying and reporting theory to guide and evaluate interventions.
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Aoun SM, Shahid S, Le L, Packer TL. The role and influence of 'champions' in a community-based lifestyle risk modification programme. J Health Psychol 2012; 18:528-41. [PMID: 22791139 DOI: 10.1177/1359105312449194] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article describes the training and implementation of the Waist Disposal Challenge in service clubs in Western Australia in 2009-2010. Ninety-three Champions from 52 clubs were trained to deliver educational presentations to 1100 peers and facilitate a BMI competition among 764 peers. Champions reported significant improvements in their knowledge and confidence to motivate their peers to make changes to their diet and physical activity with 82% of participants completing the BMI competition and on average 58% experiencing and sustaining a BMI reduction for 12 months. It is evident that the Champions had influenced the uptake and success of the intervention.
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Affiliation(s)
- Samar M Aoun
- Curtin Health Innovation Research Institute (CHIRI), Curtin University of Technology, Australia.
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11
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Qiu SH, Sun ZL, Cai X, Liu L, Yang B. Improving patients' adherence to physical activity in diabetes mellitus: a review. Diabetes Metab J 2012; 36:1-5. [PMID: 22363915 PMCID: PMC3283821 DOI: 10.4093/dmj.2012.36.1.1] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Regular physical activity (PA) is a key element in the prevention and management of type 2 diabetes mellitus (T2DM). Participation in regular PA improves blood glucose control and can prevent or delay T2DM and its complications, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. However, most people with T2DM are not active and show poor adherence. This paper reviews the possible barriers to PA and strategies to improve the adherence to PA. Based on the currently available literature, it is concluded that self-efficacy and social support from family, friends, and health care providers play the important role in adoption and maintenance of regular PA. Here we also highlight some new modern and innovative interventions that facilitate exercise participation and improve the adherence.
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Affiliation(s)
- Shan-hu Qiu
- Department of Endocrinology and Institute of Diabetes, Zhongda Hospital, Medical School, Southeast University, China
| | - Zi-lin Sun
- Department of Endocrinology and Institute of Diabetes, Zhongda Hospital, Medical School, Southeast University, China
| | - Xue Cai
- Department of Endocrinology and Institute of Diabetes, Zhongda Hospital, Medical School, Southeast University, China
| | - Lili Liu
- Department of Endocrinology and Institute of Diabetes, Zhongda Hospital, Medical School, Southeast University, China
| | - Bingquan Yang
- Department of Endocrinology and Institute of Diabetes, Zhongda Hospital, Medical School, Southeast University, China
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12
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Ferrer RL, Carrasco AV. Capability and clinical success. Ann Fam Med 2010; 8:454-60. [PMID: 20843888 PMCID: PMC2939422 DOI: 10.1370/afm.1163] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Revised: 03/02/2010] [Accepted: 03/15/2010] [Indexed: 11/09/2022] Open
Abstract
Better outcomes for chronic diseases remain elusive because success depends on events outside the control of the health care system: patients' ability to mange their health behaviors and chronic diseases. Among the most powerful influences on self-management are the social and environmental constraints on healthy living, yet the clinical response to these environmental determinants is poorly developed. A potential approach for addressing social determinants in practice, as well as planning and evaluating community responses, is the capability framework. Defined as the real opportunity to achieve a desired lifestyle, capability focuses attention on the material conditions that constrain real opportunity and how opportunity emerges from the interaction between personal resources and the social environment. Using examples relevant to chronic disease and behavior change, we discuss the clinical application of the capability framework.
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Affiliation(s)
- Robert L Ferrer
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA.
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Plotnikoff RC, Johnson ST, Luchak M, Pollock C, Holt NL, Leahy A, Liebreich T, Sigal RJ, Boulé NG. Peer Telephone Counseling for Adults With Type 2 Diabetes Mellitus. DIABETES EDUCATOR 2010; 36:717-29. [DOI: 10.1177/0145721710376327] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this case study was to determine the feasibility of peer-led telephone counseling for people with type 2 diabetes mellitus related to physical activity (PA) and to establish preliminary efficacy of peer-led telephone counseling for eliciting recommended changes in PA-related cognitions and behaviors for adults with type 2 diabetes mellitus. Methods A total of 8 adults (5 males and 3 females, aged 59.5 (6.5) years) with type 2 diabetes mellitus completed quantitative self-report measures of aerobic-based PA, resistance training (RT), along with metrics from social cognitive theory (SCT) before and after a 12-week intervention. Qualitative data from weekly peer-led telephone sessions were collected by a peer counselor and subsequently organized into themes and analyzed using a mixed-methods, collective case-study approach. Results PA behaviors remained relatively constant over the 12-week intervention. Self-efficacy for RT improved ( z = -2.03; P = .04). From the peer counselor’s perspective, identifiable inhibitors to PA, which included low self-efficacy and disease condition limitations, were successfully translated into enablers/motivators. Perceived health benefits were frequently reported by the peer counselor as motivators for the participants over the study period. Participants believed peer counseling by telephone influenced their decision to continue to participate in PA. Conclusion Theory-based, peer-led telephone counseling shows some promise for increasing receptiveness to PA, but had little effect on improving behavior for most participants. Further studies will be necessary to determine the effectiveness and the sustainability of this approach.
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Affiliation(s)
| | - Steven T. Johnson
- Centre for Health Promotion Studies, School of Public
Health, University of Alberta, Edmonton, Alberta, Canada
| | - Mila Luchak
- Centre for Health Promotion Studies, School of Public
Health, University of Alberta, Edmonton, Alberta, Canada
| | - Cathy Pollock
- Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, Alberta, Canada, Center for Nursing & Health Studies, Athabasca University, Athabasca, Alberta, Canada, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Nicholas L. Holt
- Centre for Health Promotion Studies, School of Public
Health, University of Alberta, Edmonton, Alberta, Canada
| | - Annabel Leahy
- Centre for Health Promotion Studies, School of Public
Health, University of Alberta, Edmonton, Alberta, Canada
| | - Tanis Liebreich
- Centre for Health Promotion Studies, School of Public
Health, University of Alberta, Edmonton, Alberta, Canada
| | - Ronald J. Sigal
- Centre for Health Promotion Studies, School of Public
Health, University of Alberta, Edmonton, Alberta, Canada
| | - Normand G. Boulé
- Alberta Centre for Active Living, Edmonton, Alberta,
Canada, Department of Medicine, Cardiac Sciences and Community
Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary,
Calgary, Canada
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Abstract
Peer support may improve self-management among the millions of people with diabetes around the world. A major challenge to international promotion of peer support is allowing for tailoring to population, cultural, health system and other features of specific settings, while also ensuring congruence with standards for what peer support entails. One strategy to address this challenge was used in the Robert Wood Johnson Foundation Diabetes Initiative. Key functions of self-management-Resources and Supports for Self-Management-were identified. Individual programmes were then encouraged to implement these resources and support in ways that were feasible in their settings and responsive to the needs and perspectives of those they serve. Extending this to peer support, three Key functions are (i) assistance in managing and living with diabetes in daily life; (ii) social and emotional support and (iii) linkage to clinical care. International promotion may be advanced by emphasizing these key functions and then encouraging local variation in the specific ways they are addressed. Similarly, evaluation of the general benefits of peer support across several individual programmes may rest on measurement of implementation of the key functions, participants' reports of receipt of them and common end points. Challenges to promoting peer support include integrating peers amidst others in the health care system, harmonizing peers with family and other social networks, maintaining the engagement of peer supporters and those they assist and preventing training, quality improvement and professionalism from distorting the fundamental benefits of support from a peer.
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Spaulding AC, Sumbry AR, Brzozowski AK, Ramos KL, Perez SD, Maggio DM, Seals RM, Wingood GM. Pairing HIV-positive prisoners with volunteer life coaches to maintain health-promoting behavior upon release: a mixed-methods needs analysis and pilot study. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2009; 21:552-569. [PMID: 20030499 DOI: 10.1521/aeap.2009.21.6.552] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Drawing on individuals who volunteer in US prisons to mentor HIV-infected inmates returning to the community may promote successful transitions. Evaluations published in the scientific literature of such community linkage programs are scant. Our quantitative and qualitative methods needs analysis and pilot study entailed interviewing convenience samples of 24 HIV-positive persons recently released from Georgia correctional facilities and 12 potential volunteer mentors. Both releasees and potential mentors were open to the establishment of a mentoring program. Releasees wanted nonjudgmental mentors. Releasees and volunteers had statistically significant differences in marital status, education, current employment, and possession of a driver's license but not in degree of religious involvement and attitudes toward condom use. A volunteer-staffed program, perhaps more aptly named "life coaching" than mentoring, to help HIV-infected persons to transition from prison to the community may be feasible. Success will require adequately trained volunteers and a straightforward program.
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Affiliation(s)
- Anne C Spaulding
- Rollins School of Public Health, Emory, University, Atlanta, GA 30322, USA.
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Fritts M, Calvo A, Jonas W, Bezold C. Integrative medicine and health disparities: a scoping meeting. Explore (NY) 2009; 5:228-41. [PMID: 19608112 DOI: 10.1016/j.explore.2009.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
OBJECTIVE Type 2 diabetes is a progressive disease requiring constant monitoring of patients to ensure maintenance of glycemic goals and advancement of therapy when necessary. The challenges of treatment in rural areas may be different from those in urban areas. This review article will evaluate the barriers to treatment of type 2 diabetes and the role of insulin analogs in overcoming such barriers and in treating the disease, particularly with respect to rural communities. RESEARCH DESIGN AND METHODS A literature review of English language articles in the Medline Database was conducted to identify published articles through April 2008. Search terms included rural, diabetes, insulin, treatment, and treatment challenges/barriers and were used either alone or in various combinations with one another. Articles were included if they pertained to rural communities in the United States. Barriers related to treatment of type 2 diabetes and the role of insulin analogs in treatment and in overcoming such barriers, were examined. RESULTS Health-care providers and patients in rural areas face barriers both common to the general population and unique to the rural setting. Challenges include limited access to health care, lack of health-care resources, and lack of multidisciplinary staff. CONCLUSIONS A number of strategies exist, including simple, stepwise treatment algorithms for insulin therapy, to manage type 2 diabetes in rural populations effectively. Because this article focused on rural communities in the United States, barriers in other rural communities may not have been identified. Additionally, although Medline is one of the largest and most comprehensive databases of published medical literature, publications not in the Medline database have not been included in this analysis.
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Affiliation(s)
- Scott Nelson
- Cleveland Family Medicine, Cleveland, MS 38732, USA.
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Gusi N, Reyes MC, Gonzalez-Guerrero JL, Herrera E, Garcia JM. Cost-utility of a walking programme for moderately depressed, obese, or overweight elderly women in primary care: a randomised controlled trial. BMC Public Health 2008; 8:231. [PMID: 18611277 PMCID: PMC2491610 DOI: 10.1186/1471-2458-8-231] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Accepted: 07/08/2008] [Indexed: 12/01/2022] Open
Abstract
Background There is a considerable public health burden due to physical inactivity, because it is a major independent risk factor for several diseases (e.g., type 2 diabetes, cardiovascular disease, moderate mood disorders neurotic diseases such as depression, etc.). This study assesses the cost utility of the adding a supervised walking programme to the standard "best primary care" for overweight, moderately obese, or moderately depressed elderly women. Methods One-hundred six participants were randomly assigned to an interventional group (n = 55) or a control group (n = 51). The intervention consisted of an invitation, from a general practitioner, to participate in a 6-month walking-based, supervised exercise program with three 50-minute sessions per week. The main outcome measures were the healthcare costs from the Health System perspective and quality adjusted life years (QALYs) using EuroQol (EQ-5D.) Results Of the patients invited to participate in the program, 79% were successfully recruited, and 86% of the participants in the exercise group completed the programme. Over 6 months, the mean treatment cost per patient in the exercise group was €41 more than "best care". The mean incremental QALY of intervention was 0.132 (95% CI: 0.104–0.286). Each extra QALY gained by the exercise programme relative to best care cost €311 (95% CI, €143–€394). The cost effectiveness acceptability curves showed a 90% probability that the addition of the walking programme is the best strategy if the ceiling of inversion is €350/QALY. Conclusion The invitation strategy and exercise programme resulted in a high rate of participation and is a feasible and cost-effective addition to best care. The programme is a cost-effective resource for helping patients to increase their physical activity, according to the recommendations of general practitioners. Moreover, the present study could help decision makers enhance the preventive role of primary care and optimize health care resources. Trial Registration [ISRCTN98931797]
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Affiliation(s)
- Narcis Gusi
- Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain.
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Pérez-Escamilla R, Hromi-Fiedler A, Vega-López S, Bermúdez-Millán A, Segura-Pérez S. Impact of peer nutrition education on dietary behaviors and health outcomes among Latinos: a systematic literature review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2008; 40:208-25. [PMID: 18565462 PMCID: PMC2746903 DOI: 10.1016/j.jneb.2008.03.011] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Revised: 03/13/2008] [Accepted: 03/19/2008] [Indexed: 05/12/2023]
Abstract
OBJECTIVE This systematic review assesses the impact of peer education/counseling on nutrition and health outcomes among Latinos and identifies future research needs. DESIGN A systematic literature search was conducted by: (1) searching Internet databases; (2) conducting backward searches from reference lists of articles of interest; (3) manually reviewing the archives of the Center for Eliminating Health Disparities among Latinos; (4) searching the Journal of Nutrition Education and Behavior; and (5) directly contacting researchers in the field. The authors reviewed 22 articles derived from experimental or quasi-experimental studies. OUTCOME MEASURES Type 2 diabetes behavioral and metabolic outcomes, breastfeeding, nutrition knowledge, attitudes and behaviors. RESULTS Peer nutrition education has a positive influence on diabetes self-management and breastfeeding outcomes, as well as on general nutrition knowledge and dietary intake behaviors among Latinos. CONCLUSIONS AND IMPLICATIONS There is a need for longitudinal randomized trials testing the impact of peer nutrition education interventions grounded on goal setting and culturally appropriate behavioral change theories. Inclusion of reliable scales and the construct of acculturation are needed to further advance knowledge in this promising field. Operational research is also needed to identify the optimal peer educator characteristics, the type of training that they should receive, the client loads and dosage (ie, frequency and amount of contact needed between peer educator and client), and the best educational approaches and delivery settings.
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Affiliation(s)
- Rafael Pérez-Escamilla
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
- Connecticut Center for Eliminating Health Disparities among Latinos
| | - Amber Hromi-Fiedler
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
- Connecticut Center for Eliminating Health Disparities among Latinos
| | - Sonia Vega-López
- Hispanic Health Council, Hartford CT
- Connecticut Center for Eliminating Health Disparities among Latinos
| | - Angela Bermúdez-Millán
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
- Hispanic Health Council, Hartford CT
- Connecticut Center for Eliminating Health Disparities among Latinos
| | - Sofia Segura-Pérez
- Hispanic Health Council, Hartford CT
- Connecticut Center for Eliminating Health Disparities among Latinos
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