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Dominic OG, Chinchilli V, Wasserman E, Curry WJ, Kambic DM, Caicedo CH, Ramirez AG, Ochoa JA, Lengerich EJ. Impact of Social Support on Colorectal Cancer Screening among Adult Hispanics/Latinos: A Randomized Community-based Study in Central Pennsylvania. Cancer Prev Res (Phila) 2020; 13:531-542. [PMID: 32127350 DOI: 10.1158/1940-6207.capr-19-0333] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/22/2019] [Accepted: 02/27/2020] [Indexed: 11/16/2022]
Abstract
In the United States, the five-year survival rate of colorectal cancer for Latinos is lower than it is for White, non-Latinos. Differences in survival are due, in part, to Latinos being diagnosed at a later stage. An ethnic gap in the use of colorectal cancer screening contributes to the difference in survival. We developed, implemented, and evaluated a targeted colorectal cancer screening intervention to increase colorectal cancer screening uptake by sex, ethnicity, and geography. We measured actual colorectal cancer screening uptake in both arms as a method to determine completion rates. We used a randomized, community-based, participatory design to test the impact of social support (intervention) on completion of a provider-recommended, take-home fecal immunochemical test (FIT) kit screening test among average-risk, urban, and rural Pennsylvania Latino adults age 50 and older not currently adherent to national colorectal cancer screening guidelines (n = 264). Participants in each arm attended a community-based educational program offered at eight sites. Among the 264 participants, 154 (58%) returned a completed usable FIT kit screening test. A higher return rate was observed among participants in the social support arm (66.0%) compared with the control (47.2%). Participants in the social support arm were statistically significant 2.67 times as likely to return a completed FIT kit. Of these, 27 (17.5%) had a positive FIT kit screening test result. The results of this study suggest that social support is an effective method to increase colorectal cancer screening rates among Latinos. Future studies should examine dissemination and implementation of community-based strategies among Latinos that include social support.
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Affiliation(s)
- Oralia G Dominic
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania. .,Department of Biobehavioral Health, The Pennsylvania State University, College of Health and Human Development, University Park, Pennsylvania
| | - Vern Chinchilli
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Emily Wasserman
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - William J Curry
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.,Department of Family and Community Medicine, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Daniel M Kambic
- Kambic Family Clinic, Steelton, Pennsylvania.,Pinnacle Health System, Harrisburg, Pennsylvania
| | | | - Amelie G Ramirez
- Institute for Health Promotion Research, Health Disparities Research, UT Health Science Center at San Antonio, San Antonio, Texas
| | - John A Ochoa
- Department of Spanish, Italian and Portuguese, College of Health and Human Development, The Pennsylvania State University, State College, Pennsylvania
| | - Eugene J Lengerich
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.,Department of Biobehavioral Health, The Pennsylvania State University, College of Health and Human Development, University Park, Pennsylvania.,Department of Family and Community Medicine, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Penn State Cancer Institute, The Pennsylvania State University, State College, Pennsylvania
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The effect of commitment-making on weight loss and behaviour change in adults with obesity/overweight; a systematic review. BMC Public Health 2019; 19:816. [PMID: 31234818 PMCID: PMC6591991 DOI: 10.1186/s12889-019-7185-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/17/2019] [Indexed: 01/31/2023] Open
Abstract
Background Adherence to weight loss interventions is crucial to successful outcomes, yet little is known about how best to improve it. This suggests a need for developing and improving adherence strategies, such as formal commitments. This review aims to identify the effect of including a commitment device alongside lifestyle interventions on weight loss, and identify the most appropriate delivery mechanisms and target behaviours. Methods We searched five databases and hand-searched reference lists for trials of behavioural interventions to achieve weight loss among adults with excess weight or obesity. Interventions incorporating commitment devices were included in a narrative review and meta-analysis where appropriate. Commitment devices with financial incentives were excluded. Results Of 2675 unique studies, ten met the inclusion criteria. Data from three randomised trials including 409 participants suggests that commitment interventions increases short-term weight loss by a mean of 1.5 kg (95% CI: 0.7, 2.4). Data from two randomised trials including 302 patients suggests that benefits were sustained at 12 months (mean difference 1.7 kg; 95% CI: 0.0, 3.4). Commitment devices appeared most successful when made publicly, and targeting diet rather than physical activity. Conclusions Using commitment devices, such as behavioural contracts, as part of a weight loss intervention may be useful in improving weight loss outcomes and dietary changes, at least in the short-term. However, evidence is limited and of variable quality so results must be interpreted with caution. Poor reporting of intervention details may have limited the number of identified studies. More rigorous methodology and longer term follow-ups are required to determine the effectiveness of behavioural contracts given their potential for use in public health interventions.
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Petosa R. Using Behavioral Contracts to Promote Health Behavior Change: Application in a College Level Health Course. HEALTH EDUCATION 2013. [DOI: 10.1080/00970050.1984.10614428] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Richard Petosa
- a Department of Health Education, School of Health, Physical Education and Recreation , University of Nebraska-Lincoln , NE , 68588-0138 , USA
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Affiliation(s)
- Richard Petosa
- a Department of Physical Education, Health, and Recreation Studies, Center for Health Promotion, Lambert Hall , Purdue University , W. Lafayette , IN , 47907 , USA
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Pearson ES. Goal setting as a health behavior change strategy in overweight and obese adults: a systematic literature review examining intervention components. PATIENT EDUCATION AND COUNSELING 2012; 87:32-42. [PMID: 21852063 DOI: 10.1016/j.pec.2011.07.018] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 07/13/2011] [Accepted: 07/22/2011] [Indexed: 05/07/2023]
Abstract
OBJECTIVE This paper describes goal setting components used for behavior change specific to diet and physical activity in community-based interventions targeting overweight and obese adults. METHODS A systematic literature review was conducted. Studies were evaluated using the S.T.A.R.T. (Specificity, Timing, Acquisition, Rewards and feedback, and Tools) criteria which were developed for the purposes of this paper in order to elucidate which intervention features elicit optimal health behavior outcomes. RESULTS Eighteen studies were included. Based on the S.T.A.R.T. criteria, it was determined that developing specific goals that are in close proximity, involve the participant in acquisition, and incorporate regular feedback, are common features in this context. CONCLUSION Goal setting can be useful for effecting health behavior changes in this population. However, as different intervention components were often implemented concurrently (e.g., education sessions, self-monitoring records), it was not possible to ascertain which were responsible for positive changes independently. PRACTICE IMPLICATIONS Goal setting shows promise as a tool that can be incorporated into weight reduction programs by health care professionals and researchers. Studies are warranted to identify the specific mechanisms through which individuals with overweight or obesity can apply the S.T.A.R.T. criteria with respect to goal setting for the purposes of weight loss.
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Affiliation(s)
- Erin S Pearson
- Faculty of Health Sciences, The University of Western Ontario, London, Canada.
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Ostfeld RJ, Cheung YW, Saal I, Janis G, Cabeza Y, Du Y, Smoller S, Wylie-Rosett J. A brief office intervention is associated with improved health measures. Int J Cardiol 2007; 119:239-41. [PMID: 17070611 DOI: 10.1016/j.ijcard.2006.07.120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Accepted: 07/17/2006] [Indexed: 11/24/2022]
Abstract
Cardiovascular disease is the leading cause of morbidity and mortality for adults in developed countries. Many risk factors responsible for the development of cardiovascular disease are associated with behavior. We studied whether encouraging patients to be accountable for their own lifestyle choices would lead to improvements in subjective and objective health measures in 26 consecutive general cardiology clinic patients. Our hypothesis was, that after a simple brief cardiologist-initiated motivational discussion during a routine general cardiology clinic visit that included a weight loss "contract" signed by the patient, physician and a witness, patients would be more likely to lose weight or to remain the same weight as compared to historical controls. We found that intervention patients were more likely to lose weight or to remain the same weight, (p<0.01).
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Bosch-Capblanch X, Abba K, Prictor M, Garner P. Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities. Cochrane Database Syst Rev 2007; 2007:CD004808. [PMID: 17443556 PMCID: PMC6464838 DOI: 10.1002/14651858.cd004808.pub3] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Contracts are a verbal or written agreement that a patient makes with themselves, with healthcare practitioners, or with carers, where participants commit to a set of behaviours related to the care of a patient. Contracts aim to improve the patients' adherence to treatment or health promotion programmes. OBJECTIVES To assess the effects of contracts between patients and healthcare practitioners on patients' adherence to treatment, prevention and health promotion activities, the stated health or behaviour aims in the contract, patient satisfaction or other relevant outcomes, including health practitioner behaviour and views, health status, reported harms, costs, or denial of treatment as a result of the contract. SEARCH STRATEGY We searched: the Cochrane Consumers and Communication Review Group's Specialised Register (in May 2004); the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library 2004, issue 1); MEDLINE 1966 to May 2004); EMBASE (1980 to May 2004); PsycINFO (1966 to May 2004); CINAHL (1982 to May 2004); Dissertation Abstracts. A: Humanities and Social Sciences (1966 to May 2004); Sociological Abstracts (1963 to May 2004); UK National Research Register (2000 to May 2004); and C2-SPECTR, Campbell Collaboration (1950 to May 2004). SELECTION CRITERIA We included randomised controlled trials comparing the effects of contracts between healthcare practitioners and patients or their carers on patient adherence, applied to diagnostic procedures, therapeutic regimens or any health promotion or illness prevention initiative for patients. Contracts had to specify at least one activity to be observed and a commitment of adherence to it. We included trials comparing contracts with routine care or any other intervention. DATA COLLECTION AND ANALYSIS Selection and quality assessment of trials were conducted independently by two review authors; single data extraction was checked by a statistician. We present the data as a narrative summary, given the wide range of interventions, participants, settings and outcomes, grouped by the health problem being addressed. MAIN RESULTS We included thirty trials, all conducted in high income countries, involving 4691 participants. Median sample size per group was 21. We examined the quality of each trial against eight standard criteria, and all trials were inadequate in relation to three or more of these standards. Trials evaluated contracts in addiction (10 trials), hypertension (4 trials), weight control (3 trials) and a variety of other areas (13 trials). Sixteen trials reported at least one outcome that showed statistically significant differences favouring the contracts group, five trials reported at least one outcome that showed differences favouring the control group and 26 trials reported at least one outcome without differences between groups. Effects on adherence were not detected when measured over longer periods. AUTHORS' CONCLUSIONS There is limited evidence that contracts can potentially contribute to improving adherence, but there is insufficient evidence from large, good quality studies to routinely recommend contracts for improving adherence to treatment or preventive health regimens.
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Affiliation(s)
- X Bosch-Capblanch
- International Health Research Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK L35QA.
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Verheijden MW, Bakx JC, van Weel C, Koelen MA, van Staveren WA. Role of social support in lifestyle-focused weight management interventions. Eur J Clin Nutr 2005; 59 Suppl 1:S179-86. [PMID: 16052189 DOI: 10.1038/sj.ejcn.1602194] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Social support is important to achieve beneficial changes in risk factors for disease, such as overweight and obesity. This paper presents the theoretical and practical framework for social support, and the mechanisms by which social support affects body weight. The theoretical and practical framework is supported with a literature review addressing studies involving a social support intervention for weight loss and weight loss maintenance. A major aspect in social support research and practice is the distinction between structural and functional support. Structural support refers to the availability of potential support-givers, while functional support refers to the perception of support. Interventions often affect structural support, for example, through peer groups, yet functional support shows a stronger correlation with health. Although positive correlations between social support and health have been shown, social support may also counteract health behaviour change. Most interventions discussed in this review showed positive health outcomes. Surprisingly, social support was clearly defined on a practical level in hardly any studies, and social support was assessed as an outcome variable in even fewer studies. Future social support intervention research would benefit from clear definitions of social support, a clear description of the intended mechanism of action and the actual intervention, and the inclusion of perceived social support as a study outcome.
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Affiliation(s)
- M W Verheijden
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
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Leslie LK, Miotto MB, Liu GC, Ziemnik S, Cabrera AG, Calma S, Huang C, Slaw K. Training young pediatricians as leaders for the 21st century. Pediatrics 2005; 115:765-73. [PMID: 15741384 DOI: 10.1542/peds.2004-1223] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To conduct a needs assessment with young pediatricians who participate in a leadership training program and to evaluate the effectiveness of that program. METHODS In concert with the Johnson & Johnson Pediatric Institute, LLC, the American Academy of Pediatrics developed a 1-year strategy to train pediatricians who are <40 years old or <5 years in practice in leadership skills. Participants were nominated by American Academy of Pediatrics chapters and/or sections and were required to complete a detailed needs assessment, attend a 3-day training program, and commit to 1 leadership-related behavior change to be implemented within 6 months. A preanalytic/postanalytic design strategy was used. RESULTS A total of 56 applicants representing 33 US states participated; 44.6% were male, and more than half (51.8%) were employed at a medical school/hospital. The needs assessment indicated that participants were confident in many of their leadership qualities but desired increased training, particularly in areas of time and priority management and leading "from the middle." Postsurvey instruments (n = 54, 96% response rate) determined that participants positively evaluated the training program and improved in self-reported basic competencies; 87% also reported fully or partially achieving a leadership-related goal identified in a behavior change contract. CONCLUSIONS Results demonstrate that young physicians are eager for leadership training and that continuing medical education in this area can be provided with positive results. Core competencies, curriculum, and evaluative tools need to be developed further and training opportunities need to be expanded to other subpopulations of pediatricians and pediatric health care providers.
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Affiliation(s)
- Laurel K Leslie
- Child and Adolescent Services Research Center, Children's Hospital, 3020 Children's Way, MC 5033, San Diego, CA 92123-0282, USA.
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Specific Motivations of Milk Consumption among Pregnant Women Enrolled in or Eligible for WIC. ACTA ACUST UNITED AC 1999. [DOI: 10.1016/s0022-3182(99)70399-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Williamson DF, Serdula MK, Anda RF, Levy A, Byers T. Weight loss attempts in adults: goals, duration, and rate of weight loss. Am J Public Health 1992; 82:1251-7. [PMID: 1503167 PMCID: PMC1694328 DOI: 10.2105/ajph.82.9.1251] [Citation(s) in RCA: 156] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Although attempted weight loss is common, little is known about the goals and durations of weight loss attempts and the rates of achieved weight loss in the general population. METHODS Data were collected by telephone in 1989 from adults aged 18 years and older in 39 states and the District of Columbia. Analyses were carried out separately for the 6758 men and 14,915 women who reported currently trying to lose weight. RESULTS Approximately 25% of the men respondents and 40% of the women respondents reported that they were currently trying to lose weight. Among men, a higher percentage of Hispanics (31%) than of Whites (25%) or Blacks (23%) reported trying to lose weight. Among women, however, there were no ethnic differences in prevalence. The average man wanted to lose 30 pounds and to weigh 178 pounds; the average woman wanted to lose 31 pounds and to weigh 133 pounds. Black women wanted to lose an average of 8 pounds more than did White women, but Black women's goal weight was 10 pounds heavier. The average rate of achieved weight loss was 1.4 pounds per week for men and 1.1 pounds per week for women; these averages, however, may reflect only the experience of those most successful at losing weight. CONCLUSIONS Attempted weight loss is a common behavior, regardless of age, gender, or ethnicity, and weight loss goals are substantial; however, obesity remains a major public health problem in the United States.
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Affiliation(s)
- D F Williamson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Atlanta, Ga 30333
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Wilson RW, Martin GL, Guthmann RF. An evaluation of health contracting in the college health classroom. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 1982; 31:73-77. [PMID: 7153435 DOI: 10.1080/07448481.1982.9938920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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