1
|
Smith ML, Han G. Effectiveness of evidence-based fall prevention programs to reduce loneliness in the United States. Front Public Health 2024; 12:1459225. [PMID: 39310905 PMCID: PMC11412865 DOI: 10.3389/fpubh.2024.1459225] [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: 07/03/2024] [Accepted: 08/26/2024] [Indexed: 09/25/2024] Open
Abstract
Introduction Falls are associated with activity limitations and injuries among older adults. An estimated 25% of older adults fall each year, and over 40% of older adults report they are lonely. Small group, evidence-based fall prevention programs are widely available in the United States and may be a strategy to improve social connectedness within our aging population. The purpose of this study was to identify the effectiveness of evidence-based fall prevention programs to reduce loneliness among older adults. Administration for Community Living (ACL) grantee data were collected in a national repository. Methods Data were analyzed from 12,944 participants across 12 fall prevention programs (e.g., A Matter of Balance, Stepping On, Tai Ji Quan, Otago Exercise Program, Bingocize) between January 2021 and July 2023. To assess loneliness, participants were asked, "how often do you feel lonely or isolated?" The response choices for this single 5-point item ranged from "never" to "always." A linear mixed-effects multivariable regression, with program type included as a random effect, was fitted to assess changes in loneliness before and after fall prevention workshops. The model controlled for program type and delivery site type as well as participants' age, sex, ethnicity, race, education, living alone, number of chronic conditions, number of falls in the three months preceding baseline, and workshop delivery site type and attendance. Results Significant reductions in loneliness scores were observed from baseline to post-workshop (p < 0.001), which were more pronounced among participants with more frequent baseline loneliness (p < 0.001). Participants who attended more workshop sessions reported reduced loneliness at post-workshop (p = 0.028). From baseline to post-workshop, loneliness increased among participants who lived alone (p < 0.001) and reported two or more falls in the three months preceding baseline (p =0.002). From baseline to post-workshop, compared to White participants, increased loneliness was observed among Black (p = 0.040), and Asian (p < 0.001) participants. Participants with more chronic conditions reported more loneliness from baseline to post-workshop (p = 0.004). Relative to participants who attended workshops at senior centers, increased loneliness was observed among participants who attended workshops at residential facilities (p = 0.034) and educational institutions (p = 0.035). Discussion Findings expand our understanding about the benefits of small-group fall prevention workshops to reduce loneliness among older participants. Results suggest that disease profiles, living alone, fall history, and workshop location (and attendee dynamic) may impede social connection among some participants. Beyond small group activities, purposive strategies should be embedded within fall prevention programs to foster meaningful interactions and a sense of belonging between participants. Other social connection programs, services, and resources may complement fall prevention programming to reduce loneliness.
Collapse
Affiliation(s)
- Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, United States
- Center for Community Health and Aging, Texas A&M University, College Station, TX, United States
| | - Gang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, United States
| |
Collapse
|
2
|
Kourpas E, Makrilakis K, Dafoulas G, Iotova V, Tsochev K, Dimova R, Cardon G, González-Gil EM, Moreno L, Kivelä J, Lindström J, Rurik I, Antal E, Timpel P, Schwartz P, Mavrogianni C, Manios Y, Liatis S. Factors affecting continuous participation in follow-up evaluations during a lifestyle intervention programme for type 2 diabetes prevention: The Feel4Diabetes-study. Diabet Med 2024; 41:e15368. [PMID: 38837852 DOI: 10.1111/dme.15368] [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: 01/05/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
AIMS Community- and school-based lifestyle interventions are an efficient method of preventing type 2 diabetes in vulnerable populations. Many participants, however, fail to complete the necessary follow-ups. We investigated factors affecting the continuous participation in follow-up evaluations during the Feel4Diabetes-study, a multilevel intervention programme implemented across Europe. METHODS Socioeconomic, sociodemographic and clinical factors were assessed for 2702 participants within six participating countries: Bulgaria and Hungary (low-to-middle-income countries, LMIC), Belgium and Finland (high-income countries, HIC) and Greece and Spain (high-income countries under austerity measures, HICAM). RESULTS Statistically significant differences were detected with respect to sex, control group, education level, employment status, BMI and blood pressure measurements (systolic and diastolic blood pressure). Post hoc analysis revealed significant differences within socioeconomic regions. Higher levels of education were associated with significantly lower attrition in HIC (p < 0.05) and HICAM (p < 0.001), higher employment status was associated with lower attrition in HICAM (p < 0.001) and being female was associated with lower attrition in LMIC (p < 0.001). Surprisingly, the intervention group exhibited higher-than-expected attrition in HIC (p < 0.001) and HICAM (p = 0.003), and lower attrition in LMIC (p = 0.007). When tested together in the same multivariable predictive model, all sociodemographic and socioeconomic variables along with higher BMI retained their statistical significance, while systolic and diastolic blood pressure failed to remain significant. CONCLUSIONS Key socioeconomic and sociodemographic factors along with BMI play a significant role in determining continuous participation in follow-up evaluations during school- and community-based intervention programmes.
Collapse
Affiliation(s)
- Elias Kourpas
- Department of Business Administration, Gies College of Business, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Diabetes Centre, Laiko General Hospital, Athens, Greece
| | - George Dafoulas
- Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Roumyana Dimova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Esther M González-Gil
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Moreno
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Jemina Kivelä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Lindström
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Peter Schwartz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Diabetes Centre, Laiko General Hospital, Athens, Greece
| |
Collapse
|
3
|
Gulayin PE, Gutierrez L, Pinto D, Fontana S, Ávila M, Gómez W, Irazola V. A Multi-Component Intervention to Improve Therapeutic Adherence in Uncontrolled Hypertensive Patients Within the Primary Care Level: A Before-and-After Study. High Blood Press Cardiovasc Prev 2024; 31:271-278. [PMID: 38717676 DOI: 10.1007/s40292-024-00645-1] [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: 01/15/2024] [Accepted: 04/17/2024] [Indexed: 06/09/2024] Open
Abstract
INTRODUCTION Non-adherence to medication severely affects chronic disease control. AIM To assess whether a multi-component intervention implemented at the public primary care level in Argentina improves adherence to antihypertensive medication and helps to reduce blood pressure (BP) levels in uncontrolled hypertensive patients. METHODS A before-and-after study was conducted in five public primary care clinics located in the city of Almirante Brown, Argentina. One hundred and twenty-five uncontrolled hypertensive patients received a multi-component intervention based on the Chronic Care model and the 5As strategy (Ask, Advise, Agree, Assist, and Arrange). Medication possession ratio (MPR) and BP values were assessed before and after a 6-month period. RESULTS The follow-up rate was 96.8%. Main baseline characteristics were as follows, male: 44.8%, mean age: 57.1 years (± 8.1), exclusive public healthcare coverage: 83.5%, primary school level or less: 68.8%, and mean systolic/diastolic BP: 157.4 (± 13.6)/97.7 (± 8.2) mmHg. After implementing the intervention, a significant increase in the proportion of adequate adherence (MPR ≥ 80%) was observed, from 16.8% at baseline to 47.2% (p < 0.001). A significant reduction of 16.4 mmHg (CI 95%: 19.6, 13.1) was observed for systolic blood pressure (SBP) and 12.0 mmHg (CI 95%: 14.2, 9.9) for diastolic blood pressure (DBP) (p < 0.001). At 6 months, 51.2% of the population achieved blood pressure control (SBP < 140 mmHg and DBP < 90 mmHg). CONCLUSIONS The study intervention was associated with an increased adherence rate, achieving a significant reduction in BP values and reaching BP control in more than half of the population.
Collapse
Affiliation(s)
- Pablo Elías Gulayin
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, C1414CPV, Buenos Aires, Argentina.
- Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina.
| | - Laura Gutierrez
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, C1414CPV, Buenos Aires, Argentina
| | - Diana Pinto
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, C1414CPV, Buenos Aires, Argentina
| | - Silvina Fontana
- Secretaría de Salud de la localidad de Almirante Brown, Pcia, Buenos Aires, Argentina
| | - Mariana Ávila
- Secretaría de Salud de la localidad de Almirante Brown, Pcia, Buenos Aires, Argentina
| | - Walter Gómez
- Secretaría de Salud de la localidad de Almirante Brown, Pcia, Buenos Aires, Argentina
| | - Vilma Irazola
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, C1414CPV, Buenos Aires, Argentina
- Comisión Nacional de Investigaciones Científico Tecnológicas, CONICET, Buenos Aires, Argentina
| |
Collapse
|
4
|
Domosławska-Żylińska K, Włodarczyk D, Krysińska-Pisarek M. Cardiovascular disease threat and perceived efficacy of selected preventive behaviors among Polish men: an analysis based on the extended parallel process model. Front Public Health 2023; 11:1244302. [PMID: 38026338 PMCID: PMC10679673 DOI: 10.3389/fpubh.2023.1244302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Considering the low rate of preventive behaviors (5%), it is important to increase the effectiveness of actions that motivate the public to engage in health-promoting behaviors. The purpose of this study was to assess the way in which Polish men perceive the threat of cardiovascular diseases (CVDs) and the effectiveness of five preventive behaviors in the context of CVDs. We aimed to identify groups of recipients, based on the extended parallel process model (EPPM), for five preventive behaviors and to compare the identified groups in terms of selected characteristics. We conducted the survey in November 2022, using the computer-assisted web interviewing technique, on a representative sample of 1,000 men aged 18-65 years. Polish men showed relatively low levels of perceived susceptibility to CVDs (15.1%), but at the same time tended to perceive the consequences of CVDs as severe (54.2%). Segmentation of audiences according to the EPPM showed that regardless of the type of preventive behavior, the most numerous groups are responsive (31-37%) and indifferent (29-31%). This study revealed the need to increase awareness of the importance of a healthy diet to prevent CVDs among male population. Less than half of the men indicated that they would be able to implement effective stress management (49.8%) and smoking avoidance (39.4%), indicating the need to implement measures to increase self-efficacy in the areas.
Collapse
Affiliation(s)
- Katarzyna Domosławska-Żylińska
- Department of Education and Communication, National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Dorota Włodarczyk
- Department of Health Psychology, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Krysińska-Pisarek
- Department of Education and Communication, National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| |
Collapse
|
5
|
Kessler D, McCutcheon T, Rajachandrakumar R, Lees J, Deyell T, Levy M, Liddy C. Understanding barriers to participation in group chronic disease self-management (CDSM) programs: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 115:107885. [PMID: 37473604 DOI: 10.1016/j.pec.2023.107885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/13/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To identify factors that influence enrollment in and attendance of chronic disease self-management (CDSM) group programs. METHODS A scoping review of peer-reviewed publications that reported on factors of enrollment or attendance in group CDSM programs for adults with any type of chronic condition. Screening was completed by two reviewers and data extraction was checked for accuracy. Data were summarized and key themes were identified in collaboration with the study team. RESULTS Following screening, 52 of 2774 articles were included. Attendance rates that varied from 10.4-98.5% (mean =72.5%). There is considerable overlap between enrollment and attendance factors. These included Competing Commitments, Logistics, Personal characteristics, Perception of illness/health status, Health service provision, and Group dynamics. CONCLUSIONS Varied and individualized factors can facilitate or impede enrollment or attendance in group CDSM programs. Consideration of these factors and tailoring of programs is needed to facilitate patient ability to take part. Participatory co-design is a growing approach to ensure programs meet individual and community needs. More research is needed to identify the specific impact of using codesign on enrollment and attendance in group CDSM programs. PRACTICE IMPLICATIONS Including community members and service users in design and implementation may enhance CDSM program access.
Collapse
Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada.
| | - Tess McCutcheon
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | | | - Jodie Lees
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Tracy Deyell
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada
| | - Marisa Levy
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Canada
| |
Collapse
|
6
|
Howell BM, Peterson JR, Corbett S. Where Are All the Men? A Qualitative Review of the Barriers, Facilitators, and Recommendations to Older Male Participation in Health Promotion Interventions. Am J Health Promot 2023; 37:386-400. [PMID: 36317258 DOI: 10.1177/08901171221123053] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Older men have lower participation rates than females in health promotion interventions. We conducted a qualitative review of 20 years of existing research across a variety of academic search databases to outline the barriers, facilitators, and recommendations for this imbalance. DATA SOURCE A systematic search was conducted across Google Scholar, PubMed, MEDLINE, CINAHL, Academic Search Premier, Psychology and Behavioral Sciences Collection, and Web of Science from dates January 1, 2000 - December 31, 2020. STUDY INCLUSION AND EXCLUSION CRITERIA Abstracts were screened based on: original research, English language, recruitment or participation, health promotion or health program, and male gender. DATA EXTRACTION Of 1194 initial search results, 383 article abstracts were thoroughly screened for inclusion and 26 articles met inclusion criteria. SYNTHESIS Included studies were coded and analyzed using Grounded Theory. RESULTS Barriers included masculine gender roles as well as program scope, environment, and gender of the instructors and other participants. Facilitators included creating social groups of older males that participate in a variety of activities together, including hobbies and health promotion, over a long period of time. CONCLUSION Health promotion interventions should involve men in all aspects of program planning and implementation, take into account men's existing relationships and interests to create gender-sensitive programming, and clearly delineate the benefits to participation.
Collapse
Affiliation(s)
- Britteny M Howell
- Division of Population Health Sciences, 3291University of Alaska Anchorage, Anchorage, AK, USA
| | - Jennifer R Peterson
- Department of Psychology, 11414University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Sage Corbett
- Division of Population Health Sciences, 3291University of Alaska Anchorage, Anchorage, AK, USA
| |
Collapse
|
7
|
Ulibarri-Ochoa A, Sánchez-Gómez S, Gamboa-Moreno E, Duo-Trecet I, Garate-Echenique L, Belarra-Tellechea B, de Retana-García LO. Impact of the "Looking after my health after cancer" peer-led active patient education program on cancer survivors and their caregivers: A qualitative study. PLoS One 2023; 18:e0282018. [PMID: 36827237 PMCID: PMC9955581 DOI: 10.1371/journal.pone.0282018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Cancer survival has doubled and is likely to continue increasing in the near future. Cancer survivors experience long-term adverse effects, with associated psychological changes, and often they have needs that are yet to be met. Recognizing the lack of continuity-of-care initiatives for cancer survivors and caregivers, Osakidetza Basque Health Service has started to implement through primary care a peer-led active patient education program called "Looking after my health after cancer". This study explores how cancer survivors and their caregivers rate the experience of participating in the program, to what extent the program helps them understand and address their unmet felt needs, and helps them improve their activation for self-care and self-management. METHODS A qualitative exploratory phenomenological study was conducted using five focus groups: four with cancer survivors (n = 29) and caregivers (n = 2), and one with peer leaders (n = 7). Narrative content analysis was performed using the constant comparison method, facilitated by Atlas-ti software. Descriptive analysis of sociodemographic and clinical data was performed. The study was developed according to the Consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS Five main themes emerged from the content analysis: 1) satisfaction with the program as a positive learning experience; 2) peer sharing and learning ("if they can, so can I"); 3) fears prior to attending the program; 4) becoming more aware of unmet felt needs and feeling understood in the "new normal"; and 5) a more positive view of their experience, helping them become active in self-care and empowered in the self-management of their condition. CONCLUSIONS The peer education program has shown to have a positive impact on cancer survivors and caregivers. It is necessary to design, implement and evaluate interventions of this type to address unmet felt needs during cancer survivorship and improve their quality of life.
Collapse
Affiliation(s)
- Ainhoa Ulibarri-Ochoa
- Bioaraba Health Research Institute, Clinical Nursing and Community Health Research Group, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba Integrated Health Organisation, Vitoria-Gasteiz, Spain
- Vitoria-Gasteiz School of Nursing, University of the Basque Country, Vitoria-Gasteiz, Spain
- * E-mail:
| | - Sheila Sánchez-Gómez
- Bioaraba Health Research Institute, Healthcare Research Group, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba Integrated Health Organisation, Directorate for Healthcare Integration, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, General Directorate, Nursing Subcommittee, Araba Multidisciplinary Teaching Unit for Family and Community Healthcare, Vitoria-Gasteiz, Spain
| | - Estíbaliz Gamboa-Moreno
- Biodonostia Health Research Institute, Primary Care Research Unit, San Sebastián-Donostia, Spain
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastián-Donostia, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)
| | - Irene Duo-Trecet
- Biodonostia Health Research Institute, Primary Care Research Unit, San Sebastián-Donostia, Spain
- Osakidetza Basque Health Service, Active Patient Program (Paziente Bizia-Paciente Activo), Subdirectorate for Primary Care Coordination, San Sebastián-Donostia, Spain
| | - Lucia Garate-Echenique
- Osakidetza Basque Health Service, Coordination of Strategic Plans, Subdirectorate for Nursing, Vitoria-Gasteiz, Spain
| | - Begoña Belarra-Tellechea
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Osakidetza Basque Health Service, School of Health (Osasun Eskola), Subdirectorate for Primary Care Coordination, Vitoria-Gasteiz, Spain
| | - Lourdes Ochoa de Retana-García
- Biodonostia Health Research Institute, Primary Care Research Unit, San Sebastián-Donostia, Spain
- Osakidetza Basque Health Service, Active Patient Program (Paziente Bizia-Paciente Activo), Subdirectorate for Primary Care Coordination, San Sebastián-Donostia, Spain
| |
Collapse
|
8
|
Michel M, Arvis Souaré M, Dindorf C, Danguy V, Chevreul K. Health check-ups for the French under-consuming agricultural population: A pilot evaluation of the Instants santé MSA program. Rev Epidemiol Sante Publique 2023; 71:101420. [PMID: 36610246 DOI: 10.1016/j.respe.2022.101420] [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: 04/20/2021] [Revised: 11/17/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The social protection scheme in charge of farmers and agricultural employees (MSA) in France has developed a two-step health promotion program with a nurse appointment followed by a consultation with a doctor of the participant's choosing to reach its under-consuming beneficiaries and enroll them back into a care pathway. Our objective was to carry out a pilot evaluation of this program. METHODS The evaluation was carried out on the population invited during the second semester of 2017 using data from the program's service providers (date of invitation, of nurse appointment…), regional MSA bodies (consultation voucher), and reimbursement data (other care consumption). Participation rates were calculated overall and by participant characteristics. Medical needs were identified during the nurse appointment and new care pathways were assessed using reimbursement data. Multivariable regression models identified factors associated with participation. RESULTS 2366 beneficiaries were included in the analysis. 1559 (65.89%) were men and mean age was 52.41 (standard deviation = 14.86). 409 (17.29%) attended the nurse appointment. There was a significant increase in participation with age, in farmers vs. employees (odds ratio = 1.905, 95% confidence interval = 1.393-2.604), and in people living in the most disadvantaged areas (odds ratio = 1.579, 95% confidence interval=1.079-2.312). Participation to the consultation following the nurse appointment was high (62.35%-73.11%). 87.53% of participants had at least one medical need, and new care pathways were more frequent among those who had attended the nurse appointment (55.50% vs. 34.80%, p < 0.0001). CONCLUSIONS This pilot evaluation shows promising results which need to be confirmed with a national evaluation of the program and longer-term evidence.
Collapse
Affiliation(s)
- Morgane Michel
- Université Paris Cité, ECEVE, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, 75004 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France; INSERM, ECEVE UMR 1123, 75010 Paris, France.
| | - Mariam Arvis Souaré
- Direction du contrôle médical et de l'offre de soins, Caisse centrale de la Mutualité Sociale Agricole, 93000 Bobigny, France
| | - Christel Dindorf
- Université Paris Cité, ECEVE, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, 75004 Paris, France; INSERM, ECEVE UMR 1123, 75010 Paris, France
| | - Véronique Danguy
- Département Études et évaluation en santé, Caisse centrale de la Mutualité Sociale Agricole, 93000 Bobigny, France
| | - Karine Chevreul
- Université Paris Cité, ECEVE, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, 75004 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France; INSERM, ECEVE UMR 1123, 75010 Paris, France
| |
Collapse
|
9
|
Santoyo-Olsson J, Lorig K, Romo EM, Luzanilla M, Ramirez GA, Cheng J, Chesla C, Covinsky KE, Karliner L, Thompson DG, Fahrenwald N, Yank V. Study protocol for a hybrid effectiveness-implementation trial of the Building Better Caregivers online workshop for rural family/friend caregivers of people living with dementia. Contemp Clin Trials 2022; 121:106903. [PMID: 36057375 DOI: 10.1016/j.cct.2022.106903] [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: 06/21/2022] [Revised: 08/26/2022] [Accepted: 08/26/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Dementia caregiving is complex and disproportionally burdens caregivers living in rural areas due to fewer resources and formal support systems. There is an immediate need to identify effective, scalable, and accessible online programs to support rural caregivers' well-being. Building Better Caregivers (BBC), a possible solution, is an asynchronous online 6-week, interactive, and skills-building workshop developed for caregivers of persons with dementia. This research aims to assess the effectiveness and implementation of the BBC workshop when delivered among rural dementia caregivers in the United States. METHODS A hybrid effectiveness and implementation trial applying mixed methods will be conducted in collaboration with local, state, and national partnering organizations. Eligible participants live in a rural area of the United States, give care at least 10 h a week for a family member or friend with dementia, and have internet access. Evaluation is based on the RE-AIM framework. Effectiveness outcomes are assessed using a randomized control trial. Caregivers are randomly assigned to the BBC workshop (intervention) or attention control group. Implementation outcomes are assessed using surveys and debriefing interviews from partnering organizations and participants. The study protocol including the study design, methods of recruitment and assessment, and outcomes are described. CONCLUSION This is the first known study to evaluate both the effectiveness and implementation of a caregiver support intervention under real-world conditions in rural areas. If successful, this online workshop will be a practical and acceptable approach for promoting the health and well-being of geographically isolated rural dementia caregivers.
Collapse
Affiliation(s)
| | | | | | | | | | - Jing Cheng
- University of California San Francisco, San Francisco, CA, USA
| | | | - Kenneth E Covinsky
- University of California San Francisco, San Francisco, CA, USA; San Francisco VA Healthcare System, San Francisco, CA, USA
| | - Leah Karliner
- University of California San Francisco, San Francisco, CA, USA
| | | | | | - Veronica Yank
- University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
10
|
Tolentino DA, Ali S, Jang SY, Kettaneh C, Smith JE. Type 2 Diabetes Self-Management Interventions Among Asian Americans in the United States: A Scoping Review. Health Equity 2022; 6:750-766. [PMID: 36225656 PMCID: PMC9536350 DOI: 10.1089/heq.2021.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction: Type 2 diabetes (T2D) is one of the leading causes of death among Asian Americans. Despite being a culturally diverse racial group with differences in history, language, religion, and values, Asian Americans are often viewed as a monolith. With the high prevalence rate of T2D, a careful examination of self-management interventions across Asian Americans is needed to develop effective and culturally sensitive interventions. Objective: To describe existing literature by examining study characteristics, different intervention components, and outcome measures of various T2D interventions among Asian Americans. Methods: Using Arksey and O'Malley's framework to ground this review, six online databases were used to identify studies. Results: A total of 18 publications were included. Thirteen studies were published after 2013, with 44% and 22% of these studies focused on Chinese Americans and Korean Americans. We found a lack of geographic diversity in the location of the studies. Majority of the participants were females. Most of the interventions were implemented in person. Licensed health care providers were the most common interventionists, with a number of studies using community health workers. Outcome measures focused on three key areas: physiological, psychosocial and behavioral, and program-related outcomes. Many of the studies measured changes in HbA1C, self-efficacy, distress, depression, and quality of life. Overall, we saw improvements in physiological measures in most of the studies. For example, majority of the studies showed a decline in the participants' HbA1C. Most studies showed an increase or improvement in healthy behaviors. Studies that measured efficacy, knowledge, attitude, motivation, quality of life, or general health showed improvement from baseline. All the studies that measured distress or depression showed a reduction of symptoms postintervention. Conclusion: Overall, we found that culturally tailored interventions that focus on specific Asian American subpopulations saw an improvement in physiological, psychosocial, or behavioral measures. There were several gaps in the existing T2D self-management programs or interventions among Asian Americans studied in the United States. Based on our analysis, we recommend when designing or implementing self-management interventions among Asian Americans, considerations should be made for targeted recruitment for understudied Asian American subgroups, gender, and location.
Collapse
Affiliation(s)
- Dante Anthony Tolentino
- National Clinician Scholars Program, University of Michigan, Ann Arbor, Michigan, USA
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Samreen Ali
- Undergraduate Research Opportunity Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Seo Young Jang
- Undergraduate Research Opportunity Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Celeste Kettaneh
- Undergraduate Research Opportunity Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Judith E. Smith
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
11
|
Botchway M, Turner-McGrievy GM, Crimarco A, Wilson MJ, Davey M, Wilcox S, Frongillo EA. "They Eat What They Eat, I Eat What I Eat": Examining the Perspectives and Experiences of African Americans Who Adopt Plant-Based Diets. Am J Lifestyle Med 2022; 16:363-373. [PMID: 35706596 PMCID: PMC9189578 DOI: 10.1177/1559827620908850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
Adopting a plant-rich or plant-based diet is one of the major recommendations for addressing obesity, overweight, and related health conditions in the United States. Currently, research on African Americans' food choices in the context of plant-based diets is limited. The primary aim of this study was to understand food-related experiences and perceptions of African Americans who were participating in the Nutritious Eating with Soul (NEW Soul) study, a culturally tailored dietary intervention focused on increasing the consumption of plant-based foods. The roles of gender and ethnicity were also examined to identify how eating patterns were chosen or maintained. Twenty-one African American adults in South Carolina, who were randomly assigned to either a vegan diet (n = 11) or a low-fat omnivorous diet (n = 10) in the NEW Soul study, completed one-on-one, qualitative interviews. Emerging themes included awareness, being in control, and identity. The study revealed that access to social support and coping strategies for addressing negative comments about plant-based food choices may be important components to include in future nutrition interventions focused on African Americans.
Collapse
Affiliation(s)
- Marian Botchway
- Marian Botchway, PhD, Eck Institute for
Global Health, University of Notre Dame, 4143 Jenkins Nanovic Halls, Notre Dame,
IN 46556; e-mail:
| | - Gabrielle M. Turner-McGrievy
- Department of Health Promotion, Education, and
Behavior (MB, GMTM, AC, MJW, MD, EAF)
- Department of Exercise Science & Prevention
Research Center (SW)
- Arnold School of Public Health, University of South
Carolina, Columbia, South Carolina
- Present address: Marian Botchway, Eck Institute for
Global Health, University of Notre Dame, Notre Dame, Indiana; Anthony Crimarco,
Stanford Prevention Center, Palo Alto, California
| | - Anthony Crimarco
- Department of Health Promotion, Education, and
Behavior (MB, GMTM, AC, MJW, MD, EAF)
- Department of Exercise Science & Prevention
Research Center (SW)
- Arnold School of Public Health, University of South
Carolina, Columbia, South Carolina
- Present address: Marian Botchway, Eck Institute for
Global Health, University of Notre Dame, Notre Dame, Indiana; Anthony Crimarco,
Stanford Prevention Center, Palo Alto, California
| | - Mary J. Wilson
- Department of Health Promotion, Education, and
Behavior (MB, GMTM, AC, MJW, MD, EAF)
- Department of Exercise Science & Prevention
Research Center (SW)
- Arnold School of Public Health, University of South
Carolina, Columbia, South Carolina
- Present address: Marian Botchway, Eck Institute for
Global Health, University of Notre Dame, Notre Dame, Indiana; Anthony Crimarco,
Stanford Prevention Center, Palo Alto, California
| | - Marty Davey
- Department of Health Promotion, Education, and
Behavior (MB, GMTM, AC, MJW, MD, EAF)
- Department of Exercise Science & Prevention
Research Center (SW)
- Arnold School of Public Health, University of South
Carolina, Columbia, South Carolina
- Present address: Marian Botchway, Eck Institute for
Global Health, University of Notre Dame, Notre Dame, Indiana; Anthony Crimarco,
Stanford Prevention Center, Palo Alto, California
| | - Sara Wilcox
- Department of Health Promotion, Education, and
Behavior (MB, GMTM, AC, MJW, MD, EAF)
- Department of Exercise Science & Prevention
Research Center (SW)
- Arnold School of Public Health, University of South
Carolina, Columbia, South Carolina
- Present address: Marian Botchway, Eck Institute for
Global Health, University of Notre Dame, Notre Dame, Indiana; Anthony Crimarco,
Stanford Prevention Center, Palo Alto, California
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and
Behavior (MB, GMTM, AC, MJW, MD, EAF)
- Department of Exercise Science & Prevention
Research Center (SW)
- Arnold School of Public Health, University of South
Carolina, Columbia, South Carolina
- Present address: Marian Botchway, Eck Institute for
Global Health, University of Notre Dame, Notre Dame, Indiana; Anthony Crimarco,
Stanford Prevention Center, Palo Alto, California
| |
Collapse
|
12
|
Effectiveness of Workplace Interventions for Improving Working Conditions on the Health and Wellbeing of Fathers or Parents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084779. [PMID: 35457646 PMCID: PMC9027029 DOI: 10.3390/ijerph19084779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 01/22/2023]
Abstract
Evidence on the effectiveness of workplace interventions for improving working conditions on the health and wellbeing of fathers is scarce. We reviewed studies on the effectiveness of various workplace interventions designed to improve working conditions for the health and wellbeing of employed fathers and their families. Randomized controlled trials (RCTs) and quasi-randomized controlled trials of workplace interventions applied to employees with the aim of improving working conditions of employed parents, compared with no intervention, other active arms, placebo, wait list, or usual practice were included. Studies involving only women were excluded. An electronic search of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, ERIC and SSCI was done for eligible studies. Studies were screened against predetermined criteria and assessment of risk of bias done using the Cochrane Handbook for Systematic Reviews of Interventions for RCTs and the Risk of Bias Assessment tool for Non-randomized Studies for non-RCTs. Of the 8229 records identified, 19 reports were included in this review: 14 reports from five RCTs and five reports from two quasi-RCT studies. The studies were conducted in four different countries among working populations from various sectors. Studies addressing issues related to improving working conditions of fathers alone were lacking. All included studies assessed intervention effects on various health-related outcomes, the most common being sleep disturbances and mental health outcomes. Interventions administered yielded positive effects on various health outcomes across all seven studies. All included studies had methodological limitations, while study designs and methodologies lacked comparability. Consequently, a narrative synthesis of evidence is provided. Based on our findings, providing workplace interventions for improving working conditions may improve some aspects of the health and wellbeing of employed parents, including fathers.
Collapse
|
13
|
Smith ML, Bergeron CD, Sherman LD, Goidel K, Merianos AL. Contextualizing the Chronic Care Model among Non-Hispanic Black and Hispanic Men with Chronic Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3655. [PMID: 35329342 PMCID: PMC8951030 DOI: 10.3390/ijerph19063655] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/18/2022] [Accepted: 03/01/2022] [Indexed: 02/01/2023]
Abstract
Middle-aged and older men of color with chronic conditions have low utilization of preventive health services. In the context of the Chronic Care Model (CCM), the objective of this study was to identify perceptions about being informed, activated patients and having productive interactions in healthcare settings among non-Hispanic Black and Hispanic middle-aged and older men with chronic health conditions in the United States. Using an internet-based survey deployed nationally using a Qualtrics panel, data were collected from a sample of non-Hispanic Black and Hispanic men aged 40 years and older with one or more self-reported chronic conditions (n = 2028). Chi-square tests and one-way ANOVAs were used to describe this national sample by race/ethnicity and age group (40-64 years and ≥65 years). Results suggest that most health-related factors differed more on age than by race/ethnicity. Younger age groups reported less preventive care, greater barriers to self-care, mental health issues, and risky behavior. Findings from this study provide insight into the health status and healthcare utilization of racial/ethnic men with one or more chronic conditions. Results may help inform prevention and treatment interventions for middle-aged and older men of color.
Collapse
Affiliation(s)
- Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA; (C.D.B.); (A.L.M.)
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA
| | - Caroline D. Bergeron
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA; (C.D.B.); (A.L.M.)
- LIFE Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Ledric D. Sherman
- Department of Health and Kinesiology, College of Education, Texas A&M University, College Station, TX 77845, USA;
| | - Kirby Goidel
- Public Policy Research Institute, Texas A&M University, College Station, TX 77843, USA;
- Department of Communication, College of Liberal Arts, Texas A&M University, College Station, TX 77843, USA
| | - Ashley L. Merianos
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA; (C.D.B.); (A.L.M.)
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
| |
Collapse
|
14
|
Sherman LD, Goidel K, Bergeron CD, Smith ML. Web-Based Health Information Seeking Among African American and Hispanic Men Living With Chronic Conditions: Cross-sectional Survey Study. J Med Internet Res 2021; 23:e26180. [PMID: 34259646 PMCID: PMC8319783 DOI: 10.2196/26180] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/11/2021] [Accepted: 05/04/2021] [Indexed: 01/15/2023] Open
Abstract
Background Previous research has identified disparities in seeking and using web-based health information to inform health-related behaviors. Relatively few studies however have examined the correlations between web-based health information seeking and use based on race, gender, age, and the presence of chronic health conditions. Objective In this study, we identify factors associated with seeking and using web-based health information among a uniquely vulnerable and intersectional population—middle-aged and older (40 years and older) African American and Hispanic men living with one or more chronic conditions. Methods Survey responses were collected from a purposive sample of African American and Hispanic men using Qualtrics web-based survey management software. To qualify for inclusion in the study, respondents had to identify as African American or Hispanic men, report having at least one chronic condition, and be aged 40 years and older. A series of binary logistic regression models was created using backward elimination. Statistical significance was determined at P<.05 for all analyses. Results Web-based health information seeking among African American and Hispanic men is a function of education, the presence of multiple chronic conditions, frustration with health care providers, internet use, and the perceived reliability of web-based health information. The use of web-based health information to inform interactions with health care providers was more common among African American and Hispanic men, who rated their health as relatively good, perceived barriers to care, used technology regularly, and took more daily medications. Conclusions Understanding the factors that influence African American and Hispanic men seeking web-based health information may help improve the care and treatment of chronic conditions. African American and Hispanic men seek web-based health information as a substitute for routine care and to inform their discussions with health care providers.
Collapse
Affiliation(s)
- Ledric D Sherman
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Kirby Goidel
- Public Policy Research Institute & Department of Political Science, Texas A&M University, College Station, TX, United States
| | | | - Matthew Lee Smith
- Department of Environmental and Occupational Health, Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
| |
Collapse
|
15
|
Educational Processes for Health and Disease Self-Management in Public Health: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126448. [PMID: 34203594 PMCID: PMC8296271 DOI: 10.3390/ijerph18126448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022]
Abstract
This study systematically reviewed processes and educational programs for self-management of health and diseases that are the subject of public health attention. This systematic review of the literature (SRL) is relevant to recognizing the characteristics of the educational processes in self-managing chronic diseases in contexts where technology did not play a significant role. Following the PRISMA protocol, the authors independently reviewed full-text articles from several databases using the following criteria: (1) intervention studies evaluating the effects of self-management health programs; (2) educational process of disease self-management; (3) studies that included at least one control group, and (4) peer-reviewed studies. In addition, the Scottish Intercollegiate Guideline Network measurement tool was used to assess the risk of bias in each trial. In the final sample, 38 articles were included. The findings regarding health education methods of self-care, using community-based care and technological tools, are considered fundamental. Among the conclusions, the relevance of the pedagogy that health education processes demand improvement in post-pandemic program effectiveness stands out.
Collapse
|
16
|
The Impact of Illness Perceptions and Coping Strategies on Use of Supportive Care for Cancer. Cancers (Basel) 2021; 13:cancers13102501. [PMID: 34065475 PMCID: PMC8160678 DOI: 10.3390/cancers13102501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/15/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Cancer survivorship support programmes improve wellbeing, but most oncology patients and survivors do not use them. The current study examined whether people who saw themselves as having greater personal control over their illness used more problem-focused coping strategies, and if this resulted in higher use of survivorship support services. The study also examined the possibility that use of supportive care services was higher amongst those patients who used more emotion-focused coping strategies and who were experiencing greater emotional distress about their cancer. We found that people using more survivorship support services tended to have a greater belief in their ability to do something to control their cancer but were not emotionally distressed. Abstract Despite evidence that survivorship support programmes enhance physical and psychosocial wellbeing, cancer patients and survivors often do not use these supportive care services. This study investigated the utility of the Common Sense Model of Self-Regulation for predicting supportive care use following cancer, and the mediating role of coping strategies. Cancer patients and survivors (n = 336 from Australia, n = 61 from the UK; 191 males, 206 females) aged 20–83 years (Mean (M) = 62.73, Standard Deviation (SD) = 13.28) completed an online questionnaire. Predictor variables were cognitive and emotional representations of cancer, as measured by the Illness Perception Questionnaire—Revised (IPQ-R), and problem- and emotion-focused coping strategies, as measured by the Brief-Coping Orientation to Problems Experienced inventory (Brief-COPE). The outcome variable was survivorship support programme use within the preceding month. Perceived personal control over cancer predicted supportive care use, but cancer-related emotional distress did not. Coping was an inconsistent mediator of the relationships. Problem-focused coping mediated the relationship between personal control and supportive care use; emotion-focused coping did not mediate between emotional responses to cancer and the uptake of survivorship support programmes. The Common Sense Model provides a useful framework for understanding survivorship support programme use. However, more clarity around the relationship between illness beliefs and coping is required.
Collapse
|
17
|
Gardiner P, McGonigal L, Villa A, Kovell LC, Rohela P, Cauley A, Rinker D, Olendzki B. Our Whole Lives for Hypertension and Cardiac Risk Factors (OWL-H)—Combining a Teaching Kitchen Group Visit with an Online Platform: A Feasibility Trial (Preprint). JMIR Form Res 2021; 6:e29227. [PMID: 35576575 PMCID: PMC9152723 DOI: 10.2196/29227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background Hypertension (HTN) affects millions of Americans. Our Whole Lives: an eHealth toolkit for Hypertension and Cardiac Risk Factors (OWL-H) is an eHealth platform that teaches evidence-based lifestyle strategies, such mindfulness and cooking skills, to improve self-management of HTN. Objective The primary goal of this pilot study was to evaluate the feasibility of OWL-H combined with teaching kitchen medical group visits (TKMGVs) in a low-income population of participants with HTN. Methods We conducted a pre-post 8-week study to assess the feasibility of a hybrid program (a web-based 9-module self-management program, which includes mindfulness and Mediterranean and Dietary Approaches to Stop Hypertension diet) accompanied by 3 in-person TKMGVs among patients with HTN. Data including demographics, platform use, and satisfaction after using OWL-H were examined. Outcome data collected at baseline and 8 weeks included the Mediterranean Diet Questionnaire, Hypertension Self-Care Profile Self-Efficacy Instrument, Blood Pressure Knowledge Questionnaire, and the number of self-reported blood pressure readings. For the statistical analysis, we used descriptive statistics, paired sample t tests (1-tailed), and qualitative methods. Results Of the 25 enrolled participants, 22 (88%) participants completed the study. Participants’ average age was 57 (SD 12.1) years, and 46% (11/24) of them reported a household income <US $30,000 per year. Among the 22 participants who logged in to OWL-H, the average number of mindfulness practices completed was 7 and the average number of module sessions accessed was 4. In all, 73% (16/22) of participants reported that they were “very satisfied” with using OWL-H to help manage their HTN. Participants’ blood pressure knowledge significantly increased from baseline (mean 5.58, SD 1.44) to follow-up (mean 6.13, SD 1.23; P=.03). Participants significantly increased their adherence to a Mediterranean diet from baseline (mean 7.65, SD 2.19) to follow-up (mean 9, SD 1.68; P=.004). Participants’ self-efficacy in applying heart-healthy habits, as measured by the Hypertension Self-Care Profile Self-Efficacy Instrument, increased from baseline (mean 63.67, SD 9.06) to follow-up (mean 65.54, SD 7.56; P=.14). At the 8-week follow-up, 82% (18/22) of the participants had self-reported their blood pressure on the OWL-H platform at least once during the 8 weeks. Conclusions The eHealth platform for HTN self-management, OWL-H, and accompanying in-person TKMGVs have the potential to effectively improve lifestyle management of HTN. Trial Registration ClinicalTrials.gov NCT03974334; https://clinicaltrials.gov/ct2/show/NCT03974334
Collapse
Affiliation(s)
- Paula Gardiner
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Lisa McGonigal
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Ariel Villa
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Lara C Kovell
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Pallavi Rohela
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Andrew Cauley
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Diana Rinker
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Barbara Olendzki
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| |
Collapse
|
18
|
Su D, Garg A, Wiens J, Meyer E, Cai G. Assessing Health Needs in African American Churches: A Mixed-Methods Study. JOURNAL OF RELIGION AND HEALTH 2021; 60:1179-1197. [PMID: 31595445 DOI: 10.1007/s10943-019-00924-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Among major racial and ethnic groups in the USA, African Americans are the most religious, and faith-based organizations play an important role in health promotion for African Americans. This study aimed to assess health needs in African American churches using a mixed-methods approach. Based on quantitative and qualitative data collected from eight African American churches in Nebraska in 2017, the most prevalent chronic conditions among participating African American church members (n = 388) included hypertension (60.8%), allergies (41.0%), arthritis (36.4%), high cholesterol (35.8%), and diabetes (28.1%). Significant predictors of fair or poor health were identified as male sex, unemployment, delayed utilization of health care in the past 12 months due to cost, lower frequency of church attendance, and feeling down, depressed, or hopeless in the past 2 weeks. Pastors from participating churches identified cost as one of the primary barriers to providing church-based health services. There were substantial unmet health needs in African American faith communities, especially in the areas of chronic disease prevention and management, and churches would need more support to realize their full potential in faith-based health promotion.
Collapse
Affiliation(s)
- Dejun Su
- Department of Health Promotion, College of Public Health, 984340 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-4340, USA.
| | - Ashvita Garg
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Jessica Wiens
- Department of Health Promotion, College of Public Health, 984340 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-4340, USA
| | - Eric Meyer
- Department of Health Promotion, College of Public Health, 984340 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-4340, USA
| | - Grace Cai
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
| |
Collapse
|
19
|
Kesztyüs D, Vorwieger E, Schönsteiner D, Gulich M, Kesztyüs T. Applicability of time-restricted eating for the prevention of lifestyle-dependent diseases in a working population: results of a pilot study in a pre-post design. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2021; 19:Doc04. [PMID: 33911996 PMCID: PMC8051591 DOI: 10.3205/000291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/14/2020] [Indexed: 02/06/2023]
Abstract
Background: The ongoing epidemic of lifestyle-dependent diseases in industrialized countries threatens to overtax the health and social systems of these nations. New approaches beyond the usual therapeutic and preventive measures which have been applied so far must be tested. A paradigm shift with regard to nutrition and associated illness is overdue. Time-restricted eating (TRE) offers a low-threshold and easy-to-implement lifestyle change which may have what it takes for broad, population-wide applicability and a widely diversified range of possible effects. In this pilot study, we examine the feasibility and adherence of TRE in healthy adult employees. Methods: Pre-post design study with healthy volunteers from the staff of Ulm University and Ulm University Hospital. Participants were asked to reduce their daily eating time to 8-9 hours for three months. Surrounding the eating time, they were allowed drinks other than water for 12 hours, and water for the rest of the day. Anthropometric measurements were taken by trained staff, and blood samples were taken at baseline and follow-up. Pre- and post-data on lifestyle, health and health-related quality of life (HRQoL, recorded with the Visual Analog Scale (VAS) of the EuroQol 5-Dimension (EQ-5D)), and attitudes towards TRE were collected in questionnaires. During the course of the study, timing of the first and the last meal, as well as sleep duration and quality, were assessed in diaries. Primary outcome was the percentage of days with achievement of the fasting goal out of the total number of days recorded per participant. Results: Sixty-three participants (aged 47.8±10.5 years, 86% female) were recruited and started the intervention immediately after the baseline assessment. Two persons dropped out while all others finished the study. Ratings of compatibility of TRE with professional activities were good in 78% of participants, neither good nor difficult in 3%, and 18% reported to have encountered some difficulties. On average, the fasting target was reached on 72.2±18.9% of the recorded days. After three months of TRE, participants showed moderate reductions in weight (-1.3±2.3 kg, p≤0.001) and waist circumference (-1.7±3.2 cm, p≤0.001). HRQoL increased significantly by 5.8±12.4 (p=0.008) points between baseline and follow-up. Conclusion: TRE is feasible and well accepted, even in regularly employed persons, and may improve HRQoL. TRE may help to reduce obesity and abdominal obesity in adult working people, thereby preventing lifestyle-dependent diseases; however, volunteers need more guidance to increase effects.
Collapse
Affiliation(s)
- Dorothea Kesztyüs
- Ulm University Medical Center, Institute of General Practice, Ulm, Germany
| | - Eva Vorwieger
- Ulm University Medical Center, Institute of General Practice, Ulm, Germany
| | - Dorothée Schönsteiner
- Ulm University Medical Center, Institute of General Practice, Ulm, Germany
- Ulm University Medical Center, Clinical Chemistry, Ulm, Germany
| | - Markus Gulich
- Ulm University Medical Center, Institute of General Practice, Ulm, Germany
| | - Tibor Kesztyüs
- Georg August University Göttingen, Medical Center, Institute of Medical Informatics, Göttingen, Germany
| |
Collapse
|
20
|
Associations of time-restricted eating with health-related quality of life and sleep in adults: a secondary analysis of two pre-post pilot studies. BMC Nutr 2020; 6:76. [PMID: 33327959 PMCID: PMC7745395 DOI: 10.1186/s40795-020-00402-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022] Open
Abstract
Background Therapeutic fasting may improve health-related quality of life (HRQoL) and sleep but is not applicable for everyone. Time-restricted eating (TRE) offers a low threshold alternative but research on associations with HRQoL and sleep is rare. Methods We conducted a secondary analysis of two pilot studies in a pre-post design, which examined TRE in healthy employees at the Ulm University and in abdominal obese patients in a general practitioners office. Participants reported their HRQoL (EQ-5D visual analogue scale) before and after 3 months of restricting their daily eating to 8–9 h. They kept a diary to protocol timing of first and last meal, sleep quality (analogue scale) and duration. Pearson’s correlation coefficient was applied to test bivariate correlations between continuous variables and linear regression analyses were conducted to identify associated factors with the pre-post differences in HRQoL and the differences in sleep quality. Results Ninety-nine participants (aged aged 48.9 ± 1.1, 83.8% female) reached the fasting target of 15–16 h on average on 77.2 ± 18.7% of all recorded days. HRQoL increased by 7.8 ± 12.6 and sleep quality by 9.6 ± 13.9 points, but sleep duration was not extended. Regression analysis revealed mean fasting duration and baseline sleep quality as significant factors associated with changes in HRQoL. Improvements in sleep quality correlated with baseline sleep quality and HRQoL at follow-up but not with fasting. Changes in anthropometry did not correlate with the HRQoL or sleep quality. Conclusions TRE correlates with increased HRQoL and sleep quality independent from weight loss. TRE is easily applicable with or without medical supervision. The potential effects of TRE on health and sleep should be further investigated in larger randomized trials. Trial registration German Register for Clinical Trials (DRKS), DRKS-ID: DRKS00015057. Registered 4 July 2018.
Collapse
|
21
|
Whitaker DE, Snyder FR, San Miguel-Majors SL, Bailey LO, Springfield SA. Screen to Save: Results from NCI's Colorectal Cancer Outreach and Screening Initiative to Promote Awareness and Knowledge of Colorectal Cancer in Racial/Ethnic and Rural Populations. Cancer Epidemiol Biomarkers Prev 2020; 29:910-917. [DOI: 10.1158/1055-9965.epi-19-0972] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/20/2019] [Accepted: 02/14/2020] [Indexed: 11/16/2022] Open
|
22
|
Kesztyüs D, Cermak P, Gulich M, Kesztyüs T. Adherence to Time-Restricted Feeding and Impact on Abdominal Obesity in Primary Care Patients: Results of a Pilot Study in a Pre-Post Design. Nutrients 2019; 11:E2854. [PMID: 31766465 PMCID: PMC6950236 DOI: 10.3390/nu11122854] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 12/22/2022] Open
Abstract
The epidemic of lifestyle-dependent diseases and the failure of previous interventions to combat the main causes demand an alternative approach. Abdominal obesity is associated with most of these diseases and is a good target for therapeutic and preventive measures. Time-restricted feeding (TRF) offers a low-threshold, easy-to-implement lifestyle-modification concept with promising results from animal testing. Here, we describe a pilot study of TRF with abdominally obese participants (waist-to-height ratio, WHtR ≥0.5) in a general practitioner's office. Participants (n = 40, aged 49.1 ± 12.4, 31 females) were asked to restrict their daily eating time to 8-9 hours in order to prolong their overnight fasting period to 15-16 hours. Questionnaires, anthropometrics, and blood samples were used at baseline and at follow-up. After three months of TRF, participants had reached the fasting target, on average, on 85.5 ± 15.2% of all days recorded. Waist circumference (WC) was reduced by -5.3 ± 3.1cm (p < 0.001), and three participants reached a WHtR <0.5. HbA1c was diminished by -1.4 ± 3.5 mmol/mol (p = 0.003). TRF may be an easily understandable and readily adoptable lifestyle change with the potential to reduce abdominal obesity and lower the risk for cardiometabolic diseases. Further well-designed studies are necessary to investigate the applicability and usefulness of TRF for public health.
Collapse
Affiliation(s)
- Dorothea Kesztyüs
- Institute of General Practice, Ulm University, Helmholtzstr. 20, 89081 Ulm, Germany; (P.C.); (M.G.)
| | - Petra Cermak
- Institute of General Practice, Ulm University, Helmholtzstr. 20, 89081 Ulm, Germany; (P.C.); (M.G.)
| | - Markus Gulich
- Institute of General Practice, Ulm University, Helmholtzstr. 20, 89081 Ulm, Germany; (P.C.); (M.G.)
| | - Tibor Kesztyüs
- Institute of Medical Informatics, Georg-August University, Von-Siebold-Str. 3, 37075 Göttingen, Germany;
| |
Collapse
|
23
|
Sherman LD, Smith ML. African American Fathers' Perceived Role for the Dietary Behaviors of Their Children: A Qualitative Study. Am J Mens Health 2019; 13:1557988319840851. [PMID: 30917736 PMCID: PMC6440058 DOI: 10.1177/1557988319840851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study is to investigate African American (AA) fathers’ involvement in promoting healthful decisions related to obesity and the issues that are potentially influencing dietary patterns among their children and within their households. This exploratory study gathered data via semistructured focus groups (n = 3), which were thematically analyzed utilizing a grounded theory approach. Participants included AA fathers (n = 20) with a mean age of 37 years (±11.79), all of which had one or more children between the ages of 6 and 18 years. Three significant subthemes emerged from the focus group sessions, which included fathers’ perspectives about: (a) teaching by example; (b) eating healthy is expensive; and (c) cooking and eating at home. Understanding AA fathers’ perceived and desired role in their children’s health edification can inform initiatives that actively engage these men, and nurture their level of involvement, to promote positive health behaviors among their children. Such efforts are necessary for AA fathers to realize their potential to effectively serve as change agents and actively improve the health of their children, families, and communities.
Collapse
Affiliation(s)
- Ledric D Sherman
- 1 Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Matthew Lee Smith
- 2 Center for Population Health and Aging, Texas A&M University, College Station, TX, USA.,3 Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA.,4 Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| |
Collapse
|
24
|
Kiami SR, Sky R, Goodgold S. Facilitators and barriers to enrolling in falls prevention programming among community dwelling older adults. Arch Gerontol Geriatr 2019; 82:106-113. [PMID: 30771600 DOI: 10.1016/j.archger.2019.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 12/14/2018] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
Abstract
The purpose of this cross-sectional survey study was to identify factors that increase the likelihood of enrolling in falls prevention programming among community dwelling older adults. A convenience sample of 369 participants completed a written, selfadministered questionnaire on history and beliefs related to falls, and facilitators and barriers associated with enrollment. History of falling, fear of falling, self-efficacy, and recognition of program benefits were all associated with a greatly likelihood to enroll in falls prevention programming. Additionally, seven facilitators were associated with greater likelihood to enroll, including offered close to home (OR = 6.75(3.829-11.898); p = 0.000), free vision screen (OR = 4.816 (1.442-16.084); p = 0.005), friendly leader (OR = 3.930 (2.049-7.538); p = 0.000), coffee hour to socialize (OR = 3.789 (1.309-10.971); p = 0.009), no cost (OR = 3.653 (2.125-6.253); p = 0.000), group exercise (OR = 2.584 (1.341-4.980); p = 0.004), and safe place (OR = 2.378 (1.181-4.789); p = 0.013). Physician advice to attend a program, however, was not associated with likelihood to register (p = 0.99), supporting the need for a paradigm shift from physicians serving as the key change-agent in falls prevention to multiple partnerships. In addition, although 72% of participants were likely to register for a falls prevention program, only 28% knew if a program was being offered in their community. These findings highlight a critical need to disseminate information about falls prevention programming through social marketing in locations where older adults go in their everyday lives.
Collapse
Affiliation(s)
- Sheri R Kiami
- Northeastern University, Department of Physical Therapy, Movement & Rehabilitation Sciences, 301 Robinson Hall, 360 Huntington Avenue, Boston, MA, 02115, United States.
| | - Rebecca Sky
- Foundation for Healthy Communities, 125 Airport Road, Concord, NH, 03301, United States.
| | - Shelley Goodgold
- Simmons College, Physical Therapy Department, 300 The Fenway, Boston, MA, 02115, United States.
| |
Collapse
|