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Wayment HA, McDonald RL. Sharing a Personal Trainer: Personal and Social Benefits of Individualized, Small-Group Training. J Strength Cond Res 2018; 31:3137-3145. [PMID: 28353489 DOI: 10.1519/jsc.0000000000001764] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Wayment, HA and McDonald, RL. Sharing a personal trainer: personal and social benefits of individualized, small-group training. J Strength Cond Res 31(11): 3137-3145, 2017-We examined a novel personal fitness training program that combines personal training principles in a small-group training environment. In a typical training session, exercisers warm-up together but receive individualized training for 50 minutes with 1-5 other adults who range in age, exercise experience, and goals for participation. Study participants were 98 regularly exercising adult members of a fitness studio in the southwestern United States (64 women and 32 men), aged 19-78 years (mean, 46.52 years; SD = 14.15). Average membership time was 2 years (range, 1-75 months; mean, 23.54 months; SD = 20.10). In collaboration with the program directors, we developed a scale to assess satisfaction with key features of this unique training program. Participants completed an online survey in Fall 2015. Hypotheses were tested with a serial mediator model (model 6) using the SPSS PROCESS module. In support of the basic tenets of self-determination theory, satisfaction with small-group, individualized training supported basic psychological needs, which in turn were associated with greater autonomous exercise motivation and life satisfaction. Satisfaction with this unique training method was also associated with greater exercise self-efficacy. Autonomous exercise motivation was associated with both exercise self-efficacy and greater self-reported health and energy. Discussion focuses on why exercise programs that foster a sense of social belonging (in addition to motivation and efficacy) may be helpful for successful adherence to an exercise program.
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Affiliation(s)
- Heidi A Wayment
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, Arizona
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Bishop L, Hemingway A, Crabtree SA. Lifestyle coaching for mental health difficulties: scoping review. JOURNAL OF PUBLIC MENTAL HEALTH 2018. [DOI: 10.1108/jpmh-04-2017-0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
UK mental health strategy calls for interventions that empower people to self-manage their condition. In lifestyle coaching, coach and client work collaboratively on positive behaviour change to improve client health. There is debate about the appropriateness of coaching for mental health, yet claims have not been supported with evidence. Therefore, the purpose of this paper is to explore the nature and scope of the existing research literature in this field.
Design/methodology/approach
Scoping review.
Findings
The growing evidence base shows positive outcomes of coaching; for instance, symptom reduction, enhanced self-management and achievement of personal goals.
Research limitations/implications
The evidence base is small and of variable quality, offering insights that warrant further exploration.
Practical implications
Coaching not only supports better self-management but also addresses further mental health strategy priorities (such as improved physical health and social functioning). Coaches need not be mental health experts; therefore coaching may be a cost-effective intervention.
Social implications
As mental ill-health prevalence continues to rise despite widespread use of Improving Access to Psychological Therapies and medication, there is a need to explore how novel approaches such as coaching might be integrated into mental healthcare.
Originality/value
This is the first study to collate the evidence on mental health coaching, highlighting its extensive potential, which should be further explored in research and practice.
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Winik CL, Bonham CE. Implementation of a Screening and Management of Overweight and Obesity Clinical Practice Guideline in an Ambulatory Care Setting. Mil Med 2018; 183:e32-e39. [PMID: 29401347 DOI: 10.1093/milmed/usx022] [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: 04/20/2017] [Indexed: 11/15/2022] Open
Abstract
Introduction Obesity is a rapidly growing health problem reaching epidemic levels around the world (World Health Organization, 2014). According to the World Health Organization, the current incident rate of obesity makes it the leading risk for deaths across the globe. The United States (USA) is amidst in this growing global epidemic. The obesity epidemic is a nondiscriminatory health problem affecting millions of individuals from a variety of backgrounds and social status. One group impacted by this disease is the US military. The health-related consequences of overweight and obesity has increased our military health care expenditures and has a direct impact on our nation's military readiness (Veterans Affairs/Department of Defense, 2014). Materials and Methods The purpose of this Doctor of Nursing Practice project was to implement the Veterans Affairs/Department of Defense's Clinical Practice Guideline on Screening and Management of Overweight and Obesity at a military treatment facility in the Midwest. The goal of the project was to reduce the incidence rate of overweight and obese active duty military service members assigned to a military installation in the Midwest. With institutional review board approval, project implementation results were analyzed with descriptive and inferential statistics (paired t- tests). Results The goal to reduce the incident rate of overweight and obese by 5% was not achieved, but in turn the rate of overweight and obese increased by 1.57% over the 6-mo period. There were decreases in the normal with an increase in the overweight and obesity rate. This inverse outcome was unexpected and concerning. Conclusion Based on the project's finding, there is a need to address the perceived barriers to maintaining healthy behaviors to plan future activities. An in-depth look at whether there is a knowledge deficit, a perceived lack of self-efficacy, competing life priorities preventing engagement in health promotion behaviors, or some other element influencing the motivation to change would be beneficial to understanding how to curb the growing rate of obesity. The utilization of the transtheoretical model of behavior change would make a sound theoretical framework to base such a new study, focusing on the stages of change as it relates to health promotion behaviors.
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Affiliation(s)
- Connie L Winik
- 55th Medical Group, Ehrling Bergquist Clinic, United States Air Force, 2501 Capehart Road, Offutt Air Force Base, NE 68113
| | - C Elizabeth Bonham
- College of Nursing and Health Professions, University of Southern Indiana, 8600 University Boulevard, Evansville IN 47712
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Jordan K, Edwards J, Porcheret M, Healey E, Jinks C, Bedson J, Clarkson K, Hay E, Dziedzic K. Effect of a model consultation informed by guidelines on recorded quality of care of osteoarthritis (MOSAICS): a cluster randomised controlled trial in primary care. Osteoarthritis Cartilage 2017; 25:1588-1597. [PMID: 28591564 PMCID: PMC5613776 DOI: 10.1016/j.joca.2017.05.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/24/2017] [Accepted: 05/27/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effect of a model osteoarthritis (OA) consultation (MOAC) informed by National Institute for Health and Care Excellence (NICE) recommendations compared with usual care on recorded quality of care of clinical OA in general practice. DESIGN Two-arm cluster randomised controlled trial. SETTING Eight general practices in Cheshire, Shropshire, or Staffordshire UK. PARTICIPANTS General practitioners and nurses with patients consulting with clinical OA. INTERVENTION Following six-month baseline period practices were randomised to intervention (n = 4) or usual care (n = 4). Intervention practices delivered MOAC (enhanced initial GP consultation, nurse-led clinic, OA guidebook) to patients aged ≥45 years consulting with clinical OA. An electronic (e-)template for consultations was used in all practices to record OA quality care indicators. OUTCOMES Quality of OA care over six months recorded in the medical record. RESULTS 1851 patients consulted in baseline period (1015 intervention; 836 control); 1960 consulted following randomisation (1118 intervention; 842 control). At baseline wide variations in quality of care were noted. Post-randomisation increases were found for written advice on OA (4-28%), exercise (4-22%) and weight loss (1-15%) in intervention practices but not controls (1-3%). Intervention practices were more likely to refer to physiotherapy (10% vs 2%, odds ratio 5.30; 95% CI 2.11, 13.34), and prescribe paracetamol (22% vs 14%, 1.74; 95% CI 1.27, 2.38). CONCLUSIONS The intervention did not improve all aspects of care but increased core NICE recommendations of written advice on OA, exercise and weight management. There remains a need to reduce variation and uniformly enhance improvement in recorded OA care. TRIAL REGISTRATION NUMBER ISRCTN06984617.
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Affiliation(s)
- K.P. Jordan
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK,Keele Clinical Trials Unit, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK,Address correspondence and reprint requests to: K.P. Jordan, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK.Arthritis Research UK Primary Care CentreResearch Institute for Primary Care & Health SciencesKeele UniversityDavid Weatherall BuildingStaffordshireST5 5BGUK
| | - J.J. Edwards
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
| | - M. Porcheret
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
| | - E.L. Healey
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
| | - C. Jinks
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
| | - J. Bedson
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
| | - K. Clarkson
- Keele Clinical Trials Unit, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
| | - E.M. Hay
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
| | - K.S. Dziedzic
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
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Panagiotakos D, Georgousopoulou E, Notara V, Pitaraki E, Kokkou E, Chrysohoou C, Skoumas Y, Metaxa V, Pitsavos C, Stefanadis C. Education status determines 10-year (2002-2012) survival from cardiovascular disease in Athens metropolitan area: the ATTICA study, Greece. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:334-344. [PMID: 25754715 DOI: 10.1111/hsc.12216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2014] [Indexed: 06/04/2023]
Abstract
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and educational level seems to be an important determinant of the disease occurrence. The aim of this work was to investigate the association between education status and 10-year incidence of CVD, controlling for various socio-demographic lifestyle and clinical factors. From May 2001 to December 2002, 1514 men and 1528 women (>18 years) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. Education status was measured in years of schooling. The 10-year incidence of CVD was 15.7% [95% confidence intervals (CI) 14.1%-17.4%], 19.7% in men and 11.7% in women (Pgender < 0.001). Age-and gender-adjusted analyses revealed that those with low education (<9 years of schooling) were 1.52 times more likely (95% CI 1.03-2.23%) to have CVD compared with those with high education (>12 years of schooling). People in the low education group had higher prevalence of hypertension, diabetes and dyslipidaemias, were more likely to be smokers and sedentary, had less healthy dietary habits, as compared with those in the high education group. When controlling for participants' medical history, smoking, dietary and lifestyle habits, low education was no longer significantly associated with CVD, illustrating the mediating effect of clinical and behavioural factors in the link between education and disease. It was of interest that low education status interacted with alcohol drinking, enhancing the adverse effect of low education on CVD risk (relative risk 1.44, 95% CI 0.94%-2.20%), after various adjustments made. In this study, it was concluded that low educational level was associated with increased CVD risk. This was mainly explained by the intermediate association of low education with unhealthy choices that consequently worsen clinical status.
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Affiliation(s)
- Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Ekavi Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Venetia Notara
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Evangelia Pitaraki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eleni Kokkou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Yannis Skoumas
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Vassiliki Metaxa
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
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Costa EF, Guerra PH, Santos TID, Florindo AA. Systematic review of physical activity promotion by community health workers. Prev Med 2015; 81:114-21. [PMID: 26297816 DOI: 10.1016/j.ypmed.2015.08.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the physical activity promotion in interventions conducted by community health workers. METHODS Systematic searches in five electronic databases (LILACS, PubMed, Scopus, Web of Science and SportDiscus) and manual searches in reference lists were conducted for papers published up until May 2014. The inclusion criteria were interventions delivered in adults by community health workers that had physical activity promotion as an objective (primary or secondary). RESULTS Of the 950 references initially retrieved, 26 were included in the descriptive synthesis. At the operational level, action strategies were predominantly based on the model of health education grounded in counseling, and delivered in populations at risk or diagnosed with chronic non-communicable diseases. Only five studies had the primary outcome of physical activity promotion and twenty-five studies used self-report methods for evaluation. The majority of studies (72.4%) were classified as having low or moderate risk of bias. Sixteen studies (61.5%) reported positive results for different parameters of physical activity. Most studies were carried out in the United States. The successful interventions were conducted over a period averaging 6.5 months and targeted mainly women, individuals older than thirty, specific ethnic groups, and syndromic or at-risk individuals. CONCLUSIONS The community health workers were important for physical activity promotion, but further interventions should be carried out in different countries and less specific samples, that include physical activity as a primary outcome and employ direct methods for assessing physical activity.
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Affiliation(s)
- Evelyn Fabiana Costa
- Post Graduation Program in Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil; Group of Studies and Researches in Physical Activity Epidemiology, University of São Paulo, São Paulo, SP, Brazil.
| | - Paulo Henrique Guerra
- Group of Studies and Researches in Physical Activity Epidemiology, University of São Paulo, São Paulo, SP, Brazil; School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | - Taynã Ishii Dos Santos
- Group of Studies and Researches in Physical Activity Epidemiology, University of São Paulo, São Paulo, SP, Brazil
| | - Alex Antonio Florindo
- Post Graduation Program in Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil; Group of Studies and Researches in Physical Activity Epidemiology, University of São Paulo, São Paulo, SP, Brazil; School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil
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Florindo AA, Brownson RC, Mielke GI, Gomes GA, Parra DC, Siqueira FV, Lobelo F, Simoes EJ, Ramos LR, Bracco MM, Hallal PC. Association of knowledge, preventive counseling and personal health behaviors on physical activity and consumption of fruits or vegetables in community health workers. BMC Public Health 2015; 15:344. [PMID: 25885709 PMCID: PMC4410462 DOI: 10.1186/s12889-015-1643-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 03/16/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is evidence that if a health professional is active and has a healthy diet, he/she is more likely to advise patients about the benefits of physical activity and healthy eating The aims of this study were to: (1) describe the personal physical activity, consumption of fruits and vegetables behaviors and nutritional status of community health workers; (2) evaluate the association between knowledge, delivery of preventive counseling and personal behaviors among community health workers. METHODS This was a cross-sectional study conducted in a nationally sample of health professionals working in primary health care settings in Brazil in 2011. This survey was part of the second phase of the Guide for Useful Interventions for Activity in Brazil and Latin America project, and data were collected through telephone interviews of 269 community health workers from the Unified Health Care system of Brazil. We applied questionnaires about personal reported behaviors, knowledge and preventive counseling in physical activity and consumption of fruits and vegetables. We calculated the prevalence and associations between the variables with logistic regression. RESULTS The proportion of community health workers that practiced 150 minutes per week of physical activity in leisure time or transportation was high (64.9%). Half of community health workers were overweight and only 26.2% reported consuming five portions/day of fruits or vegetables. Most community health workers reported counseling about physical activity for more than six months (59.7%), and most were not knowledgeable of the fruits and vegetables and physical activity recommendations. Meeting the fruits and vegetables recommendations was associated with correct knowledge (OR = 4.5; CI95% 1.03;19.7), with reporting 150 minutes or more of physical activity per week (OR = 2.0; CI95% 1.03;3.7) and with reporting physical activity in leisure time (OR = 2.0; CI95% 1.05;3.6). Regular physical activity counseling was associated with reporting 10-149 minutes per week (OR = 3.8; CI95% 1.1;13.3) and with more than 150 minutes of physical activity per week (OR = 4.9; CI95% 1.5;16.5). CONCLUSION Actions to promote physical activity and healthy eating and to improve knowledge among community health workers within the health care system of Brazil could have a potential positive influence on delivery of preventive counseling to patients on this topic.
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Affiliation(s)
- Alex A Florindo
- School of Arts, Sciences and Humanities, University of São Paulo, Rua Arlindo Bettio, 1.000, CEP: 03828-000, São Paulo, SP, Brazil.
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Division of Public Health Sciences and Alvin J. Siteman Cancer Center - Washington University in St. Louis, Missouri, USA.
| | - Gregore I Mielke
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Grace Ao Gomes
- Department of Gerontology, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Diana C Parra
- Program in Physical Therapy Surgery (Prevention and Control), School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
| | - Fernando V Siqueira
- School of Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Felipe Lobelo
- Hubert Department of Global Health, Emory University - Rollins School of Public Health, Atlanta, USA.
| | - Eduardo J Simoes
- Department of Health Management and Informatics, School of Medicine, University of Missouri, Missouri, USA.
| | - Luiz R Ramos
- Department of Preventive Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil.
| | - Mário M Bracco
- Hospital Israelita Albert Einstein; Hospital Municipal Dr. Moysés Deutsch - M'Boi Mirim, São Paulo, SP, Brazil.
| | - Pedro C Hallal
- School of Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil.
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Affiliation(s)
| | - Jane South
- Centre for Health Promotion Research, Leeds Metropolitan University
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