1
|
Lemieux S. S'attaquer aux défis de l'adhésion aux principes de la saine alimentation. Appl Physiol Nutr Metab 2024. [PMID: 38587179 DOI: 10.1139/apnm-2023-0564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
The purpose of this article is to describe the impact of the research program entitled "Adherence to healthy eating recommendations: identification of measures, determinants and interventions". Beyond the main results described in this article, this program had a major impact on the training of graduate students. It was also a unique opportunity to develop and validate measurement tools relevant to nutrition research, and to make them available to the scientific community. Lastly, this program was a catalyst for establishing new collaborations and setting up larger-scale studies.
Collapse
Affiliation(s)
- Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- École de nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| |
Collapse
|
2
|
England C, Mitchell A, Atkinson C. Diet After Ileostomy Study: an observational study describing dietary intake and stoma-related symptoms in people with an ileostomy. J Hum Nutr Diet 2023; 36:1600-1612. [PMID: 36932682 DOI: 10.1111/jhn.13168] [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: 10/31/2022] [Accepted: 03/07/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND People with ileostomy are frequently advised to avoid specific foods and food groups, making it plausible that they are at risk of a range of nutrition-related adverse health consequences. Despite this there has been no recent study in the United Kingdom describing dietary intake, symptoms and food avoidance in people with ileostomy or post-reversal. METHODS A cross-sectional study was conducted at different time points in people with ileostomy and reversal. Participants were recruited at 6-10 weeks post-formation (n = 17) and ≥12 months with established ileostomy (n = 16) and with reversal (n = 20). In all participants, ileostomy/bowel-related symptoms in the previous week were assessed using a study-specific questionnaire. Dietary intake was assessed using three online diet recalls or 3-day dietary records. Food avoidance and reasons for food avoidance were assessed. Data were summarised using descriptive statistics. RESULTS Participants reported a few ileostomy/bowel-related symptoms in the previous week. However, over 85% of participants reported avoiding foods, particularly fruits and vegetables. At 6-10 weeks the most common reason was being advised to do so (71%), although 53% avoided foods due to gas. At ≥12 months the most common reasons were foods visible in the bag (60%) or advised to do so (60%). Reported intakes of most nutrients were comparable to population medians, apart from lower fibre in people with ileostomy. Intakes of free sugars and saturated fats were above recommended levels in all groups, due to high consumption of cakes and biscuits and sugar-sweetened drinks. CONCLUSION After the initial healing period, foods should not be automatically excluded unless found to be problematic after reintroduction. There may be a need for healthy eating advice for people with established ileostomies and post-reversal, targeting discretionary high-fat, high-sugar foods.
Collapse
Affiliation(s)
- Clare England
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Alexandra Mitchell
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Charlotte Atkinson
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| |
Collapse
|
3
|
Lutz R, Fischmann W, Drexler H, Nöhammer E. A German Model Project for Workplace Health Promotion-Flow of Communication, Information, and Reasons for Non-Participation in the Offered Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8122. [PMID: 35805779 PMCID: PMC9265396 DOI: 10.3390/ijerph19138122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Workplace health promotion (WHP) as a part of workplace health management (WHM) was strengthened in German legislature with the Prevention Act of 2015. However, smaller enterprises often do not offer WHM or WHP. Accordingly, a model-project for improving the uptake and implementation, particularly in micro-, small, and medium-sized enterprises (MSMEs) was carried out. The aim of the study was to determine reasons for non-participation in WHP offers and analyze communication issues, both from the employee's and employer's perspective. METHODS In total, 21 managers or persons responsible for WHP participated in the first online survey between March and April 2020, and 156 employees responded to the second online survey between June and October 2021. The importance of barriers and communication issues was investigated. Based on a principal component analysis on non-participation, differences regarding sociodemographic variables were analyzed. RESULTS Most employees knew about the offered measures and that the measures were cost free. There was no significant association between having communicated the offers to the employees and considering them suitable for their needs. Most of the managers or persons responsible for WHP rated the measures as sufficiently varied and allowed staff to take part during working-time. Reasons for non-participation from the managers' point of view were travel time to the location of the offers, lack of time, and a missing fit between offers and employees' needs. From the employees' point of view, workload (including working time) was the main barrier to participation. CONCLUSIONS For the practical implementation of model projects in MSMEs, special attention should be paid to ensuring opportunity to participate, which may be easier with in-house offers.
Collapse
Affiliation(s)
- Regina Lutz
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestraße 9-11, 91054 Erlangen, Germany; (W.F.); (H.D.)
| | - Wolfgang Fischmann
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestraße 9-11, 91054 Erlangen, Germany; (W.F.); (H.D.)
| | - Hans Drexler
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestraße 9-11, 91054 Erlangen, Germany; (W.F.); (H.D.)
| | - Elisabeth Nöhammer
- Department for Public Health, Health Services Research and HTA, UMIT—Private University for Health Sciences, Medical Informatics and Technology, 6060 Hall in Tirol, Austria;
| |
Collapse
|
4
|
Giri VN, Shimada A, Leader AE. Predictors of Population Awareness of Cancer Genetic Tests: Implications for Enhancing Equity in Engaging in Cancer Prevention and Precision Medicine. JCO Precis Oncol 2021; 5:PO.21.00231. [PMID: 34778693 PMCID: PMC8585288 DOI: 10.1200/po.21.00231] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 12/17/2022] Open
Abstract
Racial and ethnic disparities in genetic awareness (GA) can diminish the impact of personalized cancer treatment and risk assessment. We assessed factors predictive of GA in a diverse population-based sample to inform awareness strategies and reduce disparities in genetic testing. METHODS A cross-sectional study was conducted from July 2019 to August 2019, with the survey e-mailed to 7,575 adult residents in southeastern Pennsylvania and New Jersey. Constructs from National Cancer Institute Health Information and National Trends Survey assessed cancer attitudes or beliefs, health literacy, and numeracy. Characteristics were summarized with mean ± standard deviation for numeric variables and frequency counts and percentages for categorical variables. Comparison of factors by race or ethnicity (non-Hispanic White and non-Hispanic Black) and sex was conducted by t-tests, chi-square, or Fisher's exact tests. Multivariate logistic regression models were conducted to identify factors independently predictive of GA. RESULTS Of 1,557 respondents, data from 940 respondents (the mean age was 45 ± 16.2 years, 35.5% males, and 23% non-Hispanic Blacks) were analyzed. Factors associated with higher GA included female gender (P < .001), non-Hispanic White (P < .001), college education (P < .001), middle-higher income (P < .001), stronger belief in genetic basis of cancer (P < .001), lower cancer fatalism (P = .004), motivation for cancer information (P < .001), and higher numeracy (P = .002). On multivariate analysis, college education (odds ratio [OR] 1.79; 95% CI, 1.22 to 2.63), higher motivation for cancer information (OR 1.56; 95% CI, 1.17 to 2.09), stronger belief in genetics of cancer (OR 2.21; 95% CI, 1.48 to 3.30), and higher medical literacy (OR 2.21; 95% CI, 1.34 to 3.65) predicted greater GA. CONCLUSION This population-based study conducted in the precision medicine era identified novel modifiable factors, importantly perceptions of cancer genetics and medical literacy, as predictive of GA, which informs strategies to promote equitable engagement in genetically based cancer care.
Collapse
Affiliation(s)
- Veda N. Giri
- Departments of Medical Oncology, Cancer Biology, and Urology, Cancer Risk Assessment and Clinical Cancer Genetics, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Ayako Shimada
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - Amy E. Leader
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| |
Collapse
|
5
|
Lamarche B, Brassard D, Lapointe A, Laramée C, Kearney M, Côté M, Bélanger-Gravel A, Desroches S, Lemieux S, Plante C. Changes in diet quality and food security among adults during the COVID-19-related early lockdown: results from NutriQuébec. Am J Clin Nutr 2021; 113:984-992. [PMID: 33398347 PMCID: PMC7799255 DOI: 10.1093/ajcn/nqaa363] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/11/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The impact that the coronavirus disease 2019 (COVID-19)-related early lockdown has had on dietary habits of the population and on food insecurity is unknown. OBJECTIVE The aim of this study was to document the change in diet quality and in food insecurity observed during the COVID-19-related early lockdown. We hypothesized that the lockdown was associated with a deterioration in overall diet quality and an increase in food insecurity. METHODS Data are from a COVID-19 subsample of NutriQuébec, a web-based cohort destined to study temporal changes in dietary habits among adults in Quebec, Canada. Participants completed questionnaires before (between June 2019 and February 2020) and during (April to May 2020) early lockdown, including a validated web-based 24-h recall (n = 853) and a questionnaire on food security (n = 922). Primary study outcomes were temporal changes in diet quality measured by the Healthy Eating Index (HEI)-2015 and in the prevalence of food insecurity. RESULTS There was a small increase in the HEI-2015 during the COVID-19 early lockdown compared with baseline (+1.1 points; 95% CI: 0.6, 1.5), mostly due to small improvements in the intakes of whole grains, greens and beans, refined grains, total vegetables, total dairy, seafood and plant proteins, added sugar, and total protein subscores of the HEI-2015. Exploratory analyses suggested that individuals aged 18-29 y (+3.6 points; 95% CI: 2.4, 4.7), participants with lower education (+1.9 points; 95% CI: 1.3, 2.6), or with obesity (+3.8 points; 95% CI: 2.7, 4.8) showed particularly important increases in the HEI-2015. The prevalence of food insecurity was reduced from 3.8% at baseline to 1.0% during the early lockdown (prevalence ratio = 0.27; 95% CI: 0.08, 0.94). CONCLUSIONS Contrary to our hypotheses, diet quality has slightly improved and prevalence of food insecurity was reduced in this sample of adults from Quebec during the COVID-19-related early lockdown. These results may be generalizable only to relatively healthy populations.
Collapse
Affiliation(s)
- Benoît Lamarche
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada.,École de Nutrition, Faculté des Sciences de l'Agriculture et de l'Alimentation, Université Laval, Quebec City, Quebec, Canada
| | - Didier Brassard
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada.,École de Nutrition, Faculté des Sciences de l'Agriculture et de l'Alimentation, Université Laval, Quebec City, Quebec, Canada
| | - Annie Lapointe
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada
| | - Catherine Laramée
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada
| | - Michèle Kearney
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada
| | - Mélina Côté
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada.,École de Nutrition, Faculté des Sciences de l'Agriculture et de l'Alimentation, Université Laval, Quebec City, Quebec, Canada
| | - Ariane Bélanger-Gravel
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada.,Département d'Information et de Communication, Université Laval, Quebec City, Quebec, Canada.,Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Quebec City, Quebec, Canada
| | - Sophie Desroches
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada.,École de Nutrition, Faculté des Sciences de l'Agriculture et de l'Alimentation, Université Laval, Quebec City, Quebec, Canada
| | - Simone Lemieux
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada.,École de Nutrition, Faculté des Sciences de l'Agriculture et de l'Alimentation, Université Laval, Quebec City, Quebec, Canada
| | - Céline Plante
- Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
| |
Collapse
|
6
|
Kripalani S, Goggins K, Couey C, Yeh VM, Donato KM, Schnelle JF, Wallston KA. Disparities in Research Participation by Level of Health Literacy. Mayo Clin Proc 2021; 96:314-321. [PMID: 33549253 PMCID: PMC7874435 DOI: 10.1016/j.mayocp.2020.06.058] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/09/2020] [Accepted: 06/02/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine at which phase in the recruitment process for participation in clinical research studies do health literacy and other patient characteristics influence recruitment outcomes. PATIENTS AND METHODS Using a sample of 5872 patients hospitalized with cardiovascular disease approached for participation in the Vanderbilt Inpatient Cohort Study from October 2011 through December 2015, we examined the independent association of patients' health literacy with two steps in their research participation decision-making process: (1) research interest - willingness to hear more about a research study; and (2) research participation - the decision to enroll after an informed consent discussion. Best practices for effective health communication were implemented in recruitment approaches and informed consent processes. Using logistic regression models, we determined patient characteristics independently associated with patients' willingness to hear about and participate in the study. RESULTS In unadjusted analyses, participants with higher health literacy, and those who were younger, female, or had more education had higher levels of both research interest and research participation. Health literacy remained independently associated with both outcomes in multivariable models, after adjustment for sociodemographic factors. CONCLUSION Because identical variables predicted both research interest and eventual consent, efforts to recruit broad populations must include acceptable methods of approaching potential participants as well as explaining study materials.
Collapse
Affiliation(s)
- Sunil Kripalani
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN.
| | - Kathryn Goggins
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN; Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, TN
| | - Catherine Couey
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN; Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, TN
| | - Vivian M Yeh
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN
| | | | - John F Schnelle
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN
| | - Kenneth A Wallston
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN
| | | |
Collapse
|
7
|
Lapointe A, Laramée C, Belanger-Gravel A, Buckeridge DL, Desroches S, Garriguet D, Gauvin L, Lemieux S, Plante C, Lamarche B. NutriQuébec: a unique web-based prospective cohort study to monitor the population's eating and other lifestyle behaviours in the province of Québec. BMJ Open 2020; 10:e039889. [PMID: 33115902 PMCID: PMC7594370 DOI: 10.1136/bmjopen-2020-039889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION The epidemic of non-communicable diseases including cardiovascular diseases and type 2 diabetes is attributable in large part to unhealthy eating and physical inactivity. In the fall of 2016, the Québec government launched its first-ever Government Health Prevention Policy (Politique gouvernementale de prévention en santé (PGPS)) to influence factors that lead to improved health status and quality of life as well as reduced social inequalities in health in the population of Québec. NutriQuébec is a web-based prospective open cohort study whose primary aim is to provide essential data for the evaluation of the PGPS on the Québec population's eating and other lifestyle behaviours over time. METHODS AND ANALYSIS Over a first phase of 3 years, NutriQuébec will enrol 20 000 adults living in the province of Québec in Canada through a multimedia campaign designed to reach different segments of the population, including subgroups with lower socioeconomic status. Participants will be invited to complete on a web platform nine core questionnaires on a yearly basis. Questionnaires will assess several dimensions related to lifestyle, including eating and physical activity behaviours, as well as a large number of personal characteristics and global health status. Temporal trends in eating and lifestyle behaviours will be analysed in relation to the implementation of the PGPS to provide essential data for its evaluation at a population level. Data analyses will use sociodemographic weights to adjust responses of participants to achieve, so far as is possible, representativeness of the adult Québec population. ETHICS AND DISSEMINATION Université Laval Research Ethics Board approved the NutriQuébec project. Data analysis, presentations in conferences and publication of manuscripts are scheduled to start in 2020. TRIAL REGISTRATION NUMBER NCT04140071.
Collapse
Affiliation(s)
- Annie Lapointe
- Centre NUTRISS, INAF, Université Laval, Quebec City, Quebec, Canada
| | | | - Ariane Belanger-Gravel
- Centre NUTRISS, INAF, Université Laval, Quebec City, Quebec, Canada
- Department of Information and Communication, Université Laval, Quebec city, Quebec, Canada
- Quebec Heart and Lung Institute, Quebec city, Quebec, Canada
| | - David L Buckeridge
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Sophie Desroches
- Centre NUTRISS, INAF, Université Laval, Quebec City, Quebec, Canada
- School of Nutrition, Université Laval, Quebec City, Quebec, Canada
| | - Didier Garriguet
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | - Lise Gauvin
- Centre de recherche du CHUM, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Simone Lemieux
- Centre NUTRISS, INAF, Université Laval, Quebec City, Quebec, Canada
- School of Nutrition, Université Laval, Quebec City, Quebec, Canada
| | - Céline Plante
- Institut national de santé publique du Québec, Quebec City, Quebec, Canada
| | - Benoit Lamarche
- Centre NUTRISS, INAF, Université Laval, Quebec City, Quebec, Canada
- School of Nutrition, Université Laval, Quebec City, Quebec, Canada
| |
Collapse
|