Previous life experiences and social relations affecting individuals wish for support when establishing healthy habits - a qualitative study of Norwegian Healthy Life Centre participants

Participants stories about long-term achievement 60-months after attending a Healthy Life Centre programme (the VEND-RISK study) - a qualitative study

BACKGROUND

Experiences of long-term achievement in participants attending programs for changing health habits including diet and physical activity interventions aiming for weight reduction is lacking. This study aimed to explore how participants experienced their own achievement of healthy habits 60 months after attending a Healthy Life Centre programme in the Norwegian primary healthcare.

METHODS

An explorative qualitative design with an inductive approach was employed. Individual semi-structured interviews were performed with 20 participants attending a Healthy Life Centre programme 60 months ago. They were aged 30-72 years, and 55% were females. Interviews were transcribed verbatim and analysed thematically using systematic text condensation.

RESULTS

Two main themes emerged from the interviews with three subthemes each. The first theme "Changes over time" includes "Nutritional changes", "Physical activities adjusted to own presumptions" and "Health habits incorporated into life with manageable goals". The second theme "Barriers to fulfil changes" includes "Life circumstances with health issues influences the continuity to adjust to changes", "a busy everyday life" and "a lack of external drive when not having commitment to the Healthy Life Centre".

CONCLUSIONS

Focusing on changes adjusted to participants' own everyday lives and having an approach with small goals can facilitate long-term changes in health habits.

Lower education and immigrant background are associated with lower participation in a diabetes education program - Insights from adult patients in the Outcomes & Multi-morbidity In Type 2 diabetes cohort (OMIT)

OBJECTIVES

Diabetes educational programmes should be offered to patients with type 2 diabetes mellitus (T2DM). We assessed the proportion of diabetes educational program participation among adults with T2DM, and its associations with place of residence in Norway, education, and immigrant background.

METHODS

We identified 28,128 diagnosed with T2DM (2008-2019) in the Outcomes & Multi-morbidity In Type 2 diabetes cohort. To examine associations between sociodemographic factors and participation in diabetes start courses (yes/no), we computed adjusted risk ratios (95% CI) using log-binomial regression.

RESULTS

Overall, 18% participated on the diabetes start course, but partaking differed by Norwegian counties (range:12-34%). Individuals with an immigrant background were 29% less likely to participate (RR 0.71, CI 0.65-0.79). Similarly, those with a lower educational level were 23% less likely to participate (RR 0.77, CI 0.72-0.83) than those with the highest education. The association between education and start course participation was not significant in the subgroup of immigrant individuals (RR 0.88 CI 0.70-1.12).

CONCLUSIONS

We found that diabetes start course participation was overall low, especially in individuals with low education and immigrant background.

PRACTICE IMPLICATIONS

More efforts are needed to promote diabetes start courses in patients with T2DM.

Elements behind sedentary lifestyles and unhealthy eating habits in individuals with severe obesity

Purpose

This study examines elements behind sedentary lifestyles and unhealthy eating habits in individuals who lived with severe obesity during many years of their lives.

Methods

Ten post-bariatric surgery patients participated in semi-structured interviews 7 months after surgery. A year later, a second round of interviews was also conducted to address some knowledge gaps related to the study purpose. The qualitative data collected were analysed through content analysis.

Results

Embarrassment about showing their body publicly, pain and poor physical condition, and bad experiences in non-inclusive physical activity contexts were found as potential elements that contributed to their adherence to sedentary lifestyles. Poor family food education, loss of a loved one, family problems, arguments or disputes, and past traumatic events (e.g., childhood sexual abuses) could be related to their development of unhealthy eating behaviours. Findings also pointed out that participants’ failed attempts to lose weight provoked them anxiety, feelings of failure and rebellion, and influenced their return to an unhealthy diet and a sedentary lifestyle.

Conclusions

This study may be helpful to reveal some elements which could be related to the origin and perpetuation of severe obesity, and to design prevention/treatment strategies from a more holistic, sensitive, and respectful perspective.