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Gómez-Gómez I, Rodero-Cosano ML, Bellón JÁ, Zabaleta-Del-Olmo E, Maderuelo-Fernandez JA, Moreno-Peral P, Magallón-Botaya R, Oliván-Blázquez B, Casajuana-Closas M, López-Jiménez T, Bolíbar B, Llobera J, Clavería A, Sanchez-Perez A, Motrico E. Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study. J Health Psychol 2024:13591053241241015. [PMID: 38605575 DOI: 10.1177/13591053241241015] [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: 04/13/2024] Open
Abstract
This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression (β = - 0 . 076 ; p = 0 . 046 ). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.
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Affiliation(s)
- Irene Gómez-Gómez
- Universidad Loyola Andalucía, Spain
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
| | | | - Juan Á Bellón
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Biomedical Research Institute of Málaga (IBIMA), Spain
- Andalusian Health Service (SAS), Spain
- University of Málaga, Spain
| | - Edurne Zabaleta-Del-Olmo
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Institut Català de la Salut, Spain
- Universitat de Girona, Spain
| | - José A Maderuelo-Fernandez
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Spain
- Instituto de investigación Biomédica de Salamanca (IBSAL), Spain
- Gerencia de Atención Primaria de Salamanca, Spain
- Gerencia Regional de salud de Castilla y León (SACyL), Spain
| | - Patricia Moreno-Peral
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Biomedical Research Institute of Málaga (IBIMA), Spain
| | - Rosa Magallón-Botaya
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Universidad de Zaragoza, Spain
- Institute for Health Research Aragón (IISA), Spain
| | - Bárbara Oliván-Blázquez
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Universidad de Zaragoza, Spain
- Institute for Health Research Aragón (IISA), Spain
| | - Marc Casajuana-Closas
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Tomàs López-Jiménez
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Bonaventura Bolíbar
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Joan Llobera
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Servei de Salut de les Illes Balears, Spain
| | - Ana Clavería
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Área de Vigo, SERGAS, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | - Alvaro Sanchez-Perez
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- BioCruces Bizkaia Health Research Institute, Basque Healthcare Service - Osakidetza, Spain
| | - Emma Motrico
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Spain
- Instituto de Investigaciones Biomédicas de Sevilla, IBIS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), Sevilla, Spain
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Sevilla, Spain
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Curran F, Brennan C, Matthews J, O’ Donoghue G. A qualitative study of perceived barriers and facilitators to interrupting sedentary behavior among adults living with obesity. Obes Sci Pract 2024; 10:e721. [PMID: 38263998 PMCID: PMC10804343 DOI: 10.1002/osp4.721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Both obesity and sedentary behavior (SB) are associated with negative health consequences including cardiovascular disease, diabetes, certain cancers and all-cause mortality. To date, perceived barriers and facilitators to interrupting SB in adults living with obesity have not been identified. Objective This study aimed to identify these perceived barriers and facilitators by conducting a behavioral analysis underpinned by the theoretical domains framework (TDF) and the Capability, Opportunity, Motivation-Behavior (COM-B) model to enhance knowledge and inform future intervention development. Methods A purposive and snowball sample (N = 21) of adults living with obesity took part in semi-structured interviews, guided by the TDF, to investigate perceived barriers or facilitators to interrupt SB. Transcribed interviews were inductively coded using reflexive thematic analysis. Key themes and subthemes were generated by grouping similar and recurring codes. Finally, subthemes were mapped to the TDF and COM-B. Results Five key themes were identified, which influence SB across all domains of living. These relate to (i) physical and mental wellbeing; (ii) motivational readiness; (iii) roles, responsibilities and support; (iv) weight bias and stigma; and (v) the environment. These themes were then deductively mapped to all 14 TDF domains and all six of the COM-B constructs. Conclusion A complex interplay of individual, societal and policy factors contributes to the development and habituation of SB patterns in adults living with obesity. Factors identified in this study could assist in the development of interventions, strategies and policies designed to interrupt or reduce sedentary behavior in this population.
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Affiliation(s)
- Fiona Curran
- School of Public Health, Physiotherapy and Sports ScienceUniversity College DublinDublinIreland
| | - Carol Brennan
- School of Public Health, Physiotherapy and Sports ScienceUniversity College DublinDublinIreland
| | - James Matthews
- School of Public Health, Physiotherapy and Sports ScienceUniversity College DublinDublinIreland
| | - Grainne O’ Donoghue
- School of Public Health, Physiotherapy and Sports ScienceUniversity College DublinDublinIreland
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Alshamrani AM, Al-Rayes OM, Almaslmani AM, Sabr MS, Alfriedy RF, Khalifa AF. Prevalence of obesity and bariatric surgery among medical students in Riyadh, Saudi Arabia. J Family Med Prim Care 2023; 12:3064-3067. [PMID: 38361841 PMCID: PMC10866278 DOI: 10.4103/jfmpc.jfmpc_442_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 01/03/2023] [Accepted: 01/27/2023] [Indexed: 02/17/2024] Open
Abstract
Background Bariatric surgery is considered as a successful weight loss intervention in patients with high body mass index (BMI) and also in patients who are unable to lose weight in a nonsurgical way. Aim To measure the prevalence of obesity among medical students and the association between obesity and lifestyle and obesity and the rate of bariatric surgery in obese students. Method This is a cross sectional study which included 301 medical students in Riyadh. An online pretested and validated questionnaire was distributed among medical students. The collected data included weight, height, family background, lifestyle, and past medical and surgical history. Result Our results demonstrated that the prevalence of overweight, obesity, and morbid obesity was 26.6%, 9.6%, and 6.3%, respectively, among medical students. Only 44.9% of them had a family history of obesity (n = 135). Upon assessment of lifestyle, we found that 58.8% of them had a good lifestyle and 41.2% had a bad lifestyle. We found that 42.5% of medical students included in this study have obesity, and 44% of students had history of obesity in their family. In the obese group, 47.6% had a bad lifestyle. There was significant relationship between obesity and lifestyle among medical students (P = 0.0004). We found that 83.1% of students never thought of undergoing bariatric surgery, 10% of them had thought of undergoing it, and 7% of the students had undergone bariatric surgery. Conclusion the prevalence of obesity is less among medical student in comparison to other subgroups. The educational level and environmental factors play an important role in the prevalence of obesity.
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Mat Azmi ISM, Wallis GA, White MJ, Puig-Ribera A, Eves FF. Desk based prompts to replace workplace sitting with stair climbing; a pilot study of acceptability, effects on behaviour and disease risk factors. BMC Public Health 2022; 22:1985. [PMID: 36316656 PMCID: PMC9620615 DOI: 10.1186/s12889-022-14393-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/19/2022] [Indexed: 12/02/2022] Open
Abstract
Background Prolonged sitting is associated with increased risk of obesity, type 2 diabetes and cardiovascular disease. Occupational sitting accounts for up to 50 h/week for employees. This pilot study assessed the acceptability of stair climbing as an interruption to sitting throughout working hours, and provided preliminary data of the effects on glucose and lipid profiles. Methods A quasi-experimental design was conducted involving 16 sedentary office workers (five females and 11 males) for intervention (n = 8) and control groups (n = 8) with mean age of 36.38 (5.58). For the eight-week intervention, a continuous four-floor stair climb and descent was performed eight times/day spread evenly over the working day. A prompt to climb was presented on the participant’s computer eight times/day. Participants in the experimental group recorded daily floors climbed and steps (measured using pedometers) in a weekly log sheet. Blood samples were collected pre and post intervention to test effects on fasting glucose and 2 h plasma glucose, triglycerides, and total (TC), LDL and HDL cholesterol. Experimental participants were interviewed at the end of the study. The Wilcoxon signed rank test was used to compare the median changes (pre-post) of the dependent variables. Results On average, the experimental group climbed 121 floors/week when prompted. There were significant reductions in fasting blood glucose, TC and LDL, as well as the derived measures of ‘bad’ cholesterol and the TC/HDL ratio in the experimental group. Post-experimental interviews indicated that the interruption to sitting was well tolerated. Conclusion Prompted stair climbing activity had impacts on health outcomes and was found acceptable to employees at work. Trial registration Ethics for this study was approved by Science, Technology, Engineering and Mathematics Ethical Review Committee, University of Birmingham with ethics reference number ERN_15_0491. Supplementary information The online version contains supplementary material available at 10.1186/s12889-022-14393-1.
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Affiliation(s)
- Intan Suhana Munira Mat Azmi
- grid.6572.60000 0004 1936 7486School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK ,grid.449643.80000 0000 9358 3479Community Medicine Unit, Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Medical Campus, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Terengganu Malaysia
| | - Gareth A. Wallis
- grid.6572.60000 0004 1936 7486School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Mike J. White
- grid.6572.60000 0004 1936 7486School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Anna Puig-Ribera
- grid.440820.aCentre for Health and Social Care Research, Department of Physical Activity Sciences, Universitat de Vic-Universitat Central de Catalunya, Barcelona, Spain
| | - Frank F. Eves
- grid.6572.60000 0004 1936 7486School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK ,grid.440820.aCentre for Health and Social Care Research, Department of Physical Activity Sciences, Universitat de Vic-Universitat Central de Catalunya, Barcelona, Spain
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Lam K, Baurecht H, Pahmeier K, Niemann A, Romberg C, Biermann-Stallwitz J, Neusser S, Wasem J, Mugler N, Welker C, Leitzmann M, Jochem C. How effective and how expensive are interventions to reduce sedentary behavior? An umbrella review and meta-analysis. Obes Rev 2022; 23:e13422. [PMID: 35068047 DOI: 10.1111/obr.13422] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/11/2021] [Accepted: 01/03/2022] [Indexed: 01/08/2023]
Abstract
A reduction in sedentary behavior (SB) can contribute to the prevention of chronic diseases. This is the first umbrella review that summarizes the effectiveness and monetary costs of different types of interventions to reduce SB across all age groups and populations in different settings. We comprehensively searched seven databases for systematic reviews and meta-analyses and conducted an umbrella review of the effects of interventions to reduce SB. Additionally, we performed a meta-analysis of primary studies included in the umbrella review. Furthermore, we analyzed health economic aspects of interventions to reduce SB. We included 40 systematic reviews in our umbrella review, with 136 primary studies suitable for further meta-analyses. We found that interventions targeting the physical environment reduce SB most effectively in the majority of populations and settings. Workplace interventions reduced SB by -89.83 min/day (95% CI -124.58 to -55.09; p ≤ 0.0001). Twenty-two of 169 primary studies (13.0%) contained health economic information. The intervention costs per participant ranged from €0 to €3587. Our findings demonstrate that physical environment interventions most effectively reduce SB in a majority of populations and settings. Health economic information was reported in few studies and was mostly restricted to acquisition costs.
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Affiliation(s)
- Kevin Lam
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Kathrin Pahmeier
- Institute for Health Care Management and Research, University of Duisburg-Essen, Duisburg-Essen, Germany
| | - Anja Niemann
- Institute for Health Care Management and Research, University of Duisburg-Essen, Duisburg-Essen, Germany
| | - Carolin Romberg
- Institute for Health Care Management and Research, University of Duisburg-Essen, Duisburg-Essen, Germany
| | - Janine Biermann-Stallwitz
- Institute for Health Care Management and Research, University of Duisburg-Essen, Duisburg-Essen, Germany
| | - Silke Neusser
- Institute for Health Care Management and Research, University of Duisburg-Essen, Duisburg-Essen, Germany
| | - Jürgen Wasem
- Institute for Health Care Management and Research, University of Duisburg-Essen, Duisburg-Essen, Germany
| | - Nida Mugler
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Christine Welker
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Carmen Jochem
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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Collins KA, Huffman KM, Wolever RQ, Smith PJ, Siegler IC, Ross LM, Hauser ER, Jiang R, Jakicic JM, Costa PT, Kraus WE. Determinants of Dropout from and Variation in Adherence to an Exercise Intervention: The STRRIDE Randomized Trials. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022; 7:e000190. [PMID: 35669034 PMCID: PMC9165469 DOI: 10.1249/tjx.0000000000000190] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Purpose This study aimed to characterize the timing and self-reported determinants of exercise dropout among sedentary adults with overweight or obesity. We also sought to explore variations in adherence among individuals who completed a 6- to 8-month structured exercise intervention. Methods A total of 947 adults with dyslipidemia [STRRIDE I, STRRIDE AT/RT] or prediabetes [STRRIDE-PD] were enrolled to either control or to one of 10 exercise interventions, ranging from doses of 8-23 kcal/kg/week; intensities of 50%-75% V̇O2 peak; and durations of 6-8 months. Two groups included resistance training and one included dietary intervention (7% weight loss goal). Dropout was defined as an individual who withdrew from the study due a variety of determinants. Timing of intervention dropout was defined as the last session attended and categorized into phases. Exercise training adherence was calculated by dividing weekly minutes or total sets of exercise completed by weekly minutes or total sets of exercise prescribed. General linear models were used to characterize the associations between timing of dropout and determinant category. Results Compared to exercise intervention completers (n=652), participants who dropped out (n=295) were on average non-white (98% vs. 80%, p<0.01), had higher body mass index (31.0 kg/m2 vs. 30.2 kg/m2; p<0.01), and were less fit at baseline (25.0 mg/kg/min vs. 26.7 ml/kg/min, p<0.01). Of those who dropped out, 67% did so prior to the start of or while ramping up to the prescribed exercise volume and intensity. The most commonly reported reason for dropout was lack of time (40%). Notably, among individuals who completed the ramp training period, subsequent exercise intervention adherence did not waiver over the ensuing 6-8 months of training. Conclusion These findings are some of the first to delineate associations between the timing of dropout and dropout determinants, providing guidance to future exercise interventions to better support individuals at-risk for dropout.
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Affiliation(s)
- Katherine A. Collins
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
| | - Kim M. Huffman
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
- Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, NC, United States
| | - Ruth Q. Wolever
- Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Patrick J. Smith
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Ilene C. Siegler
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Leanna M. Ross
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
| | - Elizabeth R. Hauser
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States
- Cooperative Studies Program Epidemiology Center-Durham, Durham VA Health Care System, Durham, NC, United States
| | - Rong Jiang
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - John M. Jakicic
- Translational Research Institute, Advent Health, Orlando, FL, United States
| | - Paul T. Costa
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - William E. Kraus
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
- Division of Cardiology, Duke University School of Medicine, Durham, NC, United States
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James A, Lawrence B, O’Connor M. Healthy Eating as a New Way of Life: A Qualitative Study of Successful Long-Term Diet Change. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221090397. [PMID: 35418258 PMCID: PMC9016560 DOI: 10.1177/00469580221090397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Improving diet quality has been shown to be an effective way to improve
health and well-being. Yet information on how to assist those wanting to
transition to and maintain a healthier diet is still limited. The aim of
this study was to explore what motivated people to initiate and maintain a
healthy diet. Methods Semi-structured interviews were conducted with 20 participants (all
Australian residents) who had made significant improvements to their diets
and had maintained these changes for a minimum of two years
(nfemale = 15, nmale = 5, Mage = 37.7, SD = 12.4). The transcripts were analysed
using thematic analysis which identified five overarching themes: A desire
to feel better, investigation and learning, helpful habits, benefits, and
values. Results Participants reported a strong wish to feel better and investigated the role
of diet as a possible way to improve well-being. Through daily habits and
continuous engagement with the topic, healthy eating became a way of life
for many participants. Experiencing the benefits of a healthier diet and
having developed strong values regarding diet and health supported long-term
maintenance. Conclusions Findings from the present study contribute to the literature in highlighting
the importance of internal motivation and autonomy for health behaviours.
Findings may inform the development of healthy eating interventions.
Encouraging autonomy, fostering values aligned with a healthier diet, and
helping individuals establish daily habits is likely to support change.
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Affiliation(s)
- Anna James
- WA Cancer Prevention Research Unit, Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Blake Lawrence
- WA Cancer Prevention Research Unit, Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Moira O’Connor
- WA Cancer Prevention Research Unit, Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
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Syrjälä MB, Fharm E, Dempsey PC, Nordendahl M, Wennberg P. Reducing occupational sitting time in adults with type 2 diabetes: Qualitative experiences of an office-adapted mHealth intervention. Diabet Med 2021; 38:e14514. [PMID: 33415777 DOI: 10.1111/dme.14514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/03/2021] [Indexed: 11/28/2022]
Abstract
AIM Understanding barriers and facilitators for limiting occupational sitting and what impact it has on health on those with type 2 diabetes is essential for future trials and intervention development in primary healthcare settings. This study aimed to explore the feasibility and acceptability of an intervention using mobile health (mHealth) technology, together with counselling by a diabetes specialist nurse, to reduce occupational sitting in adults with type 2 diabetes. METHODS Individual semi-structured interviews were conducted in 15 participants with type 2 diabetes who completed a 3-month intervention including mHealth; activity tracker (Garmin Vivofit3) and SMS reminders, one initial face-to-face patient-centred counselling session and three telephone follow-up calls by a diabetes specialist nurse within the primary healthcare system in Sweden. The interviews were recorded, transcribed verbatim and analysed using qualitative content analysis. RESULTS Two themes were identified: (1) 'From baby steps to milestones' reflecting three categories; 'Small changes make it easier to reduce sitting', 'Encouraged by trustworthy coaching', 'Physical and mental rewards matter' and (2) 'Tailoring strategies that fit me and my workplace' reflecting four categories; 'It's up to me', 'Taking advantage of the support', 'Using creativity to find practical solutions for interrupting sitting' and 'Living up to expectations'. CONCLUSION The intervention was perceived as feasible and acceptable in different office workplaces, and led to increased awareness of sedentary behaviour in adults with type 2 diabetes. Stepwise goal setting together with personalization of the mHealth intervention should be emphasized in individual type 2 diabetes programmes aiming to reduce workplace sitting.
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Affiliation(s)
- Maria B Syrjälä
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Eva Fharm
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Paddy C Dempsey
- Baker Heart and Diabetes Institute, Melbourne, Australia
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Maria Nordendahl
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
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9
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Rawlings GH, Williams RK, Clarke DJ, English C, Fitzsimons C, Holloway I, Lawton R, Mead G, Patel A, Forster A. Exploring adults' experiences of sedentary behaviour and participation in non-workplace interventions designed to reduce sedentary behaviour: a thematic synthesis of qualitative studies. BMC Public Health 2019; 19:1099. [PMID: 31409324 PMCID: PMC6692932 DOI: 10.1186/s12889-019-7365-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 07/24/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sedentary behaviour is any waking behaviour characterised by an energy expenditure of ≤1.5 metabolic equivalent of task while in a sitting or reclining posture. Prolonged bouts of sedentary behaviour have been associated with negative health outcomes in all age groups. We examined qualitative research investigating perceptions and experiences of sedentary behaviour and of participation in non-workplace interventions designed to reduce sedentary behaviour in adult populations. METHOD A systematic search of seven databases (MEDLINE, AMED, Cochrane, PsychINFO, SPORTDiscus, CINAHL and Web of Science) was conducted in September 2017. Studies were assessed for methodological quality and a thematic synthesis was conducted. Prospero database ID: CRD42017083436. RESULTS Thirty individual studies capturing the experiences of 918 individuals were included. Eleven studies examined experiences and/or perceptions of sedentary behaviour in older adults (typically ≥60 years); ten studies focused on sedentary behaviour in people experiencing a clinical condition, four explored influences on sedentary behaviour in adults living in socio-economically disadvantaged communities, two examined university students' experiences of sedentary behaviour, two on those of working-age adults, and one focused on cultural influences on sedentary behaviour. Three analytical themes were identified: 1) the impact of different life stages on sedentary behaviour 2) lifestyle factors influencing sedentary behaviour and 3) barriers and facilitators to changing sedentary behaviour. CONCLUSIONS Sedentary behaviour is multifaceted and influenced by a complex interaction between individual, environmental and socio-cultural factors. Micro and macro pressures are experienced at different life stages and in the context of illness; these shape individuals' beliefs and behaviour related to sedentariness. Knowledge of sedentary behaviour and the associated health consequences appears limited in adult populations, therefore there is a need for provision of accessible information about ways in which sedentary behaviour reduction can be integrated in people's daily lives. Interventions targeting a reduction in sedentary behaviour need to consider the multiple influences on sedentariness when designing and implementing interventions.
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Affiliation(s)
- G H Rawlings
- Department of Clinical Psychology, University of Sheffield, Sheffield, UK
| | - R K Williams
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Temple Bank House, University of Leeds, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - D J Clarke
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Temple Bank House, University of Leeds, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK.
| | - C English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
| | - C Fitzsimons
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - I Holloway
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - R Lawton
- School of Psychology, University of Leeds, Leeds, UK
| | - G Mead
- Geriatric Medicine, Division of Health Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - A Patel
- Anita Patel Health Economics Consulting Ltd, London, UK
| | - A Forster
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Temple Bank House, University of Leeds, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
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10
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Abstract
Leisure-time sedentary behavior is an emerging modifiable risk factor for cancer. We estimated the proportion of cancers attributed to leisure-time sedentary behavior as a separate risk factor from physical activity in Canada for 2015. We projected numbers of future avoidable cancers by 2042 using various assumed levels of reduced leisure-time sedentary behavior in the population. We calculated population attributable risks (PAR) for associated cancers and all-cancers associated with leisure-time sedentary behavior. Our analysis used pooled data on leisure-time sedentary behavior from the Canadian Community Health Survey (CCHS), and incident cancer data from the Canadian Cancer Registry (CCR). Survey respondents were categorized into three levels of leisure-time sedentary behavior, "<3 h/day", "≥3-<6 h/day", and "≥6 h/day". Estimates for the future burden of leisure-time sedentary behavior were calculated using the potential impact fractions framework (PIF) and counterfactual scenarios, from 10% to 50% decreases in leisure-time sedentary behavior. The estimated prevalence of leisure-time sedentary behavior at the highest level (≥6 h/day) in Canada during the 2000s was 9.9% among both sexes combined across age-groups. The total attributable burden due to leisure-time sedentary behavior was estimated to be 10.3% for associated cancers and 6.5% for all-cancers in 2015. A 50% reduction in leisure-time sedentary behavior across the Canadian population could avoid 4054 cancers by 2042. We estimated that over 3000 cancer cases in Canada were attributable to leisure-time sedentary behavior in 2015, and that that 4054 incident cancer cases could be prevented by 2042 with meaningful reductions in leisure-time sedentary behavior.
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11
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Paz-Krumdiek M, Rodriguez-Vélez SG, Mayta-Tristán P, Bernabe-Ortiz A. Association between sitting time and obesity: A population-based study in Peru. Nutr Diet 2019; 77:189-195. [PMID: 30997733 DOI: 10.1111/1747-0080.12540] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/12/2019] [Accepted: 03/17/2019] [Indexed: 01/27/2023]
Abstract
AIM To assess if there is an association between sitting time and obesity among adult Peruvian population, using three different anthropometric measurements. METHODS A secondary analysis using data from a population-based study, the National Household Survey (ENAHO, in Spanish), was conducted enrolling adults aged ≥18 years from the 25 regions of Peru using a multistage random sampling technique. The outcome of interest was obesity, determined by body mass index (BMI > 30 kg/m2 ), waist circumference (WC > 80 and >90 cm in women and men, respectively) and waist to height ratio (WHR > 0.5); while the exposure was sitting time, measured using the last domain of the International Physical Activity Questionnaire and then categorised in <4 hours/day, 4 to <8 hours/day and 8+ hours/day. Associations were estimated using Poisson regression models, reporting prevalence ratios (PRs) and their respective 95% CI. RESULTS Data from 8587 subjects were analysed; mean age was 38.4 (SD: 13.5) and 53.6% were females. The prevalence of obesity was 16.3% (95% CI: 15.2-17.5%) by BMI, 58.5% (95% CI: 56.9-60.0%) by WC, and 78.0% (95% CI: 76.5-79.3%) by WHR. In the multivariable model, subjects reporting a sitting time of 8+ hours/day were more likely to be obese than those reporting <4 hours/day according to BMI (PR: 1.38; 95% CI: 1.15-1.65), WC (PR: 1.20; 95% CI: 1.12-1.28) and WHR (PR: 1.05; 95% CI: 1.01-1.10). CONCLUSIONS Subjects with greater sitting time were more likely to be obese, and this association was evident with three different anthropometric indicators. Findings suggest the need of generating public health actions to reduce sedentary behaviour.
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Affiliation(s)
- Melissa Paz-Krumdiek
- Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | | | - Percy Mayta-Tristán
- Dirección de Investigación y Desarrollo, Universidad Científica del Sur, Lima, Peru
| | - Antonio Bernabe-Ortiz
- Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.,CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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12
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Webber SC, Ripat JD, Pachu NS, Strachan SM. Exploring physical activity and sedentary behaviour: perspectives of individuals with osteoarthritis and knee arthroplasty. Disabil Rehabil 2019; 42:1971-1978. [DOI: 10.1080/09638288.2018.1543463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Sandra C. Webber
- Rady Faculty of Health Sciences, Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Jacquie D. Ripat
- Rady Faculty of Health Sciences, Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Navjot S. Pachu
- Applied Health Sciences Program, University of Manitoba, Winnipeg, Canada
| | - Shaelyn M. Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada
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13
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Pons-Vigués M, Pujol-Ribera E, Berenguera A, Violán C, Mahtani-Chugani V. [Public participation in research from the perspective of primary health care researchers]. GACETA SANITARIA 2018; 33:536-546. [PMID: 30337182 DOI: 10.1016/j.gaceta.2018.05.011] [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: 02/13/2018] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Explore the strengths, weaknesses, opportunities and threats (SWOT) for development of public involvement in research by Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol) according to primary health care researchers in Catalonia (Spain). METHODS Cross-sectional study carried out in 2017 with 36 primary health care research teams accredited by IDIAPJGol and its management staff. An open questionnaire (paper and online) was designed and piloted to develop a SWOT technique, and 65 answers were obtained (14 in paper and 51 online). A thematic content analysis was carried out. RESULTS Most informants consider public involvement in research a useful, innovative, viable and essential strategy, but it requires a change of mentality and a move away from the hierarchical paradigm. It can be difficult to execute and can complicate studies. They are concerned about which citizens should be involve, how to select them, possible conflicts of interest and training needs. The main proposals for its implementation are to disseminate previous strategies, encourage motivation and synergies among citizens, researchers and institutions, and to clarify the roles of the actors involved. IDIAPJGol should develop recommendations for the public involvement in research, encourage their inclusion, have a mentor and advise the research teams. CONCLUSIONS Despite the challenges, developing public involvement in research in primary health care is essential and feasible, what it is more should be based on a participatory strategy with all actors. The citizens can participate in any kind of design and phase of the research, adapting each project, being the primary health care a privileged area to develop the public involvement in research.
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Affiliation(s)
- Mariona Pons-Vigués
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, España; Facultat d'Infermeria, Universitat de Girona, Girona, España.
| | - Enriqueta Pujol-Ribera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, España; Facultat d'Infermeria, Universitat de Girona, Girona, España
| | - Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, España
| | - Concepción Violán
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, España
| | - Vinita Mahtani-Chugani
- Unidad de Investigación, Hospital Nuestra Señora de la Candelaria y Gerencia de Atención Primaria de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España
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14
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Solomon TPJ, Eves FF, Laye MJ. Targeting Postprandial Hyperglycemia With Physical Activity May Reduce Cardiovascular Disease Risk. But What Should We Do, and When Is the Right Time to Move? Front Cardiovasc Med 2018; 5:99. [PMID: 30073171 PMCID: PMC6058032 DOI: 10.3389/fcvm.2018.00099] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/02/2018] [Indexed: 01/14/2023] Open
Abstract
Physical inactivity and excessive postprandial hyperglycemia are two major independent risk factors for type 2 diabetes and cardiovascular-related mortality. Current health policy guidelines recommend at least 150 min of physical activity per week coupled with reduced daily sedentary behavior by interrupting prolonged sitting with bouts of light activity every 30-min. This evidence-based strategy promotes health and quality of life. Since modern lifestyle enforces physical inactivity through motorized transportation and seated office working environments, this review examines the practical strategies (standing, walking, stair climbing, and strength-based circuit exercises) for reducing sitting time and increasing activity during the workday. Furthermore, since postprandial hyperglycemia poses the greatest relative risk for developing type 2 diabetes and its cardiovascular complications, this review examines a novel hypothesis that interrupting sitting time would be best focused on the postprandial period in order to optimize blood glucose control and maximize cardiometabolic health. In doing so, we aim to identify the science gaps which urgently need filling if we are to optimize healthcare policy in this critical area.
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Affiliation(s)
- Thomas P J Solomon
- School of Sport, Exercise, and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, United Kingdom.,Institute of Systems and Metabolism Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, United Kingdom
| | - Frank F Eves
- School of Sport, Exercise, and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, United Kingdom
| | - Matthew J Laye
- Department of Health and Human Performance, College of Idaho, Caldwell, ID, United States
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15
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Patterns of sedentary behavior in overweight and moderately obese users of the Catalan primary-health care system. PLoS One 2018; 13:e0190750. [PMID: 29370176 PMCID: PMC5784913 DOI: 10.1371/journal.pone.0190750] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 12/15/2017] [Indexed: 11/27/2022] Open
Abstract
Background and objectives Prolonged sitting time (ST) has negative consequences on health. Changing this behavior is paramount in overweight/obese individuals because they are more sedentary than those with normal weight. The aim of the study was to establish the pattern of sedentary behavior and its relationship to health, socio-demographics, occupation, and education level in Catalan overweight/obese individuals. Methods A descriptive study was performed at 25 healthcare centers in Catalonia (Spain) with 464 overweight/moderately obese patients, aged25 to 65 years. Exclusion criteria were chronic diseases which contraindicated physical activity and language barriers. Face-to-face interviews were conducted to collect data on age, gender, educational level, social class, and marital status. Main outcome was ‘sitting time’ (collected by the Marshall questionnaire); chronic diseases and anthropometric measurements were registered. Results 464 patients, 58.4% women, mean age 51.9 years (SD 10.1), 76.1% married, 60% manual workers, and 48.7% had finished secondary education. Daily sitting time was 6.2 hours on working days (374 minutes/day, SD: 190), and about 6 hours on non-working ones (357 minutes/day, SD: 170). 50% of participants were sedentary ≥6 hours. The most frequent sedentary activities were: working/academic activities around 2 hours (128 minutes, SD: 183), followed by watching television, computer use, and commuting. Men sat longer than women (64 minutes more on working days and 54 minutes on non-working days), and individuals with office jobs (91 minutes),those with higher levels of education (42 minutes), and younger subjects (25 to 35 years) spent more time sitting. Conclusions In our study performed in overweight/moderately obese patients the mean sitting time was around 6 hours which was mainly spent doing work/academic activities and watching television. Men, office workers, individuals with higher education, and younger subjects had longer sitting time. Our results may help design interventions targeted at these sedentary patients to decrease sitting time.
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16
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Biswas A, Faulkner GE, Oh PI, Alter DA. Patient and practitioner perspectives on reducing sedentary behavior at an exercise-based cardiac rehabilitation program. Disabil Rehabil 2017; 40:2267-2274. [PMID: 28583032 DOI: 10.1080/09638288.2017.1334232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To understand the awareness of sedentary behavior, as well as the perceived facilitators and barriers to reducing sedentary behaviors from the perspectives of patients undertaking an exercise-based cardiac rehabilitation program, and from staff involved in supporting patient self-management. MATERIALS AND METHODS A qualitative study was conducted at a large cardiac rehabilitation program in a metropolitan city in Canada. Guided by an ecological framework, semi-structured interviews were conducted individually with 15 patients, and in two focus groups with six staff. Transcribed interviews were analyzed by thematic analysis. RESULTS Patients placed little importance on reducing sedentary behavior as they were unconvinced of the health benefits, did not perceive themselves to be sedentary, or associated such behaviors with enjoyment and relaxation. While staff were aware of the risks, they saw them as less critical than other health behaviors. Intrapersonal factors (physical and psychosocial health) and environment factors (the information environment, socio-cultural factors) within leisure time, the home, and work, influenced sedentary behavior. CONCLUSIONS While these findings require further testing, future interventions may be effective if aimed at increasing awareness of the health benefits of reducing sedentary behavior, utilizing existing behavior change strategies, and using a participatory approach to tailor strategies to patients. Implications for rehabilitation Cardiac rehabilitation programs effectively use exercise promotion to improve the health of people with established cardiovascular disease. As sedentary lifestyles become more prevalent, recommendations to reduce the health risks of prolonged sedentary behavior that are specific to the characteristics and prognostic profiles of cardiac rehabilitation patients are needed. Cardiac rehabilitation programs must consider extending existing behavior change strategies utilized for exercise promotion towards addressing sedentary behaviors in order to be effective at reducing the sedentary time of patients. A participatory approach involving both patients and health professionals can support patients in reducing their sedentary behavior by providing a supportive environment for behavior change, increasing awareness and understanding of risks, discussing the feasibility of potential strategies, and setting achievable and actionable goals.
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Affiliation(s)
- Aviroop Biswas
- a Institute of Health Policy, Management & Evaluation , University of Toronto , Toronto , Canada
| | - Guy E Faulkner
- b School of Kinesiology , University of British Columbia , Vancouver , Canada
| | - Paul I Oh
- c University Health Network, Toronto Rehabilitation Institute , Toronto , Canada
| | - David A Alter
- c University Health Network, Toronto Rehabilitation Institute , Toronto , Canada
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17
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Burgess E, Hassmén P, Pumpa KL. Determinants of adherence to lifestyle intervention in adults with obesity: a systematic review. Clin Obes 2017; 7:123-135. [PMID: 28296261 DOI: 10.1111/cob.12183] [Citation(s) in RCA: 249] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 12/01/2022]
Abstract
Lifestyle intervention programmes are efficacious in the management of obesity but often report poor attendance and adherence rates that hinder treatment effectiveness and health outcomes. The aim of this systematic review is to identify (i) barriers to behaviour change and (ii) predictors of adherence to lifestyle intervention programmes in adults with obesity. Studies were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from inception to August 2016. Barriers to behaviour change include poor motivation; environmental, societal and social pressures; lack of time; health and physical limitations; negative thoughts/moods; socioeconomic constraints; gaps in knowledge/awareness; and lack of enjoyment of exercise. The most prominent predictors of adherence include early weight loss success, lower baseline body mass index (BMI), better baseline mood, being male and older age. The findings within this review provide novel insight to clinicians working in obesity and have important implications for lifestyle intervention programme design. Barriers to behaviour change need to be addressed early in treatment, with lifestyle intervention individualized accordingly. Predictors of adherence should also be taken into careful consideration, with negative moods and unrealistic weight loss expectations discussed at the outset. If adherence is improved, treatment effectiveness, health outcomes and the ultimate burden of chronic diseases could also be improved.
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Affiliation(s)
- E Burgess
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australia
| | - P Hassmén
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australia
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
| | - K L Pumpa
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australia
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, Australia
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