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Cha JY, Kim SY, Lim YW, Choi KH, Shin IS. Comparative Effectiveness of Cognitive Behavioral Therapy and Behavioral Therapy in Obesity: A Systematic Review and Network Meta-Analysis. J Clin Psychol Med Settings 2024:10.1007/s10880-023-10000-6. [PMID: 38285378 DOI: 10.1007/s10880-023-10000-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
We aimed to evaluate the effects of obesity treatment with behavioral therapy (BT) and cognitive behavioral therapy (CBT) interventions compared with multiple comparators and find effective techniques or combinations of techniques in BT and CBT interventions for weight loss. We systematically searched electronic databases and selected randomized controlled trials using CBT or BT intervention for obesity treatment in overweight adults or adults with obesity without psychological symptoms. Both pairwise meta-analysis and network meta-analysis were performed to comprehensively evaluate the comparative effects between interventions. We classified the techniques used in BT and CBT interventions and compared the treatment effects between techniques. Compared with no treatment as a common comparator, CBT was most effective for weight loss, followed by BT, usual care (UC), and minimal care (MC). CBT was a more effective intervention than BT, but the effect of CBT compared to BT was not remarkable in network estimates. The most used BT techniques were feedback and monitoring, and the most used CBT technique was cognitive restructuring. Our results indicated that CBT and BT are effective interventions for weight loss, and that successful weight loss requires more aggressive interventions such as BT or CBT than MC and UC.
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Affiliation(s)
- Jin-Young Cha
- Nubebe Obesity Research Institute, Seoul, South Korea
| | - Seo-Young Kim
- Nubebe Obesity Research Institute, Seoul, South Korea
- Nubebe Korean Medical Clinic (Incheon Center), Incheon, South Korea
| | - Young-Woo Lim
- Nubebe Obesity Research Institute, Seoul, South Korea
- Nubebe Korean Medical Clinic (Bundang Center), Seongnam, South Korea
| | - Ka-Hye Choi
- Nubebe Korean Medical Clinic (Hongdae Center), Seoul, South Korea
| | - In-Soo Shin
- Graduate School of Education, Dongguk University, 30, Pildong-ro 1 gil, Jung-gu, Seoul, 04620, South Korea.
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Jiménez-Mérida MR, Vaquero-Abellán M, Alcaide-Leyva JM, Cantón-Habas V, Raya-Cano E, Romero-Saldaña M. Effectiveness of Multicomponent Interventions and Physical Activity in the Workplace to Reduce Obesity: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:healthcare11081160. [PMID: 37107994 PMCID: PMC10137796 DOI: 10.3390/healthcare11081160] [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: 03/10/2023] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Overweight and obesity are public health problems that affects the workplace. This paper aims to analyse the effectiveness of workplace health promotion interventions in reducing Body Mass Index (BMI); Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, MEDLINE, and SCOPUS databases. The inverse variance statistical method was used for the meta-analysis with a random effects analysis model and standardised means. The results have been represented by Forest Plots and Funnel Plots graphs; Results: The multicomponent approach had the best results for reducing BMI (-0.14 [-0.24, -0.03], 95% CI; p = 0.009) compared to performing physical activity only (-0.09 [-0.39, 0.21], 95% CI; p = 0.56). However, both methods resulted in positive changes in reducing BMI in the general analysis (-0.12 [-0.22, -0.02], 95% CI; p = 0.01). The GRADE evaluation showed low certainty due to the high heterogeneity between interventions (I2 = 59% for overall analysis). CONCLUSIONS The multicomponent approach could be an effective intervention to reduce obesity in the working population. However, workplace health promotion programs must be standardised to conduct quality analyses and highlight their importance to workers' well-being.
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Affiliation(s)
- M Rocío Jiménez-Mérida
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Manuel Vaquero-Abellán
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - José M Alcaide-Leyva
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Vanesa Cantón-Habas
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Elena Raya-Cano
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Manuel Romero-Saldaña
- Grupo Asociado de Investigación GA16 Estilos de Vida, Tecnología y Salud, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
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Description of a Hybrid Mindfulness-Integrated Multidisciplinary Workplace Weight Management Intervention Module ‘Mind-SLIMSHAPE’ Using the TIDieR Checklist. Nutrients 2022; 14:nu14153140. [PMID: 35956318 PMCID: PMC9370606 DOI: 10.3390/nu14153140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 12/10/2022] Open
Abstract
Published reports of workplace-based weight management interventions are often poorly described and are focused on dietary, physical, and behavioral management. These strategies are often unsustainable and only have short-term effectiveness. The Mind-SLIMSHAPETM is a mindfulness-integrated multidisciplinary intervention developed to address overweight and obesity problems among desk-bound employees while improving weight-related behavior through mindfulness meditation and mindful eating exercises. The integration of mindfulness and mindful eating aims to improve the individual’s focus on the present and heighten their sensitivity towards internal and external eating cues. The aim of this article is to describe the Mind-SLIMSHAPETM intervention program using The Template for Intervention Description and Replication (TIDieR) checklist. The Mind-SLIMSHAPETM module is a 24-week intervention program that was delivered in a quasi-experimental study among employees with BMI ≥ 25.0 kg/m² in a selected higher learning institution. The module was delivered via hybrid sessions that included both face-to-face and virtual online sessions. The novelty of our description includes summaries of each intervention component with its intensity, details of the theory grounded for this program, and the rationale for the intervention components. The Mind-SLIMSHAPETM module is ready to be implemented and replicated in a similar setting with possible refinement and enhancement of the mindfulness and mindful eating elements.
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Kim SY, Shin IS, Park YJ. Comparative effectiveness of a low-calorie diet combined with acupuncture, cognitive behavioral therapy, meal replacements, or exercise for obesity over different intervention periods: A systematic review and network meta-analysis. Front Endocrinol (Lausanne) 2022; 13:772478. [PMID: 36093081 PMCID: PMC9458910 DOI: 10.3389/fendo.2022.772478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 08/09/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the comparative effectiveness of a low-calorie diet (LCD) combined with acupuncture, cognitive behavioral therapy (CBT), meal replacements (MR), and exercise on weight loss. METHODS The electronic databases MEDLINE, EMBASE, CENTRAL, CNKI, RISS, and KISS were searched systematically. Randomized controlled trials (RCTs) that directly compared the effect of a low-calorie diet (LCD)-combined acupuncture, CBT, and exercise and an MR-based diet on weight loss with LCD-alone for adults with simple obesity (body mass index [BMI] > 25) published before August 2021 were included in the study. Two investigators extracted and coded the data using a template. Any disagreements between investigators were resolved through discussion. Changes in BMI or weight were transformed to Hedges' g values with a 95% CI, and network meta-analyses using a Bayesian random-effects model were conducted. RESULTS A total of thirty-two trials involving 3,364 patients were finally included in the study. The effect sizes of four interventions were medium, in the order of acupuncture (Hedges' g = 0.48, 95% CI = 0.25 - 0.71), CBT (Hedges' g = 0.42, 95% CI = 0.20 - 0.63), MR (Hedges' g = 0.32, 95% CI = 0.19 - 0.45), and exercise (Hedges' g = 0.27, 95% CI = 0.06 - 0.46).In terms of intervention period, acupuncture was effective in the short period (≤ 12 weeks, Hedges' g = 0.39, 95% CI = 0.12 - 0.67) and the long period (>12 weeks, Hedges' g = 0.89, 95% CI = 0.37 - 1.40), whereas CBT (Hedges' g = 0.51, 95% CI = 0.26 - 0.76) and exercise (Hedges' g = 0.37, 95% CI = 0.12 - 0.59) were effective only in the long period. MR was effective only in the short period (Hedges' g = 0.35, 95% CI = 0.18 - 0.53). CONCLUSIONS This study suggests that acupuncture, CBT, MR, and exercise for simple obesity show a medium effect size, and their effectiveness differs according to the intervention period.
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Affiliation(s)
- Seo-Young Kim
- Department of Biofunctional Medicine & Diagnostics of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - In-Soo Shin
- Department of Transdisciplinary Security, Dongguk University, Seoul, South Korea
| | - Young-Jae Park
- Department of Biofunctional Medicine & Diagnostics of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
- Department of Biofunctional Medicine & Diagnostics, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
- Department of Diagnosis and Biofunctional Medicine, College of Korean Medicine Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
- *Correspondence: Young-Jae Park,
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Peñalvo JL, Sagastume D, Mertens E, Uzhova I, Smith J, Wu JHY, Bishop E, Onopa J, Shi P, Micha R, Mozaffarian D. Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2021; 6:e648-e660. [PMID: 34454642 PMCID: PMC8627548 DOI: 10.1016/s2468-2667(21)00140-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 12/17/2022]
Abstract
Background The workplace offers a unique opportunity for effective health
promotion. We aimed to comprehensively study the effectiveness of
multicomponent worksite wellness programmes for improving diet and
cardiometabolic risk factors. Methods We did a systematic literature review and meta-analysis, following
PRISMA guidelines. We searched PubMed-MEDLINE, Embase, the Cochrane Library,
Web of Science, and Education Resources Information Center, from Jan 1,
1990, to June 30, 2020, for studies with controlled evaluation designs that
assessed multicomponent workplace wellness programmes. Investigators
independently appraised the evidence and extracted the data. Outcomes were
dietary factors, anthropometric measures, and cardiometabolic risk factors.
Pooled effects were calculated by inverse-variance random-effects
meta-analysis. Potential sources of heterogeneity and study biases were
evaluated. Findings From 10 169 abstracts reviewed, 121 studies (82 [68%] randomised
controlled trials and 39 [32%] quasi-experimental interventions) met the
eligibility criteria. Most studies were done in North America (57 [47%]),
and Europe, Australia, or New Zealand (36 [30%]). The median number of
participants was 413·0 (IQR 124·0–904·0), and
median duration of intervention was 9·0 months
(4·5–18·0). Workplace wellness programmes improved
fruit and vegetable consumption (0·27 servings per day [95% CI
0·16 to 0·37]), fruit consumption (0·20 servings per
day [0·11 to 0·28]), body-mass index (−0·22
kg/m2 [−0·28 to −0·17]), waist
circumference (−1·47 cm [−1·96 to
−0·98]), systolic blood pressure (−2·03 mm Hg
[−3·16 to −0·89]), and LDL cholesterol
(−5·18 mg/dL [−7·83 to −2·53]),
and to a lesser extent improved total fat intake (−1·18% of
daily energy intake [−1·78 to −0·58]), saturated
fat intake (−0·70% of daily energy [−1·22 to
−0·18]), bodyweight (−0·92 kg
[−1·11 to −0·72]), diastolic blood pressure
(−1·11 mm Hg [−1·78 to −0·44]),
fasting blood glucose (−1·81 mg/dL [−3·33 to
−0·28]), HDL cholesterol (1·11 mg/dL [0·48 to
1·74]), and triglycerides (−5·38 mg/dL
[−9·18 to −1·59]). No significant benefits were
observed for intake of vegetables (0·03 servings per day [95% CI
−0·04 to 0·10]), fibre (0·26 g per day
[−0·15 to 0·67]), polyunsaturated fat
(−0·23% of daily energy [−0·59 to 0·13]),
or for body fat (−0·80% [−1·80 to 0·21]),
waist-to-hip ratio (−0·00 ratio [−0·01 to
0·00]), or lean mass (1·01 kg [−0·82 to
2·83]). Heterogeneity values ranged from 46·9% to
91·5%. Between-study differences in outcomes were not significantly
explained by study design, location, population, or similar factors in
heterogeneity analyses. Interpretation Workplace wellness programmes are associated with improvements in
specific dietary, anthropometric, and cardiometabolic risk indicators. The
heterogeneity identified in study designs and results should be considered
when using these programmes as strategies to improve cardiometabolic
health.
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Affiliation(s)
- José L Peñalvo
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Diana Sagastume
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Elly Mertens
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Irina Uzhova
- Department of Health and Nutritional Sciences, Institute of Technology Sligo, Sligo, Ireland
| | - Jessica Smith
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; Bell Institute of Health and Nutrition, General Mills, Minneapolis, MN, USA
| | - Jason H Y Wu
- George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Eve Bishop
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jennifer Onopa
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; Department of Food Science and Human Nutrition, University of Thessaly, Thessaly, Greece
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Jones RA, Lawlor ER, Birch JM, Patel MI, Werneck A, Hoare E, Griffin SJ, van Sluijs EM, Sharp SJ, Ahern AL. The impact of adult behavioural weight management interventions on mental health: A systematic review and meta-analysis. Obes Rev 2021; 22:e13150. [PMID: 33103340 PMCID: PMC7116866 DOI: 10.1111/obr.13150] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/04/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022]
Abstract
There is good evidence that behavioural weight management interventions improve physical health; however, the impact on mental health remains unclear. We evaluated the impact of behavioural weight management interventions on mental health-related outcomes in adults with overweight or obesity at intervention-end and 12 months from baseline. Eligible studies were randomized controlled trials (RCTs) or cluster RCTs of adult behavioural weight loss interventions reporting affect, anxiety, binge eating, body image, depression, emotional eating, quality of life, self-esteem and stress. We searched seven databases from inception to 7 May 2019 and included 43 articles reporting 42 RCTs. Eighteen studies were deemed to be at high risk of bias. We conducted random-effects meta-analyses, stratified analyses and meta-regression using Stata. Interventions generated greater improvements than comparators for depression, mental health-related quality of life and self-efficacy at intervention-end and 12 months from baseline. There was no difference between groups for anxiety, overall quality of life, self-esteem or stress at intervention-end. There was insufficient evidence to assess the impact on anxiety, binge eating, body image, emotional eating, affect, life satisfaction, self-esteem or stress at intervention-end and/or 12 months from baseline. Although evidence suggests that interventions benefit some aspects of mental health, high-quality, transparently reported RCTs measuring a range of mental health outcomes over longer durations are required to strengthen the evidence base.
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Affiliation(s)
| | - Emma R. Lawlor
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Jack M. Birch
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Manal I. Patel
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Andre Werneck
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Erin Hoare
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Food and Mood Centre, Centre for Innovation in Mental and Physical Health and Clinical Treatment, School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC 3004, Australia
| | - Simon J. Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Esther M.F. van Sluijs
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | | | - Amy L. Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Peer Support in the Treatment of Chronic Pain in Adolescents: A Review of the Literature and Available Resources. CHILDREN-BASEL 2020; 7:children7090129. [PMID: 32906581 PMCID: PMC7552767 DOI: 10.3390/children7090129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 11/19/2022]
Abstract
Peer support has found applications beyond the mental health field and is useful for managing several chronic disorders and supporting healthy lifestyle choices. Communication through telephone and the Internet allows for greater access to those who cannot meet in person. Adolescent chronic pain would seem ideally suited to benefit from online peer support groups. Research is lacking, however, to characterize benefit in terms of pain and function, despite a clear desire among adolescents for access to such programs. More rapid development of online applications is needed for peer support, and research into the associated outcomes will be necessary to optimally design such programs.
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Comșa L, David O, David D. Outcomes and mechanisms of change in cognitive-behavioral interventions for weight loss: A meta-analysis of randomized clinical trials. Behav Res Ther 2020; 132:103654. [PMID: 32683134 DOI: 10.1016/j.brat.2020.103654] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To evaluate the efficacy of CBT in relation to weight loss and related psychological components and to analyze the relationship between alleged cognitive mechanisms of change and weight loss. METHODS The studies we considered eligible were the randomized clinical trials which included and reported a quantitative assessment of change in weight and of potential cognitive mechanisms of successful change in weight and comparing at least one active CBT intervention with a control for adults. RESULTS We included 16 studies (18 contrasts) with a total of 1.663 participants. The pooled ESs in which a CBT-intervention was compared to a control condition for weight loss, was Hedges' g= 0.31 (95% CI 0.04 to 0.58) favoring CBT and for cognitive factors was g = 0.37 (95% CI 0.22 to 0.45). Results indicated a significant association between motivation outcomes ESs (slope= 0.992, 95% CI 0.13 to 1.85, p =0.02) and selfefficacy ESs (slope= 1.59, 95% CI 0.24 to 2.94, p =0.02) and weight outcomes. DISCUSSION Current evidence suggests that CBT is effective in weight loss. Clinicians will be more effective if they add to their weight loss interventions components for increasing the motivation and self-efficacy of their patients.
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Affiliation(s)
- Loana Comșa
- Doctoral School of Evidence-based Assessment and Psychological Interventions, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Oana David
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Republicii Street 37, 400015, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj- Napoca, Romania.
| | - Daniel David
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Republicii Street 37, 400015, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj- Napoca, Romania; Icahn School of Medicine at Mount Sinai, New York, USA
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Gray ID, Kross AR, Renfrew ME, Wood P. Precision Medicine in Lifestyle Medicine: The Way of the Future? Am J Lifestyle Med 2020; 14:169-186. [PMID: 32231483 PMCID: PMC7092395 DOI: 10.1177/1559827619834527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/21/2018] [Accepted: 02/08/2019] [Indexed: 02/06/2023] Open
Abstract
Precision medicine has captured the imagination of the medical community with visions of therapies precisely targeted to the specific individual's genetic, biological, social, and environmental profile. However, in practice it has become synonymous with genomic medicine. As such its successes have been limited, with poor predictive or clinical value for the majority of people. It adds little to lifestyle medicine, other than in establishing why a healthy lifestyle is effective in combatting chronic disease. The challenge of lifestyle medicine remains getting people to actually adopt, sustain, and naturalize a healthy lifestyle, and this will require an approach that treats the patient as a person with individual needs and providing them with suitable types of support. The future of lifestyle medicine is holistic and person-centered rather than technological.
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Affiliation(s)
- Ian D. Gray
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Andrea R. Kross
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Melanie E. Renfrew
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Paul Wood
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
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10
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Mulchandani R, Chandrasekaran AM, Shivashankar R, Kondal D, Agrawal A, Panniyammakal J, Tandon N, Prabhakaran D, Sharma M, Goenka S. Effect of workplace physical activity interventions on the cardio-metabolic health of working adults: systematic review and meta-analysis. Int J Behav Nutr Phys Act 2019; 16:134. [PMID: 31856826 PMCID: PMC6923867 DOI: 10.1186/s12966-019-0896-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 12/04/2019] [Indexed: 02/02/2023] Open
Abstract
Background Adults in urban areas spend almost 77% of their waking time being inactive at workplaces, which leaves little time for physical activity. The aim of this systematic review and meta-analysis was to synthesize evidence for the effect of workplace physical activity interventions on the cardio-metabolic health markers (body weight, waist circumference, body mass index (BMI), blood pressure, lipids and blood glucose) among working adults. Methods All experimental studies up to March 2018, reporting cardio-metabolic worksite intervention outcomes among adult employees were identified from PUBMED, EMBASE, COCHRANE CENTRAL, CINAHL and PsycINFO. The Cochrane Risk of Bias tool was used to assess bias in studies. All studies were assessed qualitatively and meta-analysis was done where possible. Forest plots were generated for pooled estimates of each study outcome. Results A total of 33 studies met the eligibility criteria and 24 were included in the meta-analysis. Multi-component workplace interventions significantly reduced body weight (16 studies; mean diff: − 2.61 kg, 95% CI: − 3.89 to − 1.33) BMI (19 studies, mean diff: − 0.42 kg/m2, 95% CI: − 0.69 to − 0.15) and waist circumference (13 studies; mean diff: − 1.92 cm, 95% CI: − 3.25 to − 0.60). Reduction in blood pressure, lipids and blood glucose was not statistically significant. Conclusions Workplace interventions significantly reduced body weight, BMI and waist circumference. Non-significant results for biochemical markers could be due to them being secondary outcomes in most studies. Intervention acceptability and adherence, follow-up duration and exploring non-RCT designs are factors that need attention in future research. Prospero registration number: CRD42018094436.
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Affiliation(s)
- Rubina Mulchandani
- Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, India
| | | | | | - Dimple Kondal
- Centre for Chronic Disease Control, New Delhi, India
| | - Anurag Agrawal
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | - Jeemon Panniyammakal
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Government Medical College, Thiruvananthapuram, Kerala, India.,Public Health Foundation of India, Gurgaon, India
| | - Nikhil Tandon
- All India Institute of Medical Sciences, Delhi, India
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India.,Public Health Foundation of India, Gurgaon, India
| | | | - Shifalika Goenka
- Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, India. .,Centre for Chronic Disease Control, New Delhi, India.
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Organizational Wellness Program Implementation and Evaluation: A Holistic Approach to Improve the Wellbeing of Middle Managers. J Occup Environ Med 2019; 60:515-520. [PMID: 29461387 DOI: 10.1097/jom.0000000000001306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
: Employee wellness programs can provide benefits to institutions as well as employees and their families. Despite the attempts of some organizations to implement programs that take a holistic approach to improve physical, mental, and social wellness, the most common programs are exclusively comprised of physical and nutritional components. In this study, we implemented a wellness program intervention, including training using a holistic approach to improve the wellbeing of middle managers in several multinational organizations. We included control and experimental groups to measure wellness and teamwork with two repeated measures. Our results indicated that employees receiving the intervention had improved measures of wellness and teamwork. A positive relationship was found between wellness and teamwork in the experimental group when compared with the control group. Taken together, the data suggest that implementation of these programs would provide valuable outcomes for both employees and organizations.
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Neate SL, Taylor KL, Jelinek GA, De Livera AM, Brown CR, Weiland TJ. Taking active steps: Changes made by partners of people with multiple sclerosis who undertake lifestyle modification. PLoS One 2019; 14:e0212422. [PMID: 30817765 PMCID: PMC6394935 DOI: 10.1371/journal.pone.0212422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 02/01/2019] [Indexed: 01/08/2023] Open
Abstract
Background Multiple sclerosis (MS), a demyelinating condition of the central nervous system with an unpredictable course, has a major impact on the lives of people with MS. Partners of people with MS may be significantly affected by the diagnosis, management and uncertainty around disease progression and may provide substantial support and care. Modification of lifestyle risk factors in conjunction with standard medical management has been associated with improved physical and mental quality of life. Adopting major lifestyle modification may have a multi-faceted impact on the person with MS and their partner. Experiences of partners of people with MS have been previously explored, but the experiences of partners of people with MS who adopt this strategy have not. As part of a larger study that aimed to explore partners’ lived experiences of and attitudes towards MS and lifestyle modification, this study reports the active steps and significant changes partners undertook to assist the person with MS and, at times, to also modify their own lives. Design Within an interpretive framework, using Heidegger’s phenomenological philosophy, a qualitative study of semi-structured interviews was conducted. Participants Aged greater than 18 years and in a spousal relationship with a person with MS who had undertaken an intensive residential lifestyle educational intervention promoting healthy lifestyle. Results Themes identified were: adjusting to lifestyle modification, understanding motivations and practical aspects of adjustment; seeking knowledge and support, exploring the ways partners sought positive support for themselves and the person with MS and abandoned negative influences; and embracing well-being, commitment and change, describing the major changes that partners made to their lives professionally and personally. Conclusions The experiences of these partners provide clinicians with insight into potential motivations and outcomes of lifestyle modification and suggest potentially positive aspects for those directly and indirectly affected by MS.
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Affiliation(s)
- Sandra L. Neate
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
- * E-mail:
| | - Keryn L. Taylor
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - George A. Jelinek
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Alysha M. De Livera
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Chelsea R. Brown
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Tracey J. Weiland
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
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Fernández-Ruiz VE, Armero-Barranco D, Paniagua-Urbano JA, Sole-Agusti M, Ruiz-Sánchez A, Gómez-Marín J. Short-medium-long-term efficacy of interdisciplinary intervention against overweight and obesity: Randomized controlled clinical trial. Int J Nurs Pract 2018; 24:e12690. [DOI: 10.1111/ijn.12690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/17/2018] [Accepted: 07/09/2018] [Indexed: 01/10/2023]
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Wong EYS, Lee AH, James AP, Jancey J. Physical activity and nutrition intervention for Singaporean women aged 50 years and above: study protocol for a randomised controlled trial. Trials 2018; 19:257. [PMID: 29703218 PMCID: PMC5923190 DOI: 10.1186/s13063-018-2562-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/22/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The majority of the older Singaporean women aged 50 years and above are physically inactive and have unhealthy dietary habits, placing them at 'high risk' of non-communicable diseases (NCDs). The adoption of regular physical activity (PA) and a healthy diet are essential lifestyle behaviours to reduce this risk. This randomised controlled trial (RCT) involves the development, implementation and evaluation of a PA and nutrition programme for community-dwelling Singaporean women who currently attend recreational centres (RCs are public facilities supporting social leisure activities) in their local area. The intervention will be developed after conducting formative evaluation with RC attendees and managers through focus group discussions and pilot testing of resources (i.e. surveys, accelerometers, and health booklets). Programme ambassadors (trained, certified fitness instructors and nutritionists) will deliver all sessions in English and Mandarin; implement classes to meet participants' varying needs; and conduct sessions at different times at convenient venues. Social Cognitive Theory (SCT) has been selected as the theoretical framework to inform intervention strategies as it explores the interactions of human behaviour with the environment and has been found to be valuable when developing behavioural change interventions particularly in older adults (J Gerontol B Psychol Sci Soc Sci 67B(1):18-26, 2012; Obesity Reviews 15(12):983-95, 2014). Its major construct, self-efficacy, is invaluable in achieving successful behaviour change, such as increasing levels of PA or improving dietary intake (Trials. 2017; https://doi.org/10.1186/s13063-016-1771-9 ; Psychol Health Med 18(6):714-24, 2013). METHODS The development and implementation of the PA and nutrition intervention strategies will be guided by SCT and Motivational interviewing (MI) and implemented by trained programme ambassadors at the RCs. Sixty RCs located in Singapore will be selected from five major geographical districts and randomly allocated to the intervention (n = 30) or control (n = 30) cluster. A sample of 600 (intervention n = 300; control n = 300) women aged 50 years and above will then be recruited from these 60 centres and only the intervention group will be enrolled into the PA and nutrition intervention. It is hypothesised that by the end of the intervention, the intervention group participants compared to the control group will show significantly greater improvements in the following outcome variables: PA and dietary behaviours, health-related quality of life, objective measures of PA, anthropometric, lipid and glucose profiles. Data will be collected at baseline and 6 months and analysed using mixed regression models. DISCUSSION It is anticipated that recruitment, retention and compliance of participants will be challenging due to the target group being unfamiliar with such community-based research programmes. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ACTRN12617001022358. Registered on 14 July 2017. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372984&isReview=true.
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Affiliation(s)
| | - Andy H. Lee
- School of Public Health, Curtin University, Perth, WA Australia
| | | | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, (CERIPH), School of Public Health, Curtin University, Perth, WA Australia
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Fernández-Ruiz VE, Paniagua-Urbano JA, Solé-Agustí M, Ruiz-Sánchez A, Gómez-Marín J, Armero-Barranco D. Impact of the I 2AO 2 interdisciplinary program led by nursing on psychological comorbidity and quality of life: Randomized controlled clinical trial. Arch Psychiatr Nurs 2018; 32:268-277. [PMID: 29579523 DOI: 10.1016/j.apnu.2017.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 09/05/2017] [Accepted: 11/05/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Obesity is an entity of highly prevalent multifactorial origin with associated metabolic and psychological comorbidity, causing a negative impact on the quality of life of those who suffer from it. The objective is to evaluate the impact of an interdisciplinary program for nurse-led obesity on quality of life related to health and anxiety. METHODS Randomized controlled clinical trial with a sample of 74 subjects diagnosed with obesity (EG: n=37; CG: n=37). The intervention consisted of a 12-month interdisciplinary program (with pre-test, 12month and 24month follow-up) coordinated by nurses. RESULTS The anxiety analysis shows that there is no effect of the intervention on S-STAI (F2; 144=0.246; p=0.782), which has increased in both groups. However, there is an effect on T-STAI (F2; 144=8872; p<0.001), which only increases in the control group. The interdisciplinary program has significantly improved health-related quality of life (SF-36), both in physical health parameters as well as in mental health. CONCLUSION The interdisciplinary program led by nursing professionals has improved the quality of life related to health and has prevented the increase of anxiety-trait in participants, maintaining the long-term effects.
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Tunay M, Kurdak H, Özcan S, Özdemir Ç, Özer ZY. Family Physician-Led Group Visits for Lifestyle Modification in Women with Weight Problems: A Pilot Intervention and Follow-Up Study. Obes Facts 2018; 11:1-14. [PMID: 29402785 PMCID: PMC5869599 DOI: 10.1159/000486133] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/02/2017] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Lifestyle modification requires extensive information sharing and counseling. However, one-on-one primary care consultations are lacking to cover all necessary components due to time constraints. This preliminary study aims to investigate the feasibility and effects of lifestyle-changing intervention by family physician-led group visits (GVs) on weight management in overweight and obese women. METHODS 60 volunteers fulfilling the inclusion criteria were enrolled. Baseline and 6th month assessments consisted of anthropometric measurements, SF-36 Health Survey, blood variables, exercise test, and resting metabolic rate. Weight maintenance was controlled at the 12th month. RESULTS Although weight loss among participants varied, the mean body weights were significantly decreased by 8.2% in full-attenders (n = 30). A significant increase in HDL-cholesterol and decreases in heart rate and blood pressure were found. SF-36 summary scales were significantly improved. Weight change was moderately correlated with exercise duration, compliance to diet, and baseline mental component score. It was determined that 62.5% of the participants either lost or maintained body weight at the 12th month. CONCLUSION Significant weight loss and quality of life improvement was achieved in this pilot study. GVs may be a promising alternative to primary care consultations for obesity management; however, the high dropout level and diverse outcomes need further assessment.
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Affiliation(s)
- Merthan Tunay
- Department of Family Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Hatice Kurdak
- Department of Family Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
- *Hatice Kurdak, Tıp Fakültesi, Çukurova Üniversitesi, Aile Hekimliği AD, 01330 Sarıçam, Adana, Turkey, ,
| | - Sevgi Özcan
- Department of Family Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Çiğdem Özdemir
- Department of Sports Physiology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Zeliha Yelda Özer
- Department of Family Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
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