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Kurt T, Vossen D, Schumacher F, Strunk J, Fedkov D, Peine C, Lang F, Khalil A, Brinks R, Vordenbäumen S. Effect of Lifestyle Counselling via a Mobile Application on Disease Activity Control in Inflammatory Arthritis: A Single-Blinded, Randomized Controlled Study. Nutrients 2024; 16:1488. [PMID: 38794726 PMCID: PMC11123837 DOI: 10.3390/nu16101488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/29/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Mobile applications (apps) are a resource for information on lifestyle and nutrition which are associated to improved outcomes in inflammatory arthritis. OBJECTIVE The aim of this study was to explore whether targeted lifestyle counselling via an app improves disease activity in arthritis patients. METHODS Patients with rheumatoid arthritis (RA), spondyloarthritis (SpA), psoriatic arthritis (PsA) were randomized to 12 weeks of lifestyle counselling via an app (Mida, Midaia GmbH, Germany) pertaining to a healthy Mediterranean Diet, physical activity, and mental health. Disease activity was measured with specific instruments by a blinded physician and categorized (remission, low, moderate, high). Dietary adherence was assessed by the Mediterranean Diet Adherence Screener (MEDAS). Mixed effects logistic regression adjusted to baseline disease activity, age, and sex were calculated. RESULTS Of 158 patients included (73% female, 53.3 ± 11.7 years), 74 were in the active counselling group (ACG). All showed improvement in low disease activity or remission. ACG patients had an odds ratio (OR) of 2.8 (95%-CI 1.1-7.2, p = 0.035), while OR in the control group was not significant OR = 2.1 (0.9-5.0, p = 0.097). The control group was less likely to reach a MEDAS >= 4 (OR = 0.16 (0.03-0.77), p = 0.02), while this was not seen in the ACG (OR = 0.54 (0.06-4.63), p = 0.6). Patients in the ACG showed a tendency towards improved adhesion to a Mediterranean Diet (MEDAS) (β = 0.35 (-0.05-0.74), p = 0.086). This tendency was not observed in the control group (β = 0.09 (-0.29-0.46), p = 0.64). CONCLUSIONS Individualized lifestyle and dietary counselling via app may help to improve disease control in inflammatory arthritis patients.
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Affiliation(s)
- Türker Kurt
- Department of Rheumatology, St. Elisabeth-Hospital Meerbusch-Lank, Hauptstr. 74-76, 40668 Meerbusch, Germany
- Department of Rheumatology and Hiller Research Unit, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Diana Vossen
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Claudiusstrasse 45, 44649 Herne, Germany
| | - Falk Schumacher
- Department of Rheumatology, Krankenhaus Porz am Rhein, 51149 Cologne, Germany
- Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany
| | - Johannes Strunk
- Department of Rheumatology, Krankenhaus Porz am Rhein, 51149 Cologne, Germany
| | - Dmytro Fedkov
- Midaia GmbH, 69123 Heidelberg, Germany; (D.F.)
- Department of Internal Medicine 3, Bogomolets National Medical University, 01601 Kyiv, Ukraine
| | | | - Felix Lang
- Midaia GmbH, 69123 Heidelberg, Germany; (D.F.)
| | | | - Ralph Brinks
- Medical Biometry and Epidemiology, University of Witten/Herdecke, 58448 Witten, Germany
| | - Stefan Vordenbäumen
- Department of Rheumatology, St. Elisabeth-Hospital Meerbusch-Lank, Hauptstr. 74-76, 40668 Meerbusch, Germany
- Department of Rheumatology and Hiller Research Unit, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
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Tarhan N, Arslan M. Psychometric assessment of pharmacists' counseling in dementia. PATIENT EDUCATION AND COUNSELING 2023; 115:107903. [PMID: 37506523 DOI: 10.1016/j.pec.2023.107903] [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: 02/09/2023] [Revised: 06/07/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVE This study aimed to explore pharmacists' counseling for dementia by developing a measurement tool based on the Theory of Planned Behavior. METHODS A survey was applied online to community pharmacists; in total, 190 community pharmacists participated in the study. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Mann-Whitney U test were performed. RESULTS A six-factor structure was obtained from the EFA, and the CFA confirmed the structure. These factors explained 71.294% of the total variance. The Cronbach's alpha coefficients for the factors ranged from 0.728 to 0.913. In addition, the pharmacists rated themselves as having positive attitudes and intentions toward counseling for dementia. Differences in these factors were found between the groups based on their participation in vocational training on dementia. CONCLUSION The developed measurement tool had a satisfactory construct and convergent and discriminant validities and reliabilities. PRACTICE IMPLICATIONS The developed measurement tool can be used to investigate pharmacists' self-reported counseling for dementia and can also be applied to the counseling behavior of pharmacists in various health conditions.
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Affiliation(s)
- Nilay Tarhan
- Department of Pharmacy Management, Izmir Katip Celebi University Faculty of Pharmacy, Izmir, Turkiye.
| | - Miray Arslan
- Department of Pharmacy Management, Van Yuzuncu Yil University Faculty of Pharmacy, Van, Turkiye
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Webber BJ, Wheaton AG, Lu PJ, Whitfield GP. Joint Prevalence of Influenza Preventive Behaviors Among Adults-United States, 2020. J Prim Care Community Health 2023; 14:21501319231191681. [PMID: 37571833 PMCID: PMC10422917 DOI: 10.1177/21501319231191681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION/OBJECTIVES The Centers for Disease Control and Prevention recognizes routine vaccination, sufficient sleep, and adequate physical activity as behavioral approaches to reduce the incidence of influenza. We aimed to determine the joint national prevalence of these health behaviors among U.S. adults, which has not been reported. METHODS We used the 2020 National Health Interview Survey to assess prevalence of receiving influenza vaccination in the past 12 months, obtaining sufficient sleep, and achieving adequate physical activity among U.S. adults (n = 30,312). We calculated the joint prevalence overall and by sociodemographic and health-related variables. RESULTS AND CONCLUSIONS The overall joint prevalence was 8.5% (95% CI, 8.0-9.0). Prevalence was lower among older persons (vs younger); Hispanic and non-Hispanic Black persons (vs non-Hispanic White); current and former smokers (vs never smokers); postpartum women (vs neither pregnant nor postpartum); and those with a history of coronary heart disease, hypertension, stroke, diabetes, and chronic obstructive pulmonary disease (vs not having those respective condition). In addition to recommending annual vaccination, primary care providers might encourage sufficient sleep and adequate physical activity-especially among patients who have increased risk for influenza complications and are less likely to achieve these behaviors.
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Affiliation(s)
- Bryant J. Webber
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anne G. Wheaton
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Peng-jun Lu
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Geoffrey P. Whitfield
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Kromme NMH, Ahaus KTB, Gans ROB, van de Wiel HBM. Internists’ ambivalence toward their role in health counseling and promotion: A qualitative study on the internists’ beliefs and attitudes. PLoS One 2022; 17:e0273848. [PMID: 36048849 PMCID: PMC9436108 DOI: 10.1371/journal.pone.0273848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022] Open
Abstract
Crucial to its success is that physicians enhance their competence in Lifestyle Medicine and take on their role as Health Advocates in Health Counseling and Promotion (HC&P). However, studies on patients’ views of lifestyle counseling in clinical practice demonstrate that many patients neither perceived a need to adopt a healthy lifestyle nor having had any discussion with their physician about their lifestyle. This study is part of a participatory action research project focusing on identifying areas of improvement for health promotion in the practice of internists. Within this project, we interviewed 28 internists from six different subspecialties of an academic medical center in the Netherlands. This study aims to gain insight into how internists understand their role in HC&P by a qualitative analysis of their beliefs and attitudes in the interview data. Participants claimed that promoting a healthy lifestyle is important. However, they also reflected a whole system of beliefs that led to an ambivalent attitude toward their role in HC&P. We demonstrate that little belief in the success of HC&P nurtured ambivalence about the internists’ role and their tasks and responsibilities. Ambivalence appeared to be reinforced by beliefs about the ability and motivation of patients, the internists’ motivational skills, and the patient-doctor relationship, and by barriers such as lack of time and collaboration with General Practitioners. When participants viewed HC&P as a part of their treatment and believed patients were motivated, they were less ambivalent about their role in HC&P. Based on our data we developed a conceptual framework that may inform the development of the competences of the Health Advocate role of internists in education and practice.
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Affiliation(s)
- Nicolien M. H. Kromme
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Kees T. B. Ahaus
- Erasmus School of Health Policy & Management Health Services Management & Organization (HSMO), Rotterdam, The Netherlands
| | - Reinold O. B. Gans
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Harry B. M. van de Wiel
- Wenckebach Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Mahler L, Sebo P, Favrod-Coune T, Moussa A, Cohidon C, Broers B. The prevalence of five lifestyle risk factors in primary care physicians: A cross-sectional study in Switzerland. Prev Med Rep 2022; 26:101740. [PMID: 35251911 PMCID: PMC8889261 DOI: 10.1016/j.pmedr.2022.101740] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/18/2022] [Accepted: 02/16/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Liv Mahler
- Institute for Family Medicine and Paediatrics, University of Geneva, Geneva, Switzerland
- Corresponding author at: Institute for Family Medicine and Paediatrics, University of Geneva, Rue Michel-Servet, 1, 1211 Geneva 4, Switzerland.
| | - Paul Sebo
- Institute for Family Medicine and Paediatrics, University of Geneva, Geneva, Switzerland
| | | | - Amir Moussa
- Institute for Family Medicine and Paediatrics, University of Geneva, Geneva, Switzerland
| | - Christine Cohidon
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Barbara Broers
- Primary Care Division, Geneva University Hospital, Geneva, Switzerland
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Haussmann A, Ungar N, Tsiouris A, Depenbusch J, Sieverding M, Wiskemann J, Steindorf K. Physical activity counseling to cancer patients: How are patients addressed and who benefits most? PATIENT EDUCATION AND COUNSELING 2021; 104:2999-3007. [PMID: 33972130 DOI: 10.1016/j.pec.2021.04.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study examined cancer patients' reporting on physicians' physical activity (PA) counseling, its associations with patients' PA, and comparisons of patients' and physicians' reports of the type(s) of PA counseling provided. METHODS Patients with breast, colorectal, or prostate cancer (n = 1206) participated in a nationwide cross-sectional study. Cancer patients' sociodemographic and treatment-related characteristics as well as self-reported PA levels (pre- and post-diagnosis) were assessed. PA counseling was queried according to the counseling steps of the 5As framework (Assess/Advise/Agree/Assist/Arrange). For a subsample (n = 135), matched patient-physician data were available. RESULTS Patient-reported PA counseling was categorized into "no counseling" (indicated by 20.8% of participants), "basic counseling" (Assess and/or Advise; 58.8%), and "in-depth counseling" (Agree, Assist, and/or Arrange; 20.4%). "In-depth counseling" was associated with an increase in PA levels pre- to post-diagnosis. This relationship was enhanced for patients with metastases. There were low agreements between patients' and physicians' reporting of PA counseling steps. CONCLUSION In-depth PA counseling is rarely provided to cancer patients but seems to be required to affect PA levels. Patients often report receiving less intensive PA counseling than reported by their physician. PRACTICE IMPLICATIONS Physicians should be enabled to provide routine in-depth PA counseling to all patients with cancer.
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Affiliation(s)
- Alexander Haussmann
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
| | - Nadine Ungar
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117 Heidelberg, Germany.
| | - Angeliki Tsiouris
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Clinic Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany.
| | - Johanna Depenbusch
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; Medical Faculty, Heidelberg University, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany.
| | - Monika Sieverding
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117 Heidelberg, Germany.
| | - Joachim Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Clinic Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany.
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
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