1
|
Alexander E, Tseng E, Durkin N, Jerome GJ, Dalcin A, Appel LJ, Clark JM, Gudzune KA. Long-term retention in an employer-based, commercial weight-loss programme. Clin Obes 2019; 9:e12284. [PMID: 30248246 DOI: 10.1111/cob.12284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/05/2018] [Accepted: 08/28/2018] [Indexed: 01/14/2023]
Abstract
The aim of this study is to examine factors associated with long-term retention in a commercial weight-loss programme. We conducted a retrospective analysis of an employer-based, commercial programme from 2013 to 2016. Our dependent variable was 'long-term retention', defined as continuously enrolled participants who actively engaged through coach calls at 6 and 12 months. Independent variables included baseline demographics, programme engagement and weight change. We conducted multivariate logistic regression analyses assessing for differences in long-term retention by several factors, adjusted for employer clustering. Overall, 68.3% were retained at 6% and 45.9% at 12 months. Greater number of coach calls and website logins during the first 3 months significantly increased the odds of long-term retention, while having chronic conditions significantly decreased the odds. Weight-loss success (≥5% loss at 6 months) was significantly associated with increased odds of retention (12-month: odds ratio [OR] 2.80, P < 0.001), while early weight-loss failure (≥0% weight change at 1 month) significantly decreased odds of retention (12-month: OR 0.66, P = 0.008). In an employer-based, commercial weight loss programme, greater early programme engagement was associated with long-term retention. Given these programmes' popularity and potential reach, our results could be used to develop and test strategies designed to improve retention in commercial weight-loss programmes.
Collapse
Affiliation(s)
- E Alexander
- Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - E Tseng
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - N Durkin
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
| | - G J Jerome
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
- Department of Kinesiology, Towson University, Towson, Maryland, USA
| | - A Dalcin
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
| | - L J Appel
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - J M Clark
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - K A Gudzune
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
| |
Collapse
|
2
|
Alexander E, Tseng E, Durkin N, Jerome GJ, Dalcin A, Appel LJ, Clark JM, Gudzune KA. Factors associated with early dropout in an employer-based commercial weight-loss program. Obes Sci Pract 2018; 4:545-553. [PMID: 30574348 PMCID: PMC6298204 DOI: 10.1002/osp4.304] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Minimizing program dropout is essential for weight-loss success, but factors that influence dropout among commercial programs are unclear. This study's objective was to determine factors associated with early dropout in a commercial weight-loss program. METHODS A retrospective analysis of a remotely delivered, employer-based commercial program from 2013 to 2016 was conducted. The dependent variable was 'early dropout', defined as enrollees who disengaged from telephone coaching by month 2's end. Independent variables included demographics, program website engagement and early weight change. Multivariate logistic regression analyses were used to assess for differences in early dropout by several factors, adjusted for employer clustering. RESULTS Of the 5,274 participants, 26.8% dropped out early. Having ≥1 chronic condition (odds ratio [OR] 1.41, p < 0.001) and 'weight-loss failure' defined as ≥0% weight change at month 1's end (OR 1.86, p < 0.001) had significantly increased odds of early dropout. Increasing age by 10-year intervals (OR 0.90, p = 0.002) and 'meeting the website login goal' defined as ≥90 logins in 3 months (OR 0.13, p < 0.001) significantly decreased the odds of early dropout. CONCLUSIONS Presence of comorbidities, less online engagement and weight-loss failure were associated with early dropout in a commercial program. Strategies to prevent dropout among high-risk participants, such as increased support or program tailoring, should be developed and tested.
Collapse
Affiliation(s)
- E. Alexander
- Department of Health Policy and ManagementThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - E. Tseng
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
| | - N. Durkin
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
| | - G. J. Jerome
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
- Department of KinesiologyTowson UniversityTowsonMDUSA
| | - A. Dalcin
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
| | - L. J. Appel
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - J. M. Clark
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - K. A. Gudzune
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
| |
Collapse
|
3
|
Tyraskis A, Durkin N, Davenport M. Congenital vascular anomalies of the liver. S Afr Med J 2017; 107:12130. [PMID: 29183422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/06/2017] [Indexed: 06/07/2023] Open
Abstract
Congenital vascular anomalies of the liver include a range of malformations of the portal venous, hepatic arterial and venous systems. Congenital portosystemic shunts and arteriovenous malformations make up the two most frequent such malformations. While infantile haemangiomas of the liver, endothelial tumours characterised by vascular proliferation should also be considered, as a proportion of them form prenatally. Evidence to support treatment strategies for these infants and children has been mainly based on small case series. In this review, we explore classification, clinical presentation, investigation and treatment strategies.
Collapse
Affiliation(s)
- A Tyraskis
- Department of Paediatric Surgery, King's College Hospital, London, United Kingdom.
| | | | | |
Collapse
|
4
|
Som R, Rikabi S, Chang A, Durkin N, Ramar S. Portal vein thrombosis following laparoscopic gastric plication. Ann R Coll Surg Engl 2017; 99:e6-e7. [PMID: 27652795 PMCID: PMC5392790 DOI: 10.1308/rcsbull.2017.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 06/06/2023] Open
Abstract
Portal vein thrombosis (PVT) following laparoscopic surgery including Roux-en-Y bypass, sleeve gastrectomy and Nissen's fundoplication is a rare but recognised complication. Laparoscopic gastric plication in a new procedure that is popular in some parts of the world. We report a case of a patient suffering PVT as a complication of this surgery.
Collapse
Affiliation(s)
- R Som
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| | - S Rikabi
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| | - A Chang
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| | - N Durkin
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| | - S Ramar
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| |
Collapse
|
5
|
Abstract
Portal vein thrombosis (PVT) following laparoscopic surgery including Roux-en-Y bypass, sleeve gastrectomy and Nissen's fundoplication is a rare but recognised complication. Laparoscopic gastric plication in a new procedure that is popular in some parts of the world. We report a case of a patient suffering PVT as a complication of this surgery.
Collapse
Affiliation(s)
- R Som
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| | - S Rikabi
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| | - A Chang
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| | - N Durkin
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| | - S Ramar
- Department of Upper GI and Minimal Access Surgery, King's College Hospital , London , UK
| |
Collapse
|
6
|
Dalcin AT, Jerome GJ, Fitzpatrick SL, Louis TA, Wang NY, Bennett WL, Durkin N, Clark JM, Daumit GL, Appel LJ, Coughlin JW. Perceived helpfulness of the individual components of a behavioural weight loss program: results from the Hopkins POWER Trial. Obes Sci Pract 2015; 1:23-32. [PMID: 27668085 PMCID: PMC5019229 DOI: 10.1002/osp4.6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/07/2015] [Accepted: 07/14/2015] [Indexed: 11/11/2022] Open
Abstract
Background Behavioural weight loss programs are effective first‐line treatments for obesity and are recommended by the US Preventive Services Task Force. Gaining an understanding of intervention components that are found helpful by different demographic groups can improve tailoring of weight loss programs. This paper examined the perceived helpfulness of different weight loss program components. Methods Participants (n = 236) from the active intervention conditions of the Practice‐based Opportunities for Weight Reduction (POWER) Hopkins Trial rated the helpfulness of 15 different components of a multicomponent behavioural weight loss program at 24‐month follow‐up. These ratings were examined in relation to demographic variables, treatment arm and weight loss success. Results The components most frequently identified as helpful were individual telephone sessions (88%), tracking weight online (81%) and coach review of tracking (81%). The component least frequently rated as helpful was the primary care providers' general involvement (50%). Groups such as older adults, Blacks and those with lower education levels more frequently reported intervention components as helpful compared with their counterparts. Discussion Weight loss coaching delivered telephonically with web support was well received. Findings support the use of remote behavioural interventions for a wide variety of individuals.
Collapse
Affiliation(s)
- A T Dalcin
- Division of General Internal Medicine Johns Hopkins University School of Medicine Baltimore MD USA; Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD USA
| | - G J Jerome
- Division of General Internal Medicine Johns Hopkins University School of Medicine Baltimore MD USA; Department of Kinesiology Towson University Towson MD USA
| | - S L Fitzpatrick
- Department of Preventive Medicine Rush University Medical Center Chicago IL USA
| | - T A Louis
- Department of Biostatistics Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - N-Y Wang
- Division of General Internal Medicine Johns Hopkins University School of Medicine Baltimore MD USA; Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD USA; Department of Biostatistics Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - W L Bennett
- Division of General Internal Medicine Johns Hopkins University School of Medicine Baltimore MD USA; Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD USA; Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - N Durkin
- Division of General Internal Medicine Johns Hopkins University School of Medicine Baltimore MD USA
| | - J M Clark
- Division of General Internal Medicine Johns Hopkins University School of Medicine Baltimore MD USA; Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD USA; Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - G L Daumit
- Division of General Internal Medicine Johns Hopkins University School of Medicine Baltimore MD USA; Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD USA; Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA; Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA
| | - L J Appel
- Division of General Internal Medicine Johns Hopkins University School of Medicine Baltimore MD USA; Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD USA; Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - J W Coughlin
- Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins University Baltimore MD USA; Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA
| |
Collapse
|
7
|
Rubin RR, Peyrot M, Wang NY, Coughlin JW, Jerome GJ, Fitzpatrick SL, Bennett WL, Dalcin A, Daumit G, Durkin N, Chang YT, Yeh HC, Louis TA, Appel LJ. Patient-reported outcomes in the practice-based opportunities for weight reduction (POWER) trial. Qual Life Res 2013; 22:2389-98. [PMID: 23515902 PMCID: PMC4137865 DOI: 10.1007/s11136-013-0363-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2013] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate effects of two behavioral weight-loss interventions (in-person, remote) on health-related quality of life (HRQOL) compared to a control intervention. METHODS Four hundred and fifty-one obese US adults with at least one cardiovascular risk factor completed five measures of HRQOL and depression: MOS SF-12 physical component summary (PCS) and mental component summary; EuroQoL-5 dimensions single index and visual analog scale; PHQ-8 depression symptoms; and PSQI sleep quality scores at baseline and 6 and 24 months after randomization. Change in each outcome was analyzed using outcome-specific mixed-effects models controlling for participant demographic characteristics. RESULTS PCS-12 scores over 24 months improved more among participants in the in-person active intervention arm than among control arm participants (P < 0.05, ES = 0.21); there were no other statistically significant treatment arm differences in HRQOL change. Greater weight loss was associated with improvements in most outcomes (P < 0.05 to < 0.0001). CONCLUSIONS Participants in the in-person active intervention improved more in physical function HRQOL than participants in the control arm did. Greater weight loss during the study was associated with greater improvement in all PRO except for sleep quality, suggesting that weight loss is a key factor in improving HRQOL.
Collapse
Affiliation(s)
- R R Rubin
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA,
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Hansel N, Krishnan J, Rand C, Durkin N, Patino C, Eggleston P, Diette G. Caregiver-reported environmental control measures in homes of inner city children with asthma. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
9
|
Simons E, Brosnan J, Wood R, Rand C, Kanchanaraksa S, Schwarz L, Durkin N, Eggleston P. Symptoms in atopic and non-atopic children with asthma. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80524-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
10
|
Callahan K, Eggleston P, Durkin N, Kanchanaraksa S, Wood R, Rand C. Self efficacy as a predictor of indoor allergen control. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80360-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
11
|
Affiliation(s)
- N Durkin
- Visiting Nurse Association of Greater Milford-Northbridge Area, Inc., 1 Emerson Street, P.O. Box 8, Mendon, Massachusetts 01756, USA
| |
Collapse
|
12
|
Durkin N. Boundary setting as a critical supervisory issue. Home Healthc Nurse Manag 2000; 4:29-32. [PMID: 11261154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Setting clear boundaries with patients can clarify the function of a home healthcare agency as well the roles of the various visiting staff, especially that of the nurse. When managers model boundary-setting techniques the visiting professional can more easily adopt the same in patient relationships. This article reviews the basics of this concept along with suggested supervisory strategies.
Collapse
Affiliation(s)
- N Durkin
- VNA of the Greater Milford-Northbridge Area, 1 Emerson Street, P.O. Box 8, Mendon, Massachusetts 01756, USA
| |
Collapse
|
13
|
Abstract
With increasing incidences of violence in the patient's environment, home health staff are at great risk in and outside of the client's home. This article addresses the practical steps and precautions needed to predict violent incidents and provides suggestions for implementing simple self-protection techniques when encountering situations in which violence is escalating.
Collapse
Affiliation(s)
- N Durkin
- VNA of the Greater Milford-Northbridge Area, Mendon, Massachusetts 01756, USA
| | | |
Collapse
|
14
|
Durkin N, Wilson C. The value and impact of violence prevention training in a home healthcare setting. Home Healthc Nurse Manag 1998; 2:22-8. [PMID: 10646351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
|
15
|
|
16
|
Durkin N. Empowering clients: evaluating employee needs. Occup Health (Lond) 1996; 48:168-70. [PMID: 8716556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|
17
|
Abstract
Zinc absorption was determined with 67Zn and 70Zn, stable isotopes of zinc, in six young men and six elderly men who were confined to a metabolic unit for 12 wk. Their purified formula diets, supplemented with select food items, contained 15 mg of zinc per day. Zinc absorption was determined twice for each subject by combining zinc enriched with either 70Zn or 67Zn with the formula diet. Serum, urinary, and fecal zinc and zinc balance were determined by atomic absorption spectrometry. Zinc absorption averaged 17% in elderly men, significantly less than average zinc absorption of 31% in young men. Serum zinc was also lower in elderly men and increased in both groups during the course of the study. Zinc balance did not differ between groups, and endogenous zinc losses were less in the elderly than in the young men. The results suggest that while zinc absorption is less in elderly men than in young men, the lower absorption may reflect a lower requirement for absorbed zinc by the elderly. Alternatively, less efficient zinc absorption could result in decreased endogenous losses.
Collapse
|
18
|
Durkin N. Basic science education and the nursing profession. Kenya Nurs J 1972; 1:39-40. [PMID: 4483582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
19
|
|