1
|
Jake-Schoffman DE, Silfee VJ, Sreedhara M, Rosal MC, May CN, Lopez-Cepero A, Lemon SC, Haughton CF. Reporting of Physical Activity Device Measurement and Analysis Protocols in Lifestyle Interventions. Am J Lifestyle Med 2021; 15:682-689. [PMID: 34916889 PMCID: PMC8669894 DOI: 10.1177/1559827619862179] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This systematic review examined the extent to which lifestyle physical activity interventions that used wearable devices (eg, pedometers, accelerometers) reported on the length of device wear time requested in their protocols, criteria for analytic inclusion of data, and participant compliance with device use protocols. Literature were searches were conducted using PubMed, Cochrane Central Register, and PsychInfo. Studies were included if they were the main outcomes paper of a trial that reported on a randomized or quasi-randomized trial focused on increasing lifestyle physical activity and were published between January 1, 2006 and March 30, 2016. Titles and abstracts were screened by 2 independent reviewers; eligible full texts were retrieved and reviewed by 2 independent reviewers. A total of 104 studies used wearable devices (n = 57 pedometers, n = 47 accelerometers). Most studies (n = 65, 67.3%) asked participants to wear devices for 7 days. Almost half of the studies (n = 46, 44.2%) did not report minimum device wear time required for analytic inclusion of data, and variation existed among studies reporting these criteria. Most studies (n = 60, 57.7%) did not report average device wear time, or participant compliance with device wear. Overall, there was heterogeneity in reporting of physical activity device data. Refinement and streamlining of guidelines for device use, analysis, and reporting of data could improve comparability across studies.
Collapse
Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida (DEJ-S).,Clinical Training and Development, UPMC Health Plan, Pittsburgh, Pennsylvania (VJS).,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (MS, MCR, AL-C, SCL).,Department of Psychology, Springfield College, Springfield, Massachusetts (CNM).,Friedman School of Nutrition and Policy, Tufts University, Boston, Massachusetts (CFH)
| | - Valerie J Silfee
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida (DEJ-S).,Clinical Training and Development, UPMC Health Plan, Pittsburgh, Pennsylvania (VJS).,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (MS, MCR, AL-C, SCL).,Department of Psychology, Springfield College, Springfield, Massachusetts (CNM).,Friedman School of Nutrition and Policy, Tufts University, Boston, Massachusetts (CFH)
| | - Meera Sreedhara
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida (DEJ-S).,Clinical Training and Development, UPMC Health Plan, Pittsburgh, Pennsylvania (VJS).,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (MS, MCR, AL-C, SCL).,Department of Psychology, Springfield College, Springfield, Massachusetts (CNM).,Friedman School of Nutrition and Policy, Tufts University, Boston, Massachusetts (CFH)
| | - Milagros C Rosal
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida (DEJ-S).,Clinical Training and Development, UPMC Health Plan, Pittsburgh, Pennsylvania (VJS).,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (MS, MCR, AL-C, SCL).,Department of Psychology, Springfield College, Springfield, Massachusetts (CNM).,Friedman School of Nutrition and Policy, Tufts University, Boston, Massachusetts (CFH)
| | - Christine N May
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida (DEJ-S).,Clinical Training and Development, UPMC Health Plan, Pittsburgh, Pennsylvania (VJS).,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (MS, MCR, AL-C, SCL).,Department of Psychology, Springfield College, Springfield, Massachusetts (CNM).,Friedman School of Nutrition and Policy, Tufts University, Boston, Massachusetts (CFH)
| | - Andrea Lopez-Cepero
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida (DEJ-S).,Clinical Training and Development, UPMC Health Plan, Pittsburgh, Pennsylvania (VJS).,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (MS, MCR, AL-C, SCL).,Department of Psychology, Springfield College, Springfield, Massachusetts (CNM).,Friedman School of Nutrition and Policy, Tufts University, Boston, Massachusetts (CFH)
| | - Stephenie C Lemon
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida (DEJ-S).,Clinical Training and Development, UPMC Health Plan, Pittsburgh, Pennsylvania (VJS).,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (MS, MCR, AL-C, SCL).,Department of Psychology, Springfield College, Springfield, Massachusetts (CNM).,Friedman School of Nutrition and Policy, Tufts University, Boston, Massachusetts (CFH)
| | - Christina F Haughton
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida (DEJ-S).,Clinical Training and Development, UPMC Health Plan, Pittsburgh, Pennsylvania (VJS).,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts (MS, MCR, AL-C, SCL).,Department of Psychology, Springfield College, Springfield, Massachusetts (CNM).,Friedman School of Nutrition and Policy, Tufts University, Boston, Massachusetts (CFH)
| |
Collapse
|
2
|
Yeary KHK, Alcaraz KI, Ashing KT, Chiu C, Christy SM, Felsted KF, Lu Q, Lumpkins CY, Masters KS, Newton RL, Park CL, Shen MJ, Silfee VJ, Yanez B, Yi J. Considering religion and spirituality in precision medicine. Transl Behav Med 2021; 10:195-203. [PMID: 31294809 DOI: 10.1093/tbm/ibz105] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The emerging era of precision medicine (PM) holds great promise for patient care by considering individual, environmental, and lifestyle factors to optimize treatment. Context is centrally important to PM, yet, to date, little attention has been given to the unique context of religion and spirituality (R/S) and their applicability to PM. R/S can support and reinforce health beliefs and behaviors that affect health outcomes. The purpose of this article is to discuss how R/S can be considered in PM at multiple levels of context and recommend strategies for integrating R/S in PM. We conducted a descriptive, integrative literature review of R/S at the individual, institutional, and societal levels, with the aim of focusing on R/S factors with a high level of salience to PM. We discuss the utility of considering R/S in the suitability and uptake of PM prevention and treatment strategies by providing specific examples of how R/S influences health beliefs and practices at each level. We also propose future directions in research and practice to foster greater understanding and integration of R/S to enhance the acceptability and patient responsiveness of PM research approaches and clinical practices. Elucidating the context of R/S and its value to PM can advance efforts toward a more whole-person and patient-centered approach to improve individual and population health.
Collapse
Affiliation(s)
| | | | | | - Chungyi Chiu
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | | | | | - Qian Lu
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Crystal Y Lumpkins
- School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | | | | | | | - Megan J Shen
- Weill Cornell Medical College, New York City, NY, USA
| | | | - Betina Yanez
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jean Yi
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| |
Collapse
|
3
|
Silfee VJ, Lopez-Cepero A, Lemon SC, Estabrook B, Nguyen O, Rosal MC. Recruiting low-income postpartum women into two weight loss interventions: in-person versus Facebook delivery. Transl Behav Med 2019; 9:129-134. [PMID: 29474726 DOI: 10.1093/tbm/iby013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Several studies, such as the Diabetes Prevention Program (DPP), have provided foundational evidence for the efficacy of lifestyle interventions on weight loss and cardiometabolic prevention. However, translating these interventions to real-world settings and engaging at-risk populations has proven difficult. Social media-delivered interventions have high potential for reaching high-risk populations, but there remains a need to understand the extent to which these groups are interested in social media as a delivery mode. One potential way to this is by examining recruitment rates as a proxy for interest in the intervention delivery format. The aim of this study was to describe the recruitment rates of overweight and obese low-income postpartum women into two asynchronous behavioral weight loss interventions: one delivered in-person and the other delivered via Facebook. Both interventions used the same recruitment methods: participants were overweight low-income postpartum women who were clients of Women, Infants, and Children (WIC) clinics in Worcester, MA, screened for the study by nutritionists during routine WIC visits. Similarly, eligibility criteria were the same for both interventions except for a requirement for the Facebook-delivered intervention to currently use Facebook at least once per week. Among women pre-eligible for the in-person intervention, 42.6% gave permission to be contacted to determine full eligibility and 24.1% of eligible women enrolled. Among women pre-eligible for the Facebook intervention, 31.8% gave permission to be contacted and 28.5% of eligible women enrolled. Recruitment rates for a Facebook-based weight loss intervention were similar to recruitment rates for an in-person intervention, suggesting similar interest in the two program delivery modes among low-income postpartum women.
Collapse
Affiliation(s)
- Valerie J Silfee
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Andrea Lopez-Cepero
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Barbara Estabrook
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Oanh Nguyen
- Family Health Center of Worcester, Inc., Worcester, MA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| |
Collapse
|
4
|
Budzowski AR, Parkinson MD, Silfee VJ. An Evaluation of Lifestyle Health Coaching Programs Using Trained Health Coaches and Evidence-Based Curricula at 6 Months Over 6 Years. Am J Health Promot 2019; 33:912-915. [PMID: 30669850 DOI: 10.1177/0890117118824252] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Describe health plan member-level participation, completion, and 6-month outcomes for 5 lifestyle health coaching programs offered by an integrated delivery and financing system (IDFS) over 6 years. DESIGN Case series study of 5 lifestyle programs with 180-day follow-up. SETTING Large Western PA integrated delivery and financing system (IDFS) deployed multiple coaching modalities for diverse insurance-member enrolled population. PARTICIPANTS A total of 14 591 health plan members choosing a lifestyle health coaching program. INTERVENTION Evidence- and curriculum-based lifestyle health coaching programs delivered by 1 of 4 interactive modalities. MEASURES A single metric was used as an overall indicator of clinical success for each program. Success measures include a ≥5% reduction of self-reported baseline weight, meeting physical activity guidelines, and 7-day point prevalence abstinence from tobacco. For stress and nutrition, where no single target measure exists, a metric was created that represented a net improvement across all key outcomes measured. ANALYSIS The proportion of members meeting target outcomes were calculated and described across all time points and modalities. RESULTS At 180 days, 77% of enrolled members reported reduced stress, 7% quit tobacco, 50.5% met physical activity guidelines, 65.2% improved nutrition, and 44.2% lost 5% or more of baseline weight. CONCLUSION This evaluation describes the real-world effectiveness of evidence- and curriculum-based lifestyle improvement programs delivered by trained health coaches to a diverse health plan member population.
Collapse
|
5
|
May CN, Jake-Schoffman DE, Evans M, Silfee VJ, Zhang FF, Blok AC, Carey JL, Ding E, Pritschmann RK. Interest in and barriers to participation in a Facebook-delivered weight loss program among female cancer survivors with overweight or obesity. Mhealth 2019; 5:28. [PMID: 31559273 PMCID: PMC6737402 DOI: 10.21037/mhealth.2019.08.02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/23/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Although excess body weight is linked to post-treatment complications for cancer survivors, obesity rates have increased rapidly among adult cancer survivors. Innovative approaches to weight loss programs, such as via social media, are needed to engage female cancer survivors. The purpose of this study is to explore important components of a Facebook-delivered weight loss program for female cancer survivors. METHODS Female cancer survivors who are overweight or obese and finished active treatment completed a web-based, mixed-methods survey. RESULTS Participants (N=96) were on average 54.3±9.6 years old, 89% white, 66% obese, and 87% tried to lose weight in the last year. Health concerns were the most important reason (88%) for wanting to lose weight. Barriers to weight loss included other health issues (52%) and perceived sacrifice/burden of weight loss process (35%). Qualitative themes for barriers included inability to make dietary changes (19%), lack of motivation (18%), and physical limitations (13%). Participants were most interested in a weight loss program delivered via Facebook (81%), led by a weight loss counselor (78%), provided healthy recipes (73%) and exercise videos (72%). Qualitative themes included information on cancer treatment effects (25%), calorie tracker (21%), and exercise modifications (17%). Qualitatively, concerns about weight loss included fear of cancer recurrence (20%) and lack of confidence in weight loss efforts (17%). CONCLUSIONS While female cancer survivors are interested in a Facebook-delivered weight loss program, additional research needs to address customization and delivery to address specific barriers experienced by cancer survivors.
Collapse
Affiliation(s)
- Christine N. May
- Department of Psychology, Springfield College, Springfield, MA, USA
| | - Danielle E. Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Martinus Evans
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Valerie J. Silfee
- Clinical Training and Development, UPMC Health Plan, Pittsburgh, PA, USA
| | | | - Amanda C. Blok
- Department Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jennifer L. Carey
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Eric Ding
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- Department Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Ricarda K. Pritschmann
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| |
Collapse
|
6
|
Silfee VJ, Lopez-Cepero A, Lemon SC, Estabrook B, Nguyen O, Wang ML, Rosal MC. Adapting a Behavioral Weight Loss Intervention for Delivery via Facebook: A Pilot Series Among Low-Income Postpartum Women. JMIR Form Res 2018; 2:e18. [PMID: 30684423 PMCID: PMC6334676 DOI: 10.2196/formative.9597] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/28/2018] [Accepted: 07/17/2018] [Indexed: 11/20/2022] Open
Abstract
Background Efforts to translate evidence-based weight loss interventions, such as the Diabetes Prevention Program (DPP), to low-income postpartum women have resulted in poor intervention attendance and high attrition. Strategies that improve engagement and retention in this population are needed to maximize the reach of evidence-based weight loss interventions. Objective The objective of this study was to adapt a DPP-based weight loss intervention (Fresh Start) for Facebook delivery and to evaluate its feasibility among low-income postpartum women. Methods This study comprised 3 single-group pilot studies where feasibility outcomes iteratively informed changes from one pilot to the next. We paralleled the in-person program for Facebook delivery by translating the protocol to a content library of Facebook posts with additional posts from lifestyle coaches. Low-income postpartum women were recruited from Women, Infants, and Children (WIC) clinics in Worcester, Massachusetts. Participants were enrolled into a 16-week weight loss intervention delivered via Facebook. During the first 8 weeks, Facebook intervention posts were delivered 2 times per day, with additional posts from coaches aiming to stimulate interaction among participants or respond to participants’ questions and challenges. For the following 8 weeks, posts were delivered once per day without additional coaching. Feasibility outcomes were engagement (defined by number of likes, comments, and posts measured throughout intervention delivery), acceptability, and retention (survey at follow-up and assessment completion rate, respectively). Changes in weight were also assessed at baseline and follow-up. Results Pilot 1 had a retention rate of 89% (24/27), and on average, 62% (17/27) of women actively engaged with the group each week during the 8-week coached phase. Mean weight loss was 2.6 (SD 8.64) pounds, and 79% (19/27) would recommend the program to a friend. Pilot 2 had a retention rate of 83% (20/24), and on average, 55% (13/24) of women actively engaged with the group weekly during the 8-week coached phase. Mean weight loss was 2.5 (SD 9.23) pounds, and 80% (16/24) would recommend the program to a friend. Pilot 3 had a retention rate of 88% (14/16), and on average, 67% (11/16) of women actively engaged with the group weekly during the 8-week coached phase. Mean weight loss was 7.0 (SD 11.6) pounds, and 100% (16/16) would recommend the program to a friend. Conclusions Our findings demonstrated that a Facebook-delivered intervention was acceptable and could be feasibly delivered to low-income postpartum women. Future research is needed to evaluate the efficacy of a Facebook-delivered weight loss intervention.
Collapse
Affiliation(s)
- Valerie J Silfee
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Andrea Lopez-Cepero
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Barbara Estabrook
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Oanh Nguyen
- Family Health Center of Worcester, Inc, Worcester, MA, United States
| | - Monica L Wang
- Department of Community Health Sciences, School of Public Health, Boston University, Boston, MA, United States
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| |
Collapse
|
7
|
Sreedhara M, Silfee VJ, Rosal MC, Waring ME, Lemon SC. Does provider advice to increase physical activity differ by activity level among US adults with cardiovascular disease risk factors? Fam Pract 2018; 35:420-425. [PMID: 29390106 PMCID: PMC6454517 DOI: 10.1093/fampra/cmx140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Regular physical activity (PA) lowers the risk of cardiovascular disease (CVD), but few US adults meet PA guidelines. The United States Preventive Services Task Force (USPSTF) recommends primary care providers offer PA counselling for CVD prevention. We examined the association between adherence to PA guidelines and reported provider advice to increase PA among US adults with overweight/obesity and ≥1 additional CVD risk factor. Methods Cross-sectional data from the National Health and Nutrition Examination Survey (2011-2014) on PA and provider advice to increase PA were analysed for 4158 adults (≥20 years old) with overweight/obesity who reported ≥1 of hypertension, high cholesterol or impaired fasting glucose. Adherence to federal PA guidelines was determined using self-reported PA data from the Global Physical Activity Questionnaire. Meeting PA guidelines was defined as ≥150 minutes/week moderate intensity PA, ≥75 minutes/week vigorous intensity, or an equivalent combination. Participants self-reported provider advice to increase PA. Results In total, 57.7% of US adults with overweight/obesity and ≥1 additional CVD risk factor who did not meet PA guidelines reported provider advice to increase PA compared to 49.7% of adults who met PA guidelines. Adults who did not meet PA guidelines were more likely to report provider PA advice (aOR = 1.21; 95% CI = 1.00-1.47). Conclusions US adults with CVD risk factors who do not meet PA guidelines are more likely to receive provider advice to increase PA, but only half receive such advice. Strategies to increase provider advice are needed to improve adherence to USPSTF guidelines among US adults with overweight/obesity and additional CVD risk factors.
Collapse
Affiliation(s)
- Meera Sreedhara
- Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA, USA
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Valerie J Silfee
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Molly E Waring
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, USA
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| |
Collapse
|
8
|
Haughton CF, Silfee VJ, Wang ML, Lopez-Cepero AC, Estabrook DP, Frisard C, Rosal MC, Pagoto SL, Lemon SC. Racial/ethnic representation in lifestyle weight loss intervention studies in the United States: A systematic review. Prev Med Rep 2018; 9:131-137. [PMID: 29616185 PMCID: PMC5880332 DOI: 10.1016/j.pmedr.2018.01.012] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 12/21/2022] Open
Abstract
Obesity remains a persistent public health and health disparity concern in the United States. Eliminating health disparities, particularly among racial/ethnic minority groups, is a major health priority in the US. The primary aim of this review was to evaluate representation of racial/ethnic sub-group members in behavioral weight loss interventions conducted among adults in the United States. The secondary aims were to assess recruitment and study design approaches to include racial/ethnic groups and the extent of racial/ethnic sub-group analyses conducted in these studies. PubMed, PsycInfo, Medline, and CINAHL were searched for behavioral weight loss intervention trials conducted in 2009–2015 using keywords: weight, loss, overweight, obese, intervention and trial. Most of the 94 studies included a majority of White participants compared to any other racial/ethnic group. Across the included studies, 58.9% of participants were White, 18.2% were African American, 8.7% were Hispanic/Latino, 5.0% were Asian and 1.0% were Native Americans. An additional 8.2% were categorized as “Other”. Nine of the 94 studies exclusively included minority samples. Lack of adequate representation of racial and ethnic minority populations in behavioral trials limits the generalizability and potential public health impact of these interventions to groups that might most benefit from weight loss. Given racial/ethnic disparities in obesity rates and the burden of obesity and obesity-related diseases among minority groups in the United States, greater inclusion in weight loss intervention studies is warranted. Describes racial/ethnic minority inclusion in behavioral weight loss studies Majority of studies continue to include a majority white sample. Modest increases in the representation of some racial/ethnic minority groups. Lack of adequate representation of minority groups limits generalizability. Greater racial/ethnic inclusion in weight loss intervention studies is warranted.
Collapse
Affiliation(s)
| | | | - Monica L. Wang
- Boston University School of Public Health, Boston, MA, USA
| | | | | | | | | | - Sherry L. Pagoto
- University of Massachusetts Medical School, Worcester, MA, USA
- University of Connecticut, Storrs, CT, USA
| | - Stephenie C. Lemon
- University of Massachusetts Medical School, Worcester, MA, USA
- Corresponding author at: UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.UMass Worcester Prevention Research CenterDivision of Preventive and Behavioral MedicineUniversity of Massachusetts Medical School55 Lake Avenue NorthWorcesterMA01655USA
| |
Collapse
|
9
|
Abstract
Background Minority and low-income women have higher rates of postpartum weight retention, contributing to increased rates of obesity in these populations. Weight perceptions may be an important factor contributing to the adoption of weight-management behaviors. The purpose of this study was to examine the relationships between weight perceptions and weight-related behaviors among overweight low-income women during postpartum enrolled in a weight loss intervention study. Methods This is a cross-sectional analysis of the Fresh Start study baseline data among overweight and obese low-income women during postpartum (N = 132). General linear regression models assessed the association between weight perceptions and energy intake, energy expenditure, self-monitoring, and self-regulation. Results Women who perceived themselves to be very overweight had significantly lower self-regulation (β = -4.0, SE = 1.6, p = 0.014) and higher energy expenditure (β = 1.3, SE = 0.7, p = 0.05) compared to women who perceived themselves to be moderately overweight or a little overweight. There were no significant associations between weight perceptions and self-monitoring or energy intake. Conclusions This study found that weight perceptions among these women are important factors to consider for weight loss. Future research should focus on investigating the impact of tailoring interventions to weight perceptions to impact engagement in weight-related behaviors in diverse low-income women during postpartum.
Collapse
Affiliation(s)
- Valerie J Silfee
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, USA
| | - Christina F Haughton
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, USA
| | - Nisha Kini
- European Medical and Clinical Division, Terumo Europe, Belgium
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, USA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, USA
| |
Collapse
|
10
|
Jake-Schoffman DE, Silfee VJ, Waring ME, Boudreaux ED, Sadasivam RS, Mullen SP, Carey JL, Hayes RB, Ding EY, Bennett GG, Pagoto SL. Methods for Evaluating the Content, Usability, and Efficacy of Commercial Mobile Health Apps. JMIR Mhealth Uhealth 2017; 5:e190. [PMID: 29254914 PMCID: PMC5748471 DOI: 10.2196/mhealth.8758] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/11/2017] [Accepted: 10/29/2017] [Indexed: 02/06/2023] Open
Abstract
Commercial mobile apps for health behavior change are flourishing in the marketplace, but little evidence exists to support their use. This paper summarizes methods for evaluating the content, usability, and efficacy of commercially available health apps. Content analyses can be used to compare app features with clinical guidelines, evidence-based protocols, and behavior change techniques. Usability testing can establish how well an app functions and serves its intended purpose for a target population. Observational studies can explore the association between use and clinical and behavioral outcomes. Finally, efficacy testing can establish whether a commercial app impacts an outcome of interest via a variety of study designs, including randomized trials, multiphase optimization studies, and N-of-1 studies. Evidence in all these forms would increase adoption of commercial apps in clinical practice, inform the development of the next generation of apps, and ultimately increase the impact of commercial apps.
Collapse
Affiliation(s)
- Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Valerie J Silfee
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.,Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, United States
| | - Edwin D Boudreaux
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.,Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Rajani S Sadasivam
- Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sean P Mullen
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Jennifer L Carey
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Rashelle B Hayes
- Division of Consultation/Liaison Psychiatry and Psychology, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
| | - Eric Y Ding
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Gary G Bennett
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States.,Duke Digital Health Science Center, Duke University, Durham, NC, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| |
Collapse
|
11
|
Silfee VJ, Haughton CF, Lemon SC, Lora V, Rosal MC. Spirituality and Physical Activity and Sedentary Behavior among Latino Men and Women in Massachusetts. Ethn Dis 2017; 27:3-10. [PMID: 28115815 DOI: 10.18865/ed.27.1.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION To examine the relationships between spirituality and physical activity and sedentary behavior in a sample of Latino adults in Massachusetts. DESIGN This is a cross-sectional analysis of the Lawrence Health and Well Being Study; a study that was conducted among patients at the Greater Lawrence Family Health Center (GLFHC) in Lawrence, Massachusetts. PARTICIPANTS 602 Latino or Hispanic adults aged 21 to 85 years completed the study. RESULTS There was a significant negative relationship between spirituality and sedentary behavior (β= -.12, p = .004). Although not statistically significant, higher spirituality was associated with increased odds of engaging in physical activity. There were no significant associations between spirituality and physical activity among men or women. Men with greater spirituality were significantly less sedentary (β = -.17, P = .005). There was no relationship between sedentary behavior and spirituality among women. CONCLUSIONS This study found that individuals who are more spiritual are also less sedentary, and this association was stronger in men than women. Findings provide insight for developing future interventions to promote activity in this high-risk population, which has been greatly understudied. Future research endeavors should consider investigating the impact of spirituality-based messages to reduce sedentary behavior among Latinos.
Collapse
Affiliation(s)
- Valerie J Silfee
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Christina F Haughton
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Vilma Lora
- City of Lawrence Mayor's Health Task Force and YWCA of Greater Lawrence, Lawrence, Massachusetts
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| |
Collapse
|
12
|
Silfee VJ, Rosal MC, Sreedhara M, Lora V, Lemon SC. Neighborhood environment correlates of physical activity and sedentary behavior among Latino adults in Massachusetts. BMC Public Health 2016; 16:966. [PMID: 27619205 PMCID: PMC5020509 DOI: 10.1186/s12889-016-3650-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 03/10/2016] [Accepted: 09/08/2016] [Indexed: 11/17/2022] Open
Abstract
Background U.S. Latinos experience high rates of cardio-metabolic diseases and have high rates of physical inactivity and sedentary behavior. Understanding the environmental factors associated with physical activity and sedentary behaviors among Latinos could inform future interventions. The purpose of this study is to explore the neighborhood environment correlates of physical activity and sedentary behavior in a sample of U.S. Latino adults. Methods Cross-sectional study of 602 Latino adults in Lawrence, MA. Survey assessments of physical activity, sedentary behavior, and neighborhood environment were verbally administered. The neighborhood environment scale assessed violence, safety, aesthetic quality, walkability, availability of healthy foods, social cohesion, and activities with neighbors. Results After controlling forage, gender, education, body mass index (BMI), and smoking status, two variables were associated with the outcomes of interest. Living in more walkable neighborhoods was associated with an increased likelihood of engaging in adequate levels of physical activity (>150 min per week, as recommended by the American College of Sports Medicine (ACSM)) (OR = 1.403, p = .018); and greater frequency of activities with neighbors was associated with greater sedentary behavior (β = .072, p = .05). Conclusions There were different neighborhood environment correlates of physical activity and sedentary behavior in this Latino community. Focusing on a greater understanding of the distinct social and physical environmental correlates of physical activity and sedentary behavior may provide important insights for reducing CVD risk and health disparities among Latinos.
Collapse
Affiliation(s)
- Valerie J Silfee
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Meera Sreedhara
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Vilma Lora
- City of Lawrence Mayor's Health Task Force and YWCA of Greater Lawrence, Lawrence, MA, USA
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| |
Collapse
|
13
|
Laurent DJ, Silfee VJ, Shaub TR, Petosa RV, Focht BC. The Evaluation of a Behavioral Intervention on Self-Regulation for Physical Activity Among Overweight and Obese Adults with Type 2 Diabetes. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486784.28528.b0] [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: 11/21/2022]
|