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Cyrenne-Dussault M, Sirois M, St-Pierre J, Drouin-Chartier JP. Household food insecurity and changes in BMI z-score in a pediatric obesity management clinic. J Nutr 2023; 153:1323-1329. [PMID: 36963503 DOI: 10.1016/j.tjnut.2023.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/12/2023] [Accepted: 03/20/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Multicomponent lifestyle interventions are fundamental in pediatric obesity management. However, whether household food insecurity influences the efficacy of such interventions remains undocumented. OBJECTIVE The objective was to compare changes in body mass index z-score (BMIz) among children whose family received lifestyle counseling at a pediatric obesity management clinic in Montreal (Canada) according to their household food security status. METHODS This is a retrospective, longitudinal analysis of medical records of children (2-17 years) with overweight or obesity who received lifestyle counseling at a pediatric obesity management clinic. The number of visits at the clinic and the duration of the follow-up were individualized. Household food security status was assessed using Health Canada's Household Food Security Survey Module at the first visit at the clinic. BMIz was calculated and updated at each visit. A reduction of ≥0.25 in BMIz between the last and the first visit at the clinic was considered clinically meaningful. Statistical significance was considered at P<0.05. RESULTS Among the 214 children included in the study, 83 (38.8%) lived in a food insecure household. In multivariable-adjusted analyses, differences in BMIz between the last and the first appointment tended to be smaller among children who lived in a food insecure household compared with those in a food secure household [ΔBMIzfood insecurity=-0.432 (95% confidence interval (CI): -0.672, -0.193) vs ΔBMIzfood security=-0.556 (95% CI: -0.792, -0.319; P=0.14)]. Differences were most notable in the first 6 months of follow-up. The odds ratio of achieving a clinically significant reduction in BMIz over follow-up associated with household food insecurity, compared with household food security, was 0.57 (95% CI: 0.31, 1.05; P=0.07). CONCLUSIONS In this sample of children followed at a pediatric obesity clinic, those who lived in a food insecure household experienced smaller BMIz reductions compared with those who lived in a food secure household.
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Affiliation(s)
- Marie Cyrenne-Dussault
- NUTRISS (Nutrition, Health and Society) Research Center, Institute on Nutrition and Functional Foods (INAF), Laval University, Quebec City, QC, Canada; Faculty of Pharmacy, Laval University, Quebec City, QC, Canada
| | - Maude Sirois
- Maison de Santé Prévention - Approche 180 de Montréal, QC, Canada
| | - Julie St-Pierre
- Maison de Santé Prévention - Approche 180 de Montréal, QC, Canada;; Department of Paediatrics, McGill University, Montreal, QC, Canada
| | - Jean-Philippe Drouin-Chartier
- NUTRISS (Nutrition, Health and Society) Research Center, Institute on Nutrition and Functional Foods (INAF), Laval University, Quebec City, QC, Canada; Faculty of Pharmacy, Laval University, Quebec City, QC, Canada;.
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Rimmer JH, Wilroy J, Young HJ, Young R, Sinha T, Currie M, Lima CR, Lai B. Qualitative Evaluation of a Comprehensive Online Wellness Program (MENTOR) Among People With Spinal Cord Injury. Front Rehabil Sci 2022; 3:917898. [PMID: 36189027 PMCID: PMC9397963 DOI: 10.3389/fresc.2022.917898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/16/2022] [Indexed: 11/20/2022]
Abstract
People with spinal cord injury (SCI) experience a plethora of health conditions that hinder their health and wellness. This qualitative retrospective evaluation describes the perceptions of 14 peoples with SCI, several months after they completed an eight-week telewellness community program (MENTOR-Mindfulness, Exercise and Nutrition To Optimize Resilience). The program offered daily online classes that covered three core wellness domains (mindfulness, exercise, nutrition) and one health coaching session to introduce participants to eight other wellness domains (sleep, self-care, core values, arts & leisure, outdoor time in nature; spiritual practice, relationships, contribution to others). Qualitative analysis resulted in 4 themes related to program benefits, likes, and improvement recommendations. First, participants valued the program for the social support provided by a sense of community and relationship building with peers. Second, self-regulation was facilitated by the comprehensiveness of the program components, easy online access, and shared lifestyle goals for self-improvement among peers. Third, participants reported improved psychological wellbeing and adopted healthy behaviors that were maintained long after the program. Last, future programs should include flexible class times, post-program support, specific exercise adaptations for people with limited arm function, and supplementary in-person meetings. These preliminary findings demonstrate that MENTOR may benefit the wellbeing of people with SCI and warrant further study.
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Affiliation(s)
- James H. Rimmer
- Dean's Office, University of Alabama at Birmingham, Birmingham, AL, United States
- University of Alabama at Birmingham-Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
| | - Jereme Wilroy
- University of Alabama at Birmingham-Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Hui-Ju Young
- Dean's Office, University of Alabama at Birmingham, Birmingham, AL, United States
- University of Alabama at Birmingham-Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
| | - Raven Young
- University of Alabama at Birmingham-Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tanvee Sinha
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Madison Currie
- University of Alabama at Birmingham-Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
- Physical and Occupational Therapy Department, Rehabilitation Science Program, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Carla Rigo Lima
- University of Alabama at Birmingham-Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
- Physical and Occupational Therapy Department, Rehabilitation Science Program, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Byron Lai
- University of Alabama at Birmingham-Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
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Abbott L, Lemacks J, Greer T. Development and Evaluation of a Measure for Social Support Provided by Friends during Lifestyle Management Programs. Healthcare (Basel) 2022; 10:901. [PMID: 35628038 PMCID: PMC9140622 DOI: 10.3390/healthcare10050901] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023] Open
Abstract
Obesity is a public health crisis that contributes to chronic disease prevalence, morbidity, and mortality. Nutrition and physical activity are risk factors for many chronic diseases including cancer and cardiovascular disease, the leading causes of death in the United States. Lifestyle management programs to address obesity and potential sequelae such as chronic conditions have shown efficacy, with social support an important factor in interventions. Instruments that assess social support specifically provided by friends are lacking but could be important predictors of program success. The purpose of this study was to examine the reliability and validity of the 10-item Social Support to Eat Better and Move More instrument that was developed and designed to measure support from friends that influence dietary and physical activity behaviors during lifestyle management programs. Data were collected during a cross-sectional study using purposive sampling strategies among adult residents of two southern states. Statistical analysis was conducted to examine latent factors, internal consistency, and convergent and predictive validity. These preliminary results indicated that the Social Support to Eat Better and Move More instrument had excellent internal consistency for the overall measure (α = 0.96) as well as for informational support (α = 0.97), emotional support (α = 0.96), and encouragement (α = 0.97). The tool related well to another general social support measure as well as to diet, physical activity, and health-related variables, and it can be a useful measure in lifestyle management studies.
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Affiliation(s)
- Laurie Abbott
- College of Nursing, Florida State University, Tallahassee, FL 32306, USA
| | - Jennifer Lemacks
- College of Nursing and Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA;
| | - Tammy Greer
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS 339406, USA;
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Adhikari P, Gollub E. Evaluation of the Small Changes, Healthy Habits Pilot Program: Its Influence on Healthy Eating and Physical Activity Behaviors of Adults in Louisiana. Eur J Investig Health Psychol Educ 2021; 11:251-262. [PMID: 34542462 PMCID: PMC8314334 DOI: 10.3390/ejihpe11010019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/18/2021] [Revised: 02/24/2021] [Accepted: 02/27/2021] [Indexed: 11/16/2022] Open
Abstract
The community-based Small Changes, Healthy Habits (SCHH) program was developed to teach skills and techniques to help adults in Louisiana make and maintain small behavioral changes in their food selection, preparation, and consumption, and in physical activity routines. The content of this four-week program included habit formation and goal setting techniques; physical activity guidance; strategies for a healthier home food environment; a grocery store tour focused on label reading for healthier food selections; basic knife and cooking skills. The program was piloted at ten sites throughout the state. A survey with 14 core items was applied before and after the program to evaluate participant acquisition of skills and behaviors associated with topic areas. A total of 47 participants provided complete data sets. Post-program, these participants reported increased confidence in preparing healthy meals at home (p = 0.04); changes in fats (p = 0.03) and salt (p = 0.01) intake; increased frequency of reading nutrition labels (32%); decreased frequency of meals eaten outside the home (Improvement Index = 0.27); and decreased time/day spent sitting (p < 0.05). These short-term results suggest that the SCHH program has potential to positively affect healthy eating and to reduce sedentary behaviors, both of which are fundamental to good health and wellness.
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Affiliation(s)
- Praja Adhikari
- Department of Nutrition, University of North Carolina, Greensboro, NC 27412, USA;
| | - Elizabeth Gollub
- School of Nutrition and Food Sciences, Louisiana State University Agricultural Center, Baton Rouge, LA 70803, USA
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Wiener CH, Cassisi JE, Blaney CL, Newins AR, Gros B. A randomized trial of a brief behavioral health lifestyle program for outpatient cardiology clinics. J Health Psychol 2020; 27:176-187. [PMID: 32772857 DOI: 10.1177/1359105320945003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Research on lifestyle programs for patients with coronary artery disease (CAD) has largely recruited from hospitals and/or recruited following acute coronary syndrome. By contrast, this study evaluated a 3-session behavioral health program for patients with stable CAD treated in an outpatient cardiology clinic. Thirty-three patients were randomized to the behavioral lifestyle intervention or to Treatment as Usual (TAU). A priori feasibility and acceptability criteria were met, and reliable change analyses revealed that at post-treatment and 30-day follow-up, significantly more intervention participants than TAU participants exhibited increased self-efficacy compared with baseline.
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Rossimel E, Teasdale SB, Poole J, Fibbins H, Curtis J, Watkins A, Rosenbaum S, Ward PB. Keeping our staff in mind: Dietary results of a lifestyle intervention targeting mental health staff. Health Promot J Austr 2020; 32:451-457. [PMID: 32589312 DOI: 10.1002/hpja.377] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/22/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUES ADDRESSED 1) Describe the dietary intake of mental health staff within South Eastern Sydney Local Health District and 2) Evaluate the impact of an individualised staff lifestyle program on the following nutrition parameters; (i) energy, (ii) core food groups and (iii) discretionary foods. METHODS This was a pragmatic single-arm intervention study, conducted for all staff working in a public mental health service, in Sydney, Australia. A five-session individualised lifestyle intervention delivered over 5 weeks incorporated nutritional counselling delivered by a dietitian. Participants were assessed at baseline, following the intervention, and at follow-up using diet history to assess dietary intake. RESULTS Eighty-eight staff completed the dietary intervention and follow-up. An intake of core food groups significantly below national recommendations was reported for total vegetables (-1.75 ± 0.14 serves, P < .001), fruit (-0.29 ± 0.11 serves, P = .01), grains (-1.25 ± 0.20 serves, P < .001) and dairy servings (-1.00 ± 1.08 serves, P < .001), and protein-based foods were significantly above national recommendations (0.2 ± 0.09 serves, P = .03). At completion of the program, energy from discretionary foods was reduced by 460 kJ (95% CI -635 to -285, P < .001), and the serves of total vegetables (0.91 serves, 95% CI 0.59-1.22, P < .001) and dairy (0.31 serves, 95% CI 0.11-0.50, P < .001) were increased significantly. CONCLUSIONS A workplace-based well-being program for staff working in the mental health setting coincided with dietary improvements. SO WHAT Mental health staff can act as positive role models for clients to promote developing positive physical health behaviours.
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Affiliation(s)
- Elisa Rossimel
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
| | - Scott B Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Josephine Poole
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
| | - Hamish Fibbins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Jackie Curtis
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Andrew Watkins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Black Dog Institute, Sydney, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Schizophrenia Research Unit, South Western Sydney Local Health District, and Ingham Institute for Applied Medical Research, Sydney, Australia
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Arenaza L, Medrano M, Oses M, Amasene M, Díez I, Rodríguez-Vigil B, Labayen I. The Effect of a Family-Based Lifestyle Education Program on Dietary Habits, Hepatic Fat and Adiposity Markers in 8-12-Year-Old Children with Overweight/Obesity. Nutrients 2020; 12:E1443. [PMID: 32429379 DOI: 10.3390/nu12051443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 12/18/2022] Open
Abstract
Healthy lifestyle education programs are recommended for obesity prevention and treatment. However, there is no previous information on the effects of these programs on the reduction of hepatic fat percentage. The aims were (i) to examine the effectiveness of a 22-week family-based lifestyle education program on dietary habits, and (ii) to explore the associations of changes in dietary intake with percent hepatic fat reduction and adiposity in children with overweight/obesity. A total of 81 children with overweight/obesity (aged 10.6 ± 1.1 years, 53.1% girls) and their parents attended a 22-week family based healthy lifestyle and psychoeducational program accompanied with (intensive group) or without (control) an exercise program. Hepatic fat (magnetic resonance imaging), adiposity (dual energy X-ray absorptiometry) and dietary habits (two non-consecutive 24 h-recalls) were assessed before and after the intervention. Energy (p < 0.01) fat (p < 0.01) and added sugar (p < 0.03) intake were significantly reduced in both groups at the end of the program, while, in addition, carbohydrates intake (p < 0.04) was reduced exclusively in the control group, and simple sugar (p < 0.05) and cholesterol (p < 0.03) intake was reduced in the exercise group. Fruit (p < 0.03) and low-fat/skimmed dairy consumption (p < 0.02), the adherence to the Mediterranean Diet Quality Index for children and teenagers (KIDMED, p < 0.01) and breakfast quality index (p < 0.03) were significantly higher in both control and intervention groups after the intervention. Moreover, participants in the exercise group increased the adherence to the Dietary Approaches to Stop Hypertension (DASH) diet (p < 0.001), whereas the ratio of evening-morning energy intake was significantly lower exclusively in the control group after the program (p < 0.02). Changes in energy intake were significantly associated with changes in fat mass index (FMI) in the exercise group, whereas changes in sugar-sweetened beverages (SSB) consumption was associated with percent hepatic fat reduction (p < 0.05) in the control group. A 22-week family-based healthy lifestyle program seems to be effective on improving diet quality and health in children with overweight/obesity and these should focus on SSB avoidance and physical activity.
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McGill B, O’Hara BJ, Phongsavan P, Bauman A, Lawler L, Grunseit AC. "I'm Still on Track": A Qualitative Exploration of Participant Experiences of a Weight Loss Maintenance Program. Healthcare (Basel) 2020; 8:E21. [PMID: 31963312 PMCID: PMC7151193 DOI: 10.3390/healthcare8010021] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 01/22/2023] Open
Abstract
Qualitative evidence of participants' experiences of real-life weight loss maintenance programs is important for ongoing participant engagement and can inform program improvements. The purpose of this study was to understand how participants account for their engagement with a weight loss maintenance program and the role of the program in their weight management. A qualitative study using semi-structured interviews with 17 participants of a weight loss maintenance program was conducted; common themes were identified using a thematic inductive approach. Many participant narratives incorporated recurrent descriptions of their program experiences as a weight management journey. Our analysis generated four themes: returning to real life as a threat, the personal responsibility imperative, the program supporting agency and the program supporting self-regulation. The program, which provides external support and strategies, overlapped with the context of returning to real life and the personal responsibility imperative. Participant accounts of their journey at this intersection include the program supporting both agency and self-regulation which influences ongoing weight management. The interplay between themes identified and the maintenance program services allows compatibility between participants' sense of personal responsibility and the program components to help participants to 'stay on track' or 'get back on track'. In providing sufficient structure, opportunities to revisit successful strategies, and accountability, participants are empowered to overcome real-life threats and make positive health choices.
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Affiliation(s)
- Bronwyn McGill
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
- The Australian Prevention Partnership Centre, 235 Jones Street, Ultimo, NSW 2007, Australia
| | - Blythe J. O’Hara
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Adrian Bauman
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
- The Australian Prevention Partnership Centre, 235 Jones Street, Ultimo, NSW 2007, Australia
| | - Luke Lawler
- Prima Health Solutions, P.O. Box 7468, Warringah Mall, NSW 2100, Australia
| | - Anne C. Grunseit
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
- The Australian Prevention Partnership Centre, 235 Jones Street, Ultimo, NSW 2007, Australia
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Cheung NW, Blumenthal C, Smith BJ, Hogan R, Thiagalingam A, Redfern J, Barry T, Cinnadaio N, Chow CK. A Pilot Randomised Controlled Trial of a Text Messaging Intervention with Customisation Using Linked Data from Wireless Wearable Activity Monitors to Improve Risk Factors Following Gestational Diabetes. Nutrients 2019; 11:E590. [PMID: 30862052 PMCID: PMC6470941 DOI: 10.3390/nu11030590] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/05/2019] [Accepted: 03/05/2019] [Indexed: 01/21/2023] Open
Abstract
Gestational diabetes (GDM) is a highly prevalent disorder of pregnancy which portends a high risk for future type 2 diabetes. Limited evidence indicates lifestyle intervention prevents the development of diabetes, but most previously studied interventions are resource-intensive. Intervention programs that utilise newer technologies may be scalable at lower cost. This 6-month pilot randomized controlled trial tested the delivery of text messages linked to an activity monitor, adaptive physical activity goal setting, and limited face-to-face counseling, as an intervention to improve rates of post-partum glucose tolerance testing and lifestyle behaviours amongst women following a GDM pregnancy. Sixty subjects were randomised 2:1 intervention vs. control. Compared to control subjects, there were trends for intervention subjects to improve diet, increase physical activity, and lose weight. There was no difference between the groups in the rate of glucose tolerance testing. Only 46 (77%) subjects completed some, and 19 subjects completed all the elements of the final evaluation. Feedback regarding the text messages and activity monitor was highly positive. Overall, results suggest that a text message and activity monitor intervention is feasible for a larger study or even as a potentially scalable population health intervention. However, low completion rates necessitate carefully considered modification of the protocol.
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Affiliation(s)
- N Wah Cheung
- Department of Diabetes & Endocrinology, Westmead Hospital, Westmead NSW 2145, Australia.
- Westmead Clinical School & Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead NSW 2145, Australia.
| | - Caron Blumenthal
- Division of Women and Newborn Health, Westmead Hospital, Westmead NSW 2145, Australia.
| | - Ben J Smith
- School of Public Health, University of Sydney, Sydney NSW 2006, Australia.
| | - Roslyn Hogan
- Department of Diabetes & Endocrinology, Westmead Hospital, Westmead NSW 2145, Australia.
| | - Aravinda Thiagalingam
- Westmead Clinical School & Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead NSW 2145, Australia.
- Department of Cardiology, Westmead Hospital, Westmead NSW 2145, Australia.
| | - Julie Redfern
- Westmead Clinical School & Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead NSW 2145, Australia.
| | - Tony Barry
- Department of Cardiology, Westmead Hospital, Westmead NSW 2145, Australia.
| | - Nancy Cinnadaio
- Department of Diabetes & Endocrinology, Westmead Hospital, Westmead NSW 2145, Australia.
| | - Clara K Chow
- Westmead Clinical School & Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead NSW 2145, Australia.
- Department of Cardiology, Westmead Hospital, Westmead NSW 2145, Australia.
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Melchart D, Eustachi A, Gronwald S, Wühr E, Wifling K, Bachmeier BE. Introduction of a web portal for an Individual Health Management and observational health data sciences. Patient Relat Outcome Meas 2018; 9:183-196. [PMID: 29950912 PMCID: PMC6016587 DOI: 10.2147/prom.s157410] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background There is a global trend to a stronger active involvement of persons in the maintenance and restoring of health. The Competence Centre for Complementary Medicine and Naturopathy (CoCoNat) of the Technical University of Munich (TUM) has developed a lifestyle concept to enable each individual to manage his or her health – Individual Health Management (IHM) – and a web-based health portal named Virtual Tool for Education, Reporting, Information and Outcomes (VITERIO®), which addresses these needs for practice and research. Objectives The objectives of this study were to establish a core set of questionnaires for a self-assessment program on certain risk indications and comprehensive protection factors of health and to develop and enhance 1) tools for individual feedback, longitudinal self-monitoring, self-assessment, and (self-)care-planning; 2) training packages; 3) open notes and records for provider and patient; and 4) tools for monitoring groups and single participants in various indicators for individual coaching and scientific evaluation. Methods The CoCoNat of TUM, Faculty for Applied Health Science of Technische Hochschule Deggendorf, VITERIO® company, IHM campus network, and Erich Rothenfußer Foundation, Munich, provide a consortium responsible for content, research strategy, technical production and implication, postgraduate education for IHM coaches, implementation of IHM in various settings, and funding resources. Results A data set of indicators for health screening and self-monitoring of findings, symptoms, health behavior, and attitudes are integrated into a web-based health portal named VITERIO®. The article introduces some implemented graphical solutions of developed tools and gives examples for daily use. Conclusion Behavioral change and adaptation in attitudes and personal values are difficult issues of health education and lifestyle medicine. To address this problem best, the implementation of a patient-centric, performance measures-based program including open records and a blended learning concept were elaborated. The combination of an individual web-based health portal with personal coaching allows the implementation of IHM in everyday practice.
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Affiliation(s)
- Dieter Melchart
- Competence Centre for Complementary Medicine and Naturopathy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Axel Eustachi
- Competence Centre for Complementary Medicine and Naturopathy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Stephan Gronwald
- Applied Health Care Science, Deggendorf Institute of Technology, Deggendorf, Germany
| | - Erich Wühr
- Applied Health Care Science, Deggendorf Institute of Technology, Deggendorf, Germany
| | - Kristina Wifling
- Competence Centre for Complementary Medicine and Naturopathy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Beatrice E Bachmeier
- Competence Centre for Complementary Medicine and Naturopathy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,Institute of Laboratory Medicine, Ludwig-Maximilians-University, Munich, Germany
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Abstract
BACKGROUND Obesity is regarded as a modern lifestyle problem, causing illness, stigma, discrimination, and psychological problems. To help patients avoid these problems, physiotherapists increasingly engage in lifestyle programs specialized in weight loss. OBJECTIVE To explore how physiotherapists' encounters with patients diagnosed as "obese" acquire significance for their development as clinicians. METHOD The material draws on semi-structured interviews with eight physiotherapists. We conducted a thematic analysis inspired by van Manen's hermeneutic-phenomenological approach combined with Kvale and Brinkman's critical approach. FINDINGS The analysis identified the following four themes: 1) Striving to find one's own style of communication; 2) Relating to bodily discrepancies; 3) Developing clinical competence through bodily encounters; and 4) Gaining insight into the dilemmas of group-based lifestyle programs. Taken together, our findings highlight bodily encounters between patients and physiotherapists as an invaluable source of insight. Such insight can shape physiotherapists' development as clinicians inspiring them to develop their unique ways of communicating so that patients diagnosed as obese can feel empowerment rather than failure and shame. At the same time, our findings point to the need of critically reflecting on ones' own approach entering a double role of both controller and supporter. As such, our findings complicate and extend previous work on stigma and shame. CONCLUSION Our research leads us to conclude that more emphasis on critical thinking in physiotherapy is necessary. We suggest that this should be given more priority in research, education, as well as in clinical practice.
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Affiliation(s)
- Karen Synne Groven
- a Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway.,b Department of Health and society , Oslo University College , Norway
| | - Kristin Heggen
- a Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway
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de Sousa MV, Fukui R, Krustrup P, Pereira RMR, Silva PRS, Rodrigues AC, de Andrade JL, Hernandez AJ, da Silva MER. Positive effects of football on fitness, lipid profile, and insulin resistance in Brazilian patients with type 2 diabetes. Scand J Med Sci Sports 2015; 24 Suppl 1:57-65. [PMID: 24944132 DOI: 10.1111/sms.12258] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2014] [Indexed: 12/19/2022]
Abstract
We evaluated the effects of recreational football training combined with calorie-restricted diet (football + diet) vs calorie-restricted diet alone (diet) on aerobic fitness, lipid profile, and insulin resistance indicators in type 2 diabetes (T2D) patients. Forty-four T2D patients aged 48-68 years (27 females, 17 males) were randomly allocated to the football + diet group (FDG; n = 22) or to the diet group (DG; n = 22), of whom 19 FDG and 15 DG subjects completed the study. The football training was performed for 3 × 40 min/week for 12 weeks. Dual-energy X-ray absorptiometry scanning, treadmill testing, and fasting blood samplings were performed pre and post-intervention. After 12 weeks, maximal oxygen uptake (VO₂max ) was elevated (P < 0.05) by 10 ± 4% in FDG but not in DG (-3 ± 4%, P < 0.05). After 12 weeks, reductions in blood triglycerides (0.4 ± 0.1 mmol/L), total cholesterol (0.6 ± 0.2 mmol/L), low-density lipoprotein, and very low-density lipoprotein levels were observed only in FDG. Fat mass decreased (P < 0.05) by 3.4 ± 0.4 kg in FDG and 3.7 ± 0.4 kg in DG. The lower (P < 0.05) glucagon and homeostatic model assessment of insulin resistance indicated an improvement in insulin sensitivity in FDG. In conclusion, football combined with restricted diet was effective in enhancing VO₂max , reducing total cholesterol and triglycerides, and increasing insulin sensitivity, potentially providing better tools for the prevention of T2D complications than diet alone.
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Affiliation(s)
- M V de Sousa
- Laboratory of Medical Investigation, LIM-18, Endocrinology Division, School of Medicine, University of São Paulo, São Paulo, Brazil
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