Journal articles on the topic 'Exercise-based lifestyle interventions'
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1
Bartlett, David B., Cris A. Slentz, Margery A. Connelly, Lucy W. Piner, Leslie H. Willis, Lori A. Bateman, Esther O. Granville, Connie W. Bales, Kim M. Huffman, and William E. Kraus. "Association of the Composite Inflammatory Biomarker GlycA, with Exercise-Induced Changes in Body Habitus in Men and Women with Prediabetes." Oxidative Medicine and Cellular Longevity 2017 (2017): 1–12. http://dx.doi.org/10.1155/2017/5608287.
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GlycA is a new composite measure of systemic inflammation and a predictor of many inflammatory diseases. GlycA is the nuclear magnetic resonance spectroscopy-derived signal arising from glucosamine residues on acute-phase proteins. This study aimed to evaluate how exercise-based lifestyle interventions modulate GlycA in persons at risk for type 2 diabetes. GlycA, fitness, and body habitus were measured in 169 sedentary adults (45–75 years) with prediabetes randomly assigned to one of four six-month exercise-based lifestyle interventions. Interventions included exercise prescription based on the amount (energy expenditure (kcal/kg weight/week (KKW)) and intensity (%VO2peak). The groups were (1) low-amount/moderate-intensity (10KKW/50%) exercise; (2) high-amount/moderate-intensity (16KKW/50%) exercise; (3) high-amount/vigorous-intensity (16KKW/75%) exercise; and (4) a Clinical Lifestyle (combined diet plus low-amount/moderate-intensity exercise) intervention. Six months of exercise training and/or diet-reduced GlycA (mean Δ: −6.8 ± 29.2 μmol/L;p=0.006) and increased VO2peak(mean Δ: 1.98 ± 2.6 mL/kg/min;p<0.001). Further, visceral (mean Δ: −21.1 ± 36.6 cm2) and subcutaneous fat (mean Δ: −24.3 ± 41.0 cm2) were reduced, while liver density (mean Δ: +2.3 ± 6.5HU) increased, allp<0.001. When including individuals in all four interventions, GlycA reductions were associated with reductions in visceral adiposity (p<0.03). Exercise-based lifestyle interventions reduced GlycA concentrations through mechanisms related to exercise-induced modulations of visceral adiposity. This trial is registered with Clinical Trial Registration Number NCT00962962.
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Wang, Elizabeth Y., Rebecca E. Graff, June M. Chan, Crystal S. Langlais, Jeanette M. Broering, Justin W. Ramsdill, Elizabeth R. Kessler, Kerri M. Winters-Stone, Erin L. Van Blarigan, and Stacey A. Kenfield. "Web-Based Lifestyle Interventions for Prostate Cancer Survivors: Qualitative Study." JMIR Cancer 6, no. 2 (November 10, 2020): e19362. http://dx.doi.org/10.2196/19362.
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Background Exercise and a healthy diet can improve the quality of life and prognosis of prostate cancer survivors, but there have been limited studies on the feasibility of web-based lifestyle interventions in this population. Objective This study aims to develop a data-driven grounded theory of web-based engagement by prostate cancer survivors based on their experience in the Community of Wellness, a 12-week randomized clinical trial designed to support healthy diet and exercise habits. Methods TrueNTH’s Community of Wellness was a four-arm pilot study of men with prostate cancer (N=202) who received progressive levels of behavioral support (level 1: website; level 2: website with individualized diet and exercise recommendations; level 3: website with individualized diet and exercise recommendations, Fitbit, and text messages; and level 4: website with individualized diet and exercise recommendations, Fitbit and text messages, and separate phone calls with an exercise trainer and a registered dietitian). The primary aim of the study is to determine the feasibility and estimate the effects on behaviors (results reported in a separate paper). Following the 12-week intervention, we invited participants to participate in 4 focus groups, one for each intervention level. In this report, we used grounded theory analyses including open, axial, and selective coding to generate codes and themes from the focus group transcripts. Categories were refined across levels using embodied categorization and constant comparative methods. Results In total, 20 men with prostate cancer participated in the focus groups: 5, 4, 5, and 6 men in levels 1, 2, 3, and 4, respectively. Participants converged on 5 common factors influencing engagement with the intervention: environment (home environment, competing priorities, and other lifestyle programs), motivation (accountability and discordance experienced within the health care system), preparedness (technology literacy, health literacy, trust, and readiness to change), program design (communication, materials, and customization), and program support (education, ally, and community). Each of these factors influenced the survivors’ long-term impressions and habits. We proposed a grounded theory associating these constructs to describe the components contributing to the intuitiveness of a web-based lifestyle intervention. Conclusions These analyses suggest that web-based lifestyle interventions are more intuitive when we optimize participants’ technology and health literacy; tailor interface design, content, and feedback; and leverage key motivators (ie, health care providers, family members, web-based coach) and environmental factors (ie, familiarity with other lifestyle programs). Together, these grounded theory–based efforts may improve engagement with web-based interventions designed to support prostate cancer survivorship.
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Chang, Shu-Hung, Nai-Hui Chien, and Ching-Yi Yu. "Long-Term Lifestyle Intervention in Elderly With Metabolic Syndrome." Clinical Nursing Research 28, no. 6 (December 24, 2017): 658–75. http://dx.doi.org/10.1177/1054773817749923.
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The purpose of this study was to examine the effects of a long-term community-based lifestyle intervention on the biochemical indicators and prevalence of metabolic syndrome among elderly adults. This was a randomized controlled trial in northern Taiwan from August 2013 to February 2015. Sixty-nine elderly adults participated in this study. There were three measurements. The experimental group participated in exercise and diet interventions. The control group participated in the exercise intervention. Repeated measurement and ANCOVA were performed to evaluate the effectiveness. After 18 months, body weight (1.06 kg), body mass index (1.21 kg/m2), waist circumference (3.32 cm), blood pressure, and prevalence (30.4%) of metabolic syndrome were significantly reduced in all subjects. There were significant differences in waist circumference and high-density lipoprotein cholesterol between the two groups. This intervention can lower the indicators and prevalence of metabolic syndrome. Exercise and diet interventions could promote further metabolic changes.
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Nichols, Simon, Gordon McGregor, Jeff Breckon, and Lee Ingle. "Current Insights into Exercise-based Cardiac Rehabilitation in Patients with Coronary Heart Disease and Chronic Heart Failure." International Journal of Sports Medicine 42, no. 01 (July 10, 2020): 19–26. http://dx.doi.org/10.1055/a-1198-5573.
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AbstractCardiac rehabilitation is a package of lifestyle secondary prevention strategies designed for patients with coronary heart disease and chronic heart failure. A community-based cardiac rehabilitation programme provides patients with a structured exercise training intervention alongside educational support and psychological counselling. This review provides an update regarding the clinical benefits of community-based cardiac rehabilitation from a psycho-physiological perspective, and also focuses on the latest epidemiological evidence regarding potential survival benefits. Behaviour change is key to long-term adoption of a healthy and active lifestyle following a cardiac event. In order for lifestyle interventions such as structured exercise interventions to be adopted by patients, practitioners need to ensure that behaviour change programmes are mapped against patient’s priorities and values, and adapted to their level of readiness and intention to engage with the target behaviour. We review the evidence regarding behaviour change strategies for cardiac patients and provide practitioners with the latest guidance. The ‘dose’ of exercise training delivered to patients attending exercise-based cardiac rehabilitation is an important consideration because an improvement in peak oxygen uptake requires an adequate physiological stimulus to invoke positive physiological adaptation. We conclude by critically reviewing the latest evidence regarding exercise dose for cardiac patients including the role of traditional and more contemporary training interventions including high intensity interval training.
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Chen, X., C. Chiu, HT Cheung, ME White, X. Chen, L. Trinh, and AE Arthur. "Breast Cancer Survivors’ Preferences and Barriers Related to ICT-Based Diet and Physical Activity Interventions." Current Developments in Nutrition 5, Supplement_2 (June 2021): 967. http://dx.doi.org/10.1093/cdn/nzab051_011.
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Abstract Objectives To establish the preferences and perceived barriers related to physical activity and diet programming of breast cancer survivors (BCS) to inform the development of Information and Communication Technology (ICT)-based lifestyle interventions. Methods This was a cross-sectional study of 197 BSC aged 18 years or older and diagnosed with ductal carcinoma in situ (DCIS) or Stage I-IV breast cancer. The BCS were recruited during routine oncology appointments at a Midwestern cancer center. A survey was conducted to query survivors’ level of interest in, preferences for, and perceived barriers to participating in an exercise and dietary intervention program, with a specific emphasis on ICT-based programming. Results Overall, 85% of BCS reported they would consider participating in exercise and diet intervention research. Approximately 45% of participants reported that they had received diet and/or exercise information as part of their cancer care. However, only 15% of the participants received such information from healthcare professionals with the appropriate expertise (e.g., Dietitian, Exercise Specialist). Over two-thirds of the participants reported frequent use of mobile devices and the internet, and 80% indicated comfort using these devices (e.g., tablet, smart phone). The top three preferred formats for an ICT-based diet and exercise intervention program were “website”, “mobile apps” and “e-mails”. Older participants (>60 years) were more likely to report a preference for e-mails while younger participants (<60 years) were more likely to report a preference for websites or mobile apps. The most common perceived barriers to participation in a lifestyle intervention included fatigue, family responsibility and work. Conclusions Most BCS in this study were interested in exercise and diet interventions and would be comfortable with an ICT-based format with a preference for delivery via websites, mobile apps or e-mails. Future ICT-based lifestyle interventions should be designed with consideration of BCS’ age, barriers, facilitators and other characteristics. Funding Sources USDA-NIFA Hatch Project 1,011,487
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Geerkens, Maud J. M., Nieck S. A. Pouwels, and Harry P. Beerlage. "The effectiveness of lifestyle interventions to reduce side effects of androgen deprivation therapy for men with prostate cancer: a systematic review." Quality of Life Research 29, no. 4 (December 12, 2019): 843–65. http://dx.doi.org/10.1007/s11136-019-02361-z.
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Abstract Purpose The aim of this review is to systematically review randomized controlled trials on lifestyle interventions on PCa patients undergoing androgen deprivation therapy. Methods A literature search was conducted using the electronic databases Medline and PubMed. To be eligible, studies had to be randomized controlled trials (RCTs) that focused on side effects of ADT and lifestyle interventions to reduce side effects for men undergoing ADT with PCa. Lifestyle interventions were defined as interventions that included any dietary or behavioral components. Results Twenty-nine trials were included. Most of them focused on exercise interventions, while some investigated the effect of dietary or behavioral interventions. The effect of different lifestyle influencing modalities aimed to improve on the adverse effects of ADT varied greatly. Conclusions It is not possible to draw one conclusion on the effect of exercise-based interventions, but noted on several adverse effects of ADT improvement. Further studies are necessary to develop personalized lifestyle interventions in order to mitigate the adverse effects.
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Ko, Yi, and Soi Moi Chye. "Lifestyle intervention to prevent Alzheimer’s disease." Reviews in the Neurosciences 31, no. 8 (November 18, 2020): 817–24. http://dx.doi.org/10.1515/revneuro-2020-0072.
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AbstractAlzheimer’s disease (AD) is the most common neurodegenerative disease that leads to significant morbidities in elderly. The major pathological hallmark of AD is beta-amyloid plaques (Aβ) and intracellular neurofibrillary tangles (NFTs) deposition in hippocampus of the brain. These abnormal protein deposition damages neuronal cells resulting in neurodegeneration and cognitive decline. As a result of limited treatment options available for this disease, there is huge economic burden for patients and social health care system. Thus, alternative approaches (lifestyle intervention) to prevent this disease are extremely important. In this systemic review, we summarized epidemiological evidence of lifestyle intervention and the mechanisms involved in delaying and/or preventing AD. Lifestyle interventions include education, social engagement and cognitive stimulation, smoking, exercise, depression and psychological stress, cerebrovascular disease (CVD), hypertension (HTN), dyslipidaemia, diabetes mellitus (DM), obesity and diet. The methods are based on a literature review of available sources found on the research topic in four acknowledged databases: Web of Science, Scopus, Medline and PubMed. Results of the identified original studies revealed that lifestyle interventions have significant effects and our conclusion is that combination of early lifestyle interventions can decrease the risk of developing AD.
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Quinn, Lori, Anne Rosser, and Monica Busse. "Critical Features in the Development of Exercise-based Interventions for People with Huntington's Disease." European Neurological Review 8, no. 1 (2012): 10. http://dx.doi.org/10.17925/enr.2013.08.01.10.
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Exercise and physical therapies are increasingly being considered as a lifestyle intervention in people with Huntington's disease (HD). In addition to possible effects on motor function, there may be benefits in mood, behaviour and cognition from early in the disease. Certainly exercise may also infer general health benefits and there are recent suggestions that exercise may indeed potentiate disease modification. This review provides an overview of a strategic approach to the development and evaluation of complex exercise interventions in this neurodegenerative disease with a view to informing future clinical trials.
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Kim, Tae Jin, and Kyo Chul Koo. "Pathophysiology of Bone Loss in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy and Lifestyle Modifications for the Management of Bone Health: A Comprehensive Review." Cancers 12, no. 6 (June 10, 2020): 1529. http://dx.doi.org/10.3390/cancers12061529.
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Androgen-deprivation therapy (ADT) is a systemic therapy administered for the management of advanced prostate cancer (PCa). Although ADT may improve survival, long-term use reduces bone mass density (BMD), posing an increased risk of fracture. Considering the long natural history of PCa, it is essential to preserve bone health and quality-of-life in patients on long-term ADT. As an alternative to pharmacological interventions targeted at preserving BMD, current evidence recommends lifestyle modifications, including individualized exercise and nutritional interventions. Exercise interventions include resistance training, aerobic exercise, and weight-bearing impact exercise, and have shown efficacy in preserving BMD. At the same time, it is important to take into account that PCa is a progressive and debilitating disease in which a substantial proportion of patients on long-term ADT are older individuals who harbor axial bone metastases. Smoking cessation and limited alcohol consumption are commonly recommended lifestyle measures in patients receiving ADT. Contemporary guidelines regarding lifestyle modifications vary by country, organization, and expert opinion. This comprehensive review will provide an evidence-based, updated summary of lifestyle interventions that could be implemented to preserve bone health and maintain quality-of-life throughout the disease course of PCa.
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Motl, Robert W. "Lifestyle physical activity in persons with multiple sclerosis: the new kid on the MS block." Multiple Sclerosis Journal 20, no. 8 (March 6, 2014): 1025–29. http://dx.doi.org/10.1177/1352458514525873.
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Supervised exercise training has substantial benefits for persons with multiple sclerosis (MS), yet 80% of those with MS do not meet recommended levels of moderate-to-vigorous physical activity (MVPA). This same problem persisted for decades in the general population of adults and prompted a paradigm shift away from “exercise training for fitness” toward “physical activity for health.” The paradigm shift reflects a public health approach of promoting lifestyle physical activity through behavioral interventions that teach people the skills, techniques, and strategies based on established theories for modifying and self-regulating health behaviors. This paper describes: (a) the definitions of and difference between structured exercise training and lifestyle physical activity; (b) the importance and potential impact of the paradigm shift; (c) consequences of lifestyle physical activity in MS; and (d) behavioral interventions for changing lifestyle physical activity in MS. The paper introduces the “new kid on the MS block” with the hope that lifestyle physical activity might become an accepted partner alongside exercise training for inclusion in comprehensive MS care.
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Wiseman, Nicola, Neil Harris, and Patricia Lee. "Lifestyle knowledge and preferences in preschool children: Evaluation of the Get up and Grow healthy lifestyle education programme." Health Education Journal 75, no. 8 (July 28, 2016): 1012–24. http://dx.doi.org/10.1177/0017896916648726.
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Objective: Early childhood is considered a window of opportunity for lifestyle interventions, as this is a critical life-stage at which children accumulate knowledge and skills around behaviours such as eating and physical activity. This study examined how exposure to a settings-based healthy lifestyle programme influences knowledge and preference of food and physical play in preschool children. Design: Quasi-experimental, pre–post intervention design. Methods: Pre- and post-impact evaluation of a healthy lifestyle intervention using an innovative computerised photo-pair food and exercise questionnaire and an age-appropriate test of executive function. The study included 82 children aged 3–5 years and was structured with an intervention and a control group. Quantitative data were analysed using SPSS v22. Results: For the intervention group, there was a significant improvement in overall knowledge of healthy lifestyle behaviours post-intervention, particularly in the identification of healthy and unhealthy food choices. There was no associated change in behavioural preferences. Conclusion: The study highlighted that age-appropriate lifestyle interventions with preschool-aged children can lead to improved knowledge of healthy lifestyle choices. However, improvement in knowledge of healthy lifestyle behaviours does not necessarily lead to positive changes in food and activity preferences that inform choices.
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Zhang, Yu, Xiaohui Guo, Na Zhang, Xinyu Yan, Muxia Li, Mingzhu Zhou, Hairong He, et al. "Effect of Mobile-Based Lifestyle Intervention on Body Weight, Glucose and Lipid Metabolism among the Overweight and Obese Elderly Population in China: A Randomized Controlled Trial Protocol." International Journal of Environmental Research and Public Health 18, no. 9 (May 1, 2021): 4854. http://dx.doi.org/10.3390/ijerph18094854.
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Background: Promotion of a healthy lifestyle is considered a good strategy for dealing with chronic diseases. Mobile-based lifestyle interventions have shown beneficial effects in the control and treatment of chronic diseases such as diabetes, obesity and metabolic syndrome. Current clinical trials for mobile-based lifestyle intervention were mainly conducted among non-elderly populations, thus well-designed trials performed among the elderly who are more susceptible to chronic diseases are needed. The study aims to assess the effect of the mobile-based lifestyle intervention on the improvement of body weight, glucose and lipid metabolism among overweight and obese elderly adults in China. Materials and Methods: Participants aged 60–80 years who are overweight or obese will be randomly assigned to receive mobile-based nutrition and exercise intervention, mobile-based exercise intervention and no intervention for 3 months. Before the intervention, participants will receive the training of the mobile application and sports bracelet. The primary outcome will be the between-group (three groups) difference in body mass index at the end of intervention. The secondary outcomes will include body composition, parameters of glucose and lipid metabolism, blood pressure, dietary data and physical activity data. All these outcomes will be assessed at baseline, day 45 and day 90. Ethics and dissemination: The trial has been approved by the Ethics Committee of Peking University Health Science Center (IRB00001052-18039).
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Natalucci, Valentina, Edy Virgili, Federica Calcagnoli, Giacomo Valli, Deborah Agostini, Sabrina Donati Zeppa, Elena Barbieri, and Rita Emili. "Cancer Related Anemia: An Integrated Multitarget Approach and Lifestyle Interventions." Nutrients 13, no. 2 (February 1, 2021): 482. http://dx.doi.org/10.3390/nu13020482.
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Cancer is often accompanied by worsening of the patient’s iron profile, and the resulting anemia could be a factor that negatively impacts antineoplastic treatment efficacy and patient survival. The first line of therapy is usually based on oral or intravenous iron supplementation; however, many patients remain anemic and do not respond. The key might lie in the pathogenesis of the anemia itself. Cancer-related anemia (CRA) is characterized by a decreased circulating serum iron concentration and transferrin saturation despite ample iron stores, pointing to a more complex problem related to iron homeostatic regulation and additional factors such as chronic inflammatory status. This review explores our current understanding of iron homeostasis in cancer, shedding light on the modulatory role of hepcidin in intestinal iron absorption, iron recycling, mobilization from liver deposits, and inducible regulators by infections and inflammation. The underlying relationship between CRA and systemic low-grade inflammation will be discussed, and an integrated multitarget approach based on nutrition and exercise to improve iron utilization by reducing low-grade inflammation, modulating the immune response, and supporting antioxidant mechanisms will also be proposed. Indeed, a Mediterranean-based diet, nutritional supplements and exercise are suggested as potential individualized strategies and as a complementary approach to conventional CRA therapy.
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Van Roie, Evelien, Christophe Delecluse, Joke Opdenacker, Katrien De Bock, Eva Kennis, and Filip Boen. "Effectiveness of a Lifestyle Physical Activity Versus a Structured Exercise Intervention in Older Adults." Journal of Aging and Physical Activity 18, no. 3 (July 2010): 335–52. http://dx.doi.org/10.1123/japa.18.3.335.
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Two groups of sedentary older adults, participating in either a lifestyle physical activity intervention (LIFE,n= 60) or a structured exercise intervention (STRU,n= 60), were compared with a control group (CO,n= 66) in terms of physical fitness and cardiovascular risk factors. Participants in LIFE were stimulated to integrate physical activity into their daily routines and received an individualized home-based program. Participants in STRU completed 5 supervised training sessions every 2 wk in a fitness center. Both interventions lasted 11 months and focused on endurance, strength, flexibility, and postural/balance exercises. The results revealed that the interventions were equally effective in improving functional performance. STRU was more effective than LIFE in improving cardiorespiratory and muscular fitness. Limited effects emerged on cardiovascular risk, with STRU improving in total cholesterol and HDL. Consequently, interventions aiming at reducing cardiovascular risks among sedentary elderly should focus on long-term changes in physical activity behavior.
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Delshad Noghabi, Ali, Mohammad Hossein Bayazi, and Ali Reza Rajaei. "Effectiveness of Self-management Interventions Based on Cognitive-behavioral Group Therapy on Life-style Among Adults With Metabolic Syndrome: A Randomized Clinical Trial." Journal of Research and Health 11, no. 2 (April 1, 2021): 113–22. http://dx.doi.org/10.32598/jrh.11.2.321.3.
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Background: Metabolic syndrome is an asymptomatic disorder and an important risk factor for cardiovascular disease and type 2 diabetes. Lifestyle modification and self-management of health-promoting behaviors are the most important actions to control metabolic syndrome. This study was done to investigate the effectiveness of self-management interventions based on group Cognitive-Behavioral Therapy (CBT) on lifestyle among adults with metabolic syndrome. Methods: This research was a randomized clinical trial study. First, 80 adults with metabolic syndrome were selected using the convenience sampling method, and then, using the randomized blockchain method, they were divided into two groups of 40 people (intervention and control groups). Data collection using the Health Promotion Lifestyle Profile II Questionnaire (HPLP II) was performed in two stages before and three months after the intervention. Teaching self-management interventions based on cognitive-behavioral therapy was done twice a week for eight 90-minute sessions. Data were analyzed using the Chi-square test, independent t-tests, and Analysis of Covariance (ANCOVA). A P-value less than 0.05 was considered significant. Results: the results of ANCOVA showed that self-management intervention based on group CBT had a significant effect on the dimensions of lifestyle, including exercise and physical activity with an effect size of 0.51, nutrition with 0.49, health responsibility with 0.39, and stress management with 0.32 (P<0.05), but it did not significantly affect the two dimensions of self-actualization and spiritual growth (effect size= 0.003, P=0.669) and interpersonal relationships (effect size= 0.029, P=0.151). Conclusion: Self-management interventions based on group CBT can improve lifestyle and some dimensions in adults with metabolic syndrome. Identifying people with metabolic syndrome and performing effective interventions with the active participation of the individual through self-management based on cognitive-behavioral therapy seem necessary.
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Hodge, Allen, Alexis Williams, Anita D'Souza, Patricia M. Sheean, Parameswaran Hari, Binod Dhakal, Kathryn E. Flynn, and Melinda Stolley. "Exploring multiple myeloma survivor interest in lifestyle interventions." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e20558-e20558. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e20558.
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e20558 Background: Multiple Myeloma (MM) is the second most common hematological malignancy in the U.S., with higher rates observed in older adults and African Americans (AA). Given treatment advances, most individuals survive at least 5-10 years, making symptom management important. Many survivors struggle with pain, fatigue and limited physical function, all of which may be improved through lifestyle changes. Due to concerns about safety and patient interest, few efforts have considered such interventions. We report the results of an exploratory study to inform a lifestyle program tailored to the needs of the diverse MM survivor community. Methods: MM survivors at least 100 days post-auto transplant with ECOG status of 0-1 completed validated questionnaires and a qualitative interview assessing quality of life, physical activity patterns, social support and interests for a lifestyle program. Results: We recruited 20 survivors, mean age 70 (7.0) years, 70% women, 40% African American, 75% married, 60% college educated. Eighty-three percent were overweight or obese, mean Godin score was 17.56 (18.1) representing insufficient physical activity and 78% did not engage in resistance training at least twice weekly. PROMIS-29 scores indicated that MM survivors had worse physical function, fatigue and pain interference than the general population. However, they reported less social isolation and more social support (informational, instrumental, emotional, companionship). Qualitative data highlighted barriers to healthy lifestyles including “not knowing what dietary changes to make,” fatigue, and safety concerns related to physical activity. Although 67% reported that their oncology team had discussed lifestyle changes with them, most related minimal guidance was given, leaving them confused and wanting more information. All participants acknowledged the potential benefits of healthy eating and exercise on function, fatigue, pain and mood. Particular interests for a lifestyle program included: 1) focused dietary counseling with recipes and cooking guidance; 2) health coach to motivate, and to model and monitor safe exercise; 3) healthcare provider engagement to address health concerns; and 4) preference for in-person with opportunity for web-based program if unable to attend. Many were interested in joining an advisory group to inform intervention development and survivor engagement. Conclusions: MM survivors emphasized their strong interest in having a program where they could meet other MM survivors, discuss their concerns, but also focus on positive behavior changes.
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Jayaprakash, Manasi, Ankita Puri-Taneja, Namratha R. Kandula, Himali Bharucha, Santosh Kumar, and Swapna S. Dave. "Qualitative Process Evaluation of a Community-Based Culturally Tailored Lifestyle Intervention for Underserved South Asians." Health Promotion Practice 17, no. 6 (July 9, 2016): 802–13. http://dx.doi.org/10.1177/1524839916650165.
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Introduction. There are few examples of effective cardiovascular disease prevention interventions for South Asians (SAs). We describe the results of a process evaluation of the South Asian Heart Lifestyle Intervention for medically underserved SAs implemented at a community-based organization (CBO) using community-based participatory research methods and a randomized control design (n = 63). Method. Interviews were conducted with 23 intervention participants and 5 study staff using a semistructured interview guide focused on participant and staff perceptions about the intervention’s feasibility and efficacy. Data were thematically analyzed. Results. Intervention success was attributed to trusted CBO setting, culturally concordant study staff, and culturally tailored experiential activities. Participants said that these activities helped increase knowledge and behavior change. Some participants, especially men, found that self-monitoring with pedometers helped motivate increased physical activity. Participants said that the intervention could be strengthened by greater family involvement and by providing women-only exercise classes. Staff identified the need to reduce participant burden due to multicomponent intervention and agreed that the CBO needed greater financial resources to address participant barriers. Conclusion. Community-based delivery and cultural adaptation of an evidence-based lifestyle intervention were effective and essential components for reaching and retaining medically underserved SAs in a cardiovascular disease prevention intervention study.
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Bhimla, Aisha, Ksenia Power, Michael Sachs, Allegra Bermudez, Jessica Dinh, Nicholas San Juan, and Grace X. Ma. "Evaluating psychosocial and physical activity outcomes following an intervention among Filipino Americans." Health Promotion Perspectives 11, no. 2 (May 19, 2021): 210–18. http://dx.doi.org/10.34172/hpp.2021.26.
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Background: Physical activity (PA) is a strong contributor to enhancing a healthy lifestyle and preventing numerous chronic diseases. As ethnic minorities engage in low levels of PA, psychosocial and activity-based interventions for sustaining PA are crucial. Methods: The 6-month intervention incorporated culturally tailored educational workshops and weekly PA classes at a community center. Educational workshops were led by six trained community health workers (CHWs). Participants (n=37) completed pre- and post-intervention questionnaires regarding PA related self-efficacy, outcome expectations, social support, enjoyment, self-regulation, goal setting, and overall PA. Results: Following the intervention, study participants exhibited increases in weekly PA levels. Wilcoxon Signed-Rank test revealed higher median scores for Exercise Self-Efficacy Scale (ESES), Identified Regulation, and Intrinsic Motivation. Positive changes were observed for Physical Outcome Expectations, Social Outcome Expectations, Self-Evaluative Outcome Expectations, Physical Activity Enjoyment, Social Support for Exercise Scale – Family, Social Support for Exercise – Friends, and Exercise Goal-Setting. Conclusion: Community-based PA interventions may provide potential benefits to Filipino Americans, an ethnic Asian minority group, in identifying exercise benefits, developing proper exercise goals, increasing motivation, promoting PA behavior, and facilitating long-term PA adherence.
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Sanft, Tara B., Maura Harrigan, Brenda Cartmel, Leah M. Ferrucci, Karen Basen-Engquist, Dawn L. Hershman, Jennifer A. Ligibel, et al. "A randomized trial of a healthy lifestyle intervention versus usual care on chemotherapy and endocrine therapy adherence rate in women with breast cancer: The Lifestyle Exercise and Nutrition Early After Diagnosis (LEANER) Study." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): TPS11633. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.tps11633.
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TPS11633 Background: The World Cancer Research Fund and the American Cancer Society provide diet and exercise guidelines for cancer survivors. Many women with breast cancer do not follow these guidelines. Adoption of recommended lifestyle behaviors soon after diagnosis may prevent adverse changes in body composition, breast cancer biomarkers, and may improve adherence to treatment thereby improving breast cancer prognosis. The Lifestyle, Exercise, and Nutrition Early after Diagnosis (LEANER) study is testing the impact of a healthy lifestyle intervention on chemotherapy completion and endocrine therapy adherence. Secondary endpoints include changes in inflammatory and metabolic biomarkers, body composition, and patient reported outcomes. Methods: Eligible participants are women with stage I-III breast cancer undergoing chemotherapy. 250 participants are being recruited and randomized 1:1 to a yearlong, 16 session, healthy diet and exercise counseling intervention or usual care group. The intervention is delivered in person and/or via telephone by registered dietitians with training in exercise science. Materials include workbooks, videos, cookbooks, fit bits, and home-based exercise equipment. Intervention is focused on graduated goal setting to meet the recommended diet and exercise guidelines for cancer survivors. The primary endpoint, chemotherapy completion rate, is gathered from the Electronic Medical Record and the average Relative Dose Intensity for the originally planned regimen is calculated based on standard formulas. Assessments are completed at baseline, post chemotherapy, 1- and 2- year time points (to assess adherence to endocrine therapy). Body composition is measured using dual energy X-ray absorptiometry, blood samples and patient reported outcomes are collected. At time of submission, 39 women have been randomized. Discussion: If successful, this study has the potential to make healthy lifestyle interventions initiated shortly after diagnosis a standard component of breast cancer treatment. Clinical trial information: NCT03314688.
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Reinehr, Thomas. "Effectiveness of lifestyle intervention in overweight children." Proceedings of the Nutrition Society 70, no. 4 (August 1, 2011): 494–505. http://dx.doi.org/10.1017/s0029665111000577.
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Therapy of choice in obese children and adolescents is lifestyle intervention based on nutrition education, behavioural treatment and exercise treatment. Its efficacy even after the end of intervention has been proven by several randomised-controlled trials and meta-analyses including a recent Cochrane review. However, randomised-controlled trials are likely to overestimate the effectiveness. Studies under normal day-to-day circumstances demonstrated only a very moderate effect on weight loss (<10% success rate 2 years after the onset of intervention). A reduction of >0·5 SDS-BMI (which means a stable weight over 1 year in growing children) is associated with an improvement of cardiovascular risk factors, while improvements of quality of life seem independent of the degree of weight loss. Younger children and less overweight children particularly profit from lifestyle interventions in contrast to extremely obese adolescents. Recent studies demonstrated that involving parents is crucial for success, suggesting that parents and children and not children alone should be the primary target of interventions. Failures in weight reduction are attributed not only to a lack of motivation but also to other aspects particular to the genetic background. The techniques, more than the contents, of an intervention influence the treatment outcome. Besides behavioural therapy, systemic and solution-focused treatments are important. Future longitudinal research should focus on the identification of which children and adolescents profit from which kind of intervention, in order to be able to tailor specific treatment approaches. Studies under normal day-to-day circumstances are necessary to prove the benefit of this kind of intervention.
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Scruggs, Stacie, Scherezade K. Mama, Cindy L. Carmack, Tommy Douglas, Pamela Diamond, and Karen Basen-Engquist. "Randomized Trial of a Lifestyle Physical Activity Intervention for Breast Cancer Survivors: Effects on Transtheoretical Model Variables." Health Promotion Practice 19, no. 1 (June 19, 2017): 134–44. http://dx.doi.org/10.1177/1524839917709781.
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This study examined whether a physical activity intervention affects transtheoretical model (TTM) variables that facilitate exercise adoption in breast cancer survivors. Sixty sedentary breast cancer survivors were randomized to a 6-month lifestyle physical activity intervention or standard care. TTM variables that have been shown to facilitate exercise adoption and progress through the stages of change, including self-efficacy, decisional balance, and processes of change, were measured at baseline, 3 months, and 6 months. Differences in TTM variables between groups were tested using repeated measures analysis of variance. The intervention group had significantly higher self-efficacy ( F = 9.55, p = .003) and perceived significantly fewer cons of exercise ( F = 5.416, p = .025) at 3 and 6 months compared with the standard care group. Self-liberation, counterconditioning, and reinforcement management processes of change increased significantly from baseline to 6 months in the intervention group, and self-efficacy and reinforcement management were significantly associated with improvement in stage of change. The stage-based physical activity intervention increased use of select processes of change, improved self-efficacy, decreased perceptions of the cons of exercise, and helped participants advance in stage of change. These results point to the importance of using a theory-based approach in interventions to increase physical activity in cancer survivors.
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Biviá-Roig, Gemma, Ruth Blasco-Sanz, Ana Boldó-Roda, M. Dolores Vara, Tamara Escrivá-Martínez, Rocío Herrero, Valentina Lucia La Rosa, Rosa M. Baños, and Juan Francisco Lisón. "Efficacy of an Internet-Based Intervention to Promote a Healthy Lifestyle on the Reproductive Parameters of Overweight and Obese Women: Study Protocol for a Randomised Controlled Trial." International Journal of Environmental Research and Public Health 17, no. 22 (November 10, 2020): 8312. http://dx.doi.org/10.3390/ijerph17228312.
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Background: Infertility is estimated to affect 15% of couples of reproductive age. Weight management problems (being obese or overweight) are among the problems that produce infertility, both in women seeking spontaneous pregnancy and in those undergoing assisted reproduction techniques. Over the last few decades, the prevalence of obesity has increased alarmingly in our society and is now considered one of the most important public health problems. The combination of diet and exercise to achieve weight loss are currently considered an effective intervention for the improvement of reproductive parameters in overweight or obese infertile women. In other population groups, it has been shown that Internet-based interventions are just as effective as traditional ones, and these cover a larger population with a good cost–benefit ratio. However, to the best of our knowledge, no studies so far have analysed any specific online interventions for this group of infertile women. Thus, the objective of this project will be to evaluate the effectiveness of an online program to promote a healthy lifestyle among women who are overweight or obese who also have a diagnosis of infertility and are on the waiting list for in vitro fertilisation treatment. Methods: This will be a randomised controlled clinical trial conducted in 94 women which will compare a self-administered Internet-based intervention promoting a healthy lifestyle in terms of diet and exercise (n = 47) to a control group that will receive standard medical care. The online program will comprise nine modules, will last for 3 months, and will be monitored every 3 months after the intervention until the final follow-up at 12 months. The main outcome will be the spontaneous pregnancy rate. Secondary outcomes will include changes in body composition, dietary and physical exercise habits, glycaemic profiles, lipid profiles, hormonal profiles, and patient quality of life related to their fertility problems. The data analysis will be done on an intention-to-treat basis. Discussion: The aim of this study is to increase our knowledge of the effectiveness of online interventions specifically adapted to infertile women who are overweight or obese in the promotion of healthy lifestyles.
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Haynam, Marcy, Ciaran Fairman, Jessica Bowman, Victoria DeScenza, Zachary Chaplow, Megan Kilar, Kathryn Dispennette, et al. "Preliminary efficacy of a community-based, group-mediated cognitive behavioral lifestyle intervention among breast cancer survivors." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e24035-e24035. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e24035.
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e24035 Background: Post-treatment weight gain places breast cancer (BCa) survivors at heightened risk for cardiovascular disease, metabolic syndrome, and functional decline. Lifestyle weight management (LWM) interventions combining exercise and dietary weight loss represents an effective approach to mitigating the adverse cardiometabolic and functional effects frequently observed in BCa survivors. Unfortunately, community access to cost-effective, sustainable, LWM interventions among BCa survivors remains limited. The purpose of this study is to determine the preliminary efficacy of a community-based LWM intervention in BCa survivors on select body composition (BC), physical function, and social cognitive outcomes of the first wave of participants in the Healthy New Albany Breast Cancer (HNABC) pilot trial. Methods: The 24-week, community-based pilot trial promotes lifestyle behavior changes through a group-mediated cognitive behavioral (GMCB) approach driven by Social Cognitive Theory. The measures analyzed were BC done via Dual-energy X-ray Absorptiometry, physical function via the 400m walk test, and social cognitive outcomes via satisfaction with function and appearance and perceived competence with exercise and diet at 6-months via effect size calculations using Cohen’s d. Results: Meaningful changes were observed in fat mass ( d= -0.46), percent lean mass ( d= 0.33), lean mass ( d= -0.45), and physical function ( d= -0.59), some of which reached clinical relevance. Select self-reported outcomes also saw meaningful improvements from this LWM intervention. Conclusions: Findings from this study demonstrate the preliminary efficacy of implementing a GMCB-based LWM intervention among overweight or obese BCa survivors. Given the meaningful impact that successful weight management has on reducing risk for chronic diseases, these results highlight the utility of implementing a LWM intervention in the community for BCa survivors in an effort to extend the access, reach, and scalability of supportive care approaches during BCa survivorship.
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Demark-Wahnefried, Wendy, Elizabeth C. Clipp, Miriam C. Morey, Carl F. Pieper, Richard Sloane, Denise Clutter Snyder, and Harvey J. Cohen. "Lifestyle Intervention Development Study to Improve Physical Function in Older Adults With Cancer: Outcomes From Project LEAD." Journal of Clinical Oncology 24, no. 21 (July 20, 2006): 3465–73. http://dx.doi.org/10.1200/jco.2006.05.7224.
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Purpose Declines in physical functioning (PF) among elderly cancer patients threaten quality of life and the ability to maintain independence. Adherence to healthy lifestyle behaviors may prevent functional decline. Patients and Methods Project Leading the Way in Exercise and Diet (LEAD), an intervention development study of the Pepper Older Americans Independence Center, aimed to determine whether breast and prostate cancer survivors (age 65+ years) assigned to a 6-month home-based diet and exercise intervention experienced improvements in PF when compared with an attention control arm receiving general health information. An accrual target was set at 420, and PF (Short Form-36 subscale), physical activity (Community Healthy Activities Models Program for Seniors), and diet quality (index from 3-day recalls) were assessed at baseline and at 6 and 12 months (6 months after intervention). Results This developmental project did not achieve its accrual target (N = 182); however, PF change scores were in the direction and of the magnitude projected. Baseline to 6-month change scores in the intervention versus the control arms were as follows: PF, +3.1 v −0.5 (P = .23); physical activity energy expenditure, +111 kcal/wk v −400 kcal/wk (P = .13); and diet quality index, +2.2 v −2.9 (P = .003), respectively. Differences between arms diminished during the postintervention period. Conclusion These findings suggest that home-based diet and exercise interventions hold promise in improving lifestyle behaviors among older cancer survivors, changes that trend toward improved PF. Future studies should incorporate larger sample sizes and interventions that sustain long-term effects and also take into account secular trends; these efforts will require adequate planning and resources to overcome the numerous barriers to intervening in this difficult to reach yet vulnerable population.
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Avila, Andrea, Jomme Claes, Roselien Buys, May Azzawi, Luc Vanhees, and Veronique Cornelissen. "Home-based exercise with telemonitoring guidance in patients with coronary artery disease: Does it improve long-term physical fitness?" European Journal of Preventive Cardiology 27, no. 4 (December 1, 2019): 367–77. http://dx.doi.org/10.1177/2047487319892201.
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Background Home-based interventions might facilitate the lifelong uptake of a physically active lifestyle following completion of a supervised phase II exercise-based cardiac rehabilitation. Yet, data on the long-term effectiveness of home-based exercise training on physical activity and exercise capacity are scarce. Objective The purpose of the TeleRehabilitation in Coronary Heart disease (TRiCH) study was to compare the long-term effects of a short home-based phase III exercise programme with telemonitoring guidance to a prolonged centre-based phase III programme in coronary artery disease patients. The primary outcome was exercise capacity. Secondary outcomes included physical activity behaviour, cardiovascular risk profile and health-related quality of life. Methods Ninety coronary artery disease patients (80 men) were randomly assigned to 3 months of home-based (30), centre-based (30) or a control group (30) on a 1:1:1 basis after completion of their phase II ambulatory cardiac rehabilitation programme. Outcome measures were assessed at discharge of the phase II programme and after one year. Results Eighty patients (72 (91%) men; mean age 62.6 years) completed the one-year follow-up measurements. Exercise capacity and secondary outcomes were preserved in all three groups ( Ptime > 0.05 for all), irrespective of the intervention ( Pinteraction > 0.05 for all). Eighty-five per cent of patients met the international guidelines for physical activity ( Ptime < 0.05). No interaction effect was found for physical activity. Conclusion Overall, exercise capacity remained stable during one year following phase II cardiac rehabilitation. Our home-based exercise intervention was as effective as centre-based and did not result in higher levels of exercise capacity and physical activity compared to the other two interventions. Trial registration ClinicalTrials.gov NCT02047942. https://clinicaltrials.gov/ct2/show/NCT02047942
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Maeda, Seiji, Asako Zempo-Miyaki, Hiroyuki Sasai, Takehiko Tsujimoto, Rina So, and Kiyoji Tanaka. "Lifestyle Modification Decreases Arterial Stiffness in Overweight and Obese Men: Dietary Modification vs. Exercise Training." International Journal of Sport Nutrition and Exercise Metabolism 25, no. 1 (February 2015): 69–77. http://dx.doi.org/10.1123/ijsnem.2013-0107.
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Obesity and increased arterial stiffness are independent risk factors for cardiovascular disease. Arterial stiffness is increased in obese individuals than in age-matched nonobese individuals. We demonstrated that dietary modification and exercise training are effective in reducing arterial stiffness in obese persons. However, the differences in the effect on arterial stiffness between dietary modification and exercise training are unknown. The purpose of the current study was to compare the effect of dietary modification and aerobic exercise training on arterial stiffness and endothelial function in overweight and obese persons. Forty-five overweight and obese men (48 ± 1 year) completed either a dietary modification (well-balanced nutrient, 1680 kcal/day) or an exercise-training program (walking, 40–60 min/day, 3 days/week) for 12 weeks. Before and after the intervention, all participants underwent anthropometric measurements. Arterial stiffness was measured based on carotid arterial compliance, brachial-ankle pulse wave velocity (baPWV), and endothelial function was determined by circulating level of endothelin-1 (ET-1) and nitric oxide metabolite (nitrites/nitrate as metabolite: NOx). Body mass and waist circumference significantly decreased after both intervention programs. Weight loss was greater after dietary modification than after exercise training (-10.1 ± 0.6 kg vs. -3.6 ± 0.5 kg, p < .01). Although arterial stiffness and the plasma levels of ET-1 and NOx were improved after dietary modification or exercise training, there were no differences in those improvements between the 2 types of interventions. Exercise training improves arterial function in obese men without as much weight loss as after dietary modification.
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O'Halloran, Peggy, DeAnn Lazovich, Ruth E. Patterson, Lisa Harnack, Simone French, Sue J. Curry, and Shirley A. A. Beresford. "Effect of Health Lifestyle Pattern on Dietary Change." American Journal of Health Promotion 16, no. 1 (September 2001): 27–33. http://dx.doi.org/10.4278/0890-1171-16.1.27.
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Purpose. To examine the effect of lifestyle on the effectiveness of a low-intensity dietary intervention. Design. A secondary data analysis was performed using data from the Eating Patterns Study, a randomized controlled trial that found that self-help materials with physician advice was effective in changing dietary intake and behavior. Setting. Primary care clinics in a large health maintenance organization. Subjects. A total of 2111 patients with a routine scheduled appointment with their primary care physicians. Measures. Participants were grouped into one of six health lifestyle patterns based on similarities in baseline measures of alcohol intake, smoking, diet quality, and exercise. Within each lifestyle pattern, changes from baseline in usual fat and fiber intake (based on a food frequency) and a fat and fiber behavior score were compared at 3 months and 12 months for intervention vs. control participants. Intervention. Self-help materials delivered by a physician with advice to change diet. Results. Intervention participants in the fitness lifestyle group made the largest changes relative to controls for each dietary outcome at 3 and 12 months. For intervention participants defined by their alcohol intake or current smoking, either no changes in diet were observed compared with controls, or early changes were not sustained over time. Intervention-control comparisons within the remaining lifestyle patterns showed smaller dietary changes compared with the fitness lifestyle. This finding was similar to previously published results. Conclusions. This randomized controlled trial had limited power to detect subgroup differences; however, these results suggest that lifestyle patterns may be useful in the development of effective, targeted interventions to change behavior.
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Roberts, Shelley, Zara Howard, Kelly A. Weir, Jennifer Nucifora, Nadine Baker, Leanne Smith, Heidi Townsend, and Lynda Ross. "Patient Perceptions of a Group-Based Lifestyle Intervention for Overweight Women with Urinary Incontinence: A Qualitative Descriptive Study." Healthcare 9, no. 3 (March 2, 2021): 265. http://dx.doi.org/10.3390/healthcare9030265.
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Urinary incontinence (UI) affects many women and impacts quality of life. Group-based interventions may be an effective and efficient method for providing UI care; however, interventions must be acceptable to patients to have an impact. This study aimed to explore patients’ perceptions of an exercise training and healthy eating group program (ATHENA) for overweight and obese women with UI. This qualitative descriptive study involved semi-structured interviews with a subset of participants sampled from a feasibility study of ATHENA. The ATHENA intervention was co-developed with end-users and implemented in Women’s Health Physiotherapy services at an Australian hospital. Interviews were recorded, transcribed and analysed thematically. Eleven female patients participated (mean ± SD age 54.2 ± 9.9 years; body mass index 30.5 ± 3.25 kg/m2). Participants found ATHENA highly acceptable, with three themes emerging from interviews: (1) Participants’ journey of change through ATHENA, describing the shifts in knowledge, attitudes, behaviours and symptoms participants experienced; (2) High satisfaction with ATHENA, including educational content, exercise components and delivery style; and (3) Group setting integral to ATHENA’s success, with participants providing support, building friendships, and facilitating each other’s learning. Overall, ATHENA was acceptable to participants, who provided each other with peer support; an unexpected moderator to ATHENA’s success.
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Misra, Anoop. "Prevention of Diabetes: Countless Opportunities and Clear Challenges." American Journal of Lifestyle Medicine 12, no. 1 (October 26, 2017): 25–29. http://dx.doi.org/10.1177/1559827617735775.
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Prevention of diabetes poses significant challenges; especially when applied as public health intervention. While several trials, most importantly Diabetes Prevention Program, show that intensive lifestyle modification leading to weight loss is the most important intervention, many individuals and some populations may show resistance to these interventions. Roadblocks to lifestyle intervention alone or in combination include: age, some ethnic groups (e.g., south Asians), genetic make-up, and some characteristics of body phenotype. Recent data show that non-alcoholic fatty liver disease along with insulin resistance may constitute ‘metabolically unhealthy phenotype’. These subgroups would need more intensive interventions to convert prediabetes to normal glucose regulation. Whether ‘fatty pancreas’ and sarcopenia, latter more often seen in Asian Indians and with advancing age, are other phenotypes requiring intensive and different interventions (e.g., more resistance exercise in latter) remains to be researched. Further, variations in dietary quality (Mediterranean diet enriched with extra virgin olive oil, high-protein diets) without changing much of calories, provide attractive options for intervention. Many of such innovations require more research. Translation of lessons from diabetes prevention studies to general population is daunting but possible. However, such community-based interventions need substantial human and material resources, which pose hurdles in underserved populations and developing countries. In such situations, low-cost modalities, for example, use of trained community educators and digital and social media, constitute attractive approaches.
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Albus, Christian, Christoph Herrmann-Lingen, Katrin Jensen, Matthes Hackbusch, Nina Münch, Catharina Kuncewicz, Maurizio Grilli, Bernhard Schwaab, and Bernhard Rauch. "Additional effects of psychological interventions on subjective and objective outcomes compared with exercise-based cardiac rehabilitation alone in patients with cardiovascular disease: A systematic review and meta-analysis." European Journal of Preventive Cardiology 26, no. 10 (March 11, 2019): 1035–49. http://dx.doi.org/10.1177/2047487319832393.
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Background Exercise-based cardiac rehabilitation (ebCR) often includes various psychological interventions for lifestyle change or distress management. However, the additional benefit of specific psychological interventions on depression, anxiety, quality of life, cardiac morbidity and cardiovascular or total mortality is not well investigated. Design Systematic review and meta-analysis. Methods Randomized controlled trials and controlled cohort trials published between January 1995 and October 2017 comparing ebCR with or without pre-specified psychosocial interventions were selected and evaluated on the basis of predefined inclusion and outcome criteria. Results Out of 15,373 records, 20 studies were identified, including 4450 patients with coronary artery disease (88.5%) or congestive heart failure (11.5%), respectively. Studies were of low to moderate quality and methodological heterogeneity was high. As compared with ebCR alone, additional psychological interventions for lifestyle change or distress management showed a trend to reduce depressive symptoms (standardized mean difference –0.13, 95% confidence interval (CI) –0.30; 0.05). Furthermore, during a follow-up of five years, distress management was associated with a trend to reduce cardiac morbidity (risk ratio 0.74, 95% CI 0.51; 1.07). There was no evidence for an additional impact of either psychological lifestyle change interventions or distress management on anxiety, quality of life, cardiovascular or total mortality. Conclusions Specific psychological interventions offered during ebCR may contribute to a reduction of depressive symptoms and cardiac morbidity, but there remains considerable uncertainty under which conditions these interventions exert their optimal effects. (CRD42015025920).
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Blocker, Erin, Andrew Fry, Paul Luebbers, Jeffrey Burns, Jaime Perales-Puchalt, David Hansen, and Eric Vidoni. "Promoting Alzheimer's Risk-Reduction through Community-Based Lifestyle Education and Exercise in Rural America: A Pilot Intervention." Kansas Journal of Medicine 13 (July 10, 2020): 179–85. http://dx.doi.org/10.17161/kjm.v13i.13872.
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Introduction. Rural Americans (RA) have poorer vascular health and physical activity levels than their urban counterparts; all are dementia risk factors. Dementia risk reduction among rural individuals requires a tailored approach. The purpose of this project was to examine preliminary efficacy of a community-based physical exercise and/or dementia risk factor-reduction curriculum among rural adults 50 and older.
Methods. Seventy-five rural dwelling adults 50 and older were randomized to one of three groups: 1) 10 weeks of Alzheimer’s disease risk-reduction education (ED), 2) risk-reduction education and supervised exercise (EDEX) or 3) control group (CON). Outcomes included baseline to 10-week follow-up difference in dementia knowledge (primary outcome) and physical activity, muscular endurance, healthy lifestyle engagement, and anthropometrics (secondary outcomes).
Results. Sixty-nine adults successfully completed the 10-week study. Dementia knowledge increased in a Treatment Arm-dependent manner (χ2 = 6.95 (2), p = 0.03), being ED and EDEX superior to CON. Engagement in healthy lifestyle behaviors did not change statistically. However, participation specifically in physical activity increased over time (χ2 = 11.47 (2), p = 0.003) with EDEX reporting the greatest increases. No significant change in average daily steps was observed for any group.
Conclusion. The results suggested dementia risk-reduction education, both with and without structured exercise, leads to improvements in dementia knowledge. When coupled with regular, supervised exercise, this education intervention also helped participants increase engagement in physical activity over 10 weeks. Tailored interventions that combine Alzheimer’s disease education and regular, supervised exercise may help reduce dementia risk in rural communities.
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Lackinger, Christian, Igor Grabovac, Sandra Haider, Ali Kapan, Eva Winzer, K. Viktoria Stein, and Thomas E. Dorner. "Adherence Is More Than Just Being Present: Example of a Lay-Led Home-Based Programme with Physical Exercise, Nutritional Improvement and Social Support, in Prefrail and Frail Community-Dwelling Older Adults." International Journal of Environmental Research and Public Health 18, no. 8 (April 15, 2021): 4192. http://dx.doi.org/10.3390/ijerph18084192.
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Background: Little is known about the implementation of lifestyle interventions in frail, community-dwelling people. This study highlights different domains of adherence to explain an effectively delivered home-based intervention. Methods: Eighty prefrail and frail persons (≥65 years) participated in a physical training, nutritional, and social support intervention over 24 weeks. A detailed log book was kept for comprehensive documentation in order to assess adherence and further organizational, exercise, and nutritional parameters. Results: Participants reached an adherence rate (performed home visits/number of planned visits) of 84.0/80.5% from week 1–12/13–24. Out of those, 59% carried out ≥75% of the offered visits. Older age was associated with a higher adherence rate. A mean of 1.5 (0.6) visits/week (2 were planned) were realized lasting for a mean of 1.5 (0.9) hours (154% of the planned duration). Per visit, 1.2 (0.6) circuits of strength training were performed (60.5% of the planned value) and 0.5 (0.3) nutritional interventions (47%). After twelve months, 4.2% still carried out the home visits regularly and 25.0% occasionally. Conclusion: Adherence is much more than “being there”. Adherence rate and category are limited parameters to describe the implementation of a complex lifestyle intervention, therefore a comprehensive documentation is needed.
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Lisón, Juan Francisco, Gonzalo Palomar, Marinna S. Mensorio, Rosa M. Baños, Ausiàs Cebolla-Martí, Cristina Botella, Vicent Benavent-Caballer, and Enrique Rodilla. "Impact of a Web-Based Exercise and Nutritional Education Intervention in Patients Who Are Obese With Hypertension: Randomized Wait-List Controlled Trial." Journal of Medical Internet Research 22, no. 4 (April 14, 2020): e14196. http://dx.doi.org/10.2196/14196.
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Background Internet-based interventions are a promising strategy for promoting healthy lifestyle behaviors. These have a tremendous potential for delivering electronic health interventions in scalable and cost-effective ways. There is strong evidence that the use of these programs can lead to weight loss and can lower patients’ average blood pressure (BP) levels. So far, few studies have investigated the effects of internet-based programs on patients who are obese with hypertension (HTN). Objective The aim of this study is to investigate the short- and long-term efficacy, in terms of body composition and BP parameters, of a self-administered internet-based intervention involving different modules and learning techniques aimed at promoting lifestyle changes (both physical activity and healthy eating) in patients who are obese with HTN. Methods A randomized wait-list controlled trial design was used. We recruited 105 adults with HTN who were overweight or obese and randomly assigned them to either a 3-month internet-based intervention group (n=55) or the wait-list control group (n=50). We assessed BMI (primary outcome), body fat mass (BFM), systolic (S)BP and diastolic (D)BP, blood glucose and insulin levels, physical activity levels, and functional capacity for aerobic exercise at Time 0 (preintervention) and Time 1 (postintervention). All the patients in the wait-list control group subsequently received the intervention, and a secondary within-group analysis, which also included these participants, was conducted at Time 2 (12-month follow-up). Results A 2-way mixed analysis of covariance showed a significant decrease in BMI, BFM, and blood glucose at 3 months in the internet-based intervention group; the effect size for the BMI and BFM parameters was moderate to large, and there was also a borderline significant trend for DBP and insulin. These results were either maintained or improved upon at Time 2 and showed significant changes for BMI (mean difference −0.4, 95% CI −0.1 to −0.6; P=.005), BFM (mean difference −2.4, 95% CI −1.1 to −3.6; P<.001), DBP (mean difference −1.8, 95% CI −0.2 to −3.3; P=.03), and blood glucose (mean difference −2, 95% CI 0 to −4; P=.04). Conclusions Implementation of our self-administered internet-based intervention, which involved different learning techniques aimed to promote lifestyle changes, resulted in positive short- and long-term health benefits in patients who are obese with HTN. Trial Registration ClinicalTrials.gov NCT03396302; https://clinicaltrials.gov/ct2/show/NCT03396302
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Schuette, Stephanie A. P., Evelyn Cordero, Katherine Slosburg, Elizabeth L. Addington, and David Victorson. "A Scoping Review of Positive Lifestyle and Wellness Interventions to Inform the Development of a Comprehensive Health Promotion Program: “HealthPro”." American Journal of Lifestyle Medicine 13, no. 4 (May 5, 2017): 336–46. http://dx.doi.org/10.1177/1559827617704825.
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Background. Lifestyle medicine has emerged as a transformational force in mainstream health care. Numerous health promotion and wellness programs have been created to facilitate the adoption of increased positive, modifiable health behaviors to prevent and lessen the effects of chronic disease. This article provides a scoping review of available health promotion interventions that focus on healthy adult populations in the past 10 years. Methods. We conducted a scoping review of the literature searching for health promotion interventions in the past 10 years. Interventions were limited to those conducted among healthy adults that offered a face-to-face, group-based format, with positive results on one or more health outcomes. We then developed a new health promotion intervention that draws on multiple components of included interventions. Results. Fifty-eight articles met our inclusion criteria. Physical activity was the primary focus of a majority (N = 47) of articles, followed by diet/nutrition (N = 40) and coping/social support (N = 40). Conclusions. Efficacious health promotion interventions are critical to address the prevention of chronic disease by addressing modifiable risk factors such as exercise, nutrition, stress, and coping. A new intervention, discussed is this article, provides a comprehensive approaches to health behavior change and may be adapted for future research.
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Chan, June M., Robert Usher Newton, S. Nicole Culos-Reed, Sarah Faithfull, Sylvie Lambert, Stacey A. Kenfield, Erin Van Blarigan, et al. "An international, population-level initiative to promote healthy lifestyle practices among prostate cancer survivors." Journal of Clinical Oncology 34, no. 3_suppl (January 20, 2016): e287-e287. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.e287.
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e287 Background: Growing evidence suggests that specific lifestyle practices (e.g., diet and exercise) may delay cancer progression among prostate cancer survivors (PCS) and restore post-treatment quality of life. However, there are limited efforts to translate this knowledge to sustainable behavior change among PCS at a population level. Methods: TrueNTH is an international partnership to develop innovative evidence-based interventions and care models to improve the physical and mental wellbeing of PCS. Within TrueNTH, four countries (U.S.A., Australia, Canada, U.K.) are developing solutions to improve lifestyle practices among PCS. Australia is implementing face-to-face and telehealth delivery of exercise and dietary programs facilitated by a web-based portal. Canada is implementing group-based exercise and yoga programs combined with a web-based portal to deliver exercise, nutrition and stress-reduction resources for PCS and caregivers. The U.K. is implementing a healthy living pharmacy approach to deliver tailored diet and exercise advice and support to men. The U.S. will implement a scalable web-based portal that reaches PCS, providers and partners and provides personalized exercise prescriptions and dietary advice, interactive guidance, and behavioral support via social media, tele-exercise, and face-to-face communities. Results: TrueNTH initiatives are in various phases of a three-year project. Australia has enrolled 30 of 80 men across 2 sites and via telehealth, and demonstrated acceptance of the portal. Canada has enrolled 30+ men in exercise programs and will soon add 4 sites and launch their portal. The UK has evaluated assessment protocols in 2 sites and will soon add a 3rd site and implement the pharmacy-based program. The U.S. is building the portal and supportive tools and will begin a trial in Fall 2016. Conclusions: Each TrueNTH program shares common goals to improve lifestyle practices among PCS. Common metrics across initiatives will allow for a global comparison of implementation approaches and assessment of impact at a population level. TrueNTH will utilize this initiative to create a lifestyle survivorship program that improves the lives of PCS worldwide.
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McGuire, Amanda Mary, Charrlotte Seib, Janine Porter-Steele, and Debra Jane Anderson. "The Association Between Web-Based or Face-to-Face Lifestyle Interventions on the Perceived Benefits and Barriers to Exercise in Midlife Women: Three-Arm Equivalency Study." Journal of Medical Internet Research 21, no. 8 (August 21, 2019): e10963. http://dx.doi.org/10.2196/10963.
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Background Noncommunicable diseases pose a significant threat to women’s health globally, with most diseases being attributed to modifiable risk factors such as physical inactivity. Women perceive a range of benefits and barriers to exercise; however, there is little evidence about the effect of different lifestyle intervention delivery modes on perceptions of exercise. Objective This study aimed to compare the effect of a multiple health behavior change (MHBC) intervention called the Women’s Wellness Program. This intervention was delivered in 3 different modes on perceived exercise benefits, perceived exercise barriers, and actual physical activity and exercise in midlife women. Methods Women aged 45 to 65 years were recruited via the study website. They were assigned in blocks to 3 different treatment groups (A: Web-based independent; B: face-to-face with nurse consultations; and C: Web-based with virtual nurse consultations). All participants received the 12-week intervention that utilizes principles from social-cognitive theory to provide a structured guide to promote healthy lifestyle behaviors with an emphasis on regular exercise and healthy eating. Data were collected using a self-report Web-based questionnaire at baseline (T1) and postintervention (T2) including perceived exercise benefits and barriers and exercise and physical activity. A data analysis examined both within- and between-group changes over time. Results Participants in this study (N=225) had a mean age of 50.9 years (SD 5.9) and most were married or living with a partner (83.3%, 185/225). Attrition was 30.2% with 157 participants completing the final questionnaire. Women in all intervention groups reported a significant increase in positive perceptions of exercise (P<.05); a significant increase in exercise and overall physical activity (P<.01) with moderate-to-large effect sizes noted for overall physical activity (d=0.5 to d=0.87). Participants receiving support from registered nurses in the face-to-face and Web-based groups had a greater magnitude of change in benefit perceptions and physical activity than those in the Web-based independent group. There was no significant change in exercise barrier perceptions within or between groups over time. Conclusions The results of this study suggest that the (MHBC) intervention is effective in increasing exercise benefit perceptions, overall physical activity, and exercise in midlife women. Although Web-based programs are cost-effective and flexible and can be delivered remotely, providing a range of options including face-to-face group delivery and personalized electronic health coaching from registered nurses has the potential to enhance participant engagement and motivation.
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Thomson, Jessica L., Lisa M. Tussing-Humphreys, Jamie M. Zoellner, and Melissa H. Goodman. "Psychosocial constructs were not mediators of intervention effects for dietary and physical activity outcomes in a church-based lifestyle intervention: Delta Body and Soul III." Public Health Nutrition 19, no. 11 (January 22, 2016): 2060–69. http://dx.doi.org/10.1017/s1368980015003602.
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AbstractObjectiveEvaluating an intervention’s theoretical basis can inform design modifications to produce more effective interventions. Hence the present study’s purpose was to determine if effects from a multicomponent lifestyle intervention were mediated by changes in the psychosocial constructs decisional balance, self-efficacy and social support.DesignDelta Body and Soul III, conducted from August 2011 to May 2012, was a 6-month, church-based, lifestyle intervention designed to improve diet quality and increase physical activity. Primary outcomes, diet quality and aerobic and strength/flexibility physical activity, as well as psychosocial constructs, were assessed via self-report, interviewer-administered surveys at baseline and post intervention. Mediation analyses were conducted using ordinary least squares (continuous outcomes) and maximum likelihood logistic (dichotomous outcomes) regression path analysis.SettingChurches (five intervention and three control) were recruited from four counties in the Lower Mississippi Delta region of the USA.SubjectsRural, Southern, primarily African-American adults (n 321).ResultsBased upon results from the multiple mediation models, there was no evidence that treatment (intervention v. control) indirectly influenced changes in diet quality or physical activity through its effects on decisional balance, self-efficacy and social support. However, there was evidence for direct effects of social support for exercise on physical activity and of self-efficacy for sugar-sweetened beverages on diet quality.ConclusionsResults do not support the hypothesis that the psychosocial constructs decisional balance, self-efficacy and social support were the theoretical mechanisms by which the Delta Body and Soul III intervention influenced changes in diet quality and physical activity.
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Wilson, Dan E., Tashina Van Vlack, Brendin P. Schievink, Eric B. Doak, Jason S. Shane, and Elizabeth Dean. "Lifestyle Factors in Hypertension Drug Research: Systematic Analysis of Articles in a Leading Cochrane Report." International Journal of Hypertension 2014 (2014): 1–10. http://dx.doi.org/10.1155/2014/835716.
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Established standards for first-line hypertension management include lifestyle modification and behavior change. The degree to which and how lifestyle modification is systematically integrated into studies of first-line drug management for hypertension is of methodological and clinical relevance. This study systematically reviewed the methodology of articles from a recent Cochrane review that had been designed to inform first-line medical treatment of hypertension and was representative of high quality established clinical trials in the field. Source articles(n=34)were systematically reviewed for lifestyle interventions including smoking cessation, diet, weight loss, physical activity and exercise, stress reduction, and moderate alcohol consumption. 54% of articles did not mention lifestyle modification; 46% contained nonspecific descriptions of interventions. We contend that hypertension management research trials (including drug studies) need to elucidate the benefits and risks of drug-lifestyle interaction, to support the priority of lifestyle modification, and that lifestyle modification, rather than drugs, is seen by patients and the public as a priority for health professionals. The inclusion of lifestyle modification strategies in research designs for hypertension drug trials could enhance current research, from trial efficacy to clinical outcome effectiveness, and align hypertension best practices of a range of health professionals with evidence-based knowledge translation.
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Katsagoni, Christina N., Eleftheria Papachristou, Amalia Sidossis, and Labros Sidossis. "Effects of Dietary and Lifestyle Interventions on Liver, Clinical and Metabolic Parameters in Children and Adolescents with Non-Alcoholic Fatty Liver Disease: A Systematic Review." Nutrients 12, no. 9 (September 19, 2020): 2864. http://dx.doi.org/10.3390/nu12092864.
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Non-alcoholic fatty liver disease (NAFLD) affects 5.5–10.3% of children worldwide, while in obese individuals, it increases to almost 34%. Pediatric NAFLD is consistently associated with metabolic syndrome and insulin resistance. As no pharmacological agents exist for the treatment of NAFLD, lifestyle modifications remain the only therapy. However, as not all overweight/obese children have NAFLD, high-quality data, focused exclusively on NAFLD population are needed. Therefore, the present systematic review assessed the efficacy of lifestyle (diet or exercise) based on randomized controlled clinical trials (RCTs) on liver, anthropometric, glucose, and lipid parameters in children, with imaging or biopsy-proven NAFLD. In general, the results were inconclusive and therefore no specific recommendations could be drawn. In most studies, differences were derived from within group comparisons, which are known to be highly misleading. However, both low-carbohydrate and low-fat diets could benefit liver outcomes, as long as weight loss is achieved, but not necessary glucose and lipid parameters. No RCTs were found on exercise alone, as compared to no intervention on pediatric NAFLD. Concerning diet plus exercise interventions, all studies led to improvements in liver outcomes accompanied with weight loss. Resolution of NAFLD was found in considerably high percentages, while improvements were also seen in glucose but were modest in lipid parameters.
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Weber, Michaela, Nacera Belala, Lindy Clemson, Elisabeth Boulton, Helen Hawley-Hague, Clemens Becker, and Michael Schwenk. "Feasibility and Effectiveness of Intervention Programmes Integrating Functional Exercise into Daily Life of Older Adults: A Systematic Review." Gerontology 64, no. 2 (September 15, 2017): 172–87. http://dx.doi.org/10.1159/000479965.
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Background: Traditionally, exercise programmes for improving functional performance and reducing falls are organised as structured sessions. An alternative approach of integrating functional exercises into everyday tasks has emerged in recent years. Objectives: Summarising the current evidence for the feasibility and effectiveness of interventions integrating functional exercise into daily life. Methods: A systematic literature search was conducted including articles based on the following criteria: (1) individuals ≥60 years; (2) intervention studies of randomised controlled trials (RCTs) and non-randomised studies (NRS); (3) using a lifestyle-integrated approach; (4) using functional exercises to improve strength, balance, or physical functioning; and (5) reporting outcomes on feasibility and/or effectiveness. Methodological quality of RCTs was evaluated using the PEDro scale. Results: Of 4,415 articles identified from 6 databases, 14 (6 RCTs) met the inclusion criteria. RCT quality was moderate to good. Intervention concepts included (1) the Lifestyle-integrated Functional Exercise (LiFE) programme integrating exercises into everyday activities and (2) combined programmes using integrated and structured training. Three RCTs evaluated LiFE in community dwellers and reported significantly improved balance, strength, and functional performance compared with controls receiving either no intervention, or low-intensity exercise, or structured exercise. Two of these RCTs reported a significant reduction in fall rate compared with controls receiving either no intervention or low-intensity exercise. Three RCTs compared combined programmes with usual care in institutionalised settings and reported improvements for some (balance, functional performance), but not all (strength, falls) outcomes. NRS showed behavioural change related to LiFE and feasibility in more impaired populations. One NRS comparing a combined home-based programme to a gym-based programme reported greater sustainability of effects in the combined programme. Conclusions: This review provides evidence for the effectiveness of integrated training for improving motor performances in older adults. Single studies suggest advantages of integrated compared with structured training. Combined programmes are positively evaluated in institutionalised settings, while little evidence exists in other populations. In summary, the approach of integrating functional exercise into daily life represents a promising alternative or complement to structured exercise programmes. However, more RCTs are needed to evaluate this concept in different target populations and the potential for inducing behavioural change.
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Tran, Dieu-My T., and Angela Sojobi. "Review of the Scientific Literature on Young Adults Related to Cardiovascular Disease Intervention." Asian/Pacific Island Nursing Journal 5, no. 1 (2020): 35–46. http://dx.doi.org/10.31372/20200501.1084.
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Many young adults are at risk for cardiovascular disease related to their behavioral choices. Irresponsible alcohol consumption, tobacco smoking, sedentary lifestyle, poor dietary habits, and excessive weight gain are some of the behaviors that put young adults at risk. The Centers for Disease Control and Prevention identified that 15% of young adults are diagnosed with chronic illnesses related to their behavioral choices. The purpose of this review is to identify, in the literature, interventions that are currently available to young adults and evaluate the adequacy and effectiveness of those interventions. An extensive electronic search was conducted using CINAHL, EBSCOhost, Cochrane, PubMed, and Google Scholar. A total of 130 articles were identified and 28 articles met the inclusion criteria. Three main interventions were identified for young adults: personalized interventions, technology-based interventions, and educational/behavioral interventions. The interventions were all effective to different degrees and interventions were most effective when they were combined. This review impacts in what manner nurses and health care providers deliver health promotion, prevention, and management of cardiovascular risk factors in young adults; in particular, nurses play a key role in lifestyle modifications including diet and exercise.
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Derry, Heather, Claire Conley, and Kelly Trevino. "Enhancing Health for the Growing Number of Older Cancer Survivors: Designing Innovative Behavioral Interventions." Innovation in Aging 4, Supplement_1 (December 1, 2020): 649–50. http://dx.doi.org/10.1093/geroni/igaa057.2238.
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Abstract By 2040, there will be an estimated 26.1 million cancer survivors in the United States, with 73% over age 65. Compared to younger survivors and those without cancer, older adult cancer survivors have an elevated comorbidity burden. Lifestyle interventions can play a key role in preventing and managing chronic health conditions and promoting quality of life during and after cancer treatment. Yet, behavioral interventions for maximizing health are under-utilized in older adults with cancer. At times, older adults may have unique needs that require tailoring to increase accessibility, optimization, and uptake of behavioral interventions. This symposium will showcase innovative approaches for enhancing health among older adult cancer survivors during and after cancer treatment. Dr. Bluethmann will discuss design considerations for using geriatric assessment in an ongoing exercise trial to manage side effects of aromatase inhibitors. Dr. Gell will present data on older survivors’ preferences regarding text messaging to support physical activity maintenance from an intervention study. Dr. Leach will discuss the use of technology to facilitate lifestyle change in older cancer survivors, presenting data on older adults’ user preferences and benefits from an eHealth tool. The discussant, Dr. Trevino, will summarize how these interventions can be leveraged to promote engagement in managing older survivors’ health and to inform next steps in intervention development. Collectively, this multidisciplinary group of speakers will provide practical information and “lessons learned” from designing behavioral and technology-based interventions, and highlight the promise that these approaches hold for improving quality of life in aging cancer survivors. Cancer and Aging Interest Group Sponsored Symposium.
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Dale, Hannah, Linsay Brassington, and Kristel King. "The impact of healthy lifestyle interventions on mental health and wellbeing: a systematic review." Mental Health Review Journal 19, no. 1 (March 5, 2014): 1–26. http://dx.doi.org/10.1108/mhrj-05-2013-0016.
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Purpose – There is growing evidence that health behaviour change interventions are associated with mental health and wellbeing improvements. This paper aims to examine the effect of healthy lifestyle interventions on mental wellbeing. Design/methodology/approach – Six databases (Medline, Evidence Based Medicine Cochrane Registered Controlled Trials, Evidence Based Medicine Full Text Reviews, British Nursing Index, Embase, PsycINFO) were searched from database commencement up to April 2013. A broad focus on lifestyle interventions and mental health and wellbeing outcomes was chosen. Papers were systematically extracted by title then abstract according to predefined inclusion and exclusion criteria. Inclusion criteria: any individual population (non-couple/family); any health behaviour change interventions; mental health and wellbeing outcomes; and a one-two level of evidence. Interventions aimed at workers were excluded, as were articles assessing cognitive functioning rather than mental health or wellbeing, or those using medications in interventions. Findings – Two authors reviewed 95 full papers. In total, 29 papers met inclusion criteria, representing a range of interventions spanning physical activity, diet, alcohol intake, drug use and smoking. A range of measures were used. The majority (n=25) of studies demonstrated improvements on at least one indicator of mental health and wellbeing. Limitations include the broad range of outcome measures used, varied follow-up times and the lack of detail in reporting interventions. Originality/value – Health behaviour change interventions targeting physical outcomes appear to have benefits to mental health and wellbeing spanning healthy populations and those with physical or mental health problems. Evidence is strongest for interventions targeting exercise and diet, particularly in combination and the actual lifestyle changes made and adherence appear to be important. However, it is not clear from this review which specific components are necessary or essential for improvements in mental health and wellbeing.
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Goodyear-Smith, Felicity, Julia McPhee, Scott Duncan, and Grant Schofield. "Evaluation of a primary care - based programme designed to increase exercise and improve nutrition in patients at risk." Journal of Primary Health Care 6, no. 4 (2014): 312. http://dx.doi.org/10.1071/hc14312.
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INTRODUCTION: Evidence is limited regarding the effectiveness of brief interventions delivered through primary care to improve healthy living and increase physical activity. The Healthy As programme delivering brief interventions programmes in primary care to promote physical activity, improved nutrition and weight management was developed, implemented and assessed. This study aimed to identify aspects of the programme that worked well, those that presented problems or barriers, along with suggestions for improvement. METHODS: Three provider organisations in Auckland were contracted to deliver the Healthy As intervention in primary care settings. Semi-structured interviews were conducted with those delivering the risk assessments and providing the intervention from each provider organisation. A thematic analysis approach based on grounded theory was used to analyse the emerging key themes. FINDINGS: The emerging themes related to the holistic nature of the programme, its structure, resources used with participants, engagement of the providers with the participants, and whether the programme was effective in changing behaviour. CONCLUSION: Initial engagement of participants was found to be particularly important for the success of the Healthy As programme. For a patient-centred approach, good communication between the patient and health provider is required to facilitate shared decision-making and self-management prior to implementation of an intervention. Patients need to indicate whether they want help to make changes. Advice on healthy eating and exercise should not be given in isolation. Patients may also need help with mental health or other lifestyle issues before they can actively engage in exercise or weight reduction programmes. KEYWORDS: Exercise; general practice; health behavior; motivational interviewing; nutrition therapy; primary health care
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Lambert, Genevieve, Nathalie Alos, Pascal Bernier, Caroline Laverdière, Dahlia Kairy, Kenneth Drummond, Noémi Dahan-Oliel, Martin Lemay, and Louis-Nicolas Veilleux. "Home-Based Telehealth Exercise Intervention in Early-On Survivors of Childhood Acute Lymphoblastic Leukemia: Feasibility Study." JMIR Cancer 7, no. 2 (June 16, 2021): e25569. http://dx.doi.org/10.2196/25569.
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Background Acute lymphoblastic leukemia is the most common type of pediatric cancer. Acute lymphoblastic leukemia causes an altered bone mineral homeostasis state, which can contribute to osteopenia, and bone fractures, most commonly vertebral fractures. With the increasing number of childhood cancer survivors, late adverse effects such as musculoskeletal comorbidities are often reported and are further influenced by inactive lifestyle habits. Physical activity has been shown to increase the mechanical workload of the bone, mitigating bone impairment in other cancer-specific populations. Objective This interventional pilot study aims to investigate the use of telehealth to deliver a home-based exercise intervention for early-on survivors of bone marrow–related hematological malignancies and to assess its impact on survivors’ musculoskeletal and functional health. Methods We aimed to recruit a group of 12 early-on survivors of acute lymphoblastic leukemia, within 6 months to 5 years of treatment, to participate in and complete the proposed telehealth intervention with a parent. The 16-week intervention included 40 potential home-based physical activity interventions supervised by a kinesiologist through a telehealth internet platform, with monthly progression. Patients were recruited to the cohort if they were able to participate in the intervention during the first month (minimum 12 weeks of intervention). Evaluation before and after the intervention protocol highlighted differences in functional capacities and musculoskeletal health of patients using mechanography, peripheral quantitative computed tomography, 6-minute walk test, and grip force test. Results The recruitment rate for the intervention was low (12/57, 21% of contacted patients). Of 12 patients, 3 were excluded (1=relapse, 1=failure to meet technical requirements, and 1=abandoned). The 9 patients who completed the intervention (6 girls; mean age 10.93, SD 2.83 years; mean BMI 21.58, SD 6.55 kg/m2; mean time since treatment completion 36.67, SD 16.37 months) had a mean adherence of 89% and a completion rate of 75%. In addition, these patients showed functional improvements in lower limb muscle force and power as well as in the 6-minute walk test distance. Participants also showed improved bone health after the intervention on the following parameters: bone mineral content, stress-strain index, total and cortical cross-sectional area at the 14% site (P=.03, P=.01, P=.01, and P=.001, respectively) and 38% site of the tibia (P=.003, P=.04, P=.001, and P=.003, respectively). Conclusions High adherence and participation rates suggest that telehealth is a feasible method to deliver exercise interventions to young early-on survivors of acute lymphoblastic leukemia. The proposed intervention seems promising in providing benefits to patients’ functional performance and bone health, but a large-scale study is needed to confirm this assumption.
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Gülnar, Emel, and Nurcan Çalişkan. "The Development and Effectiveness of a Care Protocol Using the Stevens Star Model of Knowledge Transformation in Female Patients With Stress Incontinence: An Experimental Study." Wound Management & Prevention 67, no. 3 (March 10, 2021): 36–47. http://dx.doi.org/10.25270/wmp.2021.3.3647.
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BACKGROUND: Nurse-led pelvic floor muscle exercise and lifestyle education programs are effective first-line interventions for women with stress incontinence (SI). PURPOSE: To develop an evidence-based stress incontinence care protocol (SICP) using the Stevens Star Model of Knowledge Transformation and evaluate its effect on the frequency and quantity of urinary incontinence, quality of life, pelvic muscle self-efficacy levels, and lifestyle variables of women with SI. METHODS: An SICP was developed on the basis of the Star model. The views of an expert were consulted for testing the content validity of the protocol. Using a pretest-posttest experimental design, 68 women with SI who visited an outpatient clinical at a hospital in Turkey were prospectively enrolled in the intervention (n = 34) and control (n = 34) groups. After obtaining baseline demographic and health history information, participants completed the King’s Health Questionnaire, the Broome Pelvic Muscle Exercise Self-Efficacy Scale, a 3-day voiding diary, and a 1-hour pad test. The intervention group received an 8-week program of care according to the Star model-derived SICP, and follow-up assessments were completed by both groups after 8 and 12 weeks. RESULTS: The content validity index for the SICP was 91.9%. The intervention group had a reduced quantity and frequency of urinary leakage, reduced King’s Health Questionnaire scores, and increased Broome Pelvic Muscle Exercise Self-Efficacy Scale scores (P < .05). CONCLUSION: Care provided according to the Star model-derived SICP reduced the quantity and frequency of SI and improved the perceived pelvic muscle exercise self-efficacy and quality of life of the participants.
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Demark-Wahnefried, Wendy, Bernardine M. Pinto, and Ellen R. Gritz. "Promoting Health and Physical Function Among Cancer Survivors: Potential for Prevention and Questions That Remain." Journal of Clinical Oncology 24, no. 32 (November 10, 2006): 5125–31. http://dx.doi.org/10.1200/jco.2006.06.6175.
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Cancer survivors are at increased risk, not only for progressive and recurrent disease, but also other cancers, cardiovascular disease, diabetes, osteoporosis, and functional decline. Lifestyle interventions to improve dietary and physical activity behaviors, and smoking cessation, have the potential to improve the overall health and quality of life of this vulnerable population. Studies on overall health and physical function from 1966 and beyond regarding the impact of behavioral interventions that used randomized and controlled designs were identified through MEDLINE and PubMed searches. Published reports currently exist for 22 exercise interventions, 11 diet-related interventions (excluding those limited to dietary supplements or single nutrients), two diet and exercise interventions, and 10 behavioral-based smoking cessation interventions. Although many interventions have been successful in promoting behavioral change and have resulted in improvements in various health-related outcomes, more research is needed to determine the key components of interventions that are able to produce the greatest behavioral change and the most favorable health-related benefits. The oncology care provider can play a pivotal role in improving the long-term health of cancer survivors by (1) being aware of opportunities to encourage healthful behaviors (ie, smoking cessation, weight control, and increased physical activity); (2) vigilantly tracking long-term effects among cancer survivors and exploring whether they are amenable to intervention; (3) staying abreast of current health behavior guidelines for cancer survivors and existing resources for professional and patient education; and (4) supporting and contributing to efforts aimed at primary and tertiary prevention research.
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Lehtisalo, Jenni, Tiia Ngandu, Päivi Valve, Riitta Antikainen, Tiina Laatikainen, Timo Strandberg, Hilkka Soininen, Jaakko Tuomilehto, Miia Kivipelto, and Jaana Lindström. "Nutrient intake and dietary changes during a 2-year multi-domain lifestyle intervention among older adults: secondary analysis of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) randomised controlled trial." British Journal of Nutrition 118, no. 4 (August 28, 2017): 291–302. http://dx.doi.org/10.1017/s0007114517001982.
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AbstractAdvancing age increases the risk for diseases and health concerns like cognitive decline, constituting a major public health challenge. Lifestyle, especially healthy diet, affects many risk factors related to chronic diseases, and thus lifestyle interventions among older adults may be beneficial in promoting successful ageing. We completed a randomised 2-year multi-domain lifestyle intervention trial aiming at prevention of cognitive decline among 631 participants in the intervention and 629 in the control group, aged 60–77 years at baseline. Dietary counselling was one of the intervention domains together with strength exercise, cognitive training and management of CVD risk factors. The aim of this paper was to describe success of the intervention – that is, how an intervention based on national dietary recommendations affected dietary habits as a part of multi-intervention. Composite dietary intervention adherence score comprising nine distinct goals (range 0–9 points from none to achieving all goals) was 5·0 at baseline, and increased in the intervention group after the 1st (P<0·001) and 2nd (P=0·005) year. The difference in change compared with the control group was significant at both years (P<0·001 and P=0·018). Intake of several vitamins and minerals decreased in the control group but remained unchanged or increased in the intervention group during the 2 years. Well-targeted dietary counselling may prevent age-related decline in diet quality and help in preventing cognitive decline.
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Li, Junxin, Binbin Yang, Miranda Varrasse, and Kun Li. "Sleep Among Long-Term Care Residents in China: A Narrative Review of Literature." Clinical Nursing Research 27, no. 1 (October 10, 2016): 35–60. http://dx.doi.org/10.1177/1054773816673175.
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The objective of this study is to synthesize and evaluate the current body of sleep research among long-term care (LTC) residents in China and provide insights for future research. Systematic searches identified 15 studies that examined sleep in LTC residents in China. Sleep disturbances and poor sleep quality were prevalent in Chinese LTC residents. Eight cross-sectional studies reported that demographics, comorbidities, lifestyle, and environment were associated with sleep quality in Chinese LTC residents. Seven intervention studies, including exercise, traditional Chinese medicine, light therapy, and behavioral interventions resulted in improved sleep quality. Only subjective sleep measures were used in all 15 studies. Some methodological issues were identified in studies, especially those conducted in Mainland China. Sleep research in LTC residents in China is still at the beginning stages. Future studies should consider more rigorous designs and objective sleep measures, and develop target interventions based on factors associated with sleep disturbances.
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Blackshaw, Chhour, Stepto, and Lim. "Barriers and Facilitators to the Implementation of Evidence-Based Lifestyle Management in Polycystic Ovary Syndrome: A Narrative Review." Medical Sciences 7, no. 7 (June 27, 2019): 76. http://dx.doi.org/10.3390/medsci7070076.
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Polycystic ovary syndrome (PCOS) is a complex condition that involves metabolic, psychological and reproductive complications. Insulin resistance underlies much of the pathophysiology and symptomatology of the condition and contributes to long term complications including cardiovascular disease and diabetes. Women with PCOS are at increased risk of obesity which further compounds metabolic, reproductive and psychological risks. Lifestyle interventions including diet, exercise and behavioural management have been shown to improve PCOS presentations across the reproductive, metabolic and psychological spectrum and are recommended as first line treatment for any presentation of PCOS in women with excess weight by the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2018. However, there is a paucity of research on the implementation lifestyle management in women with PCOS by healthcare providers. Limited existing evidence indicates lifestyle management is not consistently provided and not meeting the needs of the patients. In this review, barriers and facilitators to the implementation of evidence-based lifestyle management in reference to PCOS are discussed in the context of a federally-funded health system. This review highlights the need for targeted research on the knowledge and practice of PCOS healthcare providers to best inform implementation strategies for the translation of the PCOS guidelines on lifestyle management in PCOS.