scholarly journals Intervenção PRAdA: Efeitos no Peso Induzidos por Proposta de Alteração de Comportamento Alimentar em Hipertensos Medicados Nativos Portugueses e Imigrantes de Origem Africana

2014 ◽  
Vol 27 (3) ◽  
pp. 331
Author(s):  
Catarina Peixoto ◽  
Gisela Carrilho ◽  
Violeta Alarcão ◽  
Filipa Guerra ◽  
Rui Simões ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Nutrition Education ◽  
Behavioral Interventions ◽  
Success Factors ◽  
Emigrants And Immigrants ◽  
Dietary Recommendations ◽  
African Countries ◽  
Two Phase ◽  
Life Styles

<p><strong>Introduction:</strong> Blood pressure is significantly improved with weight loss. Behavioral interventions for weight loss seem to be less successful in African immigrants. Our main aims were to assess the effect of a dietary and lifestyle intervention on weight among hypertensive Portuguese natives and immigrants and to identify success factors for weight loss, and also to evaluate changes in knowledge and compliance with food recommendations.<br /><strong>Material and Methods:</strong> Hypertensive medicated patients followed in primary care setting were randomly enrolled in a two phase study, observational (15-months) and behavioral intervention (six months). Participants were divided in two groups: immigrants from African Countries of Portuguese Official Language and Portuguese natives. Participants were given dietary and life styles recommendations in individual face-to-face and telephone sessions.<br /><strong>Results:</strong> Of 110 participants with a mean BMI of 31.6 ± 3.7 Kg/m2, 60 were immigrants. The number of dietary recommendations known and followed at the end was significantly greater than at baseline; however natives performed a greater number of recommendations. Weight loss during intervention was in average 1.4 ± 2.7% in natives and 0.8 ± 3.6% in immigrants and was greater than in the observational period. Being male and consuming more than 2 servings of low-fat dairy products/day was associated with higher weight loss, independently of age and ethnicity.<br /><strong>Discussion:</strong> In general the proposed intervention was efficacious especially in Portuguese natives, confirming other studies.<br /><strong>Conclusion:</strong> The intervention increased knowledge and adherence to recommendations, highlighting the relevance of nutrition education, culturally adapted in primary care.<br /><strong>Keywords:</strong> Africa; Emigrants and Immigrants; Intervention Studies; Food Habits; Hypertension; Weight Loss; Portugal.</p>

scholarly journals Cost of behavioral weight loss programs implemented in clinical practice: The POWER trial at Johns Hopkins

2019 ◽  
Vol 10 (1) ◽  
pp. 103-113
Author(s):  
Gail L Daumit ◽  
Ellen M Janssen ◽  
Gerald J Jerome ◽  
Arlene T Dalcin ◽  
Jeanne Charleston ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Behavioral Interventions ◽  
Adult Population ◽  
Public Health Problem ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Behavioral Weight Loss ◽  
Important Public Health Problem ◽  
Support Intervention

Abstract Obesity presents an important public health problem that affects more than a third of the U.S. adult population and that is associated with increased morbidity, mortality, and costs. Previously, we documented that two primary care-based weight loss interventions were clinically effective. To encourage the implementation of and reimbursement for these interventions, we evaluated their relative cost-effectiveness. We performed a cost analysis of the Practice-based Opportunities for Weight Reduction (POWER) trial, a three-arm trial that enrolled 415 patients with obesity from six primary care practices. Trial participants were randomized to a control arm, an in-person support intervention, or a remote support intervention; in the two intervention arms, behavioral interventions were delivered over 24 months, in two phases. Weight loss was measured at 6, 12, and 24 months. Using timesheets and empirical data, we evaluated the cost of the in-person and remote support interventions from the perspective of a health care system delivering the interventions. A univariate sensitivity analysis was conducted to evaluate uncertainty around model assumptions. All comparisons were tested using independent t-tests. Cost of the in-person intervention was higher at 6 months ($113 per participant per month and $117 per kg lost) than the remote support intervention ($101 per participant per month and $99 per kg lost; p &lt; .001). Costs were also higher for the in-person support intervention at 24 months ($73 per participant per month and $342 per kg lost) than for the remote support intervention ($53 per participant per month and $275 per kg lost; p &lt; .001). In the sensitivity analyses, cost ranged from $274/kg lost to $456/kg lost for the in-person support intervention and from $218/kg to $367/kg lost for the remote support intervention. A primary care weight loss intervention administered remotely was relatively more cost-effective than an in-person intervention. Expanding the scope of reimbursable programs to include other cost-effective interventions could help ensure that a broader range of patients receive the type of support needed.

Effects of Treatment Differences on Psychosocial Predictors of Exercise and Improved Eating in Obese, Middle-Age Adults

2013 ◽  
Vol 10 (7) ◽  
pp. 1024-1031 ◽  
Author(s):  
James Annesi
Keyword(s):  
Weight Loss ◽  
Nutrition Education ◽  
Psychosocial Factors ◽  
Self Efficacy ◽  
Behavioral Interventions ◽  
Vegetable Intake ◽  
Self Regulation ◽  
Fruit And Vegetable Intake ◽  
Cognitive Behavioral ◽  
Fruit And Vegetable

Background:Behavioral interventions for weight-loss have been largely unsuccessful. Exercise is the strongest predictor of maintained weight loss and much of its effects may be from associated changes in psychosocial factors.Methods:Middle-aged, formerly sedentary adults with severe obesity were randomly selected to 6-month treatments of cognitive-behavioral exercise support paired with either standard nutrition education (n = 99) or nutrition change supported by cognitive-behavioral means with an emphasis on self-regulation (n = 101).Results:Overall improvements in self-efficacy and self-regulation for both exercise and managed eating, and mood, were found, with significantly greater improvements associated with the cognitive-behavioral nutrition condition in self-regulation for eating and mood. Change scores trended toward being stronger predictors of increased exercise and fruit and vegetable intake than scores at treatment end. Multiple regression analyses indicated that significant portions of the variance in both increased volume of exercise (R2 = 0.45) and fruit and vegetable intake (R2 = 0.21) were explained by changes in self-regulatory skill usage, self-efficacy, and mood.Conclusions:Cognitive-behavioral methods for improved eating paired with behavioral support of exercise may improve weight loss through effects on the psychosocial factors of self-regulation, self-efficacy, and overall mood more than when standard nutrition education is incorporated.

Primary Care Intervention for Weight Loss

2011 ◽  
Author(s):  
A. G. Tsai ◽  
T. A. Wadden ◽  
M. A. Rogers ◽  
S. C. Day ◽  
R. H. Moore ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Care Intervention

Impact of cognitive-behavioral interventions on weight loss and psychological outcomes: A meta-analysis.

2018 ◽  
Vol 37 (5) ◽  
pp. 417-432 ◽  
Author(s):  
Ariane Jacob ◽  
Gregory Moullec ◽  
Kim L. Lavoie ◽  
Catherine Laurin ◽  
Tovah Cowan ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behavioral Interventions ◽  
Meta Analysis ◽  
Psychological Outcomes ◽  
Cognitive Behavioral ◽  
Cognitive Behavioral Interventions

The Impact of Primary Care Resident Physician Training on Patient Weight Loss at 12 Months

Obesity ◽  
2012 ◽  
Author(s):  
Melanie R. Jay ◽  
Colleen C. Gillespie ◽  
Sheira L. Schlair ◽  
Stella M. Savarimuthu ◽  
Scott E. Sherman ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Resident Physician ◽  
Physician Training ◽  
Primary Care Resident ◽  
Patient Weight ◽  
The Impact

A Mixed Method Investigation of Parent Perspectives on Behavioral Services in Primary Care

2020 ◽  
Author(s):  
Andrew Riley ◽  
Bethany L. Walker ◽  
Krishnapriya Ramanujam ◽  
Wendy M. Gaultney ◽  
Deborah J. Cohen
Keyword(s):  
Primary Care ◽  
Mixed Method ◽  
Behavioral Interventions ◽  
Parental Participation ◽  
Parent Perspectives ◽  
Delivery Methods ◽  
Behavioral Services

Primary care is a key setting for the delivery of parent-focused behavioral interventions. Various methods of intervention show promising efficacy, but fail to engage adequate parental participation. The objective of this study was to understand factors underlying parents’ attitudes towards the content, sources, and delivery methods of behavioral guidance in primary care.

scholarly journals A web-based intervention to increase weight loss treatment initiation: results of a cluster randomized feasibility and acceptability trial

2019 ◽  
Author(s):  
Megan A McVay ◽  
William S Yancy ◽  
Gary G Bennett ◽  
Erica Levine ◽  
Seung-Hye Jung ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Treatment Initiation ◽  
Primary Care Providers ◽  
Feasibility Trial ◽  
Care Providers ◽  
Behavioral Weight Loss ◽  
Weight Loss Treatment ◽  
Primary Care Patients ◽  
Cluster Randomized

Abstract Evidence-based behavioral weight loss treatment is under-utilized. To increase initiation of treatment, we developed a single-session, online, primary care-based intervention (“mobilization tool”). We evaluated the mobilization tool's acceptability for primary care patients with obesity, trial design feasibility, and signal of an effect of the tool on treatment initiation. In this cluster randomized feasibility trial, primary care providers (PCPs) were randomized to a mobilization tool or comparator tool arm. Patients with obesity and a scheduled appointment with a randomized PCP were assigned to complete the mobilization or comparator tool prior to their appointment. The online mobilization tool asks patients to answer questions about a variety of weight-related topics and then provides automated, tailored feedback that addresses psychosocial determinants of weight loss treatment initiation. The comparator tool provided a nontailored description of treatments. All participants were offered free enrollment in behavioral weight loss treatments. Six PCPs were randomized. Sixty patients (57% female; 66% white; aged 55 ± 13 years) participated in this study of 296 contacted for eligibility evaluation (20.2%). Six-month follow-up assessments were completed by 65% (22/34) of the mobilization and 73% (19/26) of comparator tool participants. Participants completing the acceptability survey reported that the mobilization tool was usable, enjoyable, informative, and useful. Weight loss treatment was initiated by 59% (n = 19) of mobilization and 33% (n = 8) of comparator tool participants. The mobilization tool shows promise for increasing treatment initiation among primary care patients, which may increase population weight loss. Trial Registration: Clinicaltrials.gov identifier: NCT02708121.

scholarly journals Identifying and measuring the behavioural, dietary, and physical activity components of weight management consultations delivered by general practice nurses in routine care

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Heather Tong ◽  
Elizabeth Morris ◽  
Susan A. Jebb ◽  
Dimitrios A. Koutoukidis
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Weight Management ◽  
Care Group ◽  
Dietary Recommendations ◽  
Practice Nurses ◽  
Audio Recordings ◽  
Baseline Weight ◽  
Physical Activity Recommendations ◽  
Activity Recommendations

Abstract Background Many people with obesity receive weight loss consultations by general practice nurses (GPNs) in routine primary care. This exploratory study aimed to characterise the components of these consultations, including behaviour change techniques (BCTs), and dietary and physical activity recommendations. Methods We analysed audio recordings of weight management consultations conducted by 8 GPNs as part of the ‘usual care’ group in a randomised controlled trial (ISRCTN75092026). Consultations were coded against three taxonomies to classify BCTs, dietary recommendations, and physical activity recommendations. Associations between coded content and weight loss were assessed. Differences in the content of consultations where weight loss was < 5% or ≥ 5% from baseline weight at 6 months were explored. Results One hundred and fifty audio recordings were available from 53 out of 140 (38%) participants in the usual care group. Participants had on average 3 (SD = 1) recorded consultations over 3 months, lasting 14 (SD = 7) minutes each. Weight change at 3, 6, and 12 months was -3.6% (SD = 4.3), -5.5% (SD = 6.0) and -4.2% (SD = 6.5) for participants with audio recordings. GPNs used 3.9 (SD = 1.6) of 93 BCTs, 3.3 (SD = 2.7) of 30 dietary recommendations and 1.4 (SD = 1.2) of 10 physical activity recommendations per consultation. The most commonly employed BCTs were feedback on outcome of behaviour (80.0%), problem solving (38.0%), and social reward (34.3%). The most common dietary recommendations were about portion size (31.3%), nutrients (28.0%), and balanced diet (19.7%). The main physical activity recommendation was about walking (30.3%). There was no association between weight loss and the number of dietary recommendations, physical activity recommendations, or BCTs used per consultation, or per participant. Social reward was the only technique used significantly more in consultations of participants that lost ≥ 5% of their baseline weight at 6 months. Conclusions The study provides a new method that could be used to describe the content of weight management consultations. Specific dietary or physical activity recommendations and BCTs were used infrequently and inconsistently in this group of GPNs. Although replication is required in larger samples, this may point to a weakness in current practice.

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