scholarly journals Remote Health Coaching Text-based Walking Program in Ethnic Minority Primary Care Patients who are Overweight and Obese: A Feasibility and Acceptability Pilot (Preprint)

2021 ◽  
Author(s):  
Mary H. Smart ◽  
Nadia A. Nabulsi ◽  
Ben S. Gerber ◽  
Itika Grupta ◽  
Barbara Di Eugenio ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Chronic Disease ◽  
Ethnic Minority ◽  
Chronic Diseases ◽  
Text Messaging ◽  
The United States ◽  
Overweight And Obesity ◽  
Summative Evaluation ◽  
Walking Program

BACKGROUND Over half of adults in the United States have at least one chronic disease including obesity. Although physical activity is an important component of chronic disease self-management, few reach the recommended goals for physical activity. Individuals who identify as racial and ethnic minorities are disproportionally impacted by chronic diseases and physical inactivity. Interventions utilizing consumer-based wearable devices have shown promise for increasing physical activity among patients with chronic diseases; however, populations with the most to gain such as minorities, have been poorly represented to date. OBJECTIVE To assess the feasibility, acceptability, and preliminary outcomes of an 8-week text-based coaching and Fitbit program aimed to increase steps among a predominantly ethnic minority population with overweight and obesity. METHODS Overweight (body mass index [BMI] >25 kg/m2) patients were recruited from an internal medicine clinic located within an inner-city academic medical center to participate. Fitbit devices were provided. Using 2-way text messaging, HCs guided patients to establish weekly step goals that were Specific, Measurable, Attainable, Realistic, and Time-bound (SMART). Texting and Fitbit activities were managed with a custom designed application. Program feasibility was assessed via the recruitment rate, retention rate (defined as the proportion of eligible participants completing the 8-week program) and patient engagement (based on number of weekly text message goals set with the HC across the 8-week period). Acceptability was assessed through a qualitative summative evaluation. Exploratory statistical analysis included evaluating the average weekly steps in week 1 compared to week 8 using a paired t-test and modeling daily steps over time using a linear mixed model. RESULTS Thirty (91%) of the thirty-three patients initially screened were enrolled. At baseline, the average BMI was 39.3 kg/m2 (SD = 9.3 kg/m2), with 23 (73%) of the participants presenting as obese. Nine (30%) self-rated their health as either "fair" or "poor.” Twenty-two patients (87%) set up ≥6 weekly goals across the 8-week program. Twenty-eight (93%) participants completed the qualitative summative evaluation. Ten themes emerged from the evaluation: (1) patient motivation, (2) convenient texting experience, (3) social support, (4) supportive accountability, (5) technology support, (6) self-determined goals, (7) achievable goals, (8) feedback from Fitbit, and (9) challenges, and (10) habit formation. There was no significant group change in the average weekly steps for week 1 compared to week 8 (mean difference: 7.26, p=0.99). However, five participants (17.9%) had a significant increase in their daily steps. CONCLUSIONS Overall, the results demonstrate the feasibility and acceptability for a remotely delivered walking study which included a HC, text messaging, wearable device (Fitbit), and SMART goals within a ethnic minority group of patients. These preliminary results of a walking program recruiting from primary care support further development and testing in larger samples to explore the efficacy. CLINICALTRIAL n/a

Nutrition for the Healthy Adult

2018 ◽  
Author(s):  
Marijane G. Staniec
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Weight Gain ◽  
Chronic Diseases ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Healthy Adults ◽  
Dietary Guidelines ◽  
Care Providers ◽  
Added Sugars

Many of today’s healthy adults will be plagued by chronic diseases, such as obesity, hypertension, heart disease, and diabetes, and be robbed of the quality of life they desire. According to the 2015–2020 Dietary Guidelines for Americans, about half of all American adults have one or more diet-related chronic diseases. The question, “What should healthy adults eat to stay healthy?” may seem simple. However, many primary care providers feel vulnerable answering questions about nutrition. This review serves as a summary of the most up-to-date guidelines about added sugars, sodium, types of fat, and cholesterol for healthy adults and a refresher for health care providers caring for them. Other important related issues, such as the latest recommendations for physical activity, the problem of adult weight gain, the need for adiposity screening, the powerful role of the primary care provider, and suggestions nutrition-focused primary care, are discussed. This review contains 5 Figures, 5 Tables and 137 references Key words: weight gain, cholesterol, Dietary Guidelines, sugar-sweetened beverages, adiposity, added sugar, hydrogenated oils, physical activity, waist-to-height ratio, nutrition-focused, Primary Care

scholarly journals A Critical Review on New Approaches for Chronic Disease Prevention in Brazil and Canada: From Wholistic Dietary Guidelines to Physical Activity Security

2021 ◽  
Vol 8 ◽  
Author(s):  
Juliano Schwartz ◽  
Paul Oh ◽  
Maira B. Perotto ◽  
Ryan E. Rhodes ◽  
Wanda Firth ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Critical Review ◽  
Well Being ◽  
Overweight And Obesity ◽  
Dietary Guidelines ◽  
Chronic Disease Prevention ◽  
Cultural Economic ◽  
Socioeconomic Condition

In light of new evidence on the prevention of chronic diseases and the elevated rates of overweight and obesity in Brazil and Canada, this critical review aims to interpret and synthesize current aspects regarding dietary and physical activity initiatives in both countries and make future recommendations. The pioneering work presented in the last Brazilian dietary guidelines has been called a model that can be applied globally, given its conceptualization of healthy eating that translates easily to practical guidance. The new Canadian Food Guide has incorporated similar aspects, also putting the country as a leader in dietary guidance. With these new recommendations, citizens in both Brazil and Canada have access to impactful evidence-informed nutritional guidelines. Both documents propose eating patterns that focus not only on health benefits, such as chronic disease prevention, but also incorporate well-being concerning cultural, economic, sociodemographic, biological, and ecological dimensions. A similar approach is required for physical activity to allow individuals to have attainable health and life goals and thereby fully enjoy their lives, regardless of geographical location, health status, and socioeconomic condition, a concept recently described as physical activity security. The wholistic dietary guidelines from both countries represent a change in paradigm in public health. Likewise, national evidence-based policies are warranted to reduce disparities in physical activity, allowing healthier and more active lifestyles for everyone.

Exercise

2015 ◽  
Author(s):  
Elizabeth G Nabel
Keyword(s):  
Physical Activity ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Response ◽  
Exercise Physiology ◽  
The United States ◽  
Overweight And Obesity ◽  
Metabolic Effects ◽  
Global Risk ◽  
Artery Disease

Numerous observational studies have demonstrated an inverse relationship between physical activity and risk of many chronic illnesses. The protective effect of exercise is strongest against coronary artery disease, hypertension, stroke, type 2 diabetes mellitus, obesity, anxiety, depression, osteoporosis, and cancers of the colon and breast. Despite these proven benefits, only 25% of adults in the United States exercise at recommended levels. Globally, physical inactivity is the fourth leading risk factor for death, followed by overweight and obesity. This module describes exercise physiology, including cardiovascular response to dynamic exercise, pulmonary response, musculoskeletal response, metabolic effects, effects on blood lipid levels, hematologic effects, effects on vascular inflammation, effects on body fluids, and psychological effects. Exercise and the elderly and the relationship between exercise and longevity are reviewed. Prescribing exercise and complications of exercise are also discussed. Tables describe the categories of patients screened for possible coronary artery disease, exercise time required to consume 2,000 kcal, and exercise advice for patients. Figures include a graph showing the number of adults who met the federal physical activity guidelines criteria, the top 10 global risk factors for death in 2004, the process of providing energy for the muscle, and trends in physician prescriptions for exercise. This module contains 4 highly rendered figures, 3 tables, 35 references, and 5 MCQs.

Exercise

2018 ◽  
Author(s):  
Elizabeth G Nabel
Keyword(s):  
Physical Activity ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Response ◽  
Exercise Physiology ◽  
The United States ◽  
Overweight And Obesity ◽  
Metabolic Effects ◽  
Global Risk ◽  
Artery Disease

Numerous observational studies have demonstrated an inverse relationship between physical activity and risk of many chronic illnesses. The protective effect of exercise is strongest against coronary artery disease, hypertension, stroke, type 2 diabetes mellitus, obesity, anxiety, depression, osteoporosis, and cancers of the colon and breast. Despite these proven benefits, only 25% of adults in the United States exercise at recommended levels. Globally, physical inactivity is the fourth leading risk factor for death, followed by overweight and obesity. This module describes exercise physiology, including cardiovascular response to dynamic exercise, pulmonary response, musculoskeletal response, metabolic effects, effects on blood lipid levels, hematologic effects, effects on vascular inflammation, effects on body fluids, and psychological effects. Exercise and the elderly and the relationship between exercise and longevity are reviewed. Prescribing exercise and complications of exercise are also discussed. Tables describe the categories of patients screened for possible coronary artery disease, exercise time required to consume 2,000 kcal, and exercise advice for patients. Figures include a graph showing the number of adults who met the federal physical activity guidelines criteria, the top 10 global risk factors for death in 2004, the process of providing energy for the muscle, and trends in physician prescriptions for exercise. This module contains 4 highly rendered figures, 3 tables, 35 references, and 5 MCQs.

scholarly journals Optimising patient active role with a user-centred eHealth platform (CONCERTO+) in chronic diseases management: a study protocol for a pilot cluster randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e028554 ◽  
Author(s):  
Marie-Pierre Gagnon ◽  
Mame Awa Ndiaye ◽  
Alain Larouche ◽  
Guylaine Chabot ◽  
Christian Chabot ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Randomised Controlled Trial ◽  
Disease Management ◽  
Chronic Diseases ◽  
Chronic Disease Management ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Cluster Randomised ◽  
Randomised Controlled

IntroductionMultimorbidity increases care needs and primary care use among people with chronic diseases. The Concerto Health Program (CHP) has been developed to optimise chronic disease management in primary care services. However, in its current version, the CHP primarily targets clinicians and does not aim to answer directly patients’ and their informal caregivers’ needs for chronic disease management. Various studies have shown that interventions that increase patient activation level are associated with better health outcomes. Furthermore, educational tools must be adapted to patients and caregivers in terms of health literacy and usability. This project aims to develop, implement and evaluate a user-centred, multifunctional and personalised eHealth platform (CONCERTO+) to promote a more active patient role in chronic disease management and decision-making.Methods and analysisThis project uses a collaborative research approach, aiming at the personalisation of CHP through three phases: (1) the development of one module of an eHealth platform based on scientific evidence and user-centred design; (2) a feasibility study of CONCERTO+ through a pilot cluster randomised controlled trial where patients with chronic diseases from a primary healthcare practice will receive CONCERTO+ during 6 months and be compared to patients from a control practice receiving usual care and (3) an analysis of CONCERTO+ potential for scaling up. To do so, we will conduct two focus groups with patients and informal caregivers and individual interviews with health professionals at the two study sites, as well as health care managers, information officers and representatives of the Ministry of Health.Ethics and disseminationThis study received ethical approval from Ethics Committee of Université Laval. The findings will be used to inform the effectiveness of CONCERTO+ to improve management care in chronic diseases. We will disseminate findings through presentations in scientific conferences and publication in peer-reviewed journals.Trial registration numberNCT03628963; Pre-results.

Physical activity can attenuate, but not eliminate, the negative relationships of high TV viewing with some chronic diseases: findings from a cohort of 60 202 Brazilian adults

2019 ◽  
Author(s):  
André O Werneck ◽  
Adewale L Oyeyemi ◽  
Paul J Collings ◽  
Edilson S Cyrino ◽  
Enio R V Ronque ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Leisure Time Physical Activity ◽  
Sodium Intake ◽  
Viewing Time ◽  
Negative Effects ◽  
Tv Viewing ◽  
Logistic Regression Models ◽  
Nationally Representative

Abstract Background This study examined the joint associations of leisure time physical activity and television (TV) viewing time with the prevalence of chronic diseases among Brazilian adults. Methods Data from the Brazilian Health Survey, a nationally representative survey conducted in 2013 (n = 60 202; ≥18 years), were used. Time spent in TV viewing and leisure physical activity, physician diagnoses of diabetes, hypertension and heart disease and information on co-variables (chronological age, education, ethnicity, candies/sweets consumption, sodium intake and tobacco smoking) were collected via interview. Descriptive statistics (mean and 95% confidence interval) and logistic regression models were used for etiological analyses. Results Physical activity attenuated but did not eliminate the risk associated with high TV viewing for at least one chronic disease in the general population [odds ratio [OR]: 1.29 (1.11–1.50)] and among women [OR: 1.31 (1.09–1.60)], adults [OR: 1.24 (1.05–1.46)] and older adults [OR: 1.63 (1.05–2.53)]. On the other hand, physical activity eliminated the risk associated with high TV viewing for at least one chronic disease among men [OR: 1.24 (0.98–1.58)]. Conclusions We conclude that physical activity can attenuate but not eliminate the negative effects of high TV viewing on chronic disease among subgroups of Brazilian adults.

scholarly journals A PRESCRIPTION FOR WELLNESS: EXERCISE REFERRALS FOR PATIENTS AT A FEDERALLY QUALIFIED HEALTH CENTER

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S519-S519
Author(s):  
Gabriel Benavidez ◽  
Kelly Ylitalo
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Health Center ◽  
Exercise Prescription ◽  
Patient Characteristics ◽  
The United States ◽  
Health Coaching ◽  
Adult Patients ◽  
Federally Qualified Health Center ◽  
Personalized Health

Abstract Physical activity improves quality of life and prevents or delays chronic disease, but most adults in the United States are inactive. Consultation and planning with a health care provider, specifically with an exercise “prescription,” may increase physical activity, but utilization patterns and success of such programs are not well understood. This study assessed the initial 6 months of an exercise prescription program at a large, federally-qualified health center during 2018 whereby adult patients were referred via prescription to personalized health coaching by a fitness advisor. A census of all adults (n=512) who received an exercise prescription was combined with attendance data from the on-site exercise facility to classify patients as never attended, 1 to 3 visits, and ≥4 visits. Ordinal logistic regression was used to examine patient characteristics from the electronic health record that influenced exercise facility attendance. Only 30.2% of adults (mean age 44.7 years (SD 14.4)) completed ≥1 visit and 21.7% completed ≥4 visits. We identified no significant utilization differences by sex, race/ethnicity, body mass index, diabetes, hypertension, or coronary artery disease, but adults aged ≥60 years had almost twice the odds of ≥4 visits (OR=1.97; 95% CI: 1.18, 3.33; p=0.01) compared to younger patients. Many adult patients did not participate in the exercise prescription program, but older adults were more likely to participate. Exercise prescription programs with personalized health coaching may be useful for older adult patients receiving care at a federally-qualified health center. Future work will examine if or how exercise prescriptions impact chronic disease self-management.

Waging war on modern chronic diseases: primary prevention through exercise biology

2000 ◽  
Vol 88 (2) ◽  
pp. 774-787 ◽  
Author(s):  
Frank W. Booth ◽  
Scott E. Gordon ◽  
Christian J. Carlson ◽  
Marc T. Hamilton
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Chronic Disease ◽  
Primary Prevention ◽  
Chronic Diseases ◽  
20Th Century ◽  
Physical Inactivity ◽  
Funding System ◽  
Sedentary Population ◽  
Biology Research

In this review, we develop a blueprint for exercise biology research in the new millennium. The first part of our plan provides statistics to support the contention that there has been an epidemic emergence of modern chronic diseases in the latter part of the 20th century. The health care costs of these conditions were almost two-thirds of a trillion dollars and affected 90 million Americans in 1990. We estimate that these costs are now approaching $1 trillion and stand to further dramatically increase as the baby boom generation ages. We discuss the reaction of the biomedical establishment to this epidemic, which has primarily been to apply modern technologies to stabilize overt clinical problems (e.g., secondary and tertiary prevention). Because this approach has been largely unsuccessful in reversing the epidemic, we argue that more emphasis must be placed on novel approaches such as primary prevention, which requires attacking the environmental roots of these conditions. In this respect, a strong association exists between the increase in physical inactivity and the emergence of modern chronic diseases in 20th century industrialized societies. Approximately 250,000 deaths per year in the United States are premature due to physical inactivity. Epidemiological data have established that physical inactivity increases the incidence of at least 17 unhealthy conditions, almost all of which are chronic diseases or considered risk factors for chronic diseases. Therefore, as part of this review, we present the concept that the human genome evolved within an environment of high physical activity. Accordingly, we propose that exercise biologists do not study “the effect of physical activity” but in reality study the effect of reintroducing exercise into an unhealthy sedentary population that is genetically programmed to expect physical activity. On the basis of healthy gene function, exercise research should thus be viewed from a nontraditional perspective in that the “control” group should actually be taken from a physically active population and not from a sedentary population with its predisposition to modern chronic diseases. We provide exciting examples of exercise biology research that is elucidating the underlying mechanisms by which physical inactivity may predispose individuals to chronic disease conditions, such as mechanisms contributing to insulin resistance and decreased skeletal muscle lipoprotein lipase activity. Some findings have been surprising and remarkable in that novel signaling mechanisms have been discovered that vary with the type and level of physical activity/inactivity at multiple levels of gene expression. Because this area of research is underfunded despite its high impact, the final part of our blueprint for the next millennium calls for the National Institutes of Health (NIH) to establish a major initiative devoted to the study of the biology of the primary prevention of modern chronic diseases. We justify this in several ways, including the following estimate: if the percentage of all US morbidity and mortality statistics attributed to the combination of physical inactivity and inappropriate diet were applied as a percentage of the NIH's total operating budget, the resulting funds would equal the budgets of two full institutes at the NIH! Furthermore, the fiscal support of studies elucidating the scientific foundation(s) targeted by primary prevention strategies in other public health efforts has resulted in an increased efficacy of the overall prevention effort. We estimate that physical inactivity impacts 80–90% of the 24 integrated review group (IRG) topics proposed by the NIH's Panel on Scientific Boundaries for Review, which is currently directing a major restructuring of the NIH's scientific funding system. Unfortunately, the primary prevention of chronic disease and the investigation of physical activity/inactivity and/or exercise are not mentioned in the almost 200 total subtopics comprising the IRGs in the Panel's proposal. We believe this to be a glaring omission by the Panel and contend that the current reorganization of NIH's scientific review and funding system is a golden opportunity to invest in fields that study the biological mechanisms of primary prevention of chronic diseases (such as exercise biology). This would be an investment to avoid US health care system bankruptcy as well as to reduce the extreme human suffering caused by chronic diseases. In short, it would be an investment in the future of health care in the new millennium.

scholarly journals Hispanic Male’s Perspectives of Health Behaviors Related to Weight Management

2015 ◽  
Vol 11 (5) ◽  
pp. 1547-1559 ◽  
Author(s):  
David O. Garcia ◽  
Luis A. Valdez ◽  
Steven P. Hooker
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Health Behaviors ◽  
Weight Management ◽  
Health Beliefs ◽  
The United States ◽  
Overweight And Obesity ◽  
Future Research ◽  
Hispanic Males ◽  
Semistructured Interviews

Hispanic males have the highest prevalence of overweight and obesity among men in the United States; yet are significantly underrepresented in weight loss research. The purpose of the current study was to examine Hispanic male’s perspectives of health behaviors related to weight management to refine the methodologies to deliver a gender-sensitive and culturally sensitive weight loss intervention. From October 2014 to April 2015, semistructured interviews were conducted with 14 overweight Hispanic men of ages 18 to 64 years. The interviews lasted approximately 60 minutes. Participants also completed a brief questionnaire and body weight/height were measured. Grounded in a deductive process, a preliminary codebook was developed based on the topics included in the interview guides. A thematic analysis facilitated the identification of inductive themes and the finalization of the codebook used for transcript analysis. Four overarching themes were identified: (a) general health beliefs of how diet and physical activity behaviors affect health outcomes, (b) barriers to healthy eating and physical activity, (c) motivators for change, and (d) viable recruitment and intervention approaches. Future research should examine feasible and appropriate recruitment and intervention strategies identified by Hispanic males to improve weight management in this vulnerable group.

scholarly journals A randomized controlled trial into the cognitive effects of a computer-tailored physical activity intervention in older adults with chronic disease(s)

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Esmee Volders ◽  
Renate H. M. de Groot ◽  
Juul M. J. Coumans ◽  
Catherine A. W. Bolman ◽  
Lilian Lechner
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Chronic Disease ◽  
Cognitive Decline ◽  
Chronic Diseases ◽  
Verbal Memory ◽  
Daily Life ◽  
Intervention Group ◽  
Cognitive Effects ◽  
Intervention Effects

Abstract Background Cognitive functioning (CF) is important for wellbeing and an independent life. However, older adults with chronic diseases are at a higher risk of poorer CF levels. Although, research suggests that physical activity (PA) could play an essential role in maintaining good CF, older adults with chronic diseases have low levels of PA. PA interventions to prevent cognitive decline for this specific group exist. Yet, until now these interventions focused on a single specific chronic disease. Active Plus is a proven effective computer-tailored PA stimulating intervention focused on increasing PA in daily life for the older adult population suffering from a broad range of chronic diseases. This study tests the cognitive effects of Active Plus in older adults with chronic diseases. Methods In this RCT older adults with at least one chronic disease (≥65 years) were allocated to the intervention group (N = 260, mean age = 74.2) or waiting list control group (N = 325, mean age = 74.5). In total, intervention group participants received three times computer-tailored PA stimulating advice within four months (i.e., at baseline, after two months, and after three to four months). The online and print delivered advice were tailored to the specific needs and wishes of the participant and focused on incorporating PA in daily life. Baseline and follow-up measurements of the CF verbal memory (Verbal Learning Test), shifting (Trailmaking Test), inhibition (Stop-signal Task) and processing speed (Letter Digit Substitution Test) were assessed after six and 12 months. Intervention effects were analyzed with multilevel linear mixed-effects models adjusted for the clustered design and confounding variables. Results The dropout rate was 19.1% after 6 months and 25.1% after 12 months. Although both conditions improved on all verbal memory outcomes after 6 months, and all CF outcomes except inhibition after 12 months, no intervention effects were found, not even in subgroups (p > .05). Conclusions To our knowledge this is the first study to test the cognitive effects of a computer-tailored PA stimulating intervention in older adults suffering from a broad range of chronic diseases. The effects of the Active Plus intervention were not strong enough to improve CF or prevent cognitive decline. A blended approach, in which this computer-tailored intervention is combined with a face-to-face PA intervention and / or cognitive training, might be a good suggestion to increase the effects of Active Plus on PA and CF in older adults with chronic diseases. Trial registration Netherlands Trial Register NL6005; Date of Registration 03-21-2017; https://www.trialregister.nl/trial/6005

Sign in / Sign up

Export Citation Format

Share Document