Factors Influencing Men’s Experiences and Engagement with the Rugby Fans in Training—New Zealand Pilot Trial: A Healthy Lifestyle Intervention for Men

Health promotion programs designed specifically to support men to improve their lifestyle behaviours are required to improve men’s health. This study explored factors that influenced men’s experiences of, and engagement with, the Rugby Fans in Training—New Zealand pilot trial, a professional sport-based healthy lifestyle intervention for overweight men. Thirty-five men (mean age = 45, SD = 10 years) who completed the 12-week intervention participated in one of eight semi-structured focus groups. Using inductive thematic analysis, five themes represented the meanings in the data. First, a group of like-minded men all in the same boat recognised the importance of being in similar life situations and having similar reasons for joining the programme. Second, the men described the importance of the support and motivation provided by the team atmosphere created through the programme. Third, the motivational coach recognised the characteristics, skills and knowledge of the coach delivering the programme which created engagement with it. Fourth, the education sessions were valued for the knowledge gained and underpinning philosophies that guided them. Finally, the involvement of the rugby franchise influenced commitment to the programme and created initial interest. These results provide evidence for the key components that should be incorporated into the future development of and improvement to healthy lifestyle interventions for men.

Grassroots Approaches To Community-Based Representative Recruitment In Multidomain Trials

U.S. POINTER is a randomized, controlled, multi-domain clinical trial to slow the progression of cognitive decline within the American population via tailored and culturally-appropriate healthy lifestyle interventions. For findings to be broadly relevant across the American population, incorporating an inclusive and robust recruitment effort has been essential to form a diverse and properly representative participant cohort. As such, the trial’s inclusive enrollment goal is 30% from traditionally underrepresented communities that include those at elevated risk for Alzheimer’s disease and related disorders. To accomplish this goal, U.S. POINTER developed and deployed a grassroots recruitment strategy in partnership with outreach specialists at each site that includes a mix of evidence-based and innovative community engagement approaches. While the COVID-19 pandemic continues to present unique challenges for recruitment, our team has been able to strategize ways to continue working within the community to support trial recruitment. An overview of these methods will be presented.

The Impact of Body Mass Index on Physical Activity and Cardiac Workload

BackgroundHaving an abnormal body mass index (BMI) adversely affects cardiac workload and level of physical activity.ObjectiveTo examine the relationship between cardiac workload, physical activity, Sex, and BMI.MethodsThe number of steps taken per day (Steps) and minutes per week spent in targeted heart rate zones were collected from primarily first and second year university students (n = 1,801; 62% female) over a standard, 15-week long semester. Other data collected included BMI, Sex, Age, and Class Standing. Sex differences in BMI, Steps, and training heart rate zone (heart rates above 50% of max) minutes (THR) were evaluated, correlations between the study parameters were analyzed, and one-way ANOVA was used to test between competing models. The values p < .05 were considered statistically significant.ResultsStatistically significant (p < .05) differences between males and females were found for Steps, THR, and BMI. Males were more physically active but spent 18% less time with heart rates above 50% of max. Students who had abnormal BMI values, both low and high, experienced greater cardiac workload (p < .05), even though they were found to be less physically active (p < .05).ConclusionOur study revealed that university students with abnormal BMI values experienced greater cardiac workload, even though they are less physically active. Thus, physical fitness and healthy lifestyle interventions should also include underweight students in addition to students who are overweight or obese.

The OptimalMe healthy lifestyle in preconception, pregnancy and postpartum (HiPPP) intervention: Trial protocol for a randomised controlled implementation effectiveness trial (Preprint)

BACKGROUND Reproductive aged women are a high-risk population group for accelerated weight gain and obesity development, with pregnancy recognised as a critical contributory life-phase. Healthy lifestyle interventions during the antenatal period improve maternal and infant health outcomes, yet translation and implementation into real-world healthcare settings remains limited. OBJECTIVE OptimalMe is a randomised, hybrid implementation effectiveness study of an evidence based healthy lifestyle intervention. Which will evaluate intervention penetration and reach and the feasibility, acceptability, adoption and fidelity of the intervention implemented into, and in partnership with, private healthcare. Secondary outcomes include evaluation of individual health outcomes associated with implementation delivery mode, including knowledge, risk perception, health literacy, self-management and health behaviours. METHODS The study design is a parallel, two arm, randomised trial at the level of the individual. Three hundred participants aged 18-44, who are not pregnant, but wish to conceive within the next 12 months at point of recruitment and with access to the internet will be recruited. All participants will receive the same digital lifestyle intervention, OptimalMe, which is supported by health coaching and ongoing text messages across preconception, pregnancy and postpartum. Implementation delivery will be tested comparing two remote delivery methods for health coaching including telephone or video conferencing. All methods are theoretically underpinned by the Consolidated Framework for Implementation Research (CFIR) and outcomes based on the Reach, Engagement, Adaptation, Implementation and Maintenance (RE-AIM) and the Penetration, Implementation, Participation, Effectiveness (PIPE) frameworks. RESULTS The Monash Health Human Research and Ethics Committee has approved the study (reference: RES-19-0000291A, approved: 16 August 2019) which has been registered on the Australian and New Zealand Clinical Trial Registry (ACTRN12620001053910). The project is supported with funding from Medibank Private Ltd. Recruitment commenced in July 2020 with results expected to be published in 2022. CONCLUSIONS Our study design aligns with best practice implementation research, informed by evidence from across efficacy trials, integrated into systematic reviews, meta-analyses and guidelines. Results generated will inform translation of evidence from randomised controlled trials on healthy lifestyle interventions into practice targeting women across preconception, pregnancy and postpartum. Learnings will target consumers, program facilitators, health professionals, services and policy makers to inform future scale-up to ultimately benefit the health of women across these life-phases.ults expected to be published in 2022. CLINICALTRIAL ACTRN12620001053910

Evaluation of a package of risk-based pharmaceutical and lifestyle interventions in patients with hypertension and/or diabetes in rural China: A pragmatic cluster randomised controlled trial

Background Primary prevention of cardiovascular disease (CVD) requires adequate control of hypertension and diabetes. We designed and implemented pharmaceutical and healthy lifestyle interventions for patients with diabetes and/or hypertension in rural primary care, and assessed their effectiveness at reducing severe CVD events. Methods and findings We used a pragmatic, parallel group, 2-arm, controlled, superiority, cluster trial design. We randomised 67 township hospitals in Zhejiang Province, China, to intervention (34) or control (33). A total of 31,326 participants were recruited, with 15,380 in the intervention arm and 15,946 in the control arm. Participants had no known CVD and were either patients with hypertension and a 10-year CVD risk of 20% or higher, or patients with type 2 diabetes regardless of their CVD risk. The intervention included prescription of a standardised package of medicines, individual advice on lifestyle change, and adherence support. Control was usual hypertension and diabetes care. In both arms, as usual in China, most outpatient drug costs were out of pocket. The primary outcome was severe CVD events, including coronary heart disease and stroke, during 36 months of follow-up, as recorded by the CVD surveillance system. The study was implemented between December 2013 and May 2017. A total of 13,385 (87%) and 14,745 (92%) participated in the intervention and control arms, respectively. Their mean age was 64 years, 51% were women, and 90% were farmers. Of all participants, 64% were diagnosed with hypertension with or without diabetes, and 36% were diagnosed with diabetes only. All township hospitals and participants completed the 36-month follow-up. At 36 months, there were 762 and 874 severe CVD events in the intervention and control arms, respectively, yielding a non-significant effect on CVD incidence rate (1.92 and 2.01 per 100 person-years, respectively; crude incidence rate ratio = 0.90 [95% CI: 0.74, 1.08; P = 0.259]). We observed significant, but small, differences in the change from baseline to follow-up for systolic blood pressure (−1.44 mm Hg [95% CI: −2.26, −0.62; P < 0.001]) and diastolic blood pressure (−1.29 mm Hg [95% CI: −1.77, −0.80; P < 0.001]) in the intervention arm compared to the control arm. Self-reported adherence to recommended medicines was significantly higher in the intervention arm compared with the control arm at 36 months. No safety concerns were identified. Main study limitations include all participants being informed about their high CVD risk at baseline, non-blinding of participants, and the relatively short follow-up period available for judging potential changes in rates of CVD events. Conclusions The comprehensive package of pharmaceutical and healthy lifestyle interventions did not reduce severe CVD events over 36 months. Improving health system factors such as universal coverage for the cost of essential medicines is required for successful risk-based CVD prevention programmes. Trial registration ISRCTN registry ISRCTN58988083.

A Comprehensive View on Cardiovascular Diseases (CVDs): Genetics, Risk Factors & Preventions

Cardiovascular Diseases (CVDs) are one of the foremost causes of deaths across the world. This review aims to evaluate the genetics and risk factors involved in CVDs and to assess the preventive measures which can be taken for diminishing the chances of developing CVDs. The goal of this review is to provide researchers and clinicians dealing with vascular disorders with a compendium of data about the genetic causes, risk factors, and preventive strategies to combat the development of CVDs. We searched online databases including PubMed for peer-reviewed scientific papers, case studies and review articles related to CVDs, emphasizing on the role of genetics and risk factors like diabetes, hypertension, smoking, alcohol consumption, obesity, age & gender in the progression of CVDs, and reviewing the role of diet and exercise in the prevention of CVDs. Managing the risk factors involved in CVDs is the most essential step for the inhibition of vascular diseases. Healthy lifestyle interventions consisting of a well-balanced diet and physical activity are very critical for the prevention of CVDs. Trials carried out on model organisms have indicated a direct link between diet and exercise on cardiovascular conditions. Strategies involved in the treatment of vascular diseases should also include low-fat diet plans like consumption of whole grains, fruits, vegetables, yogurts and avoiding high-saturated fat-containing foods with the addition of performing moderate aerobic exercises including cycling, swimming, hiking, and running to eliminate the root of the problem.

Impact of promoting healthy lifestyle interventions among adolescents, young adults with polycystic ovarian disease in resource limited settings

Polycystic Ovarian Disease (PCOD) is a reproductive metabolic disorder caused by hormonal imbalances within women of fertile age. Mainstay for treating patients with PCOD includes pharmacological therapy and lifestyle modifications. Lifestyle modifications that play a key role in the management of PCOD are weight management, reduction in stress, physical activity, body mass index and dietary changes. There is sparse information regarding the impact of these interventional parameters among the PCOD women in the literature. This study aims to determine the impact of healthy lifestyle modifications in the management of PCOD among young adults and adolescents. It was a prospective interventional study conducted in the Gynaecology outpatient department in Government General Hospital, Kadapa over the time of 6 months from June 2019 to November 2019. Counseling on lifestyle changes and implementation of healthy lifestyle interventions were given to the study population by using the standard questionnaire forms and post counseling changes were collected after 90 days of visit to the clinic. The statistical significance was done by using the unpaired t-test and graph pad version 8.3.0. The total sample of 30 PCOD patients was compared to before patient counseling on lifestyle modifications and after follow-up. The total population was categorized into 2 groups as adolescents (10%) and young adults (27%). The current study showed that there is a significant association between dietary intervention (p <0.0113) and physical activity scores (p<0.029) among the PCOD patients. In PCOD patient’s healthy lifestyle modifications like dietary interventions and Physical activity serves as an effective treatment strategy adjunct to pharmacological therapy and improved the patient reproductive health.