Healthy Lifestyle Intervention Research Articles

Rural Residents' Perspectives on an mHealth or Personalized Health Coaching Intervention: Qualitative Study With Focus Groups and Key Informant Interviews.

BackgroundCompared with national averages, rural Appalachians experience extremely elevated rates of premature morbidity and mortality. New opportunities, including approaches incorporating personal technology, may help improve lifestyles and overcome health inequities.ObjectiveThis study aims to gather perspectives on whether a healthy lifestyle intervention, specifically an app originally designed for urban users, may be feasible and acceptable to rural residents. In addition to a smartphone app, this program—Make Better Choices 2—consists of personalized health coaching, accelerometer use, and financial incentives.MethodsWe convened 4 focus groups and 16 key informant interviews with diverse community stakeholders to assess perspectives on this novel, evidence-based diet and physical activity intervention. Participants were shown a slide presentation and asked open-ended follow-up questions. The focus group and key informant interview sessions were audiotaped, transcribed, and subjected to thematic analysis.ResultsWe identified 3 main themes regarding Appalachian residents’ perspectives on this mobile health (mHealth) intervention: personal technology is feasible and desirable; challenges persist in implementing mHealth lifestyle interventions in Appalachian communities; and successful mHealth interventions should include personal connections, local coaches, and educational opportunities. Although viewed as feasible and acceptable overall, lack of healthy lifestyle awareness, habitual behavior, and financial constraints may challenge the success of mHealth lifestyle interventions in Appalachia. Finally, participants described several minor elements that require modification, including expanding the upper age inclusion, providing extra coaching on technology use, emphasizing personal and supportive connections, employing local coaches, and ensuring adequate educational content for the program.ConclusionsBlending new technologies, health coaching, and other features is not only acceptable but may be essential to reach vulnerable rural residents.

Recent Trends in Various Types of Obesity Among Children and Adolescents in Shandong, China

Background: Childhood obesity has increased dramatically during the past decades. The present study examined the trends in various types of obesity among children and adolescents in Shandong, China from 2010 to 2019. Methods: Data for this study were obtained from two large cross-sectional surveys on students’ constitution and health carried out in 2010 and 2019. A total of 76 640 (38 822 in 2010 and 37 818 in 2019) students aged 7–17 years were included in this study. The body mass index (BMI) cut-offs recommended by the International Obesity Task Force (IOTF) were used to define general obesity. Central obesity was defined as waist-to-height ratio (WHtR) ≥0.5. Both BMI and WHtR were used to define three types of obesity as follows: general obesity only, central obesity only and combined obesity. Results: An increasing trend was observed in general obesity only, central obesity only and combined obesity between 2010 and 2019 (P<0.01), the total prevalence of the three types of obesity has reached 25.19% for boys and 15.77% for girls in 2019. Boys and children (aged 7-12 years) had higher prevalence of obesity than girls and adolescents (aged 13-17 years), respectively (P<0.01). Profiles of obesity subtypes had an obvious change, the proportion of combined obesity increased from 40.91% and 28.30% in 2010 to 49.32% and 35.22% in 2019 for boys and girls (P<0.01). Conclusion: The prevalence of obesity among children and adolescents had rapid increase over the past 9 years, healthy lifestyle education and program interventions are necessary. Funding Statement: This study was supported by the medical and health programme of Shandong, China (2014WS0376). Surveys on students’ constitution and health are conducted under the auspices of the Department of Education in Shandong Province, China. Declaration of Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Ethics Approval Statement: The study was approved by the Ethical Committee of the Shandong Center for Disease Control and Prevention, Shandong, China.

Determinants of attrition in a pediatric healthy lifestyle intervention: The CIRCUIT program experience

IntroductionAttrition in pediatric weight management programs is notoriously high. Greater understanding of its determinants is needed to inform retention strategies. We identified determinants of attrition in CIRCUIT, a healthy lifestyle intervention program for youth at risk of cardiovascular disease. MethodsA one-arm intervention study of children aged 4-18 years who initiated the CIRCUIT program in the first five years of its existence (N = 403). We defined attrition as attending the baseline visit but ceasing attendance prior to the 1-year follow-up. Potential determinants of dropout included the child’s age, sex, ethnicity, body mass index (BMI) z-score, family socio-demographic characteristics, and estimated driving time to the program, all measured at baseline. Associations were estimated bivariately, using chi-squared- and t-tests, and simultaneously in a multivariable logistic regression model. ResultsOf the 403 participants who started the program, 198 (49%) dropped out within 12 months of enrollment. Youth who dropped out were older (mean age 12.8y vs. 11.3y; p < 0.01), were less likely to live with both parents (62% vs. 71%; p = 0.05), and to have mothers who had completed high school (79% vs. 88%; p = 0.01). No group differences were observed for sex, ethnicity, baseline BMI z-score, fathers’ education, or driving time to the program. In multivariate models, only older age at initiation of the intervention (OR: 1.2; CI: 1.1,1.3) and lower maternal education (OR: 2.0; CI: 1.0,3.8) were associated with dropout. ConclusionImproved tailoring of interventions to older pediatric participants and to families of lower maternal education may help reduce attrition in CIRCUIT and similar lifestyle intervention programs.

Abstract PS8-09: Dietary supplement use in a healthy eating and exercise lifestyle intervention in breast cancer survivors: The lifestyle exercise and nutrition (LEAN) study

Abstract Background: Dietary supplements (DS), defined as herbal preparations, vitamins and minerals (DSHEA Act 1994), are used by 70% of cancer survivors. The World Cancer Research Fund/American Institute for Cancer Research 2018 Cancer Prevention Recommendations specify not to use DS to protect against cancer. There is some evidence that DS are linked to harmful outcomes, including increased mortality and breast cancer recurrence. DS have potential pharmacokinetic interactions via cytochrome P450 enzyme and pharmacodynamic interactions via estrogenic or hepatotoxic activity, which may increase or reduce clinical efficacy or potentiate adverse effects of Tamoxifen and Aromatase Inhibitors (AIs). This analysis examines baseline usage of DS and potential interactions with Tamoxifen and AIs among breast cancer survivors enrolled in the Lifestyle, Exercise, and Nutrition (LEAN) study, a randomized healthy eating and exercise lifestyle intervention. Methods: We examined the use of DS in 151 breast cancer survivors enrolled in the LEAN Study. Women with a body mass index (BMI) ≥ 25 kg/m 2 were randomly assigned to a 6-month healthy eating and exercise lifestyle intervention (n=93) or to usual care (n=58). At baseline and 6 months, we asked participants to self-report regular DS use, defined as at least 3 times a week for at least one month. The intervention group received evaluation and counseling of DS use by a Registered Dietitian (RD) with a Certified Specialty in Oncology Nutrition (CSO). Potential interactions of moderate and major ratings between DS with Tamoxifen and AIs (Letrozole, Exemestane and Anastrozole) were identified through the Natural Medicines Database by both a pharmacist specializing in oncology and a RD, CSO. Results: Out of 151 women, at baseline 120 (80%) reported using DS. Fifty-four different formulations were enumerated. The majority of women (72, 60%) were taking ≥ 3 formulations. One quarter of women (29, 24%) were taking ≥ 5 formulations (range = 1 - 20). Of the 54 formulations, 33% had potential interactions with Tamoxifen and/or AIs according to the Natural Medicines Database. Total interactions by medication were: 18 Tamoxifen, 14 Letrozole, 14 Exemestane, 9 Anastrozole. The majority of these interactions (87%) were associated with herbal preparations. Conclusions: Our findings are indicative of the high prevalence of DS use among breast cancer survivors and the potential risk of interactions with prescribed hormonal therapy. More research is needed to test if counseling from a RD, CSO can reduce DS use and ultimately lead to better outcomes due to fewer interactions with breast cancer treatments. Citation Format: ThaiHien Nguyen, Maura Harrigan, Courtney Mcgowan, Annette Hood, Fangyong Li, Brenda Cartmel, Leah Ferrucci, Melinda L Irwin, Tara Sanft. Dietary supplement use in a healthy eating and exercise lifestyle intervention in breast cancer survivors: The lifestyle exercise and nutrition (LEAN) study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS8-09.

437 Maternal inflammation, maternal and fetal metabolism, pregnancy outcomes and an antenatal healthy lifestyle intervention

Elevated maternal inflammatory markers have been linked with adverse pregnancy outcomes. Lifestyle interventions may hold potential to ameliorate these effects. In this secondary analysis of the Pregnancy Exercise And nutrition Research study (PEARs), we investigated the effect of an antenatal healthy lifestyle intervention on maternal Complement 3 (C3) and C-Reactive Protein (CRP) concentrations and assessed their relationship with pregnancy outcomes and maternal and fetal metabolism. n=406 women with available C3 and CRP concentrations determined in early pregnancy (14-6 weeks) and/or late pregnancy (28-weeks) with corresponding glucose, insulin, c-peptide, Homeostatic Model Assessment of Insulin Resistance (HOMA2-IR) and lipid profiles were included in the analysis. Pregnancy outcomes included: diagnoses of gestational diabetes (GDM), pre-eclampsia (PET) or pregnancy induced hypertension (PIH), pre-term birth (delivery < 37 weeks), low birth weight defined as birth weight < 2500g, intra-uterine growth restriction (IUGR) defined as estimated fetal weight (EFW) < 10th centile and cord blood measures of glucose and lipid metabolism. There were no differences in maternal C3 or CRP concentrations between study groups, or based on diagnosis of PET, PIH or GDM. Maternal C3 was higher in those who experienced pre-term birth (p=0.04) or delivered a low birth weight infant (p=0.02). In early pregnancy, maternal C3 was a small but significant predictor of maternal insulin (β= 0.021, p= 0.03) and total cholesterol (β = 0.005, p= 0.026) and LDL-C cholesterol in late pregnancy (β= 0.01, p= 0.003). Maternal C3 concentration in late pregnancy was a small but significant predictor or insulin (β= 0.043, p= 0.014) and insulin resistance (β= 0.007, p= 0.002) in late pregnancy. No relationship between maternal C3 or CRP and fetal glucose or lipids were observed Higher maternal C3 concentration was associated with maternal insulin resistance and un-favourable lipid profile. Levels of maternal C3 were higher in those who experienced pre-term birth or low birth weight.

Healthy recovery: A stepped wedge cluster randomised controlled trial of a healthy lifestyle intervention for people attending residential alcohol and other drug treatment

BackgroundUnhealthy lifestyle behaviours contribute to the poor health of people attending alcohol and other drug (AOD) treatment. Healthy Recovery is an 8-session group-based intervention that targets smoking, diet and physical inactivity as part of an integrated healthy lifestyle approach. The current study aimed to examine the effectiveness of Healthy Recovery when delivered within residential AOD treatment settings. MethodsThe study design was a stepped-wedge cluster randomised trial. Participants were 151 current smokers attending residential AOD programs provided by the Australian Salvation Army (n = 71, Control condition; n = 80, Intervention condition). The primary outcome was number of cigarettes smoked per day. Secondary outcomes examined other smoking behaviours (7-day point prevalence, use of nicotine replacement therapy [NRT]), diet (servings and variety of fruit and vegetables), and physical activity. ResultsThe mean number of cigarettes smoked per day was significantly lower in the Intervention condition at 2-, 5-, and 8-month follow-up. There were also significant differences in favour of the Intervention condition for number of quit attempts, use of NRT and variety of fruit. There were no other significant differences for other dietary or physical activity variables. ConclusionsHealthy Recovery had a positive impact on smoking behaviours. Future research should consider strategies to further promote smoking cessation (e.g. promoting longer-term use of NRT), as well as addressing physical activity and dietary behaviours. The introduction of broader organisational approaches (e.g. smoke free policies, organised group exercise and cooking activities) might help to enhance healthy lifestyle approaches within AOD treatment settings.

"Being There" vs "Being Direct:" Perspectives of Persons with Serious Mental Illness on Receiving Support with Physical Health from Peer and Non-Peer Providers.

Individuals with serious mental illness (SMI) face significant health disparities and multiple barriers to engaging in health behavior change. To reduce these health disparities, it is necessary to enhance the support individuals with SMI receive through the collaboration of different healthcare providers. This study explored how people with SMI living in supportive housing perceived receiving support from peer and non-peer providers for their physical health. Qualitative interviews were conducted with 28 participants receiving a peer-led healthy lifestyle intervention in the context of a randomized trial in supportive housing agencies. Interviews explored participants' experiences working with the healthy lifestyle peer specialist and a non-peer provider who assisted them with health. Interviews were audio recorded, transcribed, and analyzed using strategies rooted in grounded theory. Participants viewed their relationships with peer and non-peer providers positively, but described differences in the approach to practice, power dynamics present, and how they identified with each provider. Participants described peers as process-oriented while non-peer staff as task-oriented, focusing on accomplishing concrete objectives. Each provider sought to boost participants' motivation, but peers built hope by emphasizing the possibility of change, while non-peer providers emphasized the consequences of inaction. Participants related to peer staff through shared experiences, while identifying the importance of having a shared treatment goal with their non-peer provider. Overall, participants appreciated the unique roles of both peer and non-peer staff in supporting their health. Study findings have implications for integrating the use of peer-based health interventions to improve the health of people with SMI.

Storying My Lifestyle Change: How Breast Cancer Survivors Experience and Reflect on Their Participation in a Pilot Healthy Lifestyle Intervention

ABSTRACT Purpose: Healthy lifestyle interventions after breast cancer treatment have generally been studied in terms of weight-loss outcomes, which leaves a gap in our understanding of the phenomenological experience of such programs. Our knowledge of how or why women recovering from breast cancer engage or do not engage in these programs is limited. Thus, we aimed to share subjective experiences of lifestyle change within a 12-week group intervention entitled “Healthy Lifestyle Modification After Breast Cancer” (HLM-ABC). Methods: The present research entailed a multiple case study of four breast cancer survivors who participated in the HLM-ABC. Participants were interviewed longitudinally at four time-points: (1) pre-intervention; (2) mid-way intervention; (3) post-intervention, and (4) three-months post-intervention. Results: We analysed storytelling of participation in the HLM-ABC program to investigate participants’ unique and gradual endeavours towards living a healthier lifestyle. A qualitative, narrative analysis was applied to each participant’s set of interviews, which yielded two distinct story-telling patterns while participating in the HLM-ABC program: one “plot-driven” and one “character-driven”. Conclusions: These two narrative styles appeared to correspond with differing levels of intervention uptake and perceived success in the program. The implications of these narrative styles and their relationship to healthy lifestyle intervention are discussed.

The Effect of Healthy Lifestyle Promotion Intervention on Quality of Life in Cyclic Mastalgia via Individual Counseling: A Randomized Controlled Clinical Trial.

ABSTRACTBackground: Despite high number of visited cases, there are no certain therapeutic guidelines for mastalgia. Generally pain is associated with poor quality of life in all dimensions. The present study aimed to investigate the effect of healthy lifestyle promotion intervention on the quality of life in cyclic mastalgia.Methods: This study was a randomized controlled trial (RCT) conducted on women suffering from cyclic mastalgia at the age of 20 and older before menopausal age referred to the health centers of Karaj,Iran from September 2017 to August 2018. The participants were randomly assigned to intervention (N=40) and control groups (N=40). Intervention was carried out in two 46-minute sessions and two 90-minute sessions for the intervention group. The quality of life was assessed before and after the intervention in both groups using the World Health Organization Quality of Life-BREF (WHOQOL-BREF). The data were analyzed through SPSS statistical software(version 21) using independent sample t-test, Chi-square,and Paired t-test. Besides, P<0.05 was considered as statistically significant.Results: Before the intervention, both groups were matched in terms of marital status, educational level, occupation, history of breastfeeding, and mean scores of quality of life (P>0.05). After the intervention, the mean score of life quality in physical, social, environmental, and general health dimensions in the intervention group increased significantly compared to the control group (P>0.001). This difference was not statistically significant in the mental health dimension (P=0.086).Conclusion: The present study indicated that healthy lifestyle promotion intervention could improve the quality of life of women with cyclic mastalgia.Trial Registration Number: IRCT2017100236513N1.

Lifestyle interventions for healthy brain aging: A protocol for systematic review and meta‐analysis

AbstractBackgroundThe main objective of the present protocol is to assess the lifestyle interventions (eating habits, physical exercise, social and cultural participation) on the brain health as people age.MethodsWe will look at the following database sources, “The Cochrane Library, PubMed, EMBASE, Web of Science, and Google Scholar,” for this protocol, which is standardized by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) Protocols. Only Alzheimer's disease (AD) patients will be eligible, and no restriction will be placed on participant's gender, age, education, ethnicity, or other demographic characteristics. All the studies based on the impact of active intervention centered on lifestyle interventions, including eating habits, sleep patterns, and physical exercise on the cognitive and functional status in the elderly populations. The primary outcome is the effects of nutrition and lifestyle interventions on the patients with AD, and secondary outcomes include body mass index, body fat percentage, and muscle mass.ResultsIn this study, we hope to find lifestyle interventions, which could have a preventive effect on brain health as people age, in particular AD.ConclusionThe conclusion of our study would suggest that a healthy lifestyle interventions, defined on the basis of proper nutrition, sleep patterns, physical exercise, and social and cultural activities, can positively influence the cognitive consequences of healthy brain aging.

Family Support and Readiness to Consider Smoking Cessation among Chinese and Vietnamese American Male Smokers.

Introduction Smoking prevalence is disproportionately high among Asian American immigrant men with limited English proficiency. Understanding the role of family support may provide insights into culturally acceptable strategies to promote smoking cessation. Aims This study examined how family support was associated with readiness to consider smoking cessation among Chinese and Vietnamese American male daily smokers. Methods We analyzed baseline data (N = 340) from a cluster randomized trial of a family-based healthy lifestyle intervention. We assessed the frequency of receiving family support in various forms (encouraging use of cessation resources, praising efforts, checking in, and reminding of familial role). Multiple regression analysis was used to determine associations between family support areas and readiness to consider smoking cessation, controlling for covariates. Results/Findings. Reporting a higher frequency of receiving praise and encouragement for one's efforts to quit was positively associated with readiness to consider cessation. Other areas of family support were not significant. Conclusions These findings provide evidence to explore specific areas of family support in enhancing Asian American smokers' readiness to consider cessation. As there is high interest from Asian American family members to support their smokers for quitting, culturally specific and acceptable strategies are needed to promote smoking cessation among Asian Americans.

The effectiveness of lifestyle training program promoting adolescent health with polycystic ovarian syndrome: A study protocol for a randomized controlled study.

BACKGROUND:Lifestyle training is of a key important in adolescent age for better life in the future. Healthy lifestyle in adolescents can management of any disease such as diabetes and polycystic ovarian syndrome (PCOS). Schools can provide an important environment to identify and change the lifestyle of students. The aim of this protocol is designing and evaluating the effectiveness of school-based lifestyle training program improving the PCOS of adolescents.MATERIALS AND METHODS:A cluster-randomized controlled trial will be conducted to examine the effectiveness of school-based lifestyle training program in 16 to 18 years old adolescent girls. The healthy lifestyle program will be designed by modification of behavioral habit, dietary intake, and physical activity and educated in eight sessions for adolescents and one session for parents in the intervention groups with sixty participants.RESULTS:Changes in primary and secondary outcomes in PCOS and healthy adolescents before and after intervention in the intervention and control groups will be analyzed for evaluation effectiveness by one-way ANOVA or other nonparametric equivalents.CONCLUSION:The current study will provide information on the effectiveness of school-based lifestyle training programs for adolescents. With increasing numbers of PCOS at risk for long-term and/or late effects of treatment and other chronic diseases, efforts for promoting the healthy lifestyle of this important group are urgently needed. This lifestyle program may provide valuable information relating to the development of other healthy lifestyle interventions for PCOS and result in appropriate behavior change and self-management strategies.

Lifestyle intervention for gestational diabetes prevention in rural woman of Shoush city.

BACKGROUND:Physical activity and nutrition interventions are the most important ways to prevent gestational diabetes. The purpose of the study was to determine the effect of healthy lifestyle intervention to promote preventive behaviors of gestational diabetes in the rural woman of Shoush city.MATERIALS AND METHODS:In an experimental study, 60 pregnant women were selected using simple random sampling and allocate into intervention group (n = 30) and nutrition program. The study was conducted from September to June 2018. The data were collected in baseline and 1 month and 3 months of follow-up phase and were analyzed using Chi-square test, repeated-measure test, and generalized linear model (GLM). The α = 0.05 was considered as significance.RESULTS:The mean age in the intervention and control group was 25.9 ± 5.6 and 27.2 ± 5.9, respectively. The GLM test showed a significant increase in the physical activity level and the mean of nutrition behaviors within the intervention group over time (P = 0.013). Further, based on the results of repeated-measure test, the mean of weekly MET-minute was increased in the intervention group in comparison to the control group at 1 month and 3 months of follow-up (P < 0.001).DISCUSSION AND CONCLUSION:The lifestyle interventions are appropriate programs to the reduction of the risk of development of gestational diabetes in pregnant women.

Grounded theory of 'lifestyle adaptation' - Perspectives from persons with schizophrenia and their caregivers.

Available evidence highlights that persons diagnosed with schizophrenia are predisposed to develop physical co-morbidities. Lifestyle modification interventions are identified as appropriate strategies to maintain their physical health. A comprehensive understanding of the facilitators and barriers in adhering to healthy lifestyle interventions is critical to developing individualized interventions that are effective and accessible for these patients. To develop and formulate a theory of lifestyle adaptation for the prevention of physical co-morbidities for persons with schizophrenia and their caregivers who are availing mental health services in the psychiatry wards. The qualitative data were collected by semi-structured interviews using topic guides from persons with schizophrenia and their family caregivers from the tertiary level psychiatry center, South India. The interviews explored their perceptions and experiences of the facilitators and barriers in adopting a healthy lifestyle. Final data was analyzed based on grounded theory, and the data was used to formulate the theory of lifestyle adaptation. The persons with schizophrenia and their family caregivers' perceptions helped in formulating this theory. The present study provides recommendations for physical health services for patients with mental illness. The findings of the study may guide health professionals and mental health advocacy groups, policymakers to plan for appropriate decisions related to incorporating mental health care with physical health care services.

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 &lt;0.0113) and physical activity scores (p&lt;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.

Main Outcomes of a Peer-Led Healthy Lifestyle Intervention for People With Serious Mental Illness in Supportive Housing.

The effectiveness of the Peer-led Group Lifestyle Balance (PGLB) intervention, a 12-month manualized healthy lifestyle intervention delivered by peer specialists, was investigated in a sample of persons with serious mental illness who were overweight or obese and living in supportive housing. The authors randomly assigned 314 participants from three supportive housing agencies to PGLB or usual care, with assessments at baseline and 6, 12, and 18 months. Outcomes were clinically significant changes from baseline in weight (≥5% weight loss), cardiorespiratory fitness (CRF; increase of ≥50 meters in the 6-minute walk test), and cardiovascular disease (CVD) risk reduction (clinically significant weight loss or CRF improvement). Most participants were from racial-ethnic minority groups (82%, N=255). The mean±SD baseline weight of this sample was 218.8±54.0 pounds, and the body mass index was 33.7±7.2. Compared with the usual care group, a larger proportion of the PGLB group achieved clinically significant changes in study outcomes at 12 and 18 months, but none of these changes was statistically significant. Outcomes differed by site: two sites reported no significant differences between the two groups, and one reported that PGLB significantly outperformed usual care on clinically significant weight loss at 18 months and CVD risk reduction at 6 and 12 months. The null findings indicate that PGLB was not superior to usual care in helping participants achieve clinically significant changes in weight, CRF, and CVD risk reduction at 12 and 18 months. Questions remain regarding how PGLB works, for whom, and in which settings.

Effect of Rajyogi lifestyle in controlling and managing blood glycemic levels in participants in Madhur Madhumeh camps for type 2 diabetes patients

Objective: The effect of spiritually augmented healthy lifestyle intervention on clinical risk factors in patients with type 2 diabetes (T2DM) is still unclear. The aim and objective of this study was to assess the beneficial effects of a user-friendly, non-invasive spiritually augmented healthy lifestyle intervention to improve blood glucose levels in patients with type 2 diabetes within a reasonable time frame. Materials and Methods: A prospective study was conducted over a period of one year on 552 subjects who attended Madhur Madhumeh camps in the age group of 30 years to 82 years (mean 57.82, SD 10.38) with T2DM of at least 6 months duration and on diabetic diet and oral hypoglycemic agents and/or insulin (treatment). All the participants were trained by Rajyoga experts. In all the participants pre-camp fasting (FBS) and random (RBS) blood glucose levels were taken and further fasting and random (after 3½ hours of lunch) blood glucose levels were estimated in regular intervals during the camp to obtain 3 readings each of fasting and random blood glucose levels. Results: Comparing with standard care alone, Rajyogi lifestyle resulted in significant reduction in blood glucose levels within 24 hrs to 48 hours even after their high fasting (Max.455, 141 participants above 200 mg/dL) and random (Max.700, 104 participants above 300 mg/dL) blood glucose levels. The reduction in FBS (mean 28.24, p Conclusions: The study finds that Rajyogi lifestyle intervention showed significant benefit in reduction of blood glucose levels in T2DM patients. It is evident that Rajyogi lifestyle can be used as an adjunct therapy in effectively controlling and managing blood glycemic levels in patients with type 2 diabetes. Translating this finding into effective long term implementation requires further studies and evaluation. Keywords: Diabetes, T2DM, Rajyoga, Yogic lifestyle, Meditation.

A multi-stakeholder approach to eHealth development: Promoting sustained healthy living among cardiovascular patients

BackgroundHealthy living is key in the prevention and rehabilitation of cardiovascular disease (CVD). Yet, supporting and maintaining a healthy lifestyle is exceptionally difficult and people differ in their needs regarding optimal support for healthy lifestyle interventions. ObjectiveThe goals of this study were threefold: to uncover stakeholders’ needs and preferences, to translate these to core values, and develop eHealth technology based on these core values. Our primary research question is: What type of eHealth application to support healthy living among people with (a high risk of) CVD would provide the greatest benefit for all stakeholders? MethodsUser-centered design principles from the CeHRes roadmap for eHealth development were followed to guide the uncovering of important stakeholder values. Data were synthesized from various qualitative studies (i.e., literature studies, interviews, think-aloud sessions, focus groups) and usability tests (i.e., heuristic evaluation, cognitive walkthrough, think aloud study). We also developed an innovative application evaluation tool to perform a competitor analysis on 33 eHealth applications. Finally, to make sure to take into account all end-users needs and preferences in eHealth technology development, we created personas and a customer journey. ResultsWe uncovered 10 universal values to which eHealth-based initiatives to support healthy living in the context of CVD prevention and rehabilitation should adhere to (e.g., providing social support, stimulating intrinsic motivation, offering continuity of care). These values were translated to 14 desired core attributes and then prototype designs. Interestingly, we found that the primary attribute of good eHealth technology was not a single intervention principle, but rather that the technology should be in the form of a digital platform disseminating various interventions, i.e., a ‘one-stop-shop’. ConclusionVarious stakeholders in the field of cardiovascular prevention and rehabilitation may benefit most from utilizing one personalized eHealth platform that integrates a variety of evidence-based interventions, rather than a new tool. Instead of a one-size-fits-all approach, this digital platform should aid the matchmaking between patients and specific interventions based on personal characteristics and preferences.

Abstract PO-063: A systematic review of tandem cognitive behavioral therapy and healthy lifestyle interventions on health-related outcomes

Abstract Background Early screening and innovative treatments has elongated the lives of cancer survivors, bringing more focus on minimizing the adverse effects of cancer and its treatment. Healthy lifestyle (HL) behaviors reduce the risk of cancer recurrence and intensity of cancer-related adverse effects such as fatigue and cognitive dysfunction. However, maintaining a HL may be difficult for many. Cognitive behavioral therapy (CBT) has been used to help change behavior. Studies with patients engaged in healthy lifestyle behaviors alone and CBT alone have improved adverse effects. Yet, little is known about how such programs in tandem affect health-related outcomes. Here, we evaluate extant literature on tandem interventions with CBT and HL on health-related outcomes in cancer survivors. Methods We conducted a systematic review of randomized controlled studies examining CBT plus healthy lifestyle against a control condition in PubMed, Embase, and CINAHL databases published between 1990-2019. The search yielded 1494 studies which were evaluated by two reviewers based on pre-determined inclusion and exclusion criteria. Thirty-nine articles met inclusion criteria and were critically appraised for bias. Findings The 39 articles included a total of 5239 participants, primarily breast cancer and prostate cancer survivors. Most (27 of 39) articles omitted racial demographic data or noted that the participants were majority White. Only four articles recorded over 10% of blacks. Intervention conditions ranged from CBT with smoking cessation to CBT with physical activity. These conditions were which were compared against no intervention, usual care, and/or CBT alone or HL alone. Interventions were delivered by a variety of trained interventionists and over different durations. The most common HL targets were stress, insomnia, and quality of life. Nearly all articles (36 of 39) reported a clinically significant reduction in adverse effects. Of note, 2 studies compared CBT/HL vs HL vs usual care finding that physical activity alone was no different than CBT/HL. Moreover, only 24 articles addressed long term (&amp;gt;2 months) outcomes. Of those, positive effects ranged from being sustained (21 articles), attenuating over time (1 article), and disappearing (2 articles). Articles were appraised as poor to good quality. Conclusion This review showed that tandem interventions with CBT and healthy lifestyle components can improve health-related outcomes for cancer survivors as compared to usual care, but there is a paucity of knowledge to suggest differential outcomes in tandem interventions as compared to CBT alone or HL alone. Findings were biased with the overrepresentation of breast and prostate cancer survivors, and underrepresentation of minority groups. Thus, this review highlights the need for further research to test tandem interventions against CBT alone and HL alone, toward identifying the most efficacious interventions for dissemination and implementation across diverse groups of cancer survivors. Citation Format: Sarah Addison, Damalie Shirima, Shanon Dunovan, Maryam Lustberg, Elizabeth K. Arthur, Timiya S. Nolan. A systematic review of tandem cognitive behavioral therapy and healthy lifestyle interventions on health-related outcomes [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-063.

Can lifestyle interventions improve Canadian men's mental health? Outcomes from the HAT TRICK programme.

Engaging men in mental health promotion can be difficult because of reticence about help-seeking, especially for gender neutral programmes. Developments in men's health research has pointed to the success of gender-sensitized programmes to increase men's engagement in healthy lifestyle interventions targeting physical activity and healthy eating; however, less is known about the impact of these interventions on men's mental health. This study explored changes to men's depression risk and health-related quality of life at post-intervention (12 weeks) and 9-month follow-up, after participating in HAT TRICK, a gender-sensitized lifestyle intervention for overweight men. Participants completed validated self-report measures of mental health at baseline, post-intervention (12 weeks) and 9-month follow-up. Men's scores on the Male Depression Risk Scale (MDRS) and the SF-12 questionnaire, including physical health (PH12) and mental health (MH12) composite scores, were analyzed using mixed linear models to assess linear trends. At baseline, men (N = 62) had a mean age of 50.98 (SD = 10.09) years and BMI of 35.87 (SD = 5.51) kg/m2. Results show that both the MDRS and the MH12 showed improvements in participants' mental health, with significant linear trends (p = 0.003; p = 0.003) qualified with significant quadratic trends over time (p = 0.02; p = 0.03). There were no significant changes in the PH12 over time. Gender-sensitized programmes for overweight men, such as HAT TRICK, are a promising approach to positively influence components of men's mental health, with the potential for sustained improvements over the long term.