Healthy Lifestyle Intervention Research Articles

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.

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. 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. 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. ISRCTN registry ISRCTN58988083.

A Healthy Lifestyle Intervention for Hispanic Families: Moderating Effects of Education, Income, Nativity

ObjectiveTo explore the moderation effect of parental social determinant factors—educational attainment, income, and nativity—on intervention effects of a family-based lifestyle intervention, Familias Unidas for Health and Wellness (FUHW). DesignLongitudinal analysis across 6- and 24-months postbaseline of a randomized controlled trial. ParticipantsTwo-hundred and eighty primary caregivers. AnalysisModeration analysis was used to examine the interactive effects between intervention effects and social determinant factors. Main Outcome MeasuresParental body mass index, added sugar intake, sugar-sweetened beverage intake, and fruits and vegetable intake. ResultsFindings indicated that FUHW effects on added sugar intake were moderated by educational attainment (P = 0.006), income (P = 0.023), and nativity (P = 0.024). In addition, FUHW effects on sugar-sweetened beverage intake were moderated by parent education (P = 0.042). Conclusions and ImplicationsThis study suggests that FUHW may be helpful in reducing added sugar and sugar-sweetened beverage intake for Hispanic parents who face social determinant factors—educational attainment, income, and foreign-born status—that may influence their dietary behaviors. By including demographic information in intervention development, effects may be enhanced by ensuring that considerations related to participants’ socioeconomic and cultural status are incorporated into intervention components and help reduce overweight and obesity.

Dietary Consumption Among Youth with Antipsychotic-Induced Weight Gain and Changes Following Healthy Lifestyle Education.

Background: Youth treated with antipsychotic medications are high risk for weight gain, increased lipids/glucose, and development of metabolic syndrome. Little is known about the dietary intake/nutritional adequacy in this vulnerable population, and effect on weight gain. This secondary data analysis describes the baseline intake and changes in diet after receiving healthy lifestyle education/counseling over 6 months, in a sample of youth with antipsychotic-induced weight gain. Methods: The U.S. Department of Agriculture (USDA) Automated Multiple-Pass Method 24-hour dietary recall was administered to 117 youth at baseline, 3 months, and 6 months. Parent/child received personalized healthy lifestyle education sessions over 6 months. Baseline intake was compared with the USDA Recommended Daily Allowance using independent samples t-tests. Individual dietary covariates were examined for change over 6 months using longitudinal linear mixed modeling. Influence of each on body mass index (BMI) z-score change was tested in a pooled group analysis and then compared by treatment group. Results: Pooled analysis revealed baseline consumption high in carbohydrates, fat, protein, sugar, and refined grains, while low in fruit/vegetables, whole grains, fiber, and water. Change over 6 months demonstrated a statistically significant decrease in daily calories (p = 0.002), carbohydrates (p = 0.003), fat (p = 0.012), protein (p = 0.025), sugar (p = 0.008), refined grains (p = 0.008), total dairy (p = 0.049), and cheese (p = 0.027). Small increases in fruits/vegetables were not statistically significant, although the Healthy Eating Index subscores for total vegetables (p = 0.013) and dark green/orange vegetables (p = 0.034) were. No dietary covariates were predictors of change in BMI z-score. Nondietary predictors were parent weight/BMI and treatment group, with the metformin and switch groups experiencing significant decreases in BMI z-score. Conclusions: Further pediatric studies are necessary to assess the effects of antipsychotic medications on dietary intake, and test efficacy of healthy lifestyle interventions on change in nutrition. The relationship of nutrition to cardiometabolic health in this population must be further investigated. Clinical Trial Registration number: NCT02877823.

Use of Text Messaging and Facebook Groups to Support the Healthy Children, Strong Families 2 Healthy Lifestyle Intervention for American Indian Families

ABSTRACTBackgroundFew obesity interventions have been developed for American Indian (AI) families despite the disproportionate risk of obesity experienced within AI communities. The emergence of mobile technologies to enhance intervention delivery could particularly benefit AI communities, many of which are hard to reach and underserved.ObjectivesThis study aimed to assess the use and perceptions of text messaging and Facebook to support delivery of the Healthy Children, Strong Families 2 (HCSF2) mailed healthy lifestyle/obesity prevention intervention and discuss lessons learned regarding intervention support via these platforms among AI participants.MethodsFrom among AI families with young children (ages 2–5 y), 450 adult-child dyads were recruited from 5 rural and urban communities for a year-long intervention. Intervention content was delivered by mail and supported by text messaging and optional Facebook groups. Participants provided feedback on text message and Facebook components post-intervention, and Facebook analytic data were tracked.ResultsSelf-report feedback indicated high satisfaction with both text messaging and Facebook, with tangible content (e.g., recipes, physical activity ideas) cited as most useful. Overall, participants reported higher satisfaction with and perceived efficacy of Facebook content compared with text messaging. Analytic data indicate the optional HCSF2 Facebook groups were joined by 67.8% of adult participants. Among those who joined, 78.4% viewed, 50.8% “liked,” and 22.6% commented on ≥1 post. Engagement levels differed by urban-rural status, with more urban participants “liking” (P = 0.01) and commenting on posts (P = 0.01). Of note, nearly one-third of participants reported changing phone numbers during the intervention.ConclusionsThis study demonstrates high satisfaction regarding mobile delivery of HCSF2 intervention support components. Best practices and challenges in utilizing different mobile technologies to promote wellness among AI families are discussed, with particular focus on urban-rural differences. Future mobile-based interventions should consider the context of unstable technology maintenance, especially in low-resource communities.This work is part of the HCSF2 trial, which is registered at clinicaltrials.gov (NCT01776255).

Phew! time to focus on physical health and wellbeing: improving the assessment and management of physical health in an early intervention in psychosis service

AimsNICE guidelines recommend that patients under Early Intervention (EI) in Psychosis Services have systematic monitoring and intervention of cardiometabolic risk factors. We undertook a Quality Improvement Project (QIP) in the Bath and North East Somerset (BaNES) EI Team to improve rates of compliance with national guidelines. We aimed to increase the percentage of service users with a physical health assessment documented in the past 12 months. Other aims included improving monitoring of physical health parameters in those taking antipsychotic medication and increasing the delivery of interventions for abnormal results.BackgroundThe most common cause of premature mortality in people who experience psychosis and schizophrenia is cardiovascular disease. The 'Standards for Early Intervention in Psychosis Service' states that patients should be offered personalised healthy lifestyle interventions, including advice on diet, physical activity, and access to smoking cessation services. Physical health should be monitored at least annually, with more frequent assessments if antipsychotic medication is prescribed.MethodWe identified seven key factors for improving physical health: Body Mass Index (BMI), Blood Pressure, Glucose Regulation, Blood Lipids, Smoking, Alcohol and Illicit drug use. Baseline compliance and intervention rates were measured in March 2019. Six ‘Plan, Do, Study, Act’ Cycles were completed over the following ten months. Examples of the changes made included: a new online diary and whiteboard, abbreviation of the assessment form, teaching for the EI team, and a new weekly ‘Physical Health and Wellbeing’ (PHeW) Clinic. This clinic involved phlebotomy, discussions around lifestyle choices, review of medication side effects, and neurological examination.We measured the compliance with guidelines each month and the total number of interventions delivered at three-monthly intervals. We collected qualitative feedback on these changes in team meetings and with written questionnaires (including feedback from patients).ResultDocumentation of all key factors doubled from 30.2% at baseline to 63.3% in January 2020. The total number of interventions for raised BMI and lipid levels also increased. Feedback from staff and patients was positive. The clinic helped start conversations with patients about lifestyle choices, prompting improvements in weight, physical activity, lipid levels, and alcohol intake. Patient awareness and ownership over their physical health also improved.ConclusionThis project utilised multiple strategies to reduce health complications for BaNES EI service users. A structural change in the assessment and management of physical health proved to be an effective and sustainable solution to optimise the health and wellbeing of this patient group.

Feasibility/Acceptability of an Acceptance-Based Therapy Intervention for Diverse Adolescent Cisgender Girls With Overweight/Obesity

ObjectivesThis study assessed the feasibility and acceptability of an ABT healthy lifestyle intervention among diverse adolescent cisgender girls with overweight/obesity (OW/OB). MethodsAdolescent cisgender girls ages 14 to 19 with a BMI ≥ 85th percentile-for-sex-and-age were recruited for participation in a single-arm feasibility study. The primary outcomes were recruitment and retention while the secondary outcome was change in BMI Z-score over the 6-month intervention. Exploratory outcomes included obesity-related factors, health-related behaviors, and psychological factors. ResultsRecruitment goals were achieved; thirteen adolescents (>60% racial/ethnic minorities) participated in the intervention, and eleven completed the intervention (85% retention). In completers (n = 11), a mean decrease in BMI Z-score of –0.15 (SD = 0.34, Cohen’s d = –0.44) was observed. Improvements were also noted for change in percentage of 95th percentile (d = –0.35), % body fat (d = –0.35), quality of life (d = 0.71), psychological flexibility (d = –0.86), and depression (d = –0.86). ConclusionsThese preliminary findings suggest an ABT healthy lifestyle intervention tailored for adolescent cisgender girls with OW/OB may be an acceptable treatment that could lead to improvements in BMI Z-score, obesity-related measures, and psychological outcomes. Funding SourcesThis work is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH; UL1TR001427) and WellCare Health Plans, Inc. Dr. Cardel is also supported by the National Institutes of Health National Heart, Lung, and Blood Institute (K01HL141535 and R25HL126146).

A Comprehensive View on Cardiovascular Diseases (CVDs): Genetics, Risk Factors &amp; 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 &amp; 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.

Critical Assessment of An Economic Evaluation of a Healthy Lifestyle Intervention for Chronic Low Back Pain (LBP)

Background: Globally, chronic low back pain (LBP) contributes significantly to the overall burden of disease, placing a heavy load on society through absenteeism and associated healthcare costs. Finding cost-effective measures to treat and prevent low back pain is therefore of utmost importance. Methods: A critical assessment of the study by Williams et al 2018 was performed by using a variation of the well-known Drummond’s checklist for the critical appraisal of economic evaluations. Results: The authors performed appropriate statistical analyses using the available data. Means and proportions of baseline characteristics of the intervention group were compared to those of the control group to evaluate their comparability. Conclusion: Upon thorough assessment of the appropriateness of the economic evaluation methods used by Williams et al., it is conclusive that the validity of their results is valuable and trusted to a degree, soundly achieving many of the listed Drummond et al requirements, yet failing to take into account a few aspects that grant some weaknesses to the study.

Efficacy of a county-wide schools weight management intervention.

This study aimed to evaluate the effectiveness of the Local Authority commissioned large-scale public health service that provided a 6-week school-based weight management intervention for children aged 4-19 years. A quantitative retrospective cohort study identified participants from 130 schools consisting of 8550 potential children aged 4-19 years across a mixture of Lower Super Output Area (LSOA) deprivation groups. Participants were invited to take part in a 5- to 12-week Healthy Lifestyles intervention with a focus on weight management delivered by OneLife Suffolk between 1 January 2017 and 1 January 2020. This resulted in a final sample of 5163 participants. The following information for each child was collected anonymously: (1) age, (2) gender, (3) preprogramme body mass index (BMI), (4) postprogramme BMI, (5) weight category and (6) LSOA category. Following the 6-week school-based intervention, there was a significant decrease in mean ΔBMI SDS (standardised body mass index) of -0.07 (-14.89%) among participants. Wilcoxon signed-rank test showed a significant change in weight status post 6-week weight management programme (WMP): BMI (Z = -15.87, p < .001), BMI SDS (Z = -21.54, p < .001), centile (Z = -20.12, p < .01) and weight category (Z = -7.89, p < .001), whereas Mann-Whitney U test showed no statistically significant difference in mean BMI SDS change between gender groups (p = .24) and Kruskal-Wallis test revealed no statistically significant differences in mean BMI SDS change between child LSOA groups (c2(4) = 1.67, p = .796), school LSOA groups (c2(4) = 4.72, p = .317), ethnic groups (c2(4) = 2.53, p = .640) and weight category at the start of the intervention (c2(3) = 6.20, p = .102). This study contributes to the growing body of evidence demonstrating the efficacy of multicomponent school-based weight management interventions and demonstrates that such interventions can be successfully implemented as part of a wider healthy lifestyles service, without widening health inequalities.

The heterogeneity of reversion to normoglycemia according to prediabetes type is not explained by lifestyle factors

Healthy lifestyle interventions and drug therapies are proven to have a positive preventative influence on normal glucose regulation in prediabetes. However, little is known on the specific role that these factors play on reversion to normal glycemia according to type of prediabetes. We used data from the Observational prospective cohort study, The Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes from 2012 to 2015. A total of 1184 individuals aged 30–74 years old were included and classified based on the ADA in three mutually exclusive groups using either fasting plasma glucose (FPG) levels (from 100 to 125 mg/dl, FPG group), HbA1c (5.7–6.4%, HbA1c group) or both impaired parameters. Information on lifestyle factors and biochemical parameters were collected at baseline. Reversion to normal glucose regulation was calculated at third year of follow-up. Relationship of lifestyle factor and type of prediabetes with reversion were estimated using odds ratios (ORs) with 95% confidence intervals (95% CIs) adjusting by different groups of confounders. Proportion of reversion rates were 31% for FPG group, 31% for HbA1c group and 7.9% for both altered parameters group, respectively. Optimal life style factors such as BMI < 25 kg/m2[OR (95% CI): 1.90 (1.20–3.01)], high adherence to Mediterranean diet 1.78 (1.21–2.63) and absence of abdominal obesity 1.70 (1.19–2.43) were the strongest predictors for reversion to normal glucose. However, those did not modify the ORs of reversion to normal glucose. Taking as reference those with both impaired parameters, subjects with FPG impairment (FPG group) had an OR of 4.87 (3.10–7.65) and 3.72 (2.39–5.78) for HbA1c group. These estimates remained almost the same after further adjustment for biochemical parameters and lifestyle factors (4.55(2.84–7.28) and 3.09 (1.92–4.97), respectively). Optimal lifestyle factors showed to be a positive predictor for reversion to normal glucose regulation however, the differences of reversion risk according type of prediabetes are not explained by lifestyle factors.

Participants’ and caregivers’ experiences of a multidisciplinary programme for healthy lifestyle change in Aotearoa/New Zealand: a qualitative, focus group study

ObjectiveChild and adolescent obesity continues to be a major health issue internationally. This study aims to understand the views and experiences of caregivers and participants in a child and adolescent...

A Powerful Antidote to Physician Burnout: Intensive Healthy Lifestyle and Positive Psychology Approaches.

Burnout rates among physicians are rapidly rising. Leaders in the movement to address burnout have made the case that health care workplaces need to foster a culture of well-being, including trusting coworker interactions, collaborative and transparent leadership, work-life balance, flexibility, opportunities for meaningful work and for professional development, and effective 2-way communication. The rationale for focusing on organizational change to prevent burnout has pointed to persistent symptoms of burnout even when individual healthy lifestyle interventions are adopted. However, a case can be made that the lifestyle interventions were not implemented at the level of intensity recommended by the lifestyle medicine evidence-base to secure the desired improvement in physical and mental health when facing significant personal and environmental stressors. The lifestyle medicine community has the ethical mandate to advocate for intensive healthy lifestyle approaches to burnout prevention, in conjunction with organizational supports. By combining comprehensive and intensive lifestyle changes with organizational cultures of well-being, we can more effectively turn the tide of physician burnout.

Impact of COVID-19 on Individuals with Acquired Brain Injuries enrolled in a Healthy Lifestyle Intervention

Impact of COVID-19 on Individuals with Acquired Brain Injuries enrolled in a Healthy Lifestyle Intervention

Walking together: Exploring perspectives, attitudes, and barriers on nutrition and exercise among individuals with serious mental illness

Modifiable risk factors related to lifestyle choices contribute to the disproportionate impact of poor physical health among individuals with serious mental illness (SMI). This mixed methods study sought to elucidate factors that promote and challenge healthy lifestyle engagement. Focus groups were conducted to assess the lived perspectives of twelve individuals with SMI living independently in the community or utilizing group housing about their dietary and exercise habits. A survey was administered pre-focus group to explore participant views on and motivations for healthier living. Three major themes emerged based on focus group discussion: Meaning of Healthy Living, Obstacles to Maintaining Good Health, and Importance of Community. Overall, participants demonstrated positive attitudes and readiness for healthy lifestyle changes. Healthy lifestyle interventions with careful consideration of determinants related to health disparities and existing community resources to support such activities are recommended to improve physical health in people with SMI.

Relationship between Gender, Physical Activity, Screen Time, Body Mass Index and Wellbeing in Irish Children from Social-Disadvantage

ABSTRACT Research has shown that childhood physical activity participation has a positive relationship with markers of wellbeing, such as self-esteem and quality of life, and physical activity participation may serve as protective mechanism against some mental illnesses including depression. The aim of the current study was to examine the relationship between gender, physical activity, screen time, body mass index and wellbeing in Irish school children (N = 705; mean age: 8.74 ± 0.52 years) from social disadvantage. In Northern Ireland, schools included in the 2010 Multiple Deprivation Measure (NIMDM) were invited to participate. Schools included for participation in the Republic of Ireland were from the Delivering Equality of Opportunity in Schools (DEIS) index. Data gathered included accelerometry (physical activity), self-report (screen time and wellbeing), and anthropometric measurements. Physical activity was objectively measured during eight consecutive days using Actigraph GT1M and GT3X devices, using stringent accelerometer protocol. Screen time activities were derived using questions adapted from the Health Promotion Agencies National Children’s Survey in Northern Ireland. The KIDSCREEN-27 is a health-related quality of life measurement, and this tool was used by participants to self-report their health and wellbeing. Results suggest that boys accumulated more minutes of daily screen time than girls, however, boys were more physically active when compared to girls. Wellbeing scores for gender showed inverse associations with daily screen time. Standard multiple regression revealed that gender, physical activity, screen time and body mass index (combined) explained little variance in the prediction of wellbeing. Results indicate the importance of gender-based considerations for physical activity and screen time with children from social disadvantage. The inverse relationship found between overall screen time and wellbeing will help guide future healthy lifestyle interventions for Irish children of low-income communities.

A Family-Based Healthy Lifestyle Intervention: Crossover Effects on Substance Use and Sexual Risk Behaviors.

This study examined the efficacy of a healthy lifestyle family-based intervention in reducing substance use and sexual risk behaviors compared with prevention as usual over 24months in Hispanic adolescents. Participants were overweight/obese Hispanic adolescents (N = 280; M age 13.01; SD = .82) in the 7th/8th grade and their primary caregivers. Participants were randomized to either the healthy lifestyle family-based intervention or to the control condition (i.e., referral to community services offered for overweight and/or obese adolescents and their families). Outcomes included adolescent substance use and sexual risk behaviors among adolescents. Intervention effects were found for adolescent alcohol (b = -0.37, 95% CI = [-0.49, -0.26]), marijuana (b = -1.00, CI = [-1.22, -0.78]), and non-prescription drug use (b = -3.77, CI = [-6.49, -1.05]) over 24months. No significant intervention effects were found for adolescent sexual risk behaviors. Findings suggest that Familias Unidas for Health and Wellness reduces adolescent alcohol, marijuana, and non-prescription drug use across time. ClinicalTrials.gov Identifier: NCT03943628.

Participant Experiences With a Peer-Led Healthy Lifestyle Intervention for People With Serious Mental Illness.

This study explored the experiences of individuals with serious mental illness who were predominantly Black, were living in supportive housing, and participated in the Peer-Led Group Lifestyle Balance (PGLB) intervention. The authors examined how participants engaged in the process of behavior change and applied intervention concepts. Focus groups and interviews with 63 participants explored their motivation for engaging with PGLB, challenges to behavior change, and how they integrated intervention strategies into their lives. Interviews were transcribed and analyzed with grounded theory. A grounded model summarized the description of the cycle of behavior change and provided insight into participants' decision-making processes. Challenges to engaging in healthy lifestyle change were related to participants' general medical health, time constraints, lack of knowledge, difficulties breaking old habits and changing self-perceptions, mood state, and the social-physical environment. Participants applied many intervention strategies, such as addressing problematic social cues, contexts, and food associations; planning ahead; starting with smaller changes; portion control; food substitution; mindful eating; and integrating changes into their daily lives. They reported various behavior changes with respect to eating and physical activity and more limited shifts in self-monitoring. Improving the health of people with serious mental illness will require expanding their access to healthy lifestyle interventions in community-based settings. The findings suggest that future interventions should expand support for self-monitoring, meal planning, tailored physical activity, and advocacy. Such interventions should also enhance participants' understanding of the corresponding impact of changes on weight loss and emphasize subjective wellness outcomes to maintain motivation.

Strategies and Lessons Learned for Supporting and Supervising Peer Specialists.

As peer-delivered services are increasingly embedded within behavioral health organizations, a need has arisen to identify practices that facilitate supervision and support of peer providers. The authors present supervision strategies and lessons learned that emerged during a large pragmatic trial in three supportive housing agencies that examined a peer-delivered healthy lifestyle intervention for people with serious mental illness. Strategies included access to multiple supervisors, formal and informal support, acknowledgment of lack of role clarity, ongoing role negotiation, a collaborative approach to troubleshooting challenges, explicit emphasis on peer specialists' value, and linking peer specialists to opportunities for mutual support and professional development.

Technology-Enhanced Health Promotion for College Students: A Seed Development Project.

Obesity is an issue for young adults in the U.S. This population is particularly vulnerable to weight gain as they move from adolescence to young adulthood, especially as they transition from high school to college. Adopting a health promotion approach, a university-based cluster of researchers, community advocates, and a technology partner embarked on a two-year seed development project that focused on development, implementation, and evaluation of a web-based healthy lifestyle intervention for college students. Using a mixed-method design, two convenience samples of residential university students were recruited to participate in a 4-week intervention called Eat, Move, Live, in which they interacted with a newly-created comprehensive website about management of a healthy lifestyle. Participants’ post-intervention readiness for change increased by 15% (eating and life balance behaviors) to 23% (moving behaviors). Participants reported increased awareness of eating behaviors, and feelings of engagement in tracking their fruit and vegetable consumption. Findings suggest that technology may be utilized to enhance the effectiveness and efficiency of achieving students’ individual goals related to healthy living. These preliminary findings have implications for increasing the development and implementation of technological approaches to health promotion for young adult students.

Feasibility/acceptability of an acceptance-based therapy intervention for diverse adolescent girls with overweight/obesity.

BackgroundBehavioral obesity interventions using an acceptance‐based therapy (ABT) approach have demonstrated efficacy for adults, yet feasibility and acceptability of tailoring an ABT intervention for adolescents remains unknown.ObjectiveThis study assessed the feasibility and acceptability of an ABT healthy lifestyle intervention among diverse adolescent cisgender girls with overweight/obesity (OW/OB).MethodsAdolescent cisgender girls aged 14–19 with a BMI of ≥85th percentile‐for‐sex‐and‐age were recruited for participation in a single‐arm feasibility study. The primary outcomes were recruitment and retention while the secondary outcome was change in BMI Z‐score over the 6‐month intervention. Exploratory outcomes included obesity‐related factors, health‐related behaviors, and psychological factors.ResultsRecruitment goals were achieved; 13 adolescents (>60% racial/ethnic minorities) participated in the intervention, and 11 completed the intervention (85% retention). In completers (n = 11), a mean decrease in BMI Z‐score of −0.15 (SD = 0.34, Cohen's d = −0.44) was observed. Improvements were also noted for change in percentage of 95th percentile (d = −0.35), percent body fat (d = −0.35), quality of life (d = 0.71), psychological flexibility (d = −0.86), and depression (d = −0.86).ConclusionsThese preliminary findings suggest an ABT healthy lifestyle intervention tailored for adolescent cisgender girls with OW/OB may be an acceptable treatment that could lead to improvements in BMI Z‐score, obesity‐related measures, and psychological outcomes.