Healthy Lifestyle Practices Research Articles

Knowledge, attitude and practice of people with HIV regarding a healthy lifestyle: clinical trial.

To evaluate the effectiveness of an educational booklet on the knowledge, attitude and practice of a healthy lifestyle in people with HIV. Randomized clinical trial with 75 intervention group patients using the booklet, and 75 control group patients undergoing usual service care. Data collection occurred in four moments, with a Survey pertaining Knowledge, Attitude and Practice. Nonparametric analysis of variance of repeated measures was used. 70 participants in the intervention group and 74 in the control group completed the study. In terms of knowledge, there was no difference between groups, the booklet impact came late, increasing after reassessments. In attitudes, there was a difference between groups in the two- and four-month reassessments compared to the baseline. In practices, there was a difference in the intervention group compared to the control group at two, four, and six months compared to baseline. The booklet was effective in improving healthy lifestyle knowledge, attitudes, and practices in people with HIV.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

A Study to Evaluate the Effectiveness of Health-Care Package on Self-care Management and Prevention of Complications in Patients with Type-2 Diabetes Mellitus in Terms of the Knowledge and Practices in Diabetic Clinic of Selected Hospitals in Delhi

Introduction: The aim of this study were to prevent, control, and manage diabetes mellitus (DM) and its further consequences, it is essentially required that the diabetic patients should have adequate knowledge and adopt healthy lifestyle practices. Objectives: The objectives of this study were to evaluate the effectiveness of the health-care package on self-care management and prevention of complications in type 2 DM patients in terms of the knowledge and practices. Materials and Methods: The present study was conducted with evaluative research approach and non-randomized control group design at Safadarjung Hospital, Delhi. Sample was selected through non-probability purposive sampling technique and sample size consisted of 60. The tools for data collection included structured interview schedule and expressed practice questionnaire. The health-care package included – planned teaching program, self-care diary cum information booklet, diabetic identification card, diet chart, and pictorial/flash cards. Results: There was a significant “t” value of 15.882, df (29), P < 0.05 and “t” value of 9.86, df (29), P < 0.05 for mean pre- and post-test, knowledge and practice scores of experimental group and, significant “t” value of 9.1, df (58), P < 0.05 and “t” value of 11.45, df (58), P < 0.05 for mean post-test, and knowledge and practice scores of experimental and control group. There was also found a positive correlation r = 0.948, P < 0.05 between post-test knowledge and practice scores of experimental group. Study findings also conclude significant association of post-test, knowledge scores with educational level (χ² = 16.533*, df=6, P < 0.05), per capita income (χ² = 10.093*, df=3, P < 0.05), practice scores with educational level (χ² = 17.2*, df=6, P < 0.05), and per capita income (χ² = 8.422*, df=3, P < 0.05) of type 2 diabetic patients. Conclusion: The study findings revealed that health-care package was found to be effective in enhancing the knowledge and improving the practices of the type 2 diabetic patients.

Effectiveness of Educative Session on Knowledge, Attitude and Practice, on Diabetes and Dyslipidemia, of Patients Attending a Private Medical College Hospital in South-India

Introduction Diabetes mellitus and dyslipidemia are non-communicable diseases that can be prevented and controlled by maintaining a healthy lifestyle. Knowledge, attitude, and practice (KAP) in patients will provide information of much importance in Advocacy (to set guidelines by the Healthcare providers), Communication (increase awareness in subpopulation), and Social mobilization (improve services and expand community support). The study aimed to assess the effectiveness of an educative session on Knowledge, attitude, and practice (KAP) in patients attending a private medical college hospital on diabetes and dyslipidemia in the South-Indian population. Methodology The study was cross-sectional which included 100 patients (41 female and 59 male) of 18-50 years of age attending the hospital and the Central clinical laboratory for various disease conditions. A self-administered questionnaire on personal aspects and diabetes and dyslipidemia was collected. Result Among the study participants, 18% completed school education, 74% completed under-graduation, and 8% completed post-graduation. The frequency of livelihood showed 84% from rural and 16% from an urban background. Nearly 71% were active and 29% were sedentary performing self-activity. The source of information regarding the treatment of patients was also obtained from the patients to implement the same in advocacy. The knowledge of the study group on various aspects including the causes, symptoms, tests, complications of diabetes mellitus, lipid profile, dietary fiber, and exercises was analyzed. We found clarity of explanation about diabetes improved well after the educative session. Around 80% of responders believed that both fiber and routine exercises would contribute to preventing diabetes. Analysis of the attitude and practice revealed a significant knowledge of practicing proper diet, exercises, and routine health care after the educative session. Conclusion We conclude that healthcare providers shall focus on educating the patients according to their needs with the knowledge to have positive attitudes on healthy lifestyle practices in addition to the appropriate treatment.

Impact of COVID-19 lockdown on people living with diabetes: Experience from a low-middle income country in South Asia

AimsCOVID-19 lockdown imposes many challenges to patients with diabetes. We aimed to assess the impact of COVID-19 lockdown on health-related behavior and disease control among patients with diabetes. Materials and methodsA cross-sectional study was conducted among adults with diabetes attending a diabetes clinic in Colombo, Sri Lanka in June-July 2020. Lifestyle and disease control changes before and during the lockdown, were determined using an interviewer-administered questionnaire and review of medical records. ResultsAmong 1727 participants mean HbA1c decreased by 0.30% (95% CI 0.24−0.36, p < 0.001). HbA1c improved in 37.6% but deteriorated in 18.8%. Male sex (OR 1.36, 95% CI 1.10–1.67), better education (OR 1.10, 95% CI 1.01–1.20) and being employed (OR 1.08, 95% CI 1.00–1.16) were sociodemographic predictors of improved control. Better dietary adherence (OR 1.55, 95% CI 1.13–2.12), night-time sleep (OR 1.46, 95% CI 1.13–1.88) and indoor exercise (OR 1.62, 95% CI 1.23–2.07) were behavioural determinants of improved glycaemia. Decreases in self-monitoring of blood glucose (OR 1.45, 95% CI 1.09–1.93), exercise (OR 1.7, 95% CI 1.32–2.20), medication use (OR 1.95, 95% CI 1.37–2.78), dietary adherence (OR 1.72, 95% CI 1.32–2.26) and family income (OR 1.45, 95% CI 1.12–1.88) predicted worsening glycaemia. Only 4.1% used telehealth services; 83.1% of them reported good satisfaction. ConclusionsMean HbA1c improved during the lockdown. Overall, 37.6% of participants improved their glycaemic control. Well-educated employed men were more likely to improve glycaemic status. Improving diabetes control through healthy lifestyle practices and self-monitoring are feasible even in resource limited settings.

Association of healthy lifestyle including a healthy sleep pattern with incident type 2 diabetes mellitus among individuals with hypertension

BackgroundEvidence is limited regarding the association of healthy lifestyle including sleep pattern with the risk of complicated type 2 diabetes mellitus (T2DM) among patients with hypertension. We aimed to investigate the associations of an overall healthy lifestyle including a healthy sleep pattern with subsequent development of T2DM among participants with hypertension compared to normotension, and to estimate how much of that risk could be prevented.MethodsThis study examined six lifestyle factors with T2DM cases among hypertension (227,966) and normotension (203,005) and their interaction in the UK Biobank. Low-risk lifestyle factors were defined as standard body mass index (BMI), drinking alcohol in moderation, nonsmoking, engaging in moderate- to vigorous-intensity physical activity, eating a high-quality diet, and maintaining a healthy sleep pattern.ResultsThere were 12,403 incident T2DM cases during an average of 8.63 years of follow-up. Compared to those with 0 low-risk lifestyle factors, HRs for those with 5–6 were 0.14 (95% CI 0.10 to 0.19) for hypertensive participants, 0.13 (95% CI 0.08 to 0.19) for normotensive participants, respectively (ptrend < 0.001). 76.93% of hypertensive participants were considerably less likely to develop T2DM if they adhered to five healthy lifestyle practices, increased to 81.14% if they followed 6-factors (with a healthy sleep pattern). Compared with hypertension adults, normotensive people gain more benefits if they stick to six healthy lifestyles [Population attributable risk (PAR%) 83.66%, 95% CI 79.45 to 87.00%, p for interaction = 0.0011].ConclusionsAdherence to a healthy lifestyle pattern including a healthy sleep pattern is associated with lower risk of T2DM in hypertensives, and this benefit is even further in normotensives.

Special Considerations for Healthy Lifestyle Promotion Across the Life Span in Clinical Settings: A Science Advisory From the American Heart Association.

At a population level, engagement in healthy lifestyle behaviors is suboptimal in the United States. Moreover, marked disparities exist in healthy lifestyle behaviors and cardiovascular risk factors as a result of social determinants of health. In addition, there are specific challenges to engaging in healthy lifestyle behaviors related to age, developmental stage, or major life circumstances. Key components of a healthy lifestyle are consuming a healthy dietary pattern, engaging in regular physical activity, avoiding use of tobacco products, habitually attaining adequate sleep, and managing stress. For these health behaviors, there are guidelines and recommendations; however, promotion in clinical settings can be challenging, particularly in certain population groups. These challenges must be overcome to facilitate greater promotion of healthy lifestyle practices in clinical settings. The 5A Model (assess, advise, agree, assist, and arrange) was developed to provide a framework for clinical counseling with consideration for the demands of clinical settings. In this science advisory, we summarize specific considerations for lifestyle-related behavior change counseling using the 5A Model for patients across the life span. In all life stages, social determinants of health and unmet social-related health needs, as well as overweight and obesity, are associated with increased risk of cardiovascular disease, and there is the potential to modify this risk with lifestyle-related behavior changes. In addition, specific considerations for lifestyle-related behavior change counseling in life stages in which lifestyle behaviors significantly affect cardiovascular disease risk are outlined. Greater attention to healthy lifestyle behaviors during every clinician visit will contribute to improved cardiovascular health.

A Cross-Sectional Study Rating the Perceived Impact and Reach of the Ministry of Health and Wellness Initiatives to Curb Physical Inactivity in Jamaica

Like other countries, Jamaica in the last 2 decades has seen an increase in physical inactivity, which has significantly increased the number of people living with chronic lifestyle diseases on the island. It can be argued that increased industrialization has resulted in several ecological concerns, such as violence that may deter people from engaging in physical exercise, pollution and polluted air, lack of parks, walkways, and sports/recreational amenities. Despite the causes of physical inactivity, there is a global mobilization by the World Health Organization (WHO) and individual countries to reduce physical inactivity levels by at least 15% by 2030. The COVID-19 pandemic has surely put a dent in the physical activity (PA) targets. Many countries initiated restrictive measures (lockdowns, curfews, and social distancing) to try and contain the spread of the COVID-19 virus. For countries such as Jamaica, combating physical inactivity seems to require strategies, interventions, motivation, and the promotion of physical activity (PA) culture from all stakeholders (integrated approach) to meet the WHO’s goals and standards by 2030. The purpose of this research was to assess the perceived impact and reach of Jamaica’s Ministry of Health and Wellness (MOHW) initiatives to promote PA, impact weight loss, and lifestyle while trying to reduce sedentary behaviors in Jamaica. A standardized questionnaire was used in a single cross-sectional design that surveyed 843 Jamaicans using Google Forms. Participants ages 12-71 years old were surveyed using a hybrid sample strategy that used convenience and snowballs sampling techniques. The results of the study indicated that there was a 35% participation rate in the MOHW initiatives, with only 14.3% of the participants believed that the initiatives were impacting their weight loss and lifestyle. Additionally, 51.6% of the participants did not believe the initiatives caused them to participate more in PA; on average, the initiatives by the MOHW were rated at 50% effective. The initiatives are not very effective in reaching most of the population, which is not achieving the goal of enhancing healthy lifestyle practices and reducing physical inactivity. These implications may potentially see an increase in Jamaica’s physical inactivity levels and chronic lifestyle diseases if these initiatives are not intensified to reach the majority of the population.

The Association of Dietary Habits and Lifestyle Characteristics with Successful Aging among Older Greek Origin Individuals Living in France, Canada, and Greece: The Epidemiological Mediterranean Islands Study (MEDIS)

ABSTRACT The aim of the present work was to investigate the association of dietary habits and lifestyle characteristics with successful aging among native Greeks and Greeks of Diaspora (Canada and France). During 2005–2019, 2,434 Greek men and women, living in Greece, in France, and in Canada, over 65 years of age were enrolled voluntarily in the study. Anthropometric, clinical and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures, while successful aging was evaluated using the validated Successful Aging Index (SAI, range 0–10). The SAI of the overall sample was 2.8 ± 1.4. Greeks of Diaspora had higher SAI levels compared to their counterparts in Greece (p’s < .001). However, there was no difference between Greeks of Canada and these of France (p > .05). Actually, Greeks of Diaspora had almost 1.9 units higher SAI compared to native Greeks (p < .001). Work and financial status, dietary and lifestyle behaviors (i.e., physical activity, smoking habits), and several clinical characteristics (i.e., history of hypertension and hypercholesterolemia) were statistically different between the three groups (all p’s < .05). Greeks of Diaspora had higher SAI levels, probably because of their healthier lifestyle practices, which mainly depend on their traditions and cultural background of their homelands and living conditions in the host countries.

COVID-19 and Hypertension: A Mini-Review of Their Mutual Effect

Cases of Coronavirus disease are rapidly increasing across the world. Hypertension is the commonest co-morbidity among COVID-19 infected patients and hypertension is one of the determinants of severity of COVID-19.COVID -19 virus uses ACE-2 as an entry receptor and ACE-2 plays a vital role in blood pressure control in an individual. Certain antihypertensive medications may affect ACE-2 level and hence COVID-19 pathogenesis. At present, while the worlds focus is on the COVID-19, there is a danger that management of other illnesses like hypertension might be overlooked. It is highly recommended to take antihypertensive medications as directed and following healthy lifestyle practices like regular exercise, consuming low salt heart-healthy diet, maintaining a healthy weight and reducing stress, and practicing mindfulness even during this pandemic.

CONCEPTUALLY ABOUT THE HISTORY AND THEOLOGY OF HEALTH PRINCIPLES OF THE CHURCH OF SEVENTH DAY ADVENTISTS

The study examines the history of the development and formation of theology and practice of healthy lifestyles of members of the Seventh-day Adventist Church. The historical background of the emergence and development of the doctrine of health among Adventists is presented. Conceptually substantiated the theology of a healthy lifestyle for members of the Seventh-day Adventist Church. The concept of a holistic approach of Adventists in maintaining health is analyzed. It is proved that at the beginning of the emergence of the doctrine of health, Adventists placed greater emphasis on the practical component of the embodiment of the principles of health, namely: not smoking, drinking alcohol, chewing tobacco, unhealthy food, and the like. It is emphasized that in the process of development, Adventists gradually called for giving up the use of coffee, tea, tobacco, etc., justifying this by the fact that maintaining physical health forms good spiritual health, which in turn is the basis for building strong relationships with the Creator. The health reform proposed by Adventists dealt with various aspects of human life: proper nutrition, adequate intake of clean water, a balanced work and rest regimen, the need for physical exercise, exposure to fresh air and sunlight. It has been established that among Adventists there are those who eat meat and vegetarians, but both groups refrain from eating the meat of unclean animals named in the Bible. The understanding of the division into clean and unclean food did not come immediately to Adventists. At first, representatives of this church began to abandon the use of pork for food. This was argued only by the harmfulness to the health of the meat of these animals, but over time – this aspect was argumed by the indications from the book of Leviticus. Therefore, only at the beginning of the twentieth century came the realization of the need to observe the division into clean and unclean animals. The practice of early Adventists' refusal to drink tea, coffee and tobacco is described quite fully. It is indicated that Ellen White publicly, as well as in her writings, advocated complete abstinence from alcohol. The holistic approach of Adventists in the practice of health principles is presented.Keywords: history of doctrine, health theology, Seventh-day Adventists.

Barriers to physical activity during pregnancy among Saudi population on the Western region

Background: Physical inactivity and sedentary lifestyles among pregnant women have shown significant health risks that threaten the life of the mother and the child. Aim: This study aimed to assess the prevalence and barriers to regular physical activity (PA) during pregnancy among Saudi women in the western region. Materials and Methods: A cross-sectional study was done with 463 pregnant women using the Pregnant Physical Activity Questionnaire. A standardized questionnaire was used to collect the demographic details and information about the PA before and during pregnancy, work-related barriers, pregnancy-related barriers, and other barriers. Results: Only 22.9% of the participants engaged in PA during pregnancy, and not having enough time and intense exhaustion from work were the most common work-related reasons for not exercising during pregnancy. The most reported barriers to PA related to pregnancy were fear of injuring the fetus, feeling sick in the morning, muscle and joint pain, feeling exhausted after exercise, and lack of motivation. Younger pregnant women (&lt;20 years of age) and those who participated in a certain form of PA before pregnancy were comparatively more engaged in PA during pregnancy (P &lt; 0.05). Conclusion: The PA during pregnancy, as reported by the participants, was poor and the most commonly reported barrier to do PA among pregnant women was fear of injuring the fetus. Pregnant women should receive appropriate prenatal advice on the benefits of PA, and they should be made aware of the significance of PA in the promotion of healthy lifestyle practices.

Behavioral impact of national health campaigns on healthy lifestyle practices among young adults in Singapore: a cross-sectional study

BackgroundNational health campaigns are often used to improve lifestyle behaviors in the general population. However, evidence specifically in the young adult population is scarce. Given the general deterioration of healthy lifestyle practices from adolescence to young adulthood, it is imperative to study this age group. This study aimed to investigate the behavioral impact of a national health campaign in Singapore on the lifestyle practices of young adults, and whether sex or full-time working and schooling status affected lifestyle practices.MethodsA total of 594 Singaporean respondents aged 18–39 years old were interviewed via a cross-sectional study in December 2019. Lifestyle practices assessed were diet, exercise, alcohol consumption, current tobacco use, and participation in health screening programs. Other factors investigated included exposure to the national health campaign “War on Diabetes” (WoD), sex, ethnicity, and working/schooling status. Multivariable modified Breslow-Cox proportional hazards models were used to estimate prevalence risk ratios (PRRs) as measures for the associations in this study, after adjusting for potential confounders.ResultsExposure to the WoD campaign had a significant association with meeting dietary recommendations (PRR = 1.6, 95% CI: 1.0–2.5, p = 0.037), participation in screening (PRR = 1.2, 95% CI: 1.0–1.5, p = 0.028), and current tobacco use (PRR = 0.5, 95% CI: 0.3–0.8, p = 0.003). Males were significantly more likely to meet exercise recommendations (PRR = 2.0, 95% CI: 1.5–2.7, p < 0.001), currently use tobacco (PRR = 3.9, 95% CI: 2.2–6.9, p < 0.001), and consume alcohol excessively (PRR = 1.5, 95% CI: 1.0–2.3, p = 0.046), as compared to females. Working young adults were significantly less likely to meet exercise recommendations (PRR = 0.7, 95% CI: 0.5–0.9, p = 0.019) but significantly more likely to be current tobacco users (PRR = 1.8, 95% CI: 1.1–3.1, p = 0.024), as compared to those who were in school.ConclusionsWhile this paper affirms that national health campaigns have significant beneficial associations in diet, health screenings and current tobacco use, policymakers should acknowledge that young adults are an age group with different influences that impact their healthy lifestyle habits. Specific interventions that target these subgroups may be required for better health outcomes. Future studies should evaluate other socio-environmental factors that could play a role in modifying the effect of health campaigns among young adults.

Leisure and Tourism in the Health Concept of Women and Their Health Misconceptions

The pursuit of good health continues to be a popular pursuit in the 21st century, however not everyone understands it in the holistic sense which encompasses physical, mental, emotional, spiritual, social, and societal dimensions. Further, many do not understand how these dimensions influence their health, which leads to misconceptions and making faulty choices in healthy lifestyle practices. Leisure is strongly correlated to health and leisure activities which have been shown to have both direct and indirect effects on one’s health. Research also indicates gender inequalities in leisure disadvantage women disproportionately. This paper first summarizes the understandings of misconceptions, health, leisure, tourism, and their intersections, then introduces a small sample pilot study on the health concepts and misconceptions of female university students in Hungary.

A scoping review: global health literacy interventions for pregnant women and mothers with young children.

The World Health Organization is focused on enhancing health literacy (HL) throughout the life-course to address the growing burden of non-communicable diseases (NCDs) globally. Pregnancy and early motherhood offer a window of opportunity to address NCDs risk earlier in the life-course. Empowering women through HL may help to reduce the intergenerational impact of NCDs. A scoping review of the international literature was conducted to identify HL interventions that focused on improving NCD-related health outcomes or health behaviors of pregnant women and/or mothers with young children. The search was conducted on 4 databases and identified 5019 articles. After full text screening, 25 studies met the inclusion criteria. No study acknowledged their intervention as an HL intervention, even though they were assessed as targeting various HL dimensions. Only one study measured the HL of mothers. The review suggests that HL interventions are being underutilized and highlight the need to create awareness about the importance of addressing HL of pregnant women and mothers using appropriate tools to understand HL strengths and challenges in achieving healthy lifestyle practices. This can help to co-design locally responsive solutions that may enable women to make informed healthier lifestyle choices for themselves and for their children and thus may accelerate prevention of NCDs globally.

Economic Burden of Stroke Disease: A Systematic Review.

Globally, one of the main causes of non-communicable disease as a cause of death every year is stroke. The objective of this study was to analyze the burden in consequence of stroke. This research used a systematic review method. Furthermore, a search for articles was carried out in June–July 2020. Four databases were used to search articles from 2015 to 2020. Eligible studies were identified, analyzed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were prospective cost studies, retrospective cost studies, database analysis, mathematical models, surveys, and COI studies that assess burden of stroke in primary and referral healthcare (hospital-based). The results showed that from four databases, 9270 articles were obtained, and 13 articles were qualified. A total of 9270 articles had the identified search keywords, but only 13 articles met the set criteria for inclusion. The criteria for inclusion were stroke patients, the economic burden of stroke disease based on cost of illness method, which is approximately equal to USD 1809.51–325,108.84 (direct costs 86.2%, and indirect costs 13.8%). Those that used the health expenditure method did not present the total cost; instead, only either direct or indirect cost of health expenditure were reported. For most hospital admissions due to stroke, LOS (length of stay) was the dominant cost. The high economic burden to manage stroke justifies the promotion and preventive efforts by the policymakers and motivates the practice of healthy lifestyles by the people.

Association Between Sudarshan Kriya Yoga and Healthy Lifestyle Practices Among Working Adults: A Cross-Sectional Study from Singapore.

Objectives: There is a paucity of research on the association between yogic breathing and healthy lifestyle factors in working adults. Also, there is very little information about the frequency of yogic breathing practice and its benefits. The authors investigated the relationship between Sudarshan Kriya Yoga (SKY) frequency and the likelihood of leading a healthier lifestyle among practitioners and nonpractitioners. Design: Cross-sectional investigation on non-SKY and SKY practitioners, SKY was categorized into non-, monthly, weekly, and daily practitioners. Confounding variables included age, gender, ethnicity, marital status, and education level. A multivariate logistic regression model was used to compare practice frequencies with the odds of having a healthier lifestyle. Settings: Community centers, community events, workplaces, and universities throughout Singapore Subjects: Of the 531 working adults (54.8% female), 50.1% had a healthier lifestyle ≥ 4 healthy lifestyle factors). Outcome Measure: Having a healthier lifestyle was defined as having ≥ 4 healthy lifestyle factors out of seven (smoking, alcohol, diet, exercise, sleep, stress, and weight). Results: Multivariate analysis demonstrated that those who practiced SKY ≥ 4 days/week had significantly higher odds of having a healthier lifestyle (odds ratio = 3.62; 95% confidence interval = 2.10-6.23). The p for trend analysis demonstrated that as the frequency of practice increased the likelihood of having a healthier lifestyle also increased ( p < 0.001). Conclusion: The practice of yogic breathing may promote a healthier lifestyle in working adults. Further experimental and longitudinal investigations are warranted.

Barriers to and facilitators of diabetes self-management practices in Rupandehi, Nepal- multiple stakeholders\u2019 perspective

BackgroundSelf-management of diabetes is associated with glycaemic control and adherence to medication and healthy lifestyle practices. There is lack of information on the barriers to and facilitators of diabetes self-management practices in low income country, Nepal. This study aimed to explore the barriers to and facilitators of Type 2 diabetes self-management practices taking multiple stakeholders’ perspectives in Nepal.MethodsFour focus group discussions and 16 semi-structured interviews with people with Type 2 diabetes, caregivers, health care providers and health managers were conducted from April to May 2018 in Rupandehi district of Western Nepal. They were audio-recorded, transcribed, and analysed using a thematic approach.ResultsFive main themes emerged that influenced diabetes self-management practices: individual factors, socio-cultural and economic factors, health system and policy factors, availability and accessibility of resources, and environmental factors. The important barriers were: lack of knowledge about diabetes self-management practices, cultural practices, insufficient counselling, lack of guidelines and protocols for counselling, and financial problems. The major facilitators were: motivation; support from family, peers, and doctors; and availability of resources in the community.ConclusionBased on our findings, a multilevel approach is needed to address these barriers and facilitators. These findings will help guide strategies to develop programs that impart knowledge and skills to improve the diabetes self-management practices of people with Type 2 diabetes.

301 Evaluation of Fatigue and Healthy Lifestyle Practices among New York State Law Enforcement Professionals

Abstract Introduction An important risk factor for drowsy driving is shift work, and law enforcement, an occupation known for its atypical work schedules, is a highly vulnerable occupation. A connection between fatigue and unintentional injuries among police officers has been observed (Vila, 2006), but data supporting the connection is limited. Understanding how sleep and lifestyle practices impact this population’s driving performance and job safety is critical to officer safety. Methods An online survey was disseminated to New York State law enforcement agencies by the Governor’s Traffic Safety Committee to assess sleep health and lifestyle practices among law enforcement personnel. Statistical analysis included data cleaning, basic and advanced statistical testing. Results 7,366 survey invitations were distributed, 1,171 were returned (15.9% response rate), and after data cleaning, 1,038 surveys were included in the analysis. Respondents reported from various state, county, and local agencies, holding titles from Police Officer to Senior Management. More than 30% of officers reported driving 5 hours or more during their shift, with 12% driving greater than 7 hours. 65% of respondents reported having experienced drowsy driving. Although, 34% reported never having received education about drowsy driving. On work days, only 40% of respondents obtain 7 hours of sleep or more. On days off, 23.6% reported sleeping 6 hours or less. Work, stress, and family responsibilities were reported as having a significant impact on sleep. Almost 87% reported at least one medical issue. Daytime sleepiness (47.4%), fatigue (42.6%), and poor memory (26.8%) were reported daily. Only 23.8% and 29.3% of respondents received education on sleep or heart health, respectively. The majority (81.7%) reported they would consider education in a variety of health-related programs. Conclusion Our findings indicate that poor sleep (60%), high stress (22.7%), and anxiety (16.8%) are a concern amongst officers. Poor cardiovascular health was also noted, based on reports of obesity (34.1%), high blood pressure (23.5%), and high cholesterol (22.4%). This research supports the need for prioritizing health education programs within law enforcement agencies. Support (if any) Funded by The National Highway Traffic Safety Administration with a grant from The New York State Governor’s Traffic Safety Committee.

An Observational Study on Glycemic Outcomes, Lifestyle and Psychosocial Health of Patients With Diabetes During Covid-19 Lockdown From Bangalore

Background and Aims: Lockdown during the COVID-19 pandemic imposed many restrictions on the public. Loss of continuum of care along with improper lifestyle was expected to worsen glycemic control in people with type 2 diabetes (T2D). We aimed to identify the effects of lockdown on their glycemic status, lifestyle changes and psychosocial health.Methods: The pre- and post-lockdown data of 110 adults with T2D who were under regular follow up was collected by direct interview during their visit to the diabetes clinic. The variables analyzed included demographic data, HbA1c, body weight, lifestyle changes, psychosocial factors and use of technology.Result: The overall physical activity had dipped significantly accounting to lockdown restrictions and fear. Dietary adherence was better with participants exhibiting increased consumption of vegetables (80.9%), fruits (42.7%), and decreased unhealthy snacking (63%). 90% of them had access to medications during lockdown. There was significant change noted in the mean HbA1c (0.9- 1.45%) and body weight (1–3.5kgs) before and after lockdown. There was a great increase in Screen time attributing to Work from home and restrictions to move out. 63.6% of them spent time with their family members. Those with prior mental stress,poor sleep and unhealthy dietary habits had worsening glycemic control as seen in those with less physical activity and an unhealthy diet. An increasing trend of utilisation of health related mobile internet technology apps were noted.Conclusion: Lockdown did cause a major change in the overall glycemic control. Measures to promote healthy lifestyle practices along with ways to reduce psychosocial stress must be implemented for better T2D management during such restricted times. Telemedicine paved a greater way and scope of continuum of Diabetes care.