Lifestyle Education Research Articles

The Use of a Brief Antenatal Lifestyle Education Intervention to Reduce Preterm Birth: A Retrospective Cohort Study.

Preterm birth is a leading cause of neonatal and child mortality and morbidity worldwide. The aim of this study was to investigate associations between attending a brief antenatal lifestyle education seminar and preterm birth, and whether education timing modifies outcomes. A retrospective cohort study was conducted in a hospital-based antenatal care center in Beijing, China, where a free, 2 h, optional, face-to-face, midwife-led group seminar on healthy lifestyle choices during pregnancy was provided. Among the 3008 eligible women, 1107 (36.8%) attended the seminar during the first trimester, 515 (17.1%) attended during the second trimester or later, and 1386 (46.1%) did not attend. Multiparous women were more likely to not attend or to attend at a later stage. The overall prevalence of preterm birth was 8.7%, but it was higher for women who did not attend the antenatal seminar (11.5%). The risk of preterm birth for first trimester attendees decreased by 53%, and it decreased by 41% for later attendees. Estimates persisted after adjusting pre-existing and gestational covariates. Attending a brief antenatal lifestyle education seminar was associated with lower preterm birth risk, and attending during the first trimester had a better impact than later attendance. The results can inform the development of tailored preterm birth prevention strategies.

Attitudinal Change toward Yoga after Its Introduction in the New Curriculum

Introduction: Benefits of yoga for a healthy life and stress management are proven; yoga was introduced into the new medical curriculum (competency-based medical education) from 2019 batch. This study was conducted to compare the attitudinal change of medical students and to identify the barriers of yoga practice among those with yoga in curriculum to those without. Materials and Methods: Using a cross-sectional study design, a total of 300 students (150 each from sixth [traditional] and fourth semesters [new curriculum]) were contacted. A self-administered researcher-made questionnaire (Google form) was sent to those who consented. Data were analyzed using SPSS version 20.0. Results: In this comparative study, among fourth and sixth semester students, it was found that 43.4% of the fourth, whereas 53.7% of the sixth semester students, knew about the benefits of yoga (P = 0.040). On comparing their attitude, “it was considered to be purely a weight loss program” by 17.9% of the fourth and 8.8% of the sixth semester students, respectively (P = 0.017). 94.5% students of the fourth semester, whereas 87.1% of the sixth semester, believed that yoga helped in improving immunity (P = 0.023). The barriers for practicing yoga cited were a lack of interest (37.1% by fourth semester, whereas 40% by sixth semester) and a lack of time (33% in fourth semester and 30.5% in sixth semester). Conclusion: The study helped reveal that the integration of yoga into the medical curriculum had brought an attitudinal change in them, but had not influenced their practices. The identified barriers will help implementing yogic lifestyle education programs, increasing its acceptance among medical students.

Pemberdayaan Masyarakat Melalui Edukasi Dan Literasi Gerakan Gaya Hidup Halal

The halal factor is an important thing for Muslims in meeting their needs and desires. Halal means allowed in Islam. It should be supported in its implementation in habits or lifestyles. But in reality, many halal concepts are focused on food and drink alone. In fact, not only that, but also seen from the factors of safety, cleanliness, quality and all the goodness of what is consumed. In the halal industry, it is mentioned that in addition to food and beverages, it consists of Islamic Financial Institutions, Halal Tourism, Halal Fashion, Halal Pharmaceuticals and also Halal Cosmetics. Halal Lifestyle education is needed as one of the solutions to problems due to the low awareness and understanding of the millennial generation and generation z about the concept of halal and halal lifestyle. This paper is intended to share the urgency of halal literacy to increase knowledge and increase awareness in the application and intensify the halal lifestyle movement.

Naturopathic Medicine and Group Visits: A Natural Alignment

Group visits are a delivery mode well-suited to the principles of naturopathic medicine. Group visits are cost-effective, allowing practitioners to provide thorough lifestyle education to more participants, an important domain of both prevention and management of health concerns. The interactive nature of group visits adds unique support, motivation and learning opportunities that one-on-one appointments often cannot provide. When structured opportunities are created for reflection, peer exchange and goal setting, the likelihood of behaviour change appears to be enhanced. Group visits may also benefit practitioners, allowing for greater efficiency and reduced risk of burnout, ultimately enabling greater impact. This paper maps the alignment of group visits to naturopathic principles, highlighting benefits, risks and strategies to harness this effective approach to health care.

Empirical likelihood inference for longitudinal data with covariate measurement errors: An application to the LEAN study

Measurement errors usually arise during the longitudinal data collection process. Ignoring the effects of measurement errors will lead to invalid estimates. The Lifestyle Education for Activity and Nutrition (LEAN) study was designed to assess the effectiveness of intervention for enhancing weight loss over nine months. The covariates systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at baseline, month 4, and month 9. At each assessment time, there were two replicate measurements for SBP and DBP. The replicate measurement errors of SBP follow different distributions, as does DBP. To account for the distributional difference of replicate measurement errors, a new method for analyzing longitudinal data with replicate covariate measurement errors is developed based on the empirical likelihood method. The asymptotic properties of the proposed estimator are established under some regularity conditions. The confidence region for the parameters of interest can be constructed based on the chi-squared approximation without estimating the covariance matrix. Additionally, the proposed empirical likelihood estimator is asymptotically more efficient than the estimator of Lin et al. (2018). Extensive simulations demonstrate that the proposed method can eliminate the effects of measurement errors in the covariate and has a high estimation efficiency. The proposed method indicates the significant effect of the intervention on BMI in the LEAN study.

Cardiometabolic Effects of a 12-Month, COVID-19 Lockdown-Interrupted Lifestyle Education Program for Arab Adolescents

BackgroundChildhood obesity and pediatric metabolic syndrome (MetS) have steadily increased during the last decade in Saudi Arabia. Intervention programs to prevent cardiometabolic disorders in Arab youth are needed.ObjectiveIn this multi-school intervention study which was disrupted by COVID-19-imposed lockdowns (September 2019–April 2021), a 12-month lifestyle education program focused on improving the cardiometabolic status of Arab adolescents was investigated.MethodsA total of 2,677 Saudi students aged 12–18 years were recruited from 60 different secondary and preparatory year schools in Riyadh city, Saudi Arabia. The intervention was initially in-person counseling sessions and the subsequent sessions conducted virtually post-pandemic. Baseline anthropometrics and fasting blood samples for glucose, HbA1c, and lipid assessments were collected at baseline and after 12 months (704 participants).ResultsOnly 704 out of 2,677 (73.7% dropout) completed the intervention. At baseline, 19.6% of the participants were overweight and 18.1% were obese. A modest but significant decrease in the prevalence of central obesity [11.2 vs. 6.7% (−4.5% change, p = 0.002)], hypertension [22.3 vs. 11.4% (−10.9% change, p < 0.001)], and low-HDL cholesterol [61.6 vs. 23.3% (−38.3% change, p < 0.001)] was noted. Consequently, the prevalence of hypertriglyceridemia increased from 22.7 to 56.3% (+ 33.6%, p < 0.001) overtime. Also, the proportion of subjects who were able to change their status from MetS to non-MetS was significantly more in overweight/obese at baseline than normal weight (16.9 vs. 3.6%, adjusted OR = 3.42, p < 0.001).ConclusionInterrupted lifestyle education programs secondary to COVID-19-imposed lockdowns still provided modest effects in improving cardiometabolic indices of Arab adolescents. Given the high digital literacy of Arab youth, improving the delivery of virtual lifestyle education programs may prove beneficial.

987-P: Cost-Effectiveness of a Diabetes Prevention Program among Latino Youth with Prediabetes

Introduction: Lifestyle intervention is a cost-effective approach for preventing type 2 diabetes among adults with prediabetes. Little is known about the cost effectiveness of lifestyle programs for children with prediabetes. The purpose of this study was to examine the cost and incremental cost effectiveness of an adapted diabetes prevention intervention compared to usual care among Latino youth with prediabetes. Methods: Latino youth (age 13.5±1.4 years, mean±SD) with obesity and prediabetes were randomized to a community-based lifestyle intervention (INT, N=79) or usual care (UC, N=38) . The 6-month INT was delivered at a YMCA and included 1 d/wk of lifestyle education for families and 3 d/wk of physical activity. UC included 2 visits with a pediatric endocrinologist and registered dietician to discuss diabetes risks and healthy lifestyle changes. Data on health care costs and resource utilization were collected prospectively. Efficacy was examined as changes in 2-hr glucose concentrations during an OGTT. Cost analyses were performed from health care sector and societal perspectives. Results: The INT led to decreases in 2-hr glucose (144.5±3.4 to 132.2±3.4 mg/dL, p=0.002) but these changes were not significantly different from changes in 2-hr glucose observed in UC participants (144.1±4.6 to 139.0±4.6; interaction p=0.260) . The average health care costs per participant were $1,032 for the INT and $1,251 for the UC. Total societal costs (health care plus patient and family opportunity costs) per participant were $3,641 for the INT and $1,331 for the UC. For health care costs alone, the incremental cost-effectiveness ratio (ICER) for 2-hr glucose was -$30.3 per mg/dL. When taking total costs into account, the ICER for 2-hr glucose was $320.8 per mg/dL. Conclusion: From a health care sector perspective, INT led to greater reductions in 2-hr glucose at a lower cost compared to UC among Latino youth with prediabetes. The cost-effectiveness of INT decreases when total societal costs are included. Disclosure M.Olson: None. A.Pena: None. M.E.Putz: None. S.Ayers: None. W.C.Knowler: None. M.Mccullough: None. G.Q.Shaibi: None. Funding National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disease (R01DK10757901)

Edukasi Manajemen Pola Hidup Sehat di Desa Pegagan Julu, Kabupaten Dairi

The success of a country can be seen from the results of the Human Achievement Index (IPM) owned by the country. One indicator of HDI is health status. This community service has the aim of increasing people's motivation to maintain education on healthy lifestyles. In carrying out this community service, the method used in this community service activity is to conduct interactive health seminars, so that the expected materials and objectives can reach the community directly. The conclusions obtained from this activity are as follows, overall (100%) the people of Pegagan Julu IV village feel the benefits of the healthy lifestyle education activities that are delivered, but in their commitment to living a healthy lifestyle there are only 90% of the people who are committed to maintaining health, through a healthy lifestyle.

Effectiveness of a community health worker-delivered care intervention for hypertension control in Uganda: study protocol for a stepped wedge, cluster randomized control trial

BackgroundOver 80% of the morbidity and mortality related to non-communicable diseases (NCDs) occurs in low-income and middle-income countries (LMICs). Community health workers (CHWs) may improve disease control and medication adherence among patients with NCDs in LMICs, particularly in sub-Saharan African settings. In Uganda, and the majority of LMICs, management of uncontrolled hypertension remains limited in constrained health systems. Intervening at the primary care level, using CHWs to improve medical treatment outcomes has not been well studied. We aim to determine the effectiveness of a CHW-led intervention in blood pressure control among confirmed hypertensive patients and patient-related factors associated with uncontrolled hypertension.MethodsWe will conduct a stepped-wedge cluster randomized controlled trial study of 869 adult patients with hypertension attending two NCD clinics to test the effectiveness, acceptability, and fidelity of a CHW-led intervention. The multi-component intervention will be centered on monthly household visits by trained CHWs for a period of 1 year, consisting of the following: (1) blood pressure and sugar monitoring, (2) BMI monitoring, (3) cardiovascular disease risk assessment, (4) using checklists to guide monitoring and referral to clinics, and (5) healthy lifestyle counseling and education. During home visits, CHWs will remind patients of follow-up visits. We will measure blood pressure at baseline and 3-monthly for the entire cohort. We will conduct individual-level mixed effects analyses of study data, adjusting for time and clustering by patient and community.ConclusionThe results of this study will inform community delivered HTN management across a range of LMIC settings.Trial registrationClinicalTrials.govNCT05068505. Registered on October 6, 2021.

Blood Pressure Assessment and Treatment in the Observation Unit.

To review the pathophysiology, diagnosis, and the management of hypertension. Given the paucity of literature regarding the role of the observation unit in the management of hypertension, we will provide our recommendations based on our experience working in an observation unit. Many patients have limited access to primary care, and hypertension diagnosis often relies on office-based measurements. We will describe situations where that is not necessary to make the diagnosis. We will discuss the current non-pharmacologic treatment guidelines, the education of which should be provided to patients both in the emergency department and observation units. We will provide the current recommendations on what anti-hypertension medications can be initiated in the emergency department and observation units. Hypertension is a leading cause of morbidity and mortality in the USA. The utility of an observation unit in the diagnosis and management of patients with hypertension is beneficial particularly for those with risk factors for atherosclerotic disease. An observation unit stay provides the opportunity to diagnosis hypertension, initiate lifestyle education and pharmacologic treatment if indicated, and help to arrange appropriate follow-up for ongoing management and treatment in individuals with limited access to care.

Exercise and lifestyle education program for people living with diabetes and prediabetes in Brazil: a pilot randomized trial

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): This study was partly financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) – Finance Code 001, and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil. Background Lifestyle changes are crucial to preventing diabetes and its cardiovascular complications, including maintaining a physically active lifestyle. Morever, patient education is essential to promote diabetes self-management and health condition control. However, programs that combine physical exercise and lifestyle education are still poorly implemented in low- and middle-income countries, such as Brazil. The Diabetes College Brazil Study is a pioneer randomized clinical trial (RCT) designed to promote behavioral changes in adults with diabetes and prediabetes. PURPOSE: To test the feasibility, acceptability, and preliminary effectiveness of Diabetes College Brazil Study interventions (Exercise (Ex) vs. Exercise and Lifestyle Education (ExLE)) as part of the preparation for the development of the RCT. Methods This pilot randomized trial (NCT03914924) had two parallel arms: ExLE program (12 weeks of exercise and educational interventions) and Ex program (12 weeks of exercise intervention only) (Figure 1). Feasibility (eligibility, recruitment, retention, completeness of RCT variables measures and participation rates), acceptability (satisfaction with interventions), and preliminary effectiveness of interventions (comparison of RCT variables measured in pre-and post-assessments) were evaluated. The preliminary effectiveness of the interventions was analyzed from the values of the difference between post-and pre-intervention measures (Δ post-pre) using both per-protocol (PP) and intention to treat (ITT) analysis for the comparison between groups (Ex vs. ExLE). The value 0 was imputed to replace the missing data in the analysis that followed the ITT principle. The results were reported as estimates of effect (95% confidence interval (CI) of the difference) for variables with normal distribution. RESULTS: Thirty-seven individuals participated in the study (ExLE: n = 18, 56.9±9.5 years old, 55.6% female, 5.6% prediabetes; Ex: n = 19, 59.5±7.3 years old, 52.6% female, 21.1% prediabetes). Eligibility, recruitment and retention rates were 16%, 100% and 82% respectively. The completeness of RCT variables measures was higher in the pre-intervention assessment. Missing data in the post-intervention assessment were mainly related to modifications in research procedures due to the COVID-19 pandemic. Participation rates in supervised exercise sessions and education classes were 76% and 71%, respectively (total sample). Interventions were highly acceptable to participants. There was a trend towards better results in the ExLE than Ex for most variables, mainly for physical activity level and quality of life (Table 1). Conclusion The interventions are feasible and acceptable to participants. The results of this trial indicate the potential clinical benefit of lifestyle educational intervention associated with exercise intervention for people with diabetes and prediabetes.

Tailor-made cardiac rehabilitation for patients with obesity: results of the OPTICARE-XL randomized controlled trial

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Dutch Organisation for Health Research and Development (ZonMW) and Capri Cardiac Rehabilitation Background More than a third of the patients referred to cardiac rehabilitation (CR) suffers from obesity, and this number is growing. However, in patients with obesity, standard CR is not effective in achieving the recommended physical activity levels and results achieved in weight loss and health related quality of life (HRQOL) are unsatisfactory. Purpose To describe the effectiveness of a new state of the art CR program designed for patients with obesity, OPTICARE XL, on weight, physical activity and HRQOL. Methods A total of 201 patients that were referred to CR after a diagnosis of coronary artery disease (CAD) or atrial fibrillation (AF) and a BMI≥30 were randomized to standard CR (n=99) or OPTICARE XL CR (n=102). Standard CR consists of a 6 till 12 week aerobic exercise program, supplemented with cardiovascular lifestyle education. OPTICARE XL CR is a one-year intervention including aerobic and strength exercise, behavioral coaching on diet and physical activity and an after-care program. Weight was measured with a calibrated weight scale, physical activity (steps/day) was measured with an Actigraph GT3X+, and HRQOL with the MacNew questionnaire. Data was analyzed by means of linear mixed-effect models. Results Included patients had a mean age of 59 years, were predominantly male (73%) and the majority was referred to CR after a CAD (66% CAD, 34% AF). Patients in the OPTICARE XL group showed on average greater weight loss three months after the start of CR (mean change -3.6 kg vs -1.8 kg, respectively, p=0.002). Six months post CR, changes in body weight were equal between groups (-2.5 kg in both groups, p=0.959). No significant between-group differences were seen in improvements in physical activity both three months after the start of CR (+880 steps/day for OPTICARE XL vs +481 steps/day for standard CR, p=0.169) and six months post CR (+331 steps/ day vs +283 steps/day, p=0.919). With regard to HRQOL score, also no significant between groups differences in improvements were seen both three months after the start of CR (+0.6 for OPTICARE XL vs +0.5 for standard CR, p=0.169) and six months post CR (+0.5 for both groups, p=0.907). Conclusion OPTICARE XL had added value on the short-term, but this did not sustain on the long-term. We suggest to re-evaluate the OPTICARE XL program to expand short-term effects.

Effects of diet education on empowerment for individuals who have an increased risk of developing breast or colon cancer: A pilot study.

Strong evidence indicates following a healthy diet reduces cancer risk; however, the impact of diet education on empowerment on individuals with an increased cancer risk has not been evaluated. Study participants included patients who had met with a cancer genetic counselor without a history of cancer. Participants received pre- and post-diet education surveys including questions to measure empowerment and feedback for diet education in relation to cancer risk. Empowerment was measured using a ten-question survey adapted from the Genetic Counseling Outcome Scale. The diet education intervention consisted of viewing an infographic created for this study based on recommendations for diets that reduce cancer risk by the World Cancer Research Fund and American Institute for Cancer Research. Twenty-eight participants completed both surveys and reviewed the diet education intervention. There was no change in empowerment between pre- and post- diet education (mean change=-0.5; p=0.49). Participants previously learned about the relationship between a healthy diet and cancer risk reduction from several sources including family and friends (25.0%), online (25.0%), and primary care providers (25.0%). Most participants preferred diet education to be delivered online (42.9%), followed by on paper (39.3%), and in-person delivery (17.9%). This pilot study promotes further investigation on the impact of diet or lifestyle education on individuals who have a predisposition to developing cancer. While the results demonstrated no change in empowerment because of diet education, the results established a desire for learning about a healthy diet related to cancer risk and preferences for the modes of delivering education.

Effect of Educational Intervention Based on Self-efficacy Theory and Self-regulatory Strategies on Physical Activity of Prehypertensive Individuals

&#x0D; &#x0D; &#x0D; &#x0D; Background: Considering the importance of healthy lifestyle education in the prevention and control of hypertension and the timely identification of pre-hypertensive individuals, the present study was conducted to determine the effect of educational intervention based on self-efficacy theory and self-regulatory strategies on the physical activity of pre-hypertensive individuals.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Methods: This quasi-experimental study was performed on 90 people aged 30 to 59 referred to urban health centers in Nehbandan in 2021. They were randomly selected and divided into two groups of 50 (intervention and control). Data were collected by questionnaires on demographic information, hypertension knowledge, self-efficacy of physical activity, and physical activity by the self-administered method. After the pretest, the intervention group received six training sessions in four weeks. The posttest was performed in two groups immediately and three months after the training sessions. Data were analyzed by repeated-measures analysis of variance, Bonferroni post hoc test, independent t-test, and chi-square test in SPSS version 21software.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Results: The mean age of the participants was 45.80 ± 8.31 in the control group and 44.95 ± 8.20 in the intervention group. Data analysis showed the equality of knowledge, self-efficacy, and physical activity between the two groups before the intervention (P &gt; 0.05). After the intervention, a significant increase was observed in the mean scores of knowledge, self-efficacy, and physical activity in the intervention group immediately and three months after the intervention (P&lt;0.05). Also, the levels of knowledge, self-efficacy, and physical activity were significantly lower in the control group than in the intervention group (P&lt;0.001).&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Conclusions: The present study showed the effectiveness of an educational intervention based on self-efficacy theory and self-regulatory strategies on physical activity of pre-hypertensive individuals. Therefore, this theory is proposed to design educational interventions to promote regular physical activity.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Effects of a 12-Month Hybrid (In-Person + Virtual) Education Program in the Glycemic Status of Arab Youth.

This 12-month school-based intervention study investigated the effects of hybrid educational lifestyle modifications on glycemic control among Saudi youth with different glycemic statuses. A total of 2600 Arab adolescents aged 12–18 years were recruited from 60 randomly selected schools. Anthropometrics, blood glucose, and HbA1c were measured pre- and post-intervention. Participants were grouped according to baseline HbA1c into normal, prediabetes, and diabetes groups. All participants received lifestyle education at base line and at every 3-month interval to improve diet and exercise behavior. Diabetic and prediabetic participants received a tailored lifestyle intervention. Post-intervention, 643 participants were analyzed as follows: 20 participants from the diabetes group, 39 from prediabetes, and 584 from the normal group. A modest but significant improvement in the glycemic status of diabetic and prediabetic participants was observed, but not in the normal group. In the diabetes group, 11 (55%) participants achieved normal HbA1c levels, 5 had prediabetes levels, and only 4 remained within diabetes HbA1c levels. In the prediabetes group, 34 (87.2%) participants achieved normal HbA1c levels, while 2 (5.1%) participants remained prediabetic and 3 (7.7%) had diabetes HbA1c levels (p < 0.001). This hybrid lifestyle intervention program modestly reduces the risk of T2DM among youth with elevated HbA1c levels. The challenge of sustaining interest in adopting lifestyle changes for a longer duration should be addressed in further studies in this population.

Lifestyle risk factors for obsessive-compulsive symptoms and related phenomena: What should lifestyle interventions target?

Understanding the impact of lifestyle on mental illness symptoms is important for informing psycho-education and developing interventions which target mental and physical comorbidities. Obsessive-compulsive and related disorders can have a significant impact on health-related quality of life and physical health. However, our understanding of the impact of lifestyle on obsessive-compulsive symptoms and broader compulsive and impulsive problematic repetitive behaviours is limited. We investigated whether lifestyle factors predicted change in obsessive-compulsive symptoms and problematic repetitive behaviours in a general population sample over a 3-month period. Eight hundred thirty-five participants completed an online questionnaire battery assessing lifestyle and mental health. Of these, 538 participants completed the same battery 3 months later. We conducted negative binomial regressions to analyse the association of lifestyle factors at baseline with future (1) obsessive-compulsive symptoms, (2) compulsive problematic repetitive behaviours and (3) impulsive problematic repetitive behaviours, adjusting for baseline obsessive-compulsive symptoms and problematic repetitive behaviours. Lower vegetable (p = 0.020) and oily fish (p = 0.040) intake and lower moderate intensity physical activity (p = 0.008) predicted higher obsessive-compulsive symptoms at follow-up. Higher intake of high-fat foods (p < 0.001) predicted higher compulsive problematic repetitive behaviours at follow-up. No lifestyle factors significantly predicted impulsive problematic repetitive behaviours at follow-up. Our results speak to the potential importance of lifestyle quality screening, education and lifestyle interventions (e.g. an anti-inflammatory diet) for individuals experiencing compulsivity-related behaviours and/or symptoms. Further research into potential mechanisms of action will allow for more targeted approaches to lifestyle interventions for transdiagnostic compulsive behaviours.

Compilation and Validation of Students' Lifestyle Educational Package Based on Positive Psychology and its Effectiveness on Character Capabilities

Compilation and Validation of Students' Lifestyle Educational Package Based on Positive Psychology and its Effectiveness on Character Capabilities

Cardiac rehabilitation designed for patients with obesity: OPTICARE XL RCT results on health-related quality of life and psychosocial well-being

Purpose We studied the effectiveness of a new cardiac rehabilitation (CR) program developed for patients with obesity compared with standard CR on HRQOL and psychosocial well-being. Materials and methods OPTICARE XL was a multicentre RCT in patients with cardiac disease and obesity (Netherlands Trial Register: NL5589). Patients were randomized to OPTICARE XL CR (n = 102) or standard CR (n = 99). The one-year OPTICARE XL CR group program included endurance and resistance exercises, behavioural coaching, and after-care. Standard CR consisted of a 6- to 12-week endurance exercise group program, and cardiovascular lifestyle education. Primary endpoint was HRQOL (MacNew) at six months post CR. Second, we assessed anxiety and depression (both HADS), fatigue (FSS), and participation in society (USER-P). Results In both groups, improvements in HRQOL were observed six months post CR. Mean HRQOL improved from 4.92 to 5.40 in standard CR [mean change (95% CI): 0.48 (0.28, 0.67)] and from 4.96 to 5.45 in OPTICARE XL CR (mean change (95% CI): 0.49 (0.29, 0.70), without between-group differences. Psychosocial well-being improvements within both groups were obtained at six months post CR, regardless of allocated program. Conclusions OPTICARE XL CR did not have added value in improving HRQOL and psychosocial well-being in patients with obesity. Implications for rehabilitation More than a third of cardiac patients suffers from obesity, and standard cardiac rehabilitation (CR) programs are suboptimal in this increasing patient population. The OPTICARE XL CR program is a state-of-the art, one-year CR program designed for patients with obesity including aerobic and strength exercises, behavioural coaching towards a healthy diet and an active lifestyle, and after-care. Improvements in HRQOL and psychosocial well-being were comparable between patients with obesity allocated to standard CR and OPTICARE XL CR. Therefore, there was no additional benefit of OPTICARE XL CR.

Effects of \u2018SPRAT\u2019 programme for dietary and lifestyle education to improve psychosomatic symptoms and dietary habits among adolescents: a cluster randomised controlled trial

BackgroundDietary and lifestyle modifications to reduce subjective psychosomatic symptoms (SPS) have become an important topic worldwide. We developed a school-based dietary and lifestyle education programme that involved parents/guardians in reducing SPS in adolescents (SPRAT). The programme encouraged parents/guardians to participate in adolescents’ healthy dietary and lifestyle modifications to reduce SPS, increase enjoyment of school life, and foster appropriate dietary intake. This study evaluated the effectiveness of SPRAT in reducing SPS and in altering dietary behaviour among adolescents.MethodsA 6-month cluster randomised controlled trial using SPRAT and the usual school programme (control) was performed. Participants were middle school students in Japan who provided informed consent. Outcomes were SPS scores assessed at baseline and 2, 4, and 6 months after baseline and the proportions of dietary and lifestyle factors achieved such as enjoyment of school life and dietary intakes assessed by FFQW82. Change from baseline (CFB) at 6 months was the primary endpoint. A linear mixed-effects model was applied. As for dietary intake, the treatment effect was estimated as an interaction term between baseline and treatment “baseline*treatment”.ResultsThe intention-to treat analysis included 951 (94.7%) and 1035 (89.8%) individuals in the SPRAT and control groups, respectively. The CFB in the 6-month SPS score adjusted for baseline was lower in the SPRAT group (-0.29) than in the control group (0.62), but the difference was not statistically significant -0.91 (p = 0.093).ConclusionsAlthough the primary endpoint tended to denote improvement in the SPRAT group compared to the control group, the improvement was not significant. Favourable effects were observed in some secondary outcomes and statistically significant treatment*baseline interactions were observed for several dietary intakes. These results imply that CFBs of dietary intake were increased or decreased in a favourable direction depending on the baseline intake, especially in the SPRAT group.Trial registrationUMIN000026715. (27/03/2017)

Effects of Lifestyle Education on Depression, Anxiety, Stress, and Perceived Family Support Among Hypertensive Patients

Background: Hypertension is a major global health problem and a risk factor for cardiovascular disease. An unhealthy lifestyle can increase the risk of hypertension and psychological disorders, thereby heightening the risk of cardiovascular disease. Objectives: The study aimed to evaluate the effects of lifestyle education on depression, anxiety, stress, and perceived family support among hypertensive patients undergoing coronary angioplasty. Methods: This randomized clinical trial recruited 60 hypertensive patients undergoing angioplasty at the coronary care units of an educational hospital in Isfahan, Iran, in 2015. Then, 30 subjects were randomly allocated to each intervention and control group. The patients in the intervention group and their family members were provided with group lifestyle education in six sessions held in three successive weeks, accompanied by one-month follow-up telephone contacts. Data were collected before, immediately after, and one month after the intervention using a demographic questionnaire, the 21-item Depression, Anxiety, and Stress Scale with Cronbach’s alpha values of 0.80, 0.83, and 0.87, and a researcher-made family support questionnaire. Data analysis was done using the paired-sample t, independent-sample t, chi-square, Mann-Whitney U, and repeated-measures analysis of variance tests. Results: The study groups did not significantly differ respecting demographic characteristics, and the pretest mean scores of depression, anxiety, stress, and perceived family support (P &gt; 0.05). However, significant between-group differences were observed at both posttests, respecting the mean scores of depression, anxiety, stress, and perceived family support (P &lt; 0.05). Moreover, while these mean scores did not significantly change in the control group (P &gt; 0.05), the mean scores of depression, anxiety, and stress significantly decreased, and the mean score of perceived family support significantly increased in the intervention group across the three measurements (P &lt; 0.05). Conclusions: Lifestyle education effectively reduced depression, anxiety, and stress and improved perceived family support among patients with hypertension and angioplasty. Nurses can use such interventions to improve patient outcomes.