Lifestyle Self-management Research Articles

Identification and Evaluation of Mobile Applications for Self-Management of Diet and Lifestyle for Patients with Inflammatory Bowel Disease.

Mobile health applications (apps) providing diet and lifestyle self-management programs to patients with inflammatory bowel disease (IBD) are emerging. The objective of this study was to evaluate current apps available in the US and Canada based on app quality, perceived impact on diet and mental health and comprehensiveness to support self-management. The Apple iOS and Google Play app stores were searched for terms related to IBD. Apps were included if they targeted diet and lifestyle behaviours for patients living with IBD and were available to the general public. Apps were excluded if they were not specific to IBD, not available in English, did not target diet or lifestyle therapy, were not available in the US and Canada, or did not offer stand-alone self-management programs. The Mobile App Rating Scale was used to assess mobile app quality. A total of 1,512 apps were identified through the app stores. Six apps met inclusion criteria. My IBD Care: Crohn's and Colitis received the highest quality rating and LyfeMD received the highest overall app rating. Only these two apps provided behaviour tracking over time, and three (50 percent) apps provided good-quality information. While many IBD-related apps exist, few support self-management of diet and lifestyle behaviours. The My IBD Care and LyfeMD apps had the highest ratings and can be used to track lifestyle behaviours. The effectiveness of these apps to improve behaviours, and subsequently impact the disease course and quality of life, should be explored in future studies.

Excessively Increased Skeletal Muscle Mass of the Bilateral Lower Limbs is Associated with Hyperuricemia in Females with Polycystic Ovarian Syndrome.

This study is aimed at evaluating the correlation between the skeletal muscle mass index (SMI) of different body parts and hyperuricemia in females with polycystic ovary syndrome (PCOS), thus, providing scientific guidance on lifestyle self-management for patients with PCOS. The cross-sectional study included 171 patients with PCOS, which were divided into two distinct sub-groups based on the presence or absence of hyperuricemia. Anthropometric and serological characteristics of the population with PCOS focusing on skeletal muscle mass were conducted. PCOS patients with hyperuricemia had significantly greater SMI in different body parts. Further binary logistic regression analysis revealed that SMI of the bilateral lower limbs was positively associated with hyperuricemia with an adjusted odds ratio (95% confidence interval) of 1.235 (1.103 - 1.384), p < 0.001. The optimal cut-off value of SMI of the bilateral lower limbs in predicting hyperuricemia was 5.11 (Youden index = 0.490). Combined with the mean value of SMI in the bilateral upper limbs, the safe range of SMI of the bilateral lower limbs in patients with PCOS was calculated as 3.64 - 5.11, with the sensitivity and negative predictive values being 83.9% and 65.1%, respectively. Excessively increased SMI of the bilateral lower limbs was correlated with hyperuricemia in patients with PCOS.

The Feasibility of a Web-Based Educational Lifestyle Program for People With Multiple Sclerosis: A Randomized Controlled Trial.

BackgroundModifiable lifestyle factors are important to aid people with multiple sclerosis in the self-management of their disease. Current self-management programs are limited by their face-to-face mode of delivery but there is immense potential with the internet to deliver these programs effectively.ObjectiveThe aims of this study are to assess the feasibility of a digitalized educational lifestyle self-management program for people with MS.MethodsIn this randomized controlled trial, people with MS were randomly allocated to participate in a 6-week tailored web-based educational lifestyle program or 6-week generic standard-care educational course, and were blinded to their allocation. Participants were recruited through multiple sclerosis (MS) Societies in four countries: Australia, New Zealand, Canada, and the United States. The primary outcome was to assess acceptability of the program defined as percentage completion of all modules at 6-weeks post-course commencement. Secondary outcomes included evaluating participant responses to the follow-up survey across three domains: accessibility, learnability, and desirability.ResultsThirty-five participants from Australia, Canada, New Zealand, and the US completed the baseline survey and were randomized. Four participants were deemed ineligible due to incomplete baseline data; therefore, nine out of 15 and eight out of 16 participants completed 100% of the course in the intervention and standard-care arm courses, respectively.ConclusionsThis study found that this web-based educational lifestyle program is a feasible means of delivering educational content to people with MS via the internet according to our a priori targets of >40% of participants in the intervention arm, and >25% in the control arm to completing 100% of the course. It is therefore appropriate to evaluate this intervention further in a large, randomized controlled trial.Trial registrationThis study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ID: ACTRN12621000245897).

Trends in risk factors and management strategies used by people with type 2 diabetes in New South Wales, Australia

Adopting healthy lifestyle behaviours is an important component of Type 2 diabetes (T2D) self-management, which can lower risks of further health complications. Monitoring lifestyle risk factors including overweight or obesity, healthy diet and physical activity behaviours, alcohol consumption, smoking and psychological distress remain important. This study examined prevalence trends in these factors and adoption of three diabetes lifestyle self-management strategies in adults (aged 40+) with T2D in New South Wales (NSW), Australia. Analyses were conducted on NSW Adult Population Health Survey data, 2004–2019 (n = 142,168), using predicted probabilities from generalised linear models, weighted to population estimates. Throughout the study period overweight or obesity prevalence remained higher amongst those with T2D (83.1% to 81.7%) compared to those without diabetes (61.0 to 61.2%); only 8.9% of those with T2D were trying to lose weight. During the study period, there were declines in the proportions of those with T2D reporting sufficient fruit consumption [63.9% to 50.1%], moderate vegetable consumption (3 serves) [49.0% to 37.7%], and achieving sufficient physical activity [40.0% to 34.0%]. There were also declines in those reporting they manage their diabetes through following a special diet [73.6% to 55.9%] and exercising most days [33.5% to 22.2%]. This study highlights potential gaps in T2D secondary prevention and suggests more targeted diabetes education services are needed to address lifestyle risks. Increased understanding of why fewer people with T2D adopt these lifestyle management strategies is needed to inform policy and practice.

Incorporating African American Veterans' Success Stories for Hypertension Management: Developing a Behavioral Support Texting Protocol.

BackgroundPeer narratives engage listeners through personally relevant content and have been shown to promote lifestyle change and effective self-management among patients with hypertension. Incorporating key quotations from these stories into follow-up text messages is a novel way to continue the conversation, providing reinforcement of health behaviors in the patients’ daily lives.ObjectiveIn our previous work, we developed and tested videos in which African American Veterans shared stories of challenges and success strategies related to hypertension self-management. This study aims to describe our process for developing a text-messaging protocol intended for use after viewing videos that incorporate the voices of these Veterans.MethodsWe used a multistep process, transforming video-recorded story excerpts from 5 Veterans into 160-character texts. We then integrated these into comprehensive 6-month texting protocols. We began with an iterative review of story transcripts to identify vernacular features and key self-management concepts emphasized by each storyteller. We worked with 2 Veteran consultants who guided our narrative text message development in substantive ways, as we sought to craft culturally sensitive content for texts. Informed by Veteran input on timing and integration, supplementary educational and 2-way interactive assessment text messages were also developed.ResultsWithin the Veterans Affairs texting system Annie, we programmed five 6-month text-messaging protocols that included cycles of 3 text message types: narrative messages, nonnarrative educational messages, and 2-way interactive messages assessing self-efficacy and behavior related to hypertension self-management. Each protocol corresponds to a single Veteran storyteller, allowing Veterans to choose the story that most resonates with their own life experiences.ConclusionsWe crafted a culturally sensitive text-messaging protocol using narrative content referenced in Veteran stories to support effective hypertension self-management. Integrating narrative content into a mobile health texting intervention provides a low-cost way to support longitudinal behavior change. A randomized trial is underway to test its impact on the lifestyle changes and blood pressure of African American Veterans.Trial RegistrationClinicalTrials.gov NCT03970590; https://clinicaltrials.gov/ct2/show/NCT03970590International Registered Report Identifier (IRRID)DERR1-10.2196/29423

Outcomes of a Mindfulness-Based Healthy Lifestyle Intervention for Adolescents and Young Adults with Polycystic Ovary Syndrome

The purpose of this study was to examine the feasibility, acceptability, and preliminary efficacy of a mindfulness-based healthy lifestyle self-management intervention with adolescents and young adults diagnosed with polycystic ovary syndrome (PCOS). A pilot randomized controlled trial using a pre-post design was used. Central Texas. Individuals aged 14-23 with a diagnosis of PCOS. The PCOS Kind Mind Program integrates a manualized mindfulness training program (Taming the Adolescent Mind) with health education in 4 key areas of self-management and health promotion: (1) medication adherence, (2) nutrition, (3) physical activity, and (4) sleep. Psychological distress, mindfulness, physical activity strategies, nutrition, and exercise self-efficacy. Linear regression models revealed that those in the PCOS Kind Mind condition reported significantly higher nutrition self-efficacy (β=6.50, 95% CI, 1.71-11.28, P=0.013, d=0.48), physical activity strategies (β=0.41, 95% CI, 0.04-0.79, P=0.040, d=0.67), and physical activity self-efficacy (β=0.48, 95% CI, 0.07-0.88, P=0.028, d=0.46). The PCOS Kind Mind Program improved self-efficacy in the key areas of nutrition and physical activity and increased physical activity strategies in adolescents and young people with PCOS. These findings are encouraging and suggest the need for larger-scale, randomized controlled trials with longer-term follow-up to more robustly evaluate the effects of the PCOS Kind Mind Program on the psychological and physiological health of adolescents and young people with PCOS.

Addressing Diabetes Distress in Self-Management Programs: Results of a Randomized Feasibility Study.

BackgroundWest Virginia ranks 1st nationally in the prevalence of hypertension (HTN; 43.8%) and diabetes (16.2%). Patients with type 2 diabetes mellitus (T2DM) are distressed over physical and psychological burden of disease self-management.MethodsThis study investigated the effectiveness of an intervention to reduce diabetes distress and outcomes [glycemic control, blood pressure (BP)] among T2DM adults with comorbid HTN. Participants were randomized to a 12-week diabetes and hypertension self-management program versus a 3-month wait-listed control group. Trained health coaches and experts implemented the lifestyle program in a faith-based setting using an adapted evidence-based curriculum. Twenty adults with T2DM and HTN (n=10 per group) completed baseline and 12-week assessments. Diabetes distress was measured by using a validated Diabetes Distress Survey (17-item Likert scale; four sub-scales of emotional burden, physician related burden, regimen related burden, and interpersonal distress). Baseline and post-intervention changes in diabetes distress were compared for both groups; reduction in distress in the intervention groups are depicted using waterfall plots. The mean age, HbA1c and BMI were 55 ± 9.6 years, 7.8 ± 2.24 and 36.4 ± 8.8, respectively. Diabetes distress (total; mean) was 1.84±0.71.ResultsParticipants reported higher diabetes distress related to emotional burden (2.1±0.94) and regimen-related distress (2.0 ± 0.74); physician-related distress was the lowest (1.18±0.64). In general, diabetes distress reduced among intervention participants and was especially significant among those with HbA1c ≤ 8% (r=0.28, p=0.4), and systolic/diastolic BP ≤140/80 mm Hg (r=0.045, P=0.18).ImplicationsFindings suggest that lifestyle self-management programs have the potential to reduce diabetes distress.

PCLiON: An Ontology for Data Standardization and Sharing of Prostate Cancer Associated Lifestyles

BackgroundResearches on Lifestyle medicine (LM) have emerged in recent years to garner wide attention. Prostate cancer (PCa) could be prevented and treated by positive lifestyles, but the association between lifestyles and PCa is always personalized. ObjectivesIn order to solve the heterogeneity and diversity of different data types related to PCa, establish a standardized lifestyle ontology, promote the exchange and sharing of disease lifestyle knowledge, and support text mining and knowledge discovery. MethodsThe overall construction of PCLiON was created in accordance with the principles and methodology of ontology construction. Following the principles of evidence-based medicine, we screened and integrated the lifestyles and their related attributes. Protégé was used to construct and validate the semantic framework. All annotations in PCLiON were based on SNOMED CT, NCI Thesaurus, the Cochrane Library and FooDB, etc. HTML5 and ASP.NET was used to develop the independent Web page platform and corresponding intelligent terminal application. The PCLiON also uploaded to the National Center for Biomedical Ontology BioPortal. ResultsPCLiON integrates 397 lifestyles and lifestyle-related factors associated with PCa, and is the first of its kind for a specific disease. It contains 320 attribute annotations and 11 object attributes. The logical relationship and completeness meet the ontology requirements. Qualitative analysis was carried out for 329 terms in PCLiON, including factors which are protective, risk or associated but functional unclear, etc. PCLiON is publicly available both at http://pcaontology.net/PCaLifeStyleDefault.aspx and https://bioportal.bioontology.org/ontologies/PCALION. ConclusionsThrough the bilingual online platforms, complex lifestyle research data can be transformed into standardized, reliable and responsive knowledge, which can promote the shared-decision making (SDM) on lifestyle intervention and assist patients in lifestyle self-management toward the goal of PCa targeted prevention.

Beneficial self-management support and user involvement in Healthy Life Centres-A qualitative interview study in persons afflicted by overweight or obesity.

BackgroundRelapse is high in lifestyle interventions involving behavioural change and weight loss maintenance. The purpose of lifestyle self‐management interventions offered at Healthy Life Centres (HLCs) is to empower the participants, leading to self‐management and improved health. Exploring beneficial self‐management support and user involvement in HLCs is critical for quality, improving effectiveness and guiding approaches to lifestyle change support in overweight and obesity.ObjectiveThe aim of this study was to explore how persons afflicted by overweight or obesity attending lifestyle interventions in Norwegian HLCs experience beneficial self‐management support and user involvement.MethodSemi‐structured in‐depth interviews were conducted with 13 service users (5 men and 8 women). Data were analysed using qualitative content analysis.ResultsOne main theme was identified: regaining self‐esteem and dignity through active involvement and long‐term self‐worth support in partnership with others. This main theme comprised four themes: (a) self‐efficacy through active involvement and better perceived health, (b) valued through health‐care professionals (HPs) acknowledgement, equality and individualized support, (c) increased motivation and self‐belief through fellowship and peer support; and (d) maintenance of lifestyle change through accessibility and long‐term support.ConclusionService users’ active involvement, acknowledgement and long‐term self‐worth support from HPs and peers seem to support self‐management and user involvement and may be some of the successful ingredients to lifestyle change. However, prolonged follow‐up support is needed. A collectivistic and long‐term perspective can integrate the importance of significant others and shared responsibility.

An exploratory study of adolescents and emerging adults with spina bifida knowledge of their individual education program: Implications for health care transition planning.

The purpose of this study was to explore adolescents and emerging adults (AEA) with spina bifida (SB) understanding of their Individualized Education Program (IEP) and to identify factors related to their knowledge about their own IEP. Data were collected from January 2015 to July 2016 from 79 adolescents with SB. A ten-item questionnaire including demographics and questions specifically addressing IEPs was used. Qualitative analysis followed an iterative, emergent approach. Two experienced coders independently read and coded each of the three open-ended questions. It was determined that the responses of all three questions could feasibly be merged as the analysis of responses were similar. This was a predominately 70 (88.7%) Hispanic sample of AEA with SB who ranged in age from 12 to 20years (M= 15.3years) consisting of 41males and 38females. All reported they have/had an IEP. Four major themes and eleven subthemes emerged from the analysis. Major themes were: The Barometer of How I Am Doing, Creating the Right Match for Learning, Obtaining the Assistance I Need, and Future Goals and Planning. Findings of this study reveal the IEP knowledge gaps and lack of lifestyle self-management skills AEA with SB reported pertaining to IEPs.

The impact of brief lifestyle self-management education for the control of seizures.

this study examined a brief lifestyle self-management intervention, based on self-determination theory, to manage seizure frequency, and its effects on health-related quality of life and resilience in people with epilepsy aged over 18 years. most people with epilepsy can identify factors that may trigger seizures and may try to avoid these; however, education from clinicians on this varies. a cohort study with control design. sixty participants were purposively sampled and allocated to an intervention or a control group. moderate correlations were found, particularly between: resilience and satisfaction with life; medication adherence and psychological quality of life; and psychological quality of life and satisfaction with life. The mean seizure occurrences between the control and intervention groups were 12.71 (SD 24.55) and 6.76 (SD 13.40) respectively after the intervention. While the study was not powered to assess this, the intervention may be most effective regarding medication adherence and physical health quality of life. the relationship between self-efficacy and seizure management appeared to be strengthened by the programme. This study is the first known to measure resilience in relation to lifestyle self-management for seizure control in people with epilepsy. Relevance to practice: nurses are well placed to work with patients' strengths towards self-efficacy and potentially resilient coping.

P5437Lifestyle self-management experiences of south asians post myocardial infarction

Background: Coronary heart disease is the biggest killer in this country. South Asians carry the burden of increased incidence and prevalence and have poorer outcomes after a MI than the general UK population. Reviews have shown lifestyle modification including physical activity, healthy diet and smoking cessation, alters the course of heart disease and reduces recurrences crystallising its significance as a cost-effective public health strategy to reduce the rising burden of this disease. There are lacunae of knowledge as to what constitutes to guarantee a therapeutic lifestyle modification for better health outcomes in the South Asian community. Aim: To explore the self-management experience of South Asians after a heart attack. Method: Pioneering of its kind, this study used a grounded theory approach to elucidate how South Asians navigate these lifestyle changes. Two phase interviews at 2 weeks and 8 weeks of discharge, were conducted with 14 participants who were newly diagnosed with heart attack- from 2015 to July 2016. Results: Theoretical categories were developed through constant comparison and theoretical sampling – these were patronage of the family, affinity towards one’s group and conforming to the religious and health (causal) beliefs. Discussion: By providing a unique insight that choosing and prioritising lifestyle style changes is not an individual act, but a shared act, a case for ‘shared efficacy’ is made. The concept of ‘shared efficacy’ as an essential strategy to enhance an individual’s ability to make meaningful choice, is showcased. The novel presentation of making and maintaining lifestyle choices as a conflict resolution strategy with the aim of ‘maintaining harmony’ among South Asians calls for a ‘harmony model’ to deal with diagnosis of heart attack and subsequent lifestyle changes. This proposed harmony model homes in on a family centred approach, where there is an awareness of the family’s needs, an appreciation of the cardiac patient’s religious and causal beliefs as well as an acknowledgement of their cultural priorities, in self-management programmes. Conclusion: Migrant South Asians across the globe have an increased propensity to this disease. The findings contribute to the development of supporting negotiating strategies by capturing concepts that crystallise the significance of lifestyle self-management. To alleviate the burden, there is a need for ethno-sensitivity rather than an ethnocentricity in the delivery of services. This calls for a move from cultural competence to cultural intelligence.

A Group Lifestyle Intervention Program Is Associated with Reduced Emergency Department Presentations for People with Metabolic Syndrome: A Retrospective Case-Control Study.

One quarter of the world's adults have metabolic syndrome. Lifestyle modification is the first line of intervention as improvements in diet and exercise can have positive effects on the individual components of metabolic syndrome. The primary aim of this research was to evaluate the effect of an 8-week lifestyle intervention program for people with metabolic syndrome on emergency department presentations, hospital admissions, and metabolic parameters. A retrospective case-control study of adults (n = 58, mean age 60 ± 7 years) with metabolic syndrome referred to a group lifestyle self-management intervention program between 2013 and 2015. The intervention program consisted of 8 weekly sessions of group exercise and education delivered in a community healthcare setting. The intervention group (n = 29) was compared with a group of people who declined to attend the program (n = 29). Data were collected from the time a participant was referred to the program, and all participants were followed for a minimum of 100 days. Participants who attended the lifestyle intervention program had significantly fewer emergency department presentations [risk ratio (RR) 0.31, 95% confidence interval (CI) 0.11 to 0.83] and potentially avoidable emergency department presentations (RR 0.06, 95% CI 0.004 to 0.097) over the follow-up period (mean 495 ± 224 days per participant). There were no differences between the groups in hospital admissions and there were insufficient data to determine changes in metabolic parameters. Lifestyle group participants increased their exercise capacity [6-min walk test mean difference (MD) 41 m, 95% CI 20 to 62, P < 0.001] and had a mild decrease in weight (MD -0.8 kg, 95% CI -1.5 to -0.2, P = 0.018) and waist circumference (MD -1.3 cm, 95% CI -2.1 to -0.6, P = 0.002) after 8 weeks. Implementation of a group lifestyle intervention program to improve activity and self-management skills may assist in decreasing emergency department presentations.

Efficacy of a type 2 diabetes self-management model with family doctor team support in southern China: a randomised controlled trial

BackgroundChina has the highest number of people with diabetes in the world, with a diabetes prevalence of 11·6% and prediabetes prevalence of 50·1%. In China, diabetes self-management support is poorly implemented, with low adherence to self-care recommendations. Effective strategies to assist patients in managing diabetes are therefore urgently needed. The purpose of this study was to investigate the efficacy of a novel self-management model plus family doctor team support for patients with type 2 diabetes. MethodsThis randomised controlled trial was done in Longfeng Street Community Health Service Center (LSCHSC) in Guangdong province, southern China. Patients with type 2 diabetes with no hepatic or renal dysfunction, mental illness, or language disorders were eligible. Patients were randomly selected (using computer-generated randomisation numbers) from the diabetic archives in LSCHSC, and assigned (1:1) to either the intervention or control group, also using a computer-generated randomisation list. Participants, investigators, and those assessing outcomes were not masked to group assignment. Each patient in the intervention group signed a contract with the family doctor team of LSCHSC. Standard operating procedures for follow-up management were developed for patients in the intervention group, and an individual medical record system was established to monitor lifestyle interventions. Additionally, patients' family doctor teams provided training on healthy lifestyle self-management for the patients and their family members (eg, lectures and consultations, in-person interviews, diabetic clubs, and diabetes outreach activities), which is ongoing. Patients in the control group were provided with regular health education. The primary endpoint was laboratory measures and fundus disorders at 18 months after initiation of the intervention, analysed in the per-protocol population. The study was approved by the ethics committee of LSCHSC, and informed consent was obtained from each participant. FindingsBetween March 1, 2015, and May 31, 2015, 600 adults with type 2 diabetes were enrolled (300 to the intervention group and 300 to the control group). Baseline demographic, clinical characteristics, and laboratory measures were similar between groups. After 18 months of follow-up, 263 participants in the intervention group and 278 in the control group remained in the study and were analysed. Concentrations of several laboratory measures were significantly lower in intervention group than the control group (triglyceride, p=0·0082; total cholesterol, p=0·001; low-density lipoprotein, p=0·002; urinary creatinine, p=0·001; fasting blood glucose, p<0·0001; and post-prandial blood glucose, p=0·008), whereas high-density lipoprotein concentrations were significantly higher in the intervention group (p=0·019). No significant differences in HbA1c (p=0·10), urinary albumin (p=0·30), and the ratio of urinary albumin to urinary creatinine (p=0·24) were noted between the two groups. The proportion of patients with diabetic retinopathy (stage R0) did not significantly differ between the two groups (37 [11%] of 346 eyes in the intervention group vs 50 [12%] of 432 eyes in the control group; p=0·75). InterpretationType 2 diabetes self-management with support from a family doctor team in a community health service centre might be an effective strategy to control disease progression and improve patients' quality of life. Benefits to ocular complication of diabetes need further investigation. FundingNational Nature Science Foundation of China (81570843) and National Natural Science Foundation of China for Young Scholar (81600707).

Effects of a tailored lifestyle self-management intervention (TALENT) study on weight reduction: a randomized controlled trial

ObjectiveOverweight and obesity are globally increasing risk factors for diseases in the context of metabolic syndrome. A randomized controlled trial was conducted to investigate whether there are any existing differences between two lifestyle intervention strategies with respect to weight reduction after 1 year.Subjects and methodsA total of 166 subjects with a body mass index of 28–35 kg/m2 were enrolled in this trial at seven study centers; 109 were randomly allocated to the intervention group (comprehensive lifestyle modification program: web-based Individual Health Management [IHM]) with 3-month reduction phase plus 9-month maintenance phase, and 57 were allocated to the control group (written information with advice for healthy food habits: usual care [UC]). Body weight, waist circumference, blood pressure, laboratory findings, and bioimpedance analysis used to determine body composition were measured at baseline and after 3, 6, 9, and 12 months. The primary outcome parameter was body weight at month 12 compared to baseline.ResultsWith respect to baseline status there were no statistically significant differences between the groups. Based on the intent-to-treat population, body weight showed a mean decrease of 8.7 kg (SD 6.1) in the intervention group (IHM) and 4.2 kg (SD 5) in the control group (UC) at month 12. This statistically significant difference (P<0.001) was confirmed by various sensitivity analyses. Body mass index, waist circumference, high-density lipid cholesterol, body fat, and the ratio of fat and body cell mass improved to a significantly higher degree in the IHM group.ConclusionIHM proved to be superior to UC in weight reduction after 1 year. With a mean loss of about 10% of the baseline weight, a clinically high relevant risk reduction for cardio-metabolic diseases is achievable.

Effect of Health-related Lifestyle Self-management Program on Quality of Life of Patients with Ischaemic Heart Disease: A Quasi-experimental Study

Effect of Health-related Lifestyle Self-management Program on Quality of Life of Patients with Ischaemic Heart Disease: A Quasi-experimental Study

Acceptability of a team-based mobile health (mHealth) application for lifestyle self-management in individuals with chronic illnesses.

With increased incidence of chronic illnesses arising due to unhealthy lifestyle habits, it is increasingly important to leverage technology applications to promote and sustain health behavior change. We developed a smartphone-based application, NutriWalking (NW), which recommends personalized daily exercise goals and promotes healthy nutritional habits in small peer teams. Here, we demonstrate an early study of usability and acceptability of this app in patients with type 2 Diabetes Mellitus and Depression. Our goal was to evaluate the potential of NW as a self-management support tool. Findings point to design considerations for team-based self-management tools delivered via mHealth platforms.

A cloud-based type-2 diabetes mellitus lifestyle self-management system

In this paper, we designed a patient-centric cloud-based diabetes lifestyle management system. It is composed of three layers, namely sensing, communication and user interface. The goal of this cloud-based diabetes lifestyle management system is to provide type-2 diabetes mellitus patients useful information to remind user's blood sugar level. The function of the sensor networks in this framework is to collect the data from human body and human activity as well as environmental information that may have effects on the healthy statement of the diabetes patients. The communication and central server part will handle the data exchange and data analysis that help to generate a final decision data and sent to user interface to remind the user of valuable information. Different from traditional m-health system, the presented approach provides a rule algorithm which enables the rescue decision in the cloud server and transmits through the communication level, and finally provides an integrated user interface for diabetes users. An early warning user interface for diabetes patients has been designed and presented in this paper. The evaluation results show that diabetes has higher occurrence of people in elder groups who have smoking habitant, and less social activities.

The talent study: a multicentre randomized controlled trial assessing the impact of a 'tailored lifestyle self-management intervention' (talent) on weight reduction.

BackgroundOverweight is considered an important risk factor for diseases in the context of metabolic syndrome. Lifestyle modifications are the means of choice to reduce weight in persons with a Body Mass Index of 28 to 35. The study examines whether there are any differences between two intervention strategies regarding weight reduction in overweight persons.Methods/DesignThe study is a multicentre randomized controlled trial with observation duration of 12 months. Eight study centres are involved to include a minimal sample size of 150 participants. Randomization ratio is 2:1. Feasible persons are checked according to inclusion and exclusion criteria and after given informed consent are assigned randomly to one of two intervention programs: A) intervention group: comprehensive lifestyle modification program (Individual Health Management IHM) with 3 months reduction phase plus 9 months maintaining phase, B) control group: written information with advice for healthy food habits (Usual care UC). Participants of the IHM group have access to a web-based health portal and join 3 full-day and 10 two-hour training sessions during the first 3 months. During the remaining 9 months four refresh trainings will be performed. There are 3 different diet strategies (fasting, two-day diet, meal replacement) for free choice. Participants of the control group are provided with acknowledged rules for healthy food according to the German Nutrition Society (DGE). Examinations are conducted at baseline, after 3, 6, 9 and 12 months. They include body weight, waist circumference, blood pressure, laboratory findings and a bio-impedance analysis to measure body composition. Statistical analysis of the primary outcome ‘change of body weight after 12 months’ is based on ITT population including analysis of variance of the weight differences between month 0 and 12 with the factors ‘group’, ‘baseline value’ and ‘study centre’. Secondary outcomes will be analyzed exploratively.DiscussionThe monitoring of the study will implement different measures to enhance compliance, avoid attrition and ensure data quality. Based on a blended learning concept and using web-based e-health tools the program promises to achieve sustainable effects in weight reduction.Trial registrationGerman Clinical Trials Register Freiburg (DRKS): DRKS00006736 (date registered 20/09/2014).Electronic supplementary materialThe online version of this article (doi:10.1186/s40608-015-0069-x) contains supplementary material, which is available to authorized users.

Abstract NS6: Family History of Stroke: Invisibility of a Key Stroke Risk Factor among High Risk African Americans

Background &amp; Purpose: Young to middle aged African Americans (AA) are at greater risk for a first-ever stroke, severe neurologic disability, and stroke-related mortality, than Caucasians of similar age; however, it remains unclear what role a family history of stroke (FHS) plays in promoting adoption of healthier lifestyles in this cohort. The purpose of this study was to explore differences between rural Stroke Belt AA with a FHS (e.g. parent/grandparent/sibling) on modifiable stroke risk factors, knowledge, perceived threat and perceived control of stroke, and exercise behaviors to AA without a FHS. Methods: A cross-sectional study was conducted recruiting AA aged 19-54 from the Black Belt region of Alabama via a mobile health clinic. Participants’ perceptions, knowledge, exercise history/intent, physiologic data, and health history were recorded. Results: Participants (N=66) averaged 43.3+9.4 years, were 71% female, with at least 12 years of school (89%), and unemployed (62%). Common risk factors were insufficient exercise (76%), obesity (59%), hypertension (53%; blood pressure M=145+17.6/88.3+12.9), and cigarette smoking (38%). Participants with a FHS (n=33) did not differ on average number of risk factors compared to those without a FHS (FHS 2.8+1.4 vs. 2.2+1.5; t(64)= 1.73, p=.089), nor did they differ on physiologic data. However, participants with a FHS were more likely to report a history of hypertension (67%) compared to those without a FHS (33%; χ2 =4.93, p &lt;.05). There were no significant differences between groups for knowledge of stroke risk factors, perceived threat and perceived control of stroke, or recent exercise performance, although participants with a FHS (3.4+1.2) had significantly lower future intentions to exercise compared to those without a FHS (3.9+0.8); t(64)=2.45, p&lt;.05). Conclusions: Although FHS is a significant non-modifiable risk factor for stroke and was common in this young to middle-aged AA cohort, FHS did not drive perceived stroke risk, risk factor control, or current/future intentions to exercise. Identification of interventions designed to personalize FHS as a key stroke risk factor, while promoting lifestyle change and self-management, may play an important role in future primary stroke prevention.