Multicomponent Program Research Articles

Validity of the two-minute step test for healthy older adults

BackgroundIn healthy older adults, the two-minute step test (2MST) does not have its concurrent validity tested against the six-minute walk test (6MWT), which is a valid cardiorespiratory fitness test frequently applied in geriatric samples. ObjectiveTo derive an equation to predict 6MWT from 2MST and to observe the agreement between observed and estimated 6MWT distances. Methods6MWT and 2MST were measured in 51 older adults (72.9±4.6 years) from community multicomponent exercise programs. Multiple linear regression derives the predictive equation of 6MWT walked distance (dependent outcome) from steps obtained in 2MST, age, sex, and body mass index (independent outcomes). ResultsCorrelation between 6MWT and 2MST was strong (r=0.696, p<0.001). The regression equation showed good agreement with measured values, when 6MWT was below 600 m. ConclusionThe equation stands as a novel approach to obtaining a valid 6MWT estimation from the 2MST. 2MST is easier and faster, representing an alternative approach when time and space are limited.

‘The fact that I know I can do it is quite a motivator now’: a qualitative study exploring experiences maintaining weight loss 6 months after completing a weight loss programme for knee osteoarthritis

ObjectiveTo explore experiences maintaining weight loss 6 months after completing a multicomponent weight loss programme for knee osteoarthritis.DesignQualitative study based on an interpretivist paradigm and a phenomenological approach that was...

Influence of multicomponent exercise program or self-selected physical activity on physical, mental, and biochemical health indicators of older women

The aim of this study was to compare physical, mental, and biochemical health indicators of 48 older women (67 ± 1 year) who practiced multicomponent exercise program (ME, n = 25) and self-selected physical activity (PA, n = 23) for 6 months. It was an observational study, which aimed to relate a prospective intervention. Displacement speed, lower limb (LL) power, functional capacity, body composition, biochemical profile, physical activity levels (PAL), sedentary behavior (SB), quality of life (QoL), and mental illness risk (MIR) were evaluated. ME presented better values compared to the PA in the gait speed (p = 0.001, large ES), aerobic capacity (p = 0.0001, large ES), agility/dynamic balance (p = 0.0001, large ES), LL flexibility (p = 0.0003, large ES), UL flexibility (p = 0.04, large ES), upper limb (UL) strength (p = 0.07, moderate ES), Total cholesterol (p = 0.009, large ES), triglycerides (p = 0.003, large ES), creatinine (p = 0.007, large ES), glycated hemoglobin (p= 0.007, large ES), and lower mean glucose value (p = 0.008, large ES). ME was more efficient than PA to improve indicators of gait speed, and functional capacity, regulate glycated hemoglobin, blood glucose, and serum creatinine. Thys study also brings practical applications for coaches, which could adapt and use creativity to develop different types of systematized ME, aiming to enhance positive adaptations in the older people at multilevel outcomes.

Effects of a Multi-component, Resistance-Based Exercise Program Combined with Additional Lean Red Meat on Health-Related Quality of Life in Older Adults: Secondary Analysis of a 6-Month Randomized Controlled Trial

ObjectivesTo assess whether consumption of lean red meat on three exercise training days per week can promote greater improvements than exercise alone in health-related quality of life (HR-QoL) in community-dwelling older adults.DesignThis study is a secondary analysis from a 6 month, two-arm, parallel randomized controlled trial conducted in 2014 and 2015.SettingCommunity-dwelling older adults living in metropolitan Melbourne, Australia.ParticipantsOne hundred and fifty-four men and women aged ≥65 years.InterventionAll participants were enrolled in a multi-component, resistance-based exercise program (3 d/week) and randomly allocated to either a group asked to consume lean red meat (2x80g cooked servings/day) on each of the three training days (Ex+Meat, n=77) or a control group asked to consume one serving of carbohydrates (1/2 cup rice/pasta or 1 medium potato; Ex+C, n=77).MeasurementsHR-QoL was assessed using the Short-Form (SF)-36 health survey.ResultsOverall 62% of the participants were female, the mean age was 70.7 years (range 65 to 84 years), approximately 67% of participants were classified as either overweight or obese, and the average number of chronic conditions was two. A total of 145 participants (94%) completed the study. Mean baseline HR-QoL scores were comparable to the mean for the Australian population [Global HR-QoL (mean ± SD): Ex+Meat, 49.99 ± 6.57; Ex+C, 50.49 ± 5.27]. General Linear Mixed Models examining within and between group changes over time revealed that after 6 months, there were no within-group changes in either Ex+Meat or Ex+C nor any between-group differences for any measure of HR-QoL, with the exception that the mental health subscale improved in Ex+C versus Ex+Meat [net difference for change, −2.32 (95% CI), −4.73, 0.09, P=0.048] after adjusting for relevant covariates and the physical function subscale improved in Ex+Meat relative to baseline [mean change (95% CI), 1.88 (0.37, 3.39), P=0.011].ConclusionA multi-component resistance-based training program performed with and without the provision of lean red meat in line with current Australian dietary guidelines on each of the three training days, did not improve HR-QoL in healthy community-dwelling older adults.

Older People Trip, Some Fall—A Program to Decrease Seniors' Fall Risk

ABSTRACT Falls resulting from trips are a leading cause of injury and can sometimes result in death, especially in the older population. Numerous researchers have studied the biomechanical mechanisms that differentiate fallers from nonfallers and determined whether training can beneficially impact those outcomes. Exercise and task-specific interventions have demonstrated fewer falls after trips but can be costly and often require specialized equipment, making their applicability less practical. Qualified health and fitness practitioners can develop evidence-informed, exercise-based programs focusing on 3 components (balance training, task-specific training, and resistance exercise). Such programs may help to reduce fall risk in older adults based on previously documented studies identifying the biomechanical demands of a successful fall arrest after a trip perturbation. These multicomponent programs should include a safe task-specific training element that does not require specialized equipment.

A Scoping Review on Resources, Tools, and Programs to Support Women's Leadership in Global Health: What Is Available, What Works, and How Do We Know?

The unequal representation of women in global health leadership is a prevalent issue laterally across global health fields and vertically down experience levels. Although women compose much of the workforce, gender-based barriers prevent female talent from filling their appropriate leadership roles, which funnels unique expertise and problem-solving skills on a diversity of health topics out of positions of leadership. Currently, many calls to action have been proposed to raise awareness of the lack of women's global health leadership, with Women in Global Health as one of the more prominent movements. This paper evaluates how the priorities and strategies for leadership training and development set forth by such movements have changed the landscape of available programs and resources for women in global health, based on availability, success, and evaluation. This manuscript maps existing programs and resources that support women's leadership in global health and describes available evaluations and documented outcomes. We used a dual approach of a peer-reviewed and gray literature search to build a comprehensive list of existing programs and resources designed to support women's leadership in global health. Out of 54 items included for full-text review and 22 gray literature items screened for inclusion, a total of 31 resources were processed in the final extraction. We used descriptive quantitative analysis for categorical and binary variables, while qualitative data from evaluations were analyzed for outcomes. Resources were in the form of conferences, supplemental resources to conferences, certificate programs, coursework, stand-alone documents, single-focus programs, and mostly multicomponent programs. Most resources did not have a global health focus area, and a third of the total resources identified women first authors from predominantly high-income countries. About half of the resources mention mentorship and networking as activities incorporated as part of the resource. Over half of the resources did not have a target audience, and most resources were free to users.While there is a lack of consistent and meaningful evaluation of the resources, the available captured metrics of success were described as the number of career-advancing opportunities after using the resources. Examples of opportunities include enrollment in graduate school, receiving academic promotions, participating in internships, presenting at conferences, and publications. While the supply of existing programming and resources to advance women's leadership in the global health field is limited in terms of quantity, it is rich in diverse formats, content, and implementation. This scoping review supports the notion that empowered female leadership in global health requires a complementary support system that encourages the unique needs and talents of female leaders. Such a support system needs inclusive targeting regardless of experience level, academic degree, or location. Furthermore, evaluations of resources will be critical in maintaining meaningful interventions that effectively dismantle the infrastructures that continue to limit the success of women leaders in global health.

Expanding access to treatment for stimulant use disorder in a frontier state: A qualitative study of contingency management and TRUST program implementation in Montana

BackgroundThe client population eligible for treatment services supported by State Opioid Response (SOR) grant funding, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), was expanded to include individuals with a stimulant use disorder (stimUD) in 2020. Due to a significant need to improve services for individuals with stimUD in Montana, the Behavioral Health and Developmental Disabilities Division (BHDD) of the Montana Department of Public Health and Human Services used the grant opportunity to work with experts in the field of stimUD to pilot contingency management (CM) and the Treatment for Individuals who Use Stimulants (TRUST) treatment model. The CM protocol included twice weekly visits for twelve weeks, using an escalating schedule of gift card incentives contingent upon stimulant-negative urine samples. TRUST is a multi-component treatment program, incorporating exercise, group therapy, and individual therapy with content guided by cognitive behavioral therapy (CBT) and clinical research associate (CRA) materials. In addition to SOR dollars, BHDD used additional funding for CM reinforcers provided by state tax dollars to meet research-supported target incentive totals. MethodsIn this pilot project, TRUST/CM was implemented by four state-approved treatment providers and three Federally Qualified Health Centers (FQHCs), all of which had little prior experience with CM as a component of their treatment programs for stimUD. This article examines the processes of training staff, the experiences among staff with initial implementation of the treatment model, and the client characteristics of initial pilot treatment cohorts. Data for this study include primary qualitative data collected from providers, as well as client characteristics collected on the SAMHSA Government Performance and Results Act (GPRA) data collection form. ResultsSeven sites were trained in TRUST/CM, and these sites enrolled a total of 70 patients in the program. Qualitative data collected through interviews with site staff revealed the following themes: the value of intensive technical assistance being integrated in the program, concerns about staff retention and loss of expertise, adjustments of target client populations, and the importance of creative strategies for the provision of evidence-informed incentive totals. ConclusionsTRUST/CM was implemented throughout Montana, including rural and urban communities. Qualitative and quantitative data support that providers viewed the CM component as beneficial for treatment retention and improved outcomes for people with stimUD. These implementation study results provide insight into challenges and solutions for providers who are considering the implementation of CM within either a state-approved substance use treatment clinic or FQHC.

Effect of aerobic and resistance exercises on body composition and quality of life in overweight and obese women: a randomized control trial

BackgroundObesity has become a major health issue in the world and directly reduces the quality of life. The aim of this study was to compare the effect of aerobic and resistance exercises on body composition and quality of life (QoL) in overweight and obese women. Method An experimental study involving 90 overweight/obese women aged between 20-45 years participated in the study voluntarily and were randomized into control (n=30), aerobic exercise (AE) (n=30), and resistance exercise (RE) (n=30) groups. Either AE or RE groups performed exercise for 60 minutes per day for 10 weeks, whereas the control group did not perform any exercise. The body composition and QoL of the women were measured before and after the exercise. ResultsBody weight, BMI, fat mass, and waist and hip circumferences decreased significantly in both AE and RE groups after the exercise intervention compared to the control group (p&lt;0.05). In addition, quality of life sub-dimensions including physical health, psychological health, social relationship, and environment sub-dimensions improved significantly in the AE and RE groups compared to the control group (p&lt;0.001). Post hoc Tukey test showed that AE was as effective as RE for improving body composition parameters and QoL sub dimension compared to control group. ConclusionThis study demonstrated that both AE and RE were effective in improving body composition and thereby increasing the QoL in overweight and obese women. Both AE and RE programs are effective and should be considered within any multicomponent therapy program in overweight and obese women.

Long-term functional performance changes and detraining in community-dwelling older adults participating in a group-based multicomponent training program

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity and includes one of the most prevalent neurodevelopmental disorders in childhood. Despite the high prevalence, many professionals who work with children and adolescents with this disorder do not have enough knowledge on the subject. Physical education professionals deal directly with these children and need the knowledge to choose which skills and/or motor criteria to emphasize in their classes. However, issues related to neurodevelopmental disorders are not frequently addressed in the physical education courses, which impairs proper dealing with this population. AIM: This study aims to verify the level of knowledge about ADHD and its motor impairments in professionals and students of physical education. METHOD: A questionnaire was developed by researchers of motor behavior and was applied to professionals and students of physical education. The participants' responses were then analyzed through descriptive and inferential statistics. RESULTS: The results indicate that although the volunteers have basic notions about the subject, they do not have enough preparation to deal with children with ADHD. CONCLUSION: It was concluded that the knowledge about ADHD is insufficient and a reformulation in the curriculum of physical education courses is recommended.

Effects of Exercise Behavior, Social Cohesion, and Social Support on Health Behaviors in Older Adults: Intervention in a Multi-Component Exercise Program

Effects of Exercise Behavior, Social Cohesion, and Social Support on Health Behaviors in Older Adults: Intervention in a Multi-Component Exercise Program

The imperious need for telemedicine for the care of diabetes during the COVID-19 pandemic. A comprehensive approach study

Patients with diabetes experience difficulties to maintain glycemic control during the confinement due to the COVID-19 pandemic, with the risk of developing diabetes chronic complications and severe COVID-19. The purpose of this study was to evaluate the conversion of an outpatient diabetes primary care center from a face-to-face care modality to a telemedicine care service by telephone. Medical consultations were made by telephone during the initial phase of confinement (April to June 2020), to then continue the follow-up of patients admitted to a multicomponent diabetes care program. A total of 1,118 consultations were made by telephone and follow-up was subsequently continued in 192 patients with type 2 diabetes. Different professionals from different health areas participated, including medical care, diabetes education, nutrition, psychology and podiatry. Multicomponent diabetes care was successfully transformed from a face-to-face care modality to a telemedicine service. Many primary care patients may be candidates for telemedicine. A redesign of the care model that incorporates telemedicine should be considered to mitigate chronic diseases burden of morbidity and mortality imposed by COVID-19 pandemic, but also for the post-COVID-19 era.

Optimizing transition from pediatric to adult care in short bowel syndrome and intestinal failure.

As the majority of children with short bowel syndrome (SBS) and intestinal failure (IF) are now surviving into adulthood, there is a paradigm shift from short-term management to long-term outcomes and a growing need to focus on healthcare transition (HCT). It is imperative that adolescents and young adults with SBS and IF receive disease education, empowerment, and support as they navigate the transition from pediatric to adult care. Furthermore, both pediatric and adult healthcare providers who manage these patients should be aware of the challenges faced by this population, barriers to their HCT, and strategies to overcome them. This article reviews the literature on HCT in children with chronic illnesses, discusses barriers to HCT in SBS/IF, identifies the important constituents of the transition process in SBS/IF, and provides recommendations for the successful and smooth transition of the pediatric patient to the adult healthcare environment. Structured and multicomponent HCT programs should become the standard of care to ensure uninterrupted high-quality care across the life span for patients with SBS/IF.

Process evaluation of workplace health promotion in a sheltered workplace: a care ethics perspective.

Despite the potential health benefits of workplace health promotion for employees in sheltered workplaces, participation is often limited. The aim of this study was (i) to understand this limited participation, and (ii) to find opportunities for adapting workplace health promotion, such that it better meets the needs of the target population. A responsive process evaluation of an extensive multi-component workplace health promotion program targeting lifestyle behaviors, financial behaviors, literacy and citizenship, was performed in a large, sheltered workplace in the Netherlands (>3500 employees). To understand the limited participation, interviews with employees (n = 8), supervisors (n = 7) and managers (n = 2), and 10 participant observations were performed. To find opportunities for improving workplace health promotion in the sheltered workplace, 7 dialogs with employees were performed (n = 30). The interview data on the barriers for participation were evaluated through the lens of care ethics, as this allowed to understand the role of various stakeholders in the limited participation, as well as the indirect role of the institutional context. Findings showed that participation in workplace health promotion could increase if it is organized in a way that it encourages employees to work on health together, allow to tailor activities to different needs and capabilities of employees, and connects activities to employees' daily lives. A strength of this study is that the responsive process evaluation focused both on barriers for participation, as well as on opportunities to increase participation.

A quasi-experimental study of a peer-assisted strategy-based reading intervention in elementary school

Promising methods of reading instruction for elementary school students incorporate peer-assisted learning routines and reading strategies. In addition, models of reading comprehension point to the importance of various determinants of reading competence such as reading fluency and vocabulary knowledge. Multicomponent reading intervention programs need to be evaluated to determine IF and HOW they unfold their effects on the reading competence of elementary school students on the basis of such theoretical and empirical models. Accordingly, the present study was designed as a quasi-experimental study of a 20-lesson peer-assisted and strategy-based multicomponent intervention for whole-class instruction in elementary school. Linear mixed models and latent growth models were used to analyze the longitudinal data (pre-, post- and follow-up test) on the reading competencies (reading fluency, vocabulary knowledge, reading strategy competence, reading comprehension) and intrinsic reading motivation of students in the intervention (N = 187) and control group (N = 177). The results showed an interaction between the groups and the change in reading comprehension, indicating a significantly increased score in the intervention group at the posttest (d = 0.15) but not at the follow-up test (d = 0.12). The results of the latent growth model point to the importance of designing interventions that explicitly integrate reading strategies, reading fluency and vocabulary knowledge and also foster intrinsic reading motivation. In addition, reading fluency was revealed to be the strongest predictor of reading comprehension and the change in fluency over time was closely linked to reading comprehension development.

Retention and Overdose Risk among Patients Receiving Substance Use Disorder Treatment, Mental Health Care and Peer Recovery Support: A Longitudinal Analysis.

Drug overdose remains a major crisis in the United States. Expanding substance use disorder (SUD) treatment and recovery support services is critical for reducing overdose risk during disasters such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) pandemic. We evaluated the outcomes of an innovative multicomponent service, inclusive of medications for SUD, and peer support, colocated in an outpatient infectious disease clinic in Baltimore City. Our goal was to examine whether a multicomponent SUD program can support patients in recovery during a pandemic. One hundred five patients in the RESTORE service between 2019-2020 completed baseline, 3-month, and 6-month surveys. Telemedicine and phone-based support groups were implemented in March 2020 after statewide restrictions on face-to-face services due to SARS-CoV2. Data from surveys and electronic medical records were integrated and analyzed using mixed-effects regression models. At baseline, most patients (88%) reported using drugs/alcohol in the preceding 30 days; 48% of patients reported a history of drug overdose, as well anxiety (23%) and depression (28%) symptoms. Despite pandemic-related disruptions and procedural changes, retention in RESTORE was high (83% after 3 months, 76% after 6 months). Mixed-effects regression models indicated decreased anxiety, alcohol use, heroin use, and nonfatal overdose after 6 months of enrollment (all P < 0.05). Multicomponent SUD services that are colocated within infectious disease specialty services could help patients to successfully manage their overdose risk and mental health even during future disasters. This model of care could be implemented in other specialty settings that see high rates of SUD.

Experience, facilitators, and barriers to the implementation of a multicomponent programme in older people living in the community, +AGIL Barcelona: A qualitative study.

The +AGIL Barcelona programme is a multicomponent care intervention for frail older adults (FOAs) living in the community. To improve the programme, it is essential to investigate the experience of all participants. Our objective was to explore the perspective of FOA and professionals about the barriers, facilitators, and improvement elements of the development of the +AGIL Barcelona programme. Qualitative descriptive approach. Were included FOA and professionals who participated in the +AGIL Barcelona programme. Three focus groups and four interviews were conducted. These were analyzed following the qualitative method of content analysis. The criteria of scientific rigor of credibility, dependence, and transferability were ensured throughout the study. Three themes and seven sub-themes were developed: facilitators (positive experience and perceived benefits), barriers (self-perceived health status, digital divide, and continuity of the programme at home), and improvements elements (programme continuity and adaptation of technology). All the participants felt satisfied, highlighting aspects such as interpersonal relationships and social contact, face-to-face sessions guided by a physiotherapist, and the functional improvement achieved. Some of the difficulties were the self-perception of frailty, the need for technological support, and continuing the exercise programme at home. The FOA who participated in the +AGIL Barcelona programme perceived direct benefits for their health and physical condition due to the development of self-confidence by being able to perform physical exercise despite their baseline condition, and the professionals experienced an improvement in the quality of care due to work in a multidisciplinary team.

Understanding effective university programs on physical activity: A realist review guided by the health-belief model

Introduction: The study aimed to understand why and how effective university programs on physical activity work. Methods: Guided by the Health Belief Model in the context of a realist review design, the researchers conducted a search among seven peer-reviewed electronic databases in the health and education fields. Two reviewers independently conducted title, abstract, and full-text screening for each study. Disagreements in the screening and study selection phases were resolved through consensus. Data pertaining to the contexts, mechanisms, and outcomes (CMO) of university-based physical activity programs were extracted and analyzed using descriptive statistics. Content analysis was also conducted to inform the CMO configurations. Results: The search identified a total of 6219 records, of which 16 programs contributed to data synthesis. Eight CMO statements were created with the following key themes: 1) tailored and individualized interventions, 2) medium-term incentivization, 3) lifestyle education programs utilizing information and communications technology, 4) interdisciplinary multicomponent programs, 5) use of self-monitoring strategies, 6) social support, 7) shared experiences among employees and students, and 8) theory-based physical activity programs. Analysis of the mechanisms of these effective university-based physical activity programs revealed processes and structures that were consistent with the elements of the Health Belief Model. Discussion: The results of this review demonstrate that effective university wellness programs on physical activity are those that address elements of behavior change. Physical therapists working in and with universities can further advocate for physical activity engagement among university constituents through their involvement in program and policy creation, implementation, and evaluation.

The Effectiveness of the Interventions to Reduce Sound Levels in the ICU: A Systematic Review.

Databases of PubMed, EMBASE, PsychINFO, CINAHL, and Web of Science were systematically searched from inception to September 14, 2022. Two independent reviewers assessed titles and abstracts against study eligibility criteria. Noise mitigating ICU studies were included when having at least one quantitative acoustic outcome measure expressed in A-weighted sound pressure level with an experimental, quasi-experimental, or observational design. Discrepancies were resolved by consensus, and a third independent reviewer adjudicated as necessary. After title, abstract, and full-text selection, two reviewers independently assessed the quality of each study using the Cochrane's Risk Of Bias In Nonrandomized Studies of Interventions tool. Data were synthesized according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and interventions were summarized. After screening 12,652 articles, 25 articles were included, comprising either a mixed group of healthcare professionals (n = 17) or only nurses (n = 8) from adult or PICU settings. Overall, the methodological quality of the studies was low. Noise reduction interventions were categorized into education (n = 4), warning devices (n = 3), multicomponent programs (n = 15), and architectural redesign (n = 3). Education, a noise warning device, and an architectural redesign significantly decreased the sound pressure levels. Staff education and visual alert systems seem promising interventions to reduce noise with a short-term effect. The evidence of the studied multicomponent intervention studies, which may lead to the best results, is still low. Therefore, high-quality studies with a low risk of bias and a long-term follow-up are warranted. Embedding noise shielding within the ICU-redesign is supportive to reduce sound pressure levels.

Characteristics and effects of physical exercise programs for older adults during the COVID-19 pandemic: an integrative review

Objective: To evaluate the characteristics of physical exercise programs for older adults and their effects during the COVID-19 pandemic. Methods: An integrative review was conducted between January and March 2022. A search was conducted in MEDLINE via PubMed, Lilacs via BVS, PEDro, and Cochrane Library. Experimental articles (randomized clinical trials, non-randomized trials, or quasi-experimental studies) published from 2019 to 2021, with no language restriction, and that used physical exercise programs for older adults (&gt; 60 years) in their intervention were included. The studies were selected by reading the title, abstract, and full text. The selected articles had their results extracted using an online form, tabulated using an electronic spreadsheet, and analyzed qualitatively and quantitatively. Results: 113 studies were identified; 7 met the eligibility criteria and were included in the review, all randomized controlled trials. The multi-component exercise programs were more frequent (resistance, balance, flexibility, and aerobic), delivered remotely and performed 2 to 7 times a week, lasting between 30 and 50 minutes. Significant effects were observed on physical function, body composition, blood triglycerides, the incidence of falls, physical activity, and functional capacity. Conclusions: The physical exercise programs used during the COVID-19 pandemic showed promising results for older adults. The programs proved to be a viable alternative for maintaining the physical, mental, and cognitive functions of older adults in times of public calamity.

Enhancing Microservices Security with Token-Based Access Control Method.

Microservices are compact, independent services that work together with other microservices to support a single application function. Organizations may quickly deliver high-quality applications using the effective design pattern of the application function. Microservices allow for the alteration of one service in an application without affecting the other services. Containers and serverless functions, two cloud-native technologies, are frequently used to create microservices applications. A distributed, multi-component program has a number of advantages, but it also introduces new security risks that are not present in more conventional monolithic applications. The objective is to propose a method for access control that ensures the enhanced security of microservices. The proposed method was experimentally tested and validated in comparison to the centralized and decentralized architectures of the microservices. The obtained results showed that the proposed method enhanced the security of decentralized microservices by distributing the access control responsibility across multiple microservices within the external authentication and internal authorization processes. This allows for easy management of permissions between microservices and can help prevent unauthorized access to sensitive data and resources, as well as reduce the risk of attacks on microservices.