Positive Lifestyle Behaviors Research Articles

Moving Beyond Raising Awareness: Addressing Barriers.

Awareness of issues and health concerns can prompt individuals to change their lifestyle behaviors. In fact, awareness is typically one of the first steps towards behavior change. However, awareness alone does not necessarily initiate or sustain behavioral changes. Specifically, many individuals experience significant barriers that prevent behavior change. Providers can address such barriers through ecological models of behavior change. Including concepts from an ecological model in health care settings can support positive lifestyle behavior change post-diagnosis. Moving beyond awareness alone and addressing barriers to change is an important goal that ultimately increases the probability of change for patients.

Quantile regression based method for characterizing risk-specific behavioral patterns in relation to longitudinal left-censored biomarker data collected from heterogeneous populations

There are many studies aimed at promoting positive lifestyle behaviors to reduce lifetime risk of cancer and related diseases. However, assessing these modifiable behaviors through statistical modeling is challenging because of the multidimensionality of interrelated measurements that may dramatically differ between at-risk individuals. Taking into account this heterogeneity while considering the multidimensionality of behavior changes is fundamental to tailoring interventions to their needs. Biomarkers that identify high-risk individuals may help validate proximal measures, but the number of validated methods that link biomarkers to multiple behavioral measurements by determining their dynamic relations with disease risks is limited to just a few, since it requires an advanced statistical methodology to address challenges in analyzing biomarker data, including left-censoring due to limits of detection. To address these challenges, we propose a method that constructs a quantile-specific weighted index of multiple behavioral measurements. Under the quantile regression framework, the proposed method renders a multidimensional view of risk-specific behavioral patterns by connecting them with biomarker levels to provide better insights into heterogeneous behavioral profiles among at-risk populations. We evaluate performances of the proposed method through simulations, and illustrate its applications to the Tu Salud ¡Sí Cuenta! data by examining behavior changes among Mexican-American adults.

Outdoor Against Cancer Connects Us (OACCUs) Project

Objective: The main project objectives will be to characterize the lifestyle behaviours of young cancer survivors (YCS) and to examine the associations of physical activity, balanced nutrition and sustainability and nature behaviours with mental well-being and quality of life. Methods: The present cross-sectional project will include YCS between 15 to 39 years from Germany, Greece, Italy, Portugal, Spain, and Sweden. Sociodemographic aspects and disease history will be collected. The International Physical Activity Questionnaire and The International Fitness Scale will be applied to assess physical activity and sedentary levels; and self-reported fitness, respectively. The questionnaire on adherence to the Mediterranean diet will evaluate healthy diet habits, and a short set of questions will cover the environmental quality of residence of the participants, as well as their outdoor habits. In addition, the EQ‐5D‐5L instrument will measure health-related quality of life, and the Hospital Anxiety and Depression Scale will collect depression and anxiety symptoms. Results: It is hypothesised that positive lifestyle behaviours, such as increasing physical activity and following balanced nutrition, may correlate with improved mental well-being and quality of life in YCS. These findings have the potential to deepen our understanding of the intricate interplay between cancer, lifestyle and mental health

Lifestyle Modulators of Neuroplasticity in Parkinson's Disease: Evidence in Human Neuroimaging Studies.

Parkinson's disease (PD) is a neurodegenerative disease characterized by both motor and non-motor symptoms. A progressive neuronal loss and the consequent clinical impairment lead to deleterious effects on daily living and quality of life. Despite effective symptomatic therapeutic approaches, no disease-modifying therapies are currently available. Emerging evidence suggests that adopting a healthy lifestyle can improve the quality of life of PD patients. In addition, modulating lifestyle factors can positively affect the microstructural and macrostructural brain levels, corresponding to clinical improvement. Neuroimaging studies may help to identify the mechanisms through which physical exercise, dietary changes, cognitive enrichment, and exposure to substances modulate neuroprotection. All these factors have been associated with a modified risk of developing PD, with attenuation or exacerbation of motor and non-motor symptomatology, and possibly with structural and molecular changes. In the present work, we review the current knowledge on how lifestyle factors influence PD development and progression and the neuroimaging evidence for the brain structural, functional, and molecular changes induced by the adoption of positive or negative lifestyle behaviours.

Effect of Physical Activity during Pregnancy on the Risk of Hypertension Disorders and Gestational Diabetes: Evidence Generated by New RCTs and Systematic Reviews.

Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are the most common medical complications in pregnancy. Physical exercise is considered to be safe and beneficial during pregnancy. Moreover, pregnancy could be considered as an opportunity for healthcare providers to promote positive lifestyle behavior and optimize the well-being of pregnant women. Since there are few up-to-date reviews evaluating the role of exercise and the risks of developing obstetrical complications, we performed a review to investigate the effects of physical activity and exercise during pregnancy compared to a control group, focusing on the risk of development of HDP and GDM. We searched Medline and Web of Science, including only randomized controlled trials (RCTs) and systematic reviews. This review supports a beneficial effect of exercise and provides evidence that it significantly decreases the risk of HDP and GDM.

Associations between Health-Related Use of Social Media and Positive Lifestyle Behaviors: Findings from a Representative Sample of US Adult Smokers

Background: Cigarette smokers have elevated cardiovascular risk factors, which contributes significantly to mortality. Although social media is a potential avenue to deliver smoking interventions, its role in health promotion among smokers remains relatively unexplored.Objective: To examine the uptake and impact of health-related social media use in cigarette smokers.Methods: Using data from the 2017–2020 Health Information National Trends Survey, we evaluated differences in health-related social media use between smokers and nonsmokers. Multivariable logistic regression was performed to examine the association between social media use and positive health behaviors.Results: We included 1863 current smokers and 13,560 nonsmokers; Most participants were women (51.0%), White (64.6%), and 49.2% were aged ≥50 years. Smokers who used ≥1 social media site for health-related purposes in the past year were significantly more likely to meet the guideline recommendations for: (i) weekly physical activity (AOR 2.00, 95% CI 1.23–3.24), (ii) daily vegetable intake (AOR 2.48, 95% CI 1.10–5.59), and (iii) weekly strength training (AOR 1.80, 95% CI 1.10–2.94). However, the odds of reporting intentions to quit smoking (AOR 1.81, 95% CI 0.98–3.34) and attempts at smoking cessation (AOR 1.68, 95% CI 0.90–3.12) did not differ by health-related social media use.Conclusion: Smokers use social media for health-related purposes at comparable rates to nonsmokers. While our findings indicate that these platforms present a novel opportunity for health promotion among smokers, future research exploring the utility of social media in smoking cessation is crucial.

Prevalence of Obesity and Lifestyle Risk Factors Following Two Years' COVID-19 Related Service Closure at Wellness Center, Primary Health Care.

COVID-19 lockdown has affected health behaviors and daily life in unprecedented ways. This study aimed to assess (i) the prevalence of lifestyle behaviors including physical activity, sedentary behavior, sleep, and stress levels during the COVID confinement, and (ii) evaluate anthropometric measures, body composition, cardiopulmonary and muscular endurance among regular Wellness Center attendees, following two years' service closure. A cross-sectional study was undertaken between 1st June 2022 and 30th January 2023. A structured validated questionnaire was utilized to retrospectively collect data related to the closure period, and quantitative objective measurements were obtained at the time of data collection. A total of 100 adults with a mean age of 49.6 ± 10.5 years, mostly female (80%) and Qatari (76%) participated in the study. The results revealed high rates of low physical activity (47%), sedentary behavior (62%), poor sleep (58%), and stress levels (61% moderate and 5% high). Results also confirmed high prevalence of obesity (57%) marked by BMI and body circumferences, fat mass (34 ± 10.5 kg)/fat percentage (42.7 ± 7.2%) and muscle mass (20.6 ± 5.4 kg)/muscle percentage (25.4 ± 3.9%) above and below normal levels, respectively. The average cardiopulmonary (mean VO2 MAX was 15.5 ± 11 mL O2kg-1min-1) and muscular endurance (pushups per min 19 ± 8.9, L-sit 46 ± 35 secs, plank 42.7 ± 27.8 secs) were distinctly below normal levels for age and sex. The findings indicate that physically active adults have experienced adverse lifestyle behaviors during the COVID-19 lockdown. Obesity, unfavorable body composition, low cardiopulmonary and muscular endurance were evident. More emphasis should be put on the development of targeted intervention strategies to promote positive lifestyle behaviors during any potential future crises.

The impact of social media usage on lifestyle behaviors and health

AbstractIntroductionDespite the increasing popularity of social media, little research has been conducted on its impact on lifestyle behaviors and health outcomes among adults. This study aimed to investigate whether more frequent social media screen time use is associated with poorer lifestyle behaviors, overweight or obesity, and depressive symptoms. Additionally, this study examined the potential use of social media to positively influence health.MethodsAn anonymous one‐time survey was conducted among English‐speaking social media users aged 18–34 in Southern California. Self‐reported height and weight were used to calculate body mass index (BMI), and the Patient Health Questionnaire‐9 (PHQ‐9) was used to estimate the severity of depressive symptoms. A cumulative risk score for lifestyle behaviors was also tallied. Three focus groups were held with a subset of the survey population to gain insights on social media, lifestyle behaviors, and health. A mixed method analysis was used to analyze the data.ResultsThe survey data of 86 complete cases showed a positive correlation (r = 0.421; p < 0.001; 95% confidence interval [CI] [0.223, 0.585]) among PHQ‐9 depression scores and negative correlation (r = −0.230; p = 0.033; 95% CI [−0.426, −0.12]) for BMI compared to actual social media screen time usage, respectively. However, social media screen time usage ≥3 h showed no association for either BMI, depressive symptoms, or cumulative risk score. Participants viewed social media as a “double‐edged sword,” providing benefits such as “connection” and “information sharing,” but also having a negative impact on mental health (theme 1). Participants also believed public health needs to take a more proactive role in using social media, while social media platforms should manage the “authenticity” of content and modify their “algorithms” to improve health and lifestyle practices (theme 2).ConclusionsThis study suggested that social media may have some protective benefits related to becoming overweight or obese as indicated by the focus group participants, but further research is needed on the relationship between social media screen time usage and adult mental health. Social media platforms may have the potential to promote positive lifestyle behaviors and improve health if used properly.

The impact of aggregate positive lifestyle behaviors on low back pain resilience and care seeking

BACKGROUND CONTEXTLow back pain (LBP) is a global issue, and the high associated costs are mainly attributed to a small proportion of people with LBP who seek care. Importantly, the impact of aggregate positive lifestyle behaviors on LBP resilience and care seeking is not known. PURPOSEThis study aimed to evaluate the relationship between positive lifestyle behaviors and LBP resilience. STUDY DESIGNThis study was a prospective longitudinal cohort study. PATIENT SAMPLEData was collected as part of the AUstralian Twin BACK Study (AUTBACK). Participants who reported a lifetime previous history of LBP at baseline were included in this analysis (n = 340). OUTCOME MEASURESThe outcomes of interest were the number of weeks without activity limiting LBP and total number of days of healthcare usage, health practitioner care, self-management care, and medication intake. METHODSA lifestyle behavior score was built using variables of body mass index (BMI), physical activity, smoking status, and sleep quality. Negative binomial regression analyses were used to assess the relationship between the positive lifestyle behavior score and the count outcomes of number of weeks without activity limiting LBP and number of days participants used care. RESULTSAfter adjusting for covariates, no association was found between participants’ positive lifestyle behavior score and their number of weeks without activity limiting LBP (IRR: 1.02, 95% CI 1.00–1.05). There was a statistically significant relationship between higher positive lifestyle behavior scores and fewer number of days of participants’ total healthcare usage (IRR:0.69, 95% CI 0.56–0.84), healthcare practitioner visits (IRR:0.62, 95% CI 0.45–0.84), use of self-management strategies (IRR:0.74, 95% CI 0.60–0.91), and use of pain medication (IRR:0.55, 95% CI 0.44–0.68). CONCLUSIONPeople who adopt optimal lifestyle behaviors, such as engaging in adequate physical activity, achieving optimal quality sleep, maintaining an ideal BMI, and not smoking, may not experience less time suffering from activity limiting LBP, but are less likely to use healthcare and pain medication for their LBP.

Association between social media use and health promotion among individuals with depression and anxiety: Insights from the 2017–2020 Health Information National Trends Survey

IntroductionIndividuals with mental disorders have elevated risk factors for cardiovascular disease, and as a result, experience earlier mortality than the general population. Yet, evidence-based strategies and interventions to promote physical and cardiometabolic health in mental health contexts remains limited. Social media has emerged as a promising and readily affordable tool to expand the reach of mental health services, including the delivery of behavioral and physical health interventions. Despite its widespread availability, the potential for social media use to support positive lifestyle behaviors in mental health contexts remains relatively unexplored. We examined the potential for using social media tools for health promotion by people with anxiety or depression. MethodsUsing cross-sectional data from the 2017–2020 edition of the Health Information National Trends Survey (HINTS), we evaluated differences between individuals with self-reported history of diagnosed depression/anxiety and the general population concerning health-related usage of social media platforms. Multivariable logistic regression was performed to evaluate the association between social media usage and positive health behaviors. ResultsOverall, individuals with mental disorders were more likely than the general population to engage in health-related social media usage. Those with anxiety or depression who engaged in health-related social media usage were significantly more likely to; report intentions to quit smoking (OR 3.13, 95% CI 1.12 – 8.70; p = 0.029) endorse past 12-month attempts at smoking cessation (OR 3.41, 95% CI 1.32 –8.82; p = 0.012) and were more likely to meet national recommendation for weekly strength training (OR 1.49, 95% CI 1.11 – 2.00; p = 0.008). ConclusionsPeople with anxiety or depression use social media for health purposes at rates higher than the general population. Our findings suggest that these tools can reach many people with mental disorders and offer a novel window of opportunity to promote physical health and positive lifestyle behavior change in this highly vulnerable population.

Adaptation of ACTivate Your Wellbeing, a Digital Health and Well-being Program for Young Persons: Co-design Approach.

ACTivate your wellbeing is a digital health and well-being program designed to support and encourage positive lifestyle behavior change. The website includes 5 lifestyle behavior change modules and a 12-week well-being intervention based on acceptance and commitment therapy. It was timely to adapt the resource for a new audience in the wake of the COVID-19 pandemic. Young persons' mental health needs have increased substantially, and lifestyle behaviors play a critical role in both mental and physical health statuses. This study aimed to adapt an existing health and well-being website for use by young persons aged 16 to 24 years. A 3-staged participatory, co-design approach was adopted. The participants reviewed the existing program and provided feedback (stage 1) before cocreating new content (stage 2). Finally, the updated program underwent formative evaluation (stage 3). Two groups were created: one had access for 3 weeks and the other could self-select their study duration. The options were 3 weeks, 60 days, or 90 days. Outcome measures were the Warwick and Edinburgh Mental Well-being Scale, 4-item Patient Health Questionnaire, and Acceptance and Action Questionnaire version 2. Stage 1 identified that the website was appealing to the new audience (19/24, 79%), and the 3 web-based focus group discussions explored data from the written review in more depth to identify and clarify the main areas for update and adaptation. Overall, 3 themes were developed, and the data informed the creation of 6 tasks for use in 5 web-based co-design workshops. Stage 2 led to the cocreation of 36 outputs, including a new name, new content, scenarios, images, and a new user dashboard, which included streaks and an updated color scheme. After the website update program was completed, 40 participants registered to use the website for formative evaluation (stage 3). Data analysis revealed differences in engagement, completion, and mean well-being after intervention between the 2 groups. The completion rate was 68% in the 3-week duration group, and well-being scores improved after intervention. Young persons engaged actively with the participatory design process. The participants discussed the updates they desired during the web-based discussions, which worked well via Zoom (Zoom Video Communications Inc) when small groups were used. The participants easily cocreated new content during the web-based co-design workshops. The web-based format enabled a range of participants to take part, share their ideas, search for images, and design digital content creatively together. The Zoom software enabled screen sharing and collaborative whiteboard use, which helped the cocreation process. The formative evaluation suggested that younger users who engage more with the website for a shorter duration may benefit more.

Positive lifestyle behaviours and emotional health factors are associated with low back pain resilience.

To evaluate the relationship between lifestyle behaviours, emotional health factors, and low back pain (LBP) resilience. This retrospective longitudinal study utilised 1,065 twins with a recent history of LBP from the Washington State Twin Registry. A lifestyle behaviour score was built using variables of body mass index, physical activity engagement, sleep quality, smoking status, and alcohol consumption. An emotional health score was built using variables of the absence of depressed mood, perceived stress, and active coping. The main outcome was LBP resilience, assessed as recovery ("bouncing back"), and sustainability (maintaining high levels of function despite LBP). After adjusting for covariates, there was no relationship between the lifestyle behaviour score (OR 1.05, 95% CI 0.97-1.15, p = 0.218) and the emotional health score (OR 1.08, 95% CI 0.98-1.19, p = 0.142) with the likelihood of recovering from LBP. There was however, evidence of a positive association between the lifestyle behaviour score (β 0.20, 95% CI 0.04-0.36, p = 0.013), the emotional health score (β 0.22, 95% CI 0.00-0.43, p = 0.049), and greater levels of sustainability. These results were confirmed by a within-pair analysis (lifestyle behaviour score: β 1.79, 95% CI 0.05-3.53, p = 0.043) and (emotional health score: β 0.52, 95% CI 0.09-0.96, p = 0.021) adjusting for genetic and early shared environmental confounding. Findings from this study suggest that people who adopt optimal lifestyle behaviours and positive emotional factors are more likely to be resilient and maintain high levels of function despite suffering from LBP.

The impact of online health community engagement on lifestyle changes: A serially mediated model.

BackgroundDue to reduced physical labor and increased food availability, making healthy lifestyle changes is becoming increasingly challenging. Prior studies have suggested that strong ties (such as friends or family members) help promote positive lifestyle behavior changes while weak ties like online friends hardly make a difference in activating healthy lifestyle changes. More recent studies have found evidence of positive lifestyle changes brought about by health APPs. Yet, the process through which online health community (OHC) engagement is related to healthy lifestyle changes has not been fully explored.MethodsDrawing on social network theory and the self-efficacy literature, we argued that the information and emotional support which users obtained from OHCs is positively associated with health self-efficacy, which in turn is positively associated with lifestyle changes. Then we constructed a serially mediated model between OHC engagement and healthy lifestyle changes and collected 320 valid questionnaires through an online survey. We tested the model by applying structural equation modeling via Mplus 8.3, which uses bootstrapping (5,000 samples) to test the significance of the mediated paths.ResultsThis study demonstrated that the informational and emotional support that users receive from OHC engagement positively affects healthy lifestyle changes via the mediating role of health self-efficacy. We also found that healthy lifestyle changes are an outcome of enhanced health self-efficacy through the effect of informational and emotional support from OHC engagement.ConclusionsOur findings help explain how OHC users make healthy lifestyle changes by utilizing the informational and emotional support to develop health self-efficacy. The results also highlight the value of informational and emotional support as important resources which users acquire from OHC engagement. Thus, we suggest that OHC users utilize the informational and emotional support to enhance health self-efficacy and facilitate healthy lifestyle changes. Future research could explore the dynamic process through which OHC engagement influences lifestyle changes by designing longitudinal research and addressing the limitations of the present study.

The structured health intervention for truckers (SHIFT) cluster randomised controlled trial: a mixed methods process evaluation

BackgroundThis paper presents the mixed methods process evaluation of the randomised controlled trial (RCT) of the Structured Health Intervention For Truckers (SHIFT), a multi-component intervention targeting physical activity and positive lifestyle behaviours in a cohort of 382 truck drivers in the UK. The SHIFT RCT found a significant difference in daily steps between intervention and control groups at 6-months in favour of the intervention participants.MethodsSHIFT was evaluated within a cluster-RCT and involved 25 transport sites (12 intervention and 13 control sites). Intervention components included an education session, Fitbit, text messages, and cab workout equipment. Participants completed questionnaires at baseline and 6-months follow-up. Semi-structured focus groups/interviews were conducted with drivers (n = 19) and managers (n = 18) from each site, after completion of the final follow-up health assessment (16-18 months post-randomisation). Questionnaires and interviews collected information on fidelity, dose, context, implementation, barriers, sustainability, and contamination.ResultsQuestionnaire and interview data from intervention participants indicated favourable attitudes towards SHIFT, specifically towards the Fitbit with a high proportion of drivers reporting regularly using it (89.1%). 79.2% of intervention participants attended the education session, which was deemed useful for facilitating improvements in knowledge and behaviour change, dietary changes were predominantly recalled. Despite not being part of the intervention, participants reported that feedback from the health assessments motivated them to change aspects of their lifestyle (intervention = 91.1%, control = 67.5%). The cab workout equipment was used less and spoken unfavourably of in the interviews. The main barriers to a healthy lifestyle at work were reported as long hours and irregular shift patterns. The most suggested improvement for the intervention was more frequent contact with drivers. Managers were positive about the objectives of SHIFT, however almost all mentioned the challenges related to implementation, specifically in smaller sites.ConclusionsOverall, SHIFT was predominantly implemented as intended, with minimal discrepancies seen between the delivery and protocol. Having said this, transport sites each have distinct characteristics, which may require adaptations to individual settings to encourage participation. Managers and drivers reported enthusiasm and necessity for SHIFT to be included in future Certificate of Professional Competence training.Trial registrationISRCTN10483894 (date registered: 01/03/2017).

SERVE Model: Is Adherence to Five Key Evidence-Based Lifestyle Behaviors Associated with Changes in BMI Among Veterans?

ObjectivesTo examine whether: 1) adaptation of the SERVE (Sugar-Sweetened Beverages (SSB), Exercise, Restaurants, Vegetables and fruits (V/F), and Eating small portions) model help veterans to lose weight?; 2) Do single or aggregate of lifestyle changes in the SERVE model predict weight loss in veterans?MethodsThis study is a secondary longitudinal analysis of data collected from veterans with obesity or overweight with a comorbidity participating in the Goals for Eating and Moving (GEM) RCT. The SERVE model consists of 5 key evidence-based lifestyle behaviors collected at the baseline and 1 year visits: SSB intake, eating small portions, and restaurants collected via the Latino Dietary Behaviors Questionnaire, V/F intake via the Food Behavior Checklist, and exercise via the International Physical Activity Questionnaire. Logistic regression analyses were conducted to assess associations between single or aggregate of lifestyle behaviors in the SERVE model and changes in BMI controlling for the group assignment, gender, age, and race/ethnicity.ResultsOf the 240 participants, 72% were male with mean age of 51.2 years and mean BMI of 33.3 at baseline. After 1 year, the mean BMI of the veterans decreased (−0.43), more participants reported to exercise ≥150 minutes/week (23% vs 42%), eat small portions (26% vs 40%), and eat at a restaurant <3 times/week (60% vs 74%). No changes in V/F and SSB intakes were found. After controlling for confounders, those with higher portion control (many times/all the time vs never/sometimes: B = −1.8) and those with exercise level ≥ 150 minutes/week (B = −1.5) had significantly lower BMI after 1 year. Although not significant, similar trends were seen for eating at a restaurant < than 3 times/week and intakes of V/F (2 ≥ cups/day vegetables and ≥1.5 cup/day fruit) and SSBs. Those with at least 2, 3, and 4 positive lifestyle behaviors had decreases in BMI after 1 year (B = −0.8 [SERVE2]; B = −0.6 [SERVE3]; B = −0.8 [SERVE4]; all p < 0.05).ConclusionsOur findings support that the five key evidence-based lifestyle behaviors in the SERVE model are important determinants of changes in BMI and suggest that the SERVE model may be useful for dietary counseling. Results from this study may help inform future planning of interventions and policies targeting prevention of obesity and related chronic diseases in veterans.Funding SourcesNational Institutes of Health.

Impact of Nutrition and Physical Activity Interventions Provided by Nutrition and Exercise Practitioners for the Adult General Population: A Systematic Review and Meta-Analysis.

Healthy dietary intake and physical activity reduce the risk of non-communicable diseases. This systematic review and meta-analysis aimed to examine the effect of interventions including both nutrition and physical activity provided by nutrition and exercise practitioners for adults in the general population (those without diagnosed disease). The MEDLINE, CINAHL, Cochrane Central, Cochrane Database of Systematic Reviews and SportDiscus databases were searched for randomized controlled trials (RCTs) published from 2010 until April 2021. Outcomes included physical activity, fruit and vegetable intake, waist circumference, percent weight loss, quality of life (QoL) and adverse events. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods were used to synthesize and grade evidence. Meta-analyses were stratified according to participant health status. The database search identified 11,205 articles, and 31 RCTs were included. Interventions increased physical activity amount [standardized mean difference (SMD) (95% CI): 0.25 (0.08, 0.43)] (low certainty evidence); increased vegetable intake [SMD (95% CI): 0.14 (0.05, 0.23)] (moderate certainty evidence); reduced waist circumference [MD (95% CI): −2.16 cm (−2.96, −1.36)] (high certainty evidence); and increased likelihood of achieving 5% weight loss for adults with overweight and obesity [relative risk (95% CI): 2.37 (1.76, 3.19)] (high certainty evidence). Very low and low certainty evidence described little-to-no effect on QoL or adverse events. Nutrition and exercise practitioners play key roles in facilitating positive lifestyle behaviors to reduce cardiometabolic disease risk in adults.

Cardiometabolic health risks, lifestyle behaviours and quality of life in people diagnosed with early psychosis – A cross‐sectional study

WHAT IS KNOWN ON THE SUBJECT?: People diagnosed with schizophrenia have poor cardiometabolic health, with elevated 10-year cardiovascular disease risk (CVD-R) scores and low quality of life (QOL). There is a lack of understanding about CVD-R scores in people diagnosed with early psychosis and no studies have quantified CVD-R using the QRISK® 3calculator in this client group. Establishing potential relationships between modifiable lifestyle behaviours/treatment characteristics with CVD-R or QOL may identify targets for early intervention. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to quantify the individual 10-year CVD-R of people diagnosed with early psychosis utilising the QRISK® 3calculator. This is also the first study to investigate relationships between QOL and CVD-R and lifestyle factors in a cohort of Thai people diagnosed with early psychosis. We observed low levels of physical health-related QOL and high levels of CVR-R despite participants reporting relatively positive lifestyle behaviours. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The cardiometabolic health state of this client group warrants as much attention as for those with an enduring severe mental illness; early preventative interventions are warranted. It may be useful to routinely quantify the CVD-R of people diagnosed with early psychosis using the QRISK® 3calculator, even in the absence of immediate concerns about lifestyle behaviours. Mental health nurses should utilise evidence-based approaches such as increasing activity levels, dietary counselling and behaviour change interventions to mitigate poor physical health in this client group. ABSTRACT: Introduction People diagnosed with schizophrenia have poor cardiometabolic health, with elevated 10-year cardiovascular disease risk (CVD-R) scores and poor quality of life (QOL). There is lack of understanding of these issues in early psychosis. Aims To quantify CVD-R in people diagnosed with early psychosis and profile their obesity prevalence, lifestyle behaviours and QOL. Secondary aim was to explore associations between lifestyle behaviours/treatment characteristics and CVD-R/QOL. Method Baseline data from 81 RCT participants were used to profile cardiometabolic health risks (QRISK® 3, BMI and waist circumference). Participants self-reported lifestyle behaviours and QOL. Relationships between modifiable treatment/lifestyle factors and QOL/CVD-R were explored. Results Participants' relative risk for CVD over 10years was 1.93 times higher than healthy counterparts; 39% also had an obese BMI and physical QOL was poor. No significant associations were observed between CVD-R or QOL with treatment characteristics and lifestyle factors. Discussion Despite positive lifestyle behaviours, participants had elevated CVD-R scores and poor physical health-related QOL. Quantifying CVD-R with QRISK® 3may highlight the need for health promotion interventions. Implications for practice Mental health professionals should be aware that elevated CVD-R exists in the context of relatively healthy lifestyle behaviours and utilise evidence-based interventions to address these issues.

ANALISIS FAKTOR YANG MEMENGARUHI KECEMASAN PADA PEGAWAI NEGERI SIPIL (PNS) DALAM UPAYA PENCEGAHAN COVID-19 DI DINAS KESEHATAN PROVINSI SUMATERA UTARA TAHUN 2021

Anxiety is an unclear concern felt by a person with uncertainty and helplessness feeling. Civil Servants experience anxiety in efforts to prevent Covid-19 which is caused by several factors, one of them is fear of being infected. This study is aimed to determine the most dominant factors that affect the anxiety of Civil Servants (PNS) in efforts to prevent Covid-19. This type of research was quantitative with cross sectional approach. The study population was all Civil Servants (PNS) who served in North Sumatra Provincial Health Office as many as 342 people, a sample of 117 people using a random sampling technique, using a questionnaire. Chi square test results showed that there were an effect of gender, age, education, family status, fear of infection, knowledge, development of information, history of infected coworkers, presence of people without symptoms / close contact, Rapid / Swab test in the office, prevention of infection in an office environment and social stigma against anxiety with p value &lt;0.05. Meanwhile, health workers had no effect on anxiety with a value of p&gt; 0.05. The results of multiple logistic regression tests showed that the most dominant factor influencing anxiety was fear of infection (OR = 60.109), history of infected coworkers (OR = 41.172), information development (35.911), and family status (0.028). It is recommended to respondents that positive lifestyle behaviors that can improve mental health well-being such as eating healthy foods, doing regular physical activity, sleeping well, getting adequate rest, and avoiding excessive social media use related to Covid-19 can have a negative impact mental health and continue to carry out and monitor the implementation of Covid-19 prevention efforts.

The effectiveness of weight loss and health promotion interventions for healthy adult women: A systematic review protocol

Introduction: Overweight and obesity is a global public health concern. In Australia, approximately 60% of women are categorised as being overweight or obese, and this rate has been growing steadily since 1995. Positive lifestyle behaviours such as regular participation in physical activity and healthy, well balanced dietary intake can assist with weight loss and weight management, however, many adult women fail to meet recommended guidelines for these behaviours. Currently many interventions have focussed on improving these weight and lifestyle behaviours amongst specific populations (e.g., pregnant or chronically diseased), however such interventions are not always transferrable to the general healthy adult female population. The aim of this review is to systematically collate and synthesise evidence on weight loss and lifestyle behaviour interventions targeting healthy adult women. Methods: This systematic review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Four electronic databases (CINAHL, Medline, CENTRAL, and SPORTDiscus) will be searched to identify potentially relevant studies. The reference lists of all studies included in this review will also be screened to identify further studies for inclusion. The eligibility criteria for inclusion will be studies that: sample adult women (aged 18-64 years), use a randomised controlled trial study design, have weight loss or other health related behaviours (e.g., physical activity, dietary intake) as primary outcomes, and are published in English. The search strategy will include terms (and synonyms) for: weight loss, physical activity, randomised controlled trials, and lifestyle behaviours. Data on participants, study duration, mode of recruitment, study design, and outcome measures will be extracted from the studies which have been selected for inclusion. If possible, results will also be pooled for meta-analyses. Discussion: This systematic review will provide information on the effectiveness of weight loss and health promotion programs for healthy adult women, along with the components of effective interventions, and strategies for successful recruitment. Consequently, the results will help inform the development and design of future gender-tailored weight loss and health promotion programs for women. Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.

Relationship between Physiological Health Status, Lifestyle Behaviors, and Cardiovascular Disease Among Adults in Two Arab Countries

Purpose: Identify the relationships among participants’ lifestyle and their perceptions toward physiological health status. Methods: This is a cross-sectional research study. A convenience sampling was used to recruit 480 adult clients from Jordan and Saudi Arabia. Results: The majority of the participants (48.8%) rated their physiological health status as sub-optimal health. Significant positive associations were found between participants’ perceptions about physiological health status as ‘healthy’ and their positive lifestyle and low-risk behaviors for Cardiovascular Disease (CVD). Specifically, the associations were between not being smoker (χ2 = 4.17, p = 0.04), practicing physical activity (χ2 = 60.9, p &lt; 0.001), eating ≥ 5 cups of fruits and vegetables daily (χ2 = 8.33, p = 0.004), and being normal/under-weight (χ2 = 65.5, p &lt; 0.001). Conclusion: Perception about poor/sub-optimal physical health status is associated with many CVD risk factors. Using a brief screening tool to assess physical health status is recommended at each clinic visit. In addition, periodic physical assessment, full check-up, and follow-up with healthcare providers are highly suggested for those who perceived their physical health status as “poor” to prevent further CVD. Health education is pressingly recommended to improve the awareness of these Arab communities toward the prevention of CVD risk factors and enhancement of positive lifestyle behaviors.