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1.
Onno M. Tettero Marjan J. Westerman Maartje M. van Stralen Meike van den Beuken Valerie M. Monpellier Ignace M.C. Janssen Ingrid H.M. Steenhuis 《Obesity facts》2022,15(5):674
IntroductionNot all patients with suboptimal weight loss after bariatric surgery are willing to participate in postoperative behavioral intervention to improve their weight loss. The objective of this study was to explore barriers to and facilitators of participation in postoperative behavioral intervention.MethodsThirty semi-structured interviews were conducted with patients (18), physicians (6), and therapists (6) (i.e., psychologists, dieticians, or physiotherapists). A thematic analysis approach was used.ResultsEmotional responses caused by confrontation with suboptimal weight loss hampered patients'' deliberation about participation; insufficient exploration of their need for help limited patients'' ability to make informed decisions; patients were receptive to their physician''s advice when their physician respected their autonomy; using visual weight loss graphs helped to explain suboptimal weight loss to patients; and financial costs and time constraints obstructed participation.ConclusionsTo improve adequate intervention participation, healthcare providers should focus on emotion regulation, support patients in exploring their own need for help, and respect patients'' autonomy. 相似文献
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Befort CA Nollen N Ellerbeck EF Sullivan DK Thomas JL Ahluwalia JS 《Journal of behavioral medicine》2008,31(5):367-377
Compared to other racial/ethnic groups, African American (AA) women are more likely to be obese but less likely to participate
in weight loss interventions or to successfully lose weight. Sustained motivation for weight loss may be especially difficult
for AA women due to socioeconomic and cultural factors. The purpose of this study was to examine whether the addition of motivational
interviewing (MI) to a culturally-targeted behavioral weight loss program for AA women improved adherence to the program,
diet and physical activity behaviors, and weight loss outcomes. Forty-four obese
(mean BMI = 39.4, SD = 7.1) AA women were randomized to receive a 16-week behavioral weight loss program plus four MI sessions, or the same behavioral
weight loss program plus four health education (HE; attention control) sessions. Results showed that participants in both
MI and HE conditions lost a significant amount of weight, reduced their energy intake and percent calories from fat, and increased
their fruit and vegetable consumption (ps < .05). However, adherence to the behavioral weight loss program and changes in diet, physical activity, and weight did
not differ across MI and HE conditions. Future research is warranted to determine the subpopulations with which MI is most
effective. 相似文献
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Marino A. Bruce Bettina M. Beech Derek M. Griffith Roland J. Thorpe Jr. 《Behavioral medicine (Washington, D.C.)》2016,42(3):183-189
ABSTRACTSpirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12–19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07–1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02–1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors. 相似文献
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Health Status Among Urban African American Women: Associations Among Well-Being, Perceived Stress, and Demographic Factors 总被引:2,自引:0,他引:2
The purpose of this study was to evaluate the associations among health status, well-being, and perceived stress in a sample of urban African American women. African American women (n = 128) (Mean +/- SD, 49.3 +/- 10.5) from Baltimore, Maryland, enrolled in a church-based physical activity randomized trial were included in the analysis. Health status was assessed from the SF-36. Well-being, perceived stress, and demographics were also determined from self-report. Results indicated that the sample reported favorable health status, well-being, and stress levels compared to mean levels reported in the literature. Spearman rank-order correlations indicated that perceived stress score negatively correlated with most health status dimensions and well-being in the present, past, and future. Multiple regression analyses, adjusting for potential demographic confounders, indicated that higher perceived stress was associated with lower health status and well-being. If these results are confirmed in prospective investigations, they suggest that interventions designed to reduce stress may impact health status and future morbidity and mortality. 相似文献
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Aurora E. Serralde-Zuiga Alejandro G. Gonzlez-Garay Yanelli Rodríguez-Carmona Guillermo Melndez-Mier 《Obesity facts》2022,15(4):473
IntroductionUsing fluoxetine is one of many weight loss strategies. A serotonin reuptake inhibitor indicated for depression believed to impact weight control by changing an individual''s appetite; however, its benefit-risk ratio is unclear. The aim of this review was to assess the efficacy and safety of fluoxetine in reducing weight in adults with overweight or obesity.MethodsWe searched Cochrane Library, MEDLINE, Embase, and other databases without language restrictions. Cochrane Collaboration tool and GRADE instrument assessed the risk of bias of randomized controlled trials and certainty of their evidence. We conducted random-effects meta-analyses and calculated the risk ratio/mean difference with 95% confidence intervals for the outcomes.ResultsWe included 19 trials (2,216 adults) and found that fluoxetine may reduce weight by −2.7 kg (95% CI −4 to −1.4; p < 0.001) and body mass index by −1.1 kg/m2 (95% CI −3.7 to 1.4), compared with placebo; however, it would cause approximately twice as many adverse events, such as dizziness, drowsiness, fatigue, insomnia, or nausea.ConclusionsAlthough low-certainty evidence suggests that off-label fluoxetine may reduce weight, high-certainty research is needed to be conducted in the future to determine its effects exclusively as well as whether it is useful when combined with other agents. This article is based on a Cochrane Review published in the Cochrane Database of Systematic Reviews 2019, Issue 10, DOI: 10.1002/14651858.CD011688.pub2. Cochrane Reviews are regularly updated as new evidence emerges, and in response to feedback, it should be consulted for the most recent version of the review. 相似文献
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Gustavo Peixoto Soares Miguel Joao Luiz Moreira Coutinho Azevedo Carlos Gicovate Neto Cora Lavigne Castelo Branco Moreira Elaine Cristina Viana Perseu Seixas Carvalho 《Clinics (S?o Paulo, Brazil)》2009,64(11):1093-1098
OBJECTIVE
To assess glucose homeostasis and weight loss in morbidly obese patients undergoing Silastic® ring sleeve gas-trectomy.METHODS
This was a prospective clinical study. Thirty-three female patients with a mean body mass index (BMI) of 42.33 ± 1.50 kg/m2 (range: 40–45 kg/m2), a mean age of 36.7 ± 9.4 years and a mean waist circumference of 118.7 ± 5.98 cm were included in this study. Type 2 diabetes mellitus was observed in 11 patients (33.3%), and glucose intolerance was observed in 4 patients (12.1%). Mean plasma fasting glucose levels were 109.77 ± 44.19 mg/dl (75–320) in the preoperative period. All Silastic® ring sleeve gastrectomy procedures were performed by the same surgical team using the same anesthetic technique. The patients were monitored for at least 12 months after surgery.RESULTS
The mean weight of the patients decreased from 107.69 ± 6.57 kg to 70.52 ± 9.36 kg (p < 0.001), the mean BMI decreased to 27.4 ± 2.42 kg/m2 (p < 0.001), and the mean waist circumference decreased to 89.87 cm ± 6.66 (p < 0.001) in the postoperative period. Excess BMI loss was 86.5 ± 14.2%. Fasting glucose levels were reduced to 80.94 ± 6.3 mg/dl (p < 0.001). Remission of diabetes and glucose intolerance was observed in all patients.CONCLUSION
Silastic® ring sleeve gastrectomy was effective in promoting weight loss, waist circumference reduction and control of glucose homeostasis in morbidly obese patients. 相似文献8.
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Background
Most dietary programs fail to produce lasting outcomes because participants soon return to their old habits. Small behavioral and environmental changes based on simple heuristics may have the best chance to lead to sustainable habit changes over time.Objective
To evaluate participant retention, weight outcomes, and barriers for changes in a publicly available web-based healthy eating and weight loss program.Methods
The National Mindless Eating Challenge (NMEC) was a publicly available, online healthy eating and weight loss program with ongoing recruitment of participants. This volunteer sample consisted of 2053 participants (mean age 39.8 years, 89% female, 90% white/Caucasian, BMI mean 28.14). Participants completed an initial profiling survey and were assigned three targeted habit change suggestions (tips). After each month, participants were asked to complete a follow-up survey and then receive new suggestions for the subsequent month.Results
In terms of overall attrition, 75% (1549/2053) of participants who completed the intake survey never returned to follow up. Overall mean weight loss among returning participants was 0.4% of initial weight (P=.019). Participants who stayed in the program at least three calendar months and completed at least two follow-up surveys (38%, 189/504) lost on average 1.8 lbs (1.0%) of their initial weight over the course of the program (P=.009). Furthermore, participants who reported consistent adherence (25+ days/month) to the suggested changes reported an average monthly weight loss of 2.0 lbs (P<.001). Weight loss was less for those who discontinued after 1-2 months or who did not adhere to the suggested changes. Participants who reported having lost weight reported higher monthly adherence to suggestions (mean 14.9 days, SD 7.92) than participants who maintained (mean 12.4 days, SD 7.63) or gained weight (mean 12.0 days, SD 7.50; F=14.17, P<.001). Common reported barriers for changes included personally unsuitable or inapplicable suggestions, forgetting or being too busy to implement changes, unusual circumstances, and emotional eating.Conclusions
Because the bulk of the free and commercially available online diet and nutritional tools conduct no evaluation research, it is difficult to determine which aspects of a program are successful and what are reasonable expectations of results. The results of this study suggest that online interventions based on small changes have the potential to gradually lead to clinically significant weight loss, but high attrition from publically available or “free” programs still remains a challenge. Adherence to and effectiveness of small habit changes may be improved through further tailoring to individual circumstances and psychological needs. 相似文献10.
Background
The influence of obesity on the development of prediabetes among African American women (AAW) remains uncertain. Thus, we investigated whether the pathogenic mechanisms of prediabetes differ in obese (OB, BMI<35 kg/m2) and very obese (VOB, BMI>35 kg/m2) AAW.Subjects/Methods
We recruited 26-OB and 41-VOB, AAW with prediabetes, mean age (46.3 ± 10.3 years), A1C (5.9 ± 0.4%) and BMI (38.3 ± 8.2 kg/m2). OGTT and FSIVGT were performed in each subject. Body composition (% body fat) was measured using DEXA. Si, Sg acute insulin response to glucose (AIRg) and disposition index (DI) were calculated using minimal model method.Results
Mean BMI (32.6 ± 1.9 vs. 42.8 ± 5.5 kg/m2) and %body fat (44.7 ± 2.0 vs. 49.6 ± 2.2%) were significantly (p = 0.0001) lower in OB vs VOB. Mean fasting and post-glucose challenge, (glucose, insulin, c-peptide) levels were significantly (p = 0.03–0.0001) lower in OB vs VOB. Mean Si and Sg was not different. Mean AIRg tended to be higher (808 ± 776 vs. 535 ± 443 (x min [uU/L] ?1), p = 0.106) whereas DI was greater (1999 ± 1408 vs. 1511 ± 1033, (×10?2 x min?1), p = 0.01) in OB vs VOB subjects.Conclusion
We found that OB and VOB AAW had similar Si and Sg, but VOB showed attenuated AIRg and DI. These parameters should be considered when developing primary prevention programs in AAW with prediabetes. 相似文献11.
Jessica L. Paterson Amy C. Reynolds Mitch Duncan Corneel Vandelanotte Sally A. Ferguson 《Behavioral sleep medicine》2019,17(1):1-11
Objective: Many young adults obtain less than the recommended sleep duration for healthy and safe functioning. Behavior change interventions have had only moderate success in increasing sleep duration for this cohort. This may be because the way young adults think about sleep, including their willingness and ability to change sleep behavior, is unknown. The purpose of the present study was to determine what changes, if any, young adults are willing to make to their sleep behavior, and to identify factors that may enable or prevent these changes. Participants: Fifty-seven young adults (16–25 years; 57% female) took part in focus groups addressing (a) willingness to change, (b) desired outcomes of change, and (c) barriers to change in regards to sleep behavior. Methods: An inductive approach to data analysis was employed, involving data immersion, coding, categorization, and theme generation. Results: Participants were willing to change sleep behavior, and had previously employed strategies including advancing bedtime and minimizing phone use, with limited success. Desired changes were improved waking function, advanced sleep onset, optimized sleep periods, and improved sleep habits. Barriers to making these changes included time demands, technology use, difficulty switching off, and unpredictable habits. Young adults want to improve sleep behavior and waking function; this is an important first step in modifying behavior. Notably, participants wanted more efficient and better quality sleep, rather than increasing sleep duration. Conclusion: The reported barriers to sleep, particularly using technology for social purposes, will require innovative and specialized strategies if they are to be overcome. 相似文献
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Lina Tieu Urmimala Sarkar Dean Schillinger James D Ralston Neda Ratanawongsa Rena Pasick Courtney R Lyles 《Journal of medical Internet research》2015,17(12)
Background
Patient portals have the potential to support self-management for chronic diseases and improve health outcomes. With the rapid rise in adoption of patient portals spurred by meaningful use incentives among safety net health systems (a health system or hospital providing a significant level of care to low-income, uninsured, and vulnerable populations), it is important to understand the readiness and willingness of patients and caregivers in safety net settings to access their personal health records online.Objective
To explore patient and caregiver perspectives on online patient portal use before its implementation at San Francisco General Hospital, a safety net hospital.Methods
We conducted 16 in-depth interviews with chronic disease patients and caregivers who expressed interest in using the Internet to manage their health. Discussions focused on health care experiences, technology use, and interest in using an online portal to manage health tasks. We used open coding to categorize all the barriers and facilitators to portal use, followed by a second round of coding that compared the categories to previously published findings. In secondary analyses, we also examined specific barriers among 2 subgroups: those with limited health literacy and caregivers.Results
We interviewed 11 patients and 5 caregivers. Patients were predominantly male (82%, 9/11) and African American (45%, 5/11). All patients had been diagnosed with diabetes and the majority had limited health literacy (73%, 8/11). The majority of caregivers were female (80%, 4/5), African American (60%, 3/5), caregivers of individuals with diabetes (60%, 3/5), and had adequate health literacy (60%, 3/5). A total of 88% (14/16) of participants reported interest in using the portal after viewing a prototype. Major perceived barriers included security concerns, lack of technical skills/interest, and preference for in-person communication. Facilitators to portal use included convenience, health monitoring, and improvements in patient-provider communication. Participants with limited health literacy discussed more fundamental barriers to portal use, including challenges with reading and typing, personal experience with online security breaches/viruses, and distrust of potential security measures. Caregivers expressed high interest in portal use to support their roles in interpreting health information, advocating for quality care, and managing health behaviors and medical care.Conclusions
Despite concerns about security, difficulty understanding medical information, and satisfaction with current communication processes, respondents generally expressed enthusiasm about portal use. Our findings suggest a strong need for training and support to assist vulnerable patients with portal registration and use, particularly those with limited health literacy. Efforts to encourage portal use among vulnerable patients should directly address health literacy and security/privacy issues and support access for caregivers. 相似文献13.
Guevarra JS Kwate NO Tang TS Valdimarsdottir HB Freeman HP Bovbjerg DH 《Journal of behavioral medicine》2005,28(2):191-199
The concept of acculturation has been used to understand differences in health behaviors between and within a variety of racial and ethnic immigrant groups. Few studies, however, have examined the potential impact of acculturation on health behaviors among African Americans. The present study has two goals: 1) to reconfirm relations between acculturation and cigarette smoking; 2) to investigate the impact of acculturation on another type of health behavior, cancer screening and specifically breast self-examination (BSE). African American women (N = 66) attending an inner-city cancer-screening clinic completed study questionnaires. Results reconfirmed psychometric properties of the African American Acculturation Scale (AAAS); replicated the negative association between acculturation and lifetime smoking status; and found relations between acculturation and womens adherence to BSE frequency guidelines. Findings from this study raise the possibility that specific aspects of acculturation may better explain specific health behaviors.The present study was done as part of a dissertation submitted by the first author to The City University of New York 相似文献
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Udo Bongartz Uwe Hochmann Barbara Grube Ralf Uebelhack Felix Alt Constantin Erlenbeck Li Vern Peng Pee Win Chong Patricia De Costa 《Obesity facts》2022,15(3):395
IntroductionThe aim of this study was to evaluate the benefit and tolerability of two dosages of a proprietary flaxseed mucilage (IQP-LU-104) in reducing body weight in overweight and moderately obese individuals.MethodsIn a double-blind, randomized, placebo-controlled, bi-center trial, 108 participants (body mass index [BMI] 25–<35 kg/m<sup>2</sup>) were randomly allocated to receive either IQP-LU-104 high dose (104HD), IQP-LU-104 low dose (104LD), or placebo. Participants were instructed to consume 1 sachet of the investigational product (containing IQP-LU-104 or matching placebo) before or with main meals twice daily and to follow a balanced but hypocaloric diet (20% reduction of individual''s daily energy requirements) for 12 weeks. At week 0 (baseline), and weeks 4, 8, and 12 of the intervention periods, the participants'' body weight, BMI, body fat composition, and waist and hip circumferences were measured. Blood samples were collected for safety assessment at screening visit (week −2) and at the end of the study. Adverse events were assessed by the investigators through interviewing the participants and were recorded at every visit post screening.ResultsAt the end of the 12-week study, body weight reduction was greater in the 104HD group (4.96 ± 1.89 kg, p < 0.001 vs. placebo) and 104LD group (3.70 ± 2.57 kg, p < 0.001 vs. placebo) compared to the placebo group (1.33 ± 2.05 kg). 68% and 46% of participants in the 104HD group (p < 0.001 vs. placebo) and 104LD group (p = 0.002 vs. placebo), respectively, experienced at least 5% weight loss, compared to 9% of participants in the placebo group. Significant decreases in waist and hip circumferences were observed in both the 104HD and 104LD groups compared to the placebo group (each p < 0.001). 104HD group had significantly higher reduction in body fat mass (4.25 ± 5.86 kg) than the placebo group (1.06 ± 3.20 kg) (p = 0.002). Respiratory tract infections and gastrointestinal symptoms were the main adverse events reported and none of the adverse events were related to the intake of IQP-LU-104.ConclusionResults demonstrated IQP-LU-104 is safe and efficacious in body weight reduction at both dosages in overweight and moderately obese individuals. 相似文献
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Shelby RA Crespin TR Wells-Di Gregorio SM Lamdan RM Siegel JE Taylor KL 《Journal of behavioral medicine》2008,31(5):433-444
Past studies show that optimism and social support are associated with better adjustment following breast cancer treatment. Most studies have examined these relationships in predominantly non-Hispanic White samples. The present study included 77 African American women treated for nonmetastatic breast cancer. Women completed measures of optimism, social support, and adjustment within 10-months of surgical treatment. In contrast to past studies, social support did not mediate the relationship between optimism and adjustment in this sample. Instead, social support was a moderator of the optimism-adjustment relationship, as it buffered the negative impact of low optimism on psychological distress, well-being, and psychosocial functioning. Women with high levels of social support experienced better adjustment even when optimism was low. In contrast, among women with high levels of optimism, increasing social support did not provide an added benefit. These data suggest that perceived social support is an important resource for women with low optimism. 相似文献
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This prospective study examined the association between stressful life events and self-reported health in 72 inner-city, low-income African American women with HIV. Depressive symptoms were examined as a potential mediator of this association. Findings indicated that family stressors predicted deterioration in self-reported health status over the 15-month assessment period. Additionally, the association between family stress and self-reported physical health was mediated by depressive symptoms such that the strength of the association between family stress and self-reported health was no longer statistically significant after depressive symptoms were entered in the model. This study suggests a potentially important target for prevention and intervention efforts aimed at enhancing the quality of life of women with HIV. 相似文献
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Timothy I. Lawrence Jun S. Hong Kelly S. Sopchak Dexter R. Voisin 《Journal of clinical psychology》2023,79(5):1280-1292
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