The delivery of healthy lifestyle interventions for people with disability living in supported accommodation: a scoping review of intervention efficacy and consumer involvement

BackgroundPeople with disability living in supported accommodation experience health disparities that may be partly attributed to sedentary lifestyle behaviors and poor dietary quality. Healthy lifestyle interventions have been suggested as a method of health promotion for this population; however, a synthesis of their efficacy has not yet been conducted.ObjectiveThe primary aims were to (1) identify healthy lifestyle interventions delivered to people with disability living in supported accommodation and (2) examine their efficacy in supporting health and well-being. A secondary aim was to explore whether people with disability have been involved in the codesign of these interventions.MethodsA scoping review was conducted following the Joanna Briggs Institute's guidance for conducting scoping reviews, and six databases were searched from January 2011 to November 2021.ResultsThirty-two studies were included. Identified intervention types included training and education, exercise programs, and multicomponent interventions. A broad range of outcomes were examined; however, findings regarding efficacy were overall mixed and limited due to significant heterogeneity and the underreporting of consistently measured outcomes. The codesign of interventions in consultation with people with disability was underexplored.ConclusionsHealth promotion training for staff and tailored education for people with disability hold promise in creating a care environment that supports a healthy lifestyle. The paucity of interventions developed in consultation with people with disability is concerning and highlights the importance of meaningful co-design. The development of a theoretically informed intervention that is codesigned and addresses the broader social determinants that influence health behavior is recommended.     

北京市某综合大学本科生健康生活方式综合干预效果评价

目的了解北京市某综合大学在校本科生饮食,运动,日常作息等生活方式,并对相应的健康教育干预效果进行评价,为进一步在各高校推广健康生活方式的相关干预教育提供参考依据。方法以北京市某综合大学《健康生活方式与健康传播》通选课本科生为对象,通过健康知识普及,个人生活日记及点滴改变计划,榜样示范及交流感悟等方式进行健康生活方式干预。干预前后进行问卷调查,实际跟踪人数165人。结果学生对于健康知识掌握的合格率、坚持每天食用水果的人数、每天食用蔬菜水果的种类、每周运动次数均增加;吃饭时娱乐情况减少。结论合理并有针对性的健康综合干预措施使学生饮食、运动和生活作息趋向健康,对于养成良好的生活方式具有重要意义,值得推广。     

健康生活方式与糖尿病前期人群糖尿病发病关系的前瞻性研究

目的 探讨健康生活方式对糖尿病前期人群糖尿病发病风险的影响,为糖尿病前期人群的生活方式干预提供参考依据。方法 数据来源于贵州省自然人群队列研究。组合分析9种健康生活方式对糖尿病发病的影响,采用SPSS 26.0对数据进行χ2检验、单因素方差分析、Cox风险回归模型分析及分位数回归模型分析。结果 单种健康生活方式与糖尿病发病关联分析显示,烹调油摄入≤30 g/d、18.5≤BMI＜24 kg/m2能有效降低糖尿病发病风险,HR分别为0.500（95%CI:0.335～0.747）、0.420（95%CI:0.290～0.610）,未发现其他生活方式与糖尿病的发病相关。多种健康生活方式组合分析显示与0～3种相比,保持6种、7种及以上健康生活方式的人群发生糖尿病的风险分别为HR = 0.478（95%CI:0.239～0.956）、HR = 0.282（95%CI:0.108～0.737）。分位数回归结果显示,与0～3种健康生活方式相比,健康生活方式为4/5种以上,能降低0.9分位点的空腹血糖/OGTT 2 h血糖值;当健康生活方式达7种以上,能降低0.3～0.9分位点的血糖值,且分位水平越高,降低的血糖值越多。结论 健康生活方式能有效降低糖尿病前期人群血糖水平,且健康生活方式种类越多,糖尿病发病的风险越小。     

Effects of a long-term lifestyle intervention on metabolically healthy women with obesity: Metabolite profiles according to weight loss response

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北京市某医学院在校本科生健康生活方式与时间洞察力研究

目的了解北京市某医学院校本科生健康生活方式及其时间洞察力,初步探讨对相关健康教育和健康促进的影响。方法采用整群随机抽样方法抽取调查对象填写自编的《医学院校本科生健康生活方式与时间洞察力调查问卷》,使用Epi Data 3.1录入,SPSS 13.0进行统计分析。结果本次调查的医学院校312名本科生的健康生活方式标准化总平均分为68.01分;以未来时间观念为主导的学生有49人（15.7%）,以享乐主义的现在时间观念为主导的学生有26人（8.3%）,以宿命主义的现在时间观念为主导的学生有8人（2.6%）,以积极的过去时间观念为主导的学生有195人（62.5%）,以消极的过去时间观念为主导的学生有26人（8.3%）;多重线性回归分析表明,健康生活方式总得分与未来时间观念、积极的过去时间观念、享乐主义的现在时间观念呈正相关,与消极的过去时间观念、宿命主义时间观念呈负相关。结论时间洞察力在预测健康相关行为方面有着一定的意义,采取适当的影响时间洞察力的心理干预及健康教育措施可能会有助于促进本科生形成和保持良好的健康生活方式。     

Barriers and enablers to the implementation of healthy lifestyle interventions for people with disability living in supported accommodation: A systematic review using the consolidated framework for implementation research

BackgroundPeople with disability living in supported accommodation often experience significant health disparities, despite the availability of additional support. Healthy lifestyle interventions have been identified as one key health promotion strategy. Implementation science offers an opportunity to explore the factors that influence the efficacy and sustainability of these interventions, yet its application in this context has been underutilized.ObjectiveThis systematic review synthesized the barriers and enablers to the implementation of healthy lifestyle interventions delivered to people with disability living in supported accommodation settings.MethodsA systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search for relevant literature published between January 2011 and November 2021 was conducted across six databases. The findings of included studies were coded and analyzed according to the domains and constructs of the Consolidated Framework for Implementation Research (CFIR) via deductive content analysis.ResultsFive studies were included, and their findings were mapped to 21 out of 38 constructs under the CFIR. Interventions from each study delivered health promotion education and training to staff and/or people with disability. The most prominent determinants that influenced implementation success included an intervention's relevance and its flexibility to adapt to the needs of people with disability, alongside organizational resourcing, and stakeholder endorsement in supporting implementation.ConclusionsThe CFIR provided a systematic approach to explore the implementation of healthy lifestyle interventions. However, further research that is grounded in and guided by implementation science theories is warranted. Despite the scarcity of literature, several compelling, yet preliminary recommendations were drawn from the findings.     

无锡市社区居民健康生活方式分布情况及与慢性病患病关联分析

目的 分析无锡市社区居民健康生活方式分布情况以及与常见慢性病患病的关联。方法 采样分层两阶段整群随机抽样方法于2019年在江苏省无锡市开展慢性病防控社会因素调查,对34 865例调查对象分析当前不吸烟、非过量饮酒、健康饮食习惯、积极体力活动、健康体重和健康体脂6个健康生活方式分布情况及其与高血压、糖尿病、血脂异常、冠心病、脑卒中的关联。结果 无锡市社区居民平均保持3.1±1.2个健康生活方式,大部分人群保持2、3、4个健康生活方式,比例分别为23.8%、28.7%、24.6%。随着健康生活方式个数的增加,高血压、糖尿病、血脂异常患病的比值比(odds ratio,OR)逐渐降低(P_线性趋势均<0.001)。和≤1个健康生活方式相比,保持≥5个健康生活方式的研究对象患高血压、糖尿病、血脂异常的OR值(95%CI)依次为：0.23(0.20～0.26)、0.49(0.40～0.61)、0.38(0.33～0.45)。健康生活方式个数与慢性病患病OR值的负向关联在低年龄组中更为明显：和≤1个健康生活方式相比,≥5个健康生活方式与高血压的OR值(95%CI)依次为：...     

Perceived barriers to weight maintenance among university students in Kuwait: the role of gender and obesity

Objective

To investigate the barriers to weight maintenance among university students in Kuwait by gender and obesity.

Methods

A sample of 530 students was selected at convenience from four universities in Kuwait (2 public and 2 private). The age of students ranged from 19 to 26 years. A self-reported pretested questionnaire was used to obtain the barriers, which were divided into barriers to healthy eating and barriers to physical activity. Weight and height were based on self-reporting, and the students were grouped into non-obese and obese according to the WHO classification. The response options to barriers were: very important, somewhat important and not important.

Results

The main barriers to healthy eating for both genders were: “Do not have skills to plan, shop for, prepare or cook healthy foods” and “Not having time to prepare or eat healthy food”. In general, there were no significant differences between men and women in barriers to healthy eating. There were highly significant differences between men and women regarding barriers to physical activity (P values ranged from <0.001 to <0.016). “Not having time to be physically active” and “The climate is not suitable for practising exercise” were the main barriers reported. Obese men were more likely to face barriers to healthy eating than non-obese men. There were no significant differences between obese and non-obese women regarding barriers to healthy eating and physical activity.

Conclusion

The findings of this study can be utilized in intervention activities to promote a healthy lifestyle and to combat obesity in Kuwait, and maybe in other Arab countries.     

Determinants of attrition in a pediatric healthy lifestyle intervention: The CIRCUIT program experience

IntroductionAttrition in pediatric weight management programs is notoriously high. Greater understanding of its determinants is needed to inform retention strategies. We identified determinants of attrition in CIRCUIT, a healthy lifestyle intervention program for youth at risk of cardiovascular disease.MethodsA one-arm intervention study of children aged 4-18 years who initiated the CIRCUIT program in the first five years of its existence (N = 403). We defined attrition as attending the baseline visit but ceasing attendance prior to the 1-year follow-up. Potential determinants of dropout included the child’s age, sex, ethnicity, body mass index (BMI) z-score, family socio-demographic characteristics, and estimated driving time to the program, all measured at baseline. Associations were estimated bivariately, using chi-squared- and t-tests, and simultaneously in a multivariable logistic regression model.ResultsOf the 403 participants who started the program, 198 (49%) dropped out within 12 months of enrollment. Youth who dropped out were older (mean age 12.8y vs. 11.3y; p < 0.01), were less likely to live with both parents (62% vs. 71%; p = 0.05), and to have mothers who had completed high school (79% vs. 88%; p = 0.01). No group differences were observed for sex, ethnicity, baseline BMI z-score, fathers’ education, or driving time to the program. In multivariate models, only older age at initiation of the intervention (OR: 1.2; CI: 1.1,1.3) and lower maternal education (OR: 2.0; CI: 1.0,3.8) were associated with dropout.ConclusionImproved tailoring of interventions to older pediatric participants and to families of lower maternal education may help reduce attrition in CIRCUIT and similar lifestyle intervention programs.     

Challenges of a healthy lifestyle for socially disadvantaged people of Dutch,Moroccan and Turkish origin in the Netherlands: a focus group study

Lifestyle interventions often fail to successfully reach individuals with lower socio-economic status (SES), possibly because of the individual behavioural orientation to health behaviour and because limited research has included the target groups’ perspectives in the development of interventions. Certainly, in order to make lifestyle interventions more applicable, target groups’ viewpoints should to be taken into account. In order to tailor an effective lifestyle intervention to groups with lower SES of different ethnic origins, 14 focus group interviews were conducted with Turkish, Moroccan and Dutch male and female groups. The target groups’ responses highlight their viewpoint and their dilemmas with regard to physical activity behaviour and healthy eating. Exploration of the target groups’ behaviour in terms of their own logic revealed three prominent themes. Firstly, some individuals find it difficult to maintain healthy eating habits and regular physical activities, as their concept of a healthy life comprises competing values and activities. Secondly, social norms and social practices of others influence health behaviour. Thirdly, respondents’ answers reflect how they deal with the dilemma of competing values and norms. They use different ways of reasoning to make sense of their own (health) behaviour. Taken together, the results of this study suggest that considering physical activity and eating as collective social practices rather than as determinants of health will provide new opportunities to initiate healthy lifestyles and to make lifestyle interventions more applicable to target groups’ realities.     

The joint moderating effect of health consciousness and healthy lifestyle on consumers' willingness to use functional foods in Taiwan

Functional foods marketed as promoting health or reducing the risk of disease open a promising avenue for consumers to pursue a healthier life. Despite the stable growth in functional foods in Taiwan, at present little is known about whether or not consumers with varying degrees of health consciousness and different healthy lifestyles will have dissimilar attitudes toward functional foods and will vary in their willingness to use them. Regression analysis of this empirical study verifies that consumers’ attitudes toward functional foods do have an impact on their willingness to use such foods. Moreover, moderated regression analysis (MRA) reveals that the joint moderator of health consciousness and healthy lifestyle indeed exerts an impact on consumers’ willingness to consume functional foods. Finally, one-way ANOVA tests show that there are some differences between the consumers of the “Healthy Life Attentive” group and those of the “Healthy Life Inattentive” one both in attitudes toward and in willingness to consume functional foods. The empirical results and findings from this study would be valuable for the marketers in the functional food industry to formulate marketing communication strategies and facilitate this industry's development.     

Accommodating patients with obesity and mobility difficulties: Observations from physicians

BackgroundGiven the growing population of U.S. adults with obesity and mobility disability, physicians will need to accommodate these patients.ObjectiveTo explore attitudes and practices of US physicians related to caring for patients with obesity and mobility disability.MethodsThree open-ended, semi-structured, web-based focus group interviews with practicing physicians in selected specialties, which reached data saturation. Interviews were video recorded and transcribed for qualitative, conventional content analysis. Measurements included commonly expressed themes around caring for patients with obesity.ResultsPhysicians recognized obesity as a disability that poses challenges to high quality, safe, and efficient patient care. Observations coalesced around four themes: (1) difficulty routinely tracking weight; (2) reluctance to transfer obese patients to exam tables; (3) barriers to diagnostic testing; and (4) weight stigma. Physicians described difficulties accurately assessing weight, performing complete physical examinations, arranging diagnostic imaging, and providing prenatal care for obese patients. Lack of accessible medical diagnostic equipment impeded care for patients with obesity. Other participants did not contest comments of individual participants’ that suggested weight stigma.ConclusionsOur findings suggest that important gaps may remain in providing equitable access to care for patients with obesity, requiring additional training and accessible medical diagnostic equipment to safely accommodate these patients.     

中国中老年人群生活方式与心血管病发生风险关联:基于东风同济队列的综述

我国人口老龄化进程加快所带来的心血管疾病(cardiovascular disease,CVD)等慢性病问题日趋严峻,如何降低其发生已成为首要的公共卫生任务.关注中老年人群健康的东风同济队列于2008-2010年完成基线调查共纳入27 009名研究对象,至2018年12月随访已逾10年,目前已经系统地探讨了多种生活方式...     

Effectiveness to promote weight loss maintenance and healthy lifestyle habits of a group educational intervention program in adults with obesity: IGOBE program

BackgroundTo achieve sustainable weight loss and healthy lifestyle changes is a huge challenge in the fight against obesity. The objective of this study was to evaluate the effectiveness to promote weight loss maintenance and healthy lifestyle habits of a group educational intervention program, Group Intervention in OBEsity (IGOBE), compared with a usual care therapy to lose weight.MethodsPatients with obesity (n = 437; 18.5% men, 18–77 years and 40.4 ± 6.7 kg/m²) were randomised into two groups to follow a prospective interventional real-life study: a control group (CG), treated with usual clinical practice, and an intervention group (IG), in which the patients participate in a group intervention program on healthy lifestyle habits with weekly sessions for six weeks, after which a re-evaluation was made at six months and at 12 months of follow-up. After finishing the study dropout rates were 44.6% in CG and 43.4% in IG. Anthropometric, dietetic habits and body composition data were analysed in both groups at the pre-intervention and post-interventions of the subjects by completer’s analysis.ResultsAt 12 months of following IGOBE program, the IG achieved greater weight loss (–7.1% of the initial weight) than the CG, which exhibited a weight gain (3.0% of the initial weight). The body weight change induced in the IG was accompanied by a reduction in fat mass, particularly visceral fat and waist circumference. Relevantly, the IG adhered to a healthy dietary pattern and changed its eating habits, which correlated with the improvement in body weight.ConclusionsIntensive educational group treatment that induces a change of eating habits and adherence to healthy dietary pattern is more effective in a long-term to counteract obesity traits than a standard treatment performed individually. The IGOBE program could be a cost-effective practice in the clinical management of obesity.     

Role of access to parks and markets with anthropometric measurements,biological markers,and a healthy lifestyle

Background: This study examined the association between access to urban green spaces and markets with anthropometric measurements, biological markers, sociodemographic, and healthy lifestyle.

Methods: Geographic information systems were used to establish a correlation between environmental features and cardiovascular risk parameters. A total number of 832 (age range 18–74 years) individuals were selected for this study.

Results: Body mass index was significantly and positively related to the distance to parks (ρ = 0.079, p < 0.05), but negatively related to the distance to markets (ρ = ?0.125, p < 0.05). In addition, waist circumference was similar and positively related to distance to parks (ρ = 0.097, p < 0.05) and negatively related to distance to markets (ρ = ?0.092, p < 0.05). With respect to biochemical parameters, when there was an increase in the distance to markets, high-density lipoprotein cholesterol increased and glycemia decreased.

Conclusion: The results of this study suggest the importance of the role of environmental factors such as parks and markets in the development of cardiovascular risk.     

Study protocol: a randomised controlled trial investigating the effect of a healthy lifestyle intervention for people with severe mental disorders

Background  

The largest single cause of death among people with severe mental disorders is cardiovascular disease (CVD). The majority of people with schizophrenia and bipolar disorder smoke and many are also overweight, considerably increasing their risk of CVD. Treatment for smoking and other health risk behaviours is often not prioritized among people with severe mental disorders. This protocol describes a study in which we will assess the effectiveness of a healthy lifestyle intervention on smoking and CVD risk and associated health behaviours among people with severe mental disorders.