scholarly journals Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial

2021 ◽  
Author(s):  
Cesar I. Fernandez-Lazaro ◽  
Estefanía Toledo ◽  
Pilar Buil-Cosiales ◽  
Jordi Salas-Salvadó ◽  
Dolores Corella ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Longitudinal Analysis ◽  
Self Efficacy ◽  
Chronic Conditions ◽  
Dietary Intervention ◽  
Dietary Change ◽  
Multiple Chronic Conditions ◽  
Dietary Changes ◽  
Factors Associated ◽  
Baseline Factors

Abstract Purpose Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. Methods Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of ≥ 5 points for participants with baseline scores < 13 points or any increase if baseline score was ≥ 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. Results Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25–1.83; OR12-month: 1.66, 95% CI 1.37–2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07–2.46; OR12-month: 1.62, 95% CI 1.07–2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53–0.79; OR12-month: 0.76, 95% CI 0.62–0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64–0.99; OR12-month: 0.71, 95% CI 0.57–0.88). Conclusion Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions. Trial registration ISRCTN registry 89898870, 24th July 2014 retrospectively registered http://www.isrctn.com/ISRCTN89898870.

Nutritional knowledge, attitude, and use of food labels among Indian adults with multiple chronic conditions

2019 ◽  
Vol 121 (7) ◽  
pp. 1480-1494 ◽  
Author(s):  
Yam B. Limbu ◽  
Christopher McKinley ◽  
Rajesh K. Gautam ◽  
Ajay K. Ahirwar ◽  
Pragya Dubey ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Food Labels ◽  
Food Label ◽  
Nutritional Knowledge ◽  
Content Type ◽  
Food Label Use ◽  
Knowledge And Attitude ◽  
Label Use

Purpose The purpose of this paper is to examine the indirect effects of nutritional knowledge and attitude toward food label use on food label use through self-efficacy and trust, as well as whether gender moderates this relationship. Design/methodology/approach A sample of Indian adults with multiple chronic conditions was surveyed about their nutritional knowledge, attitude, self-efficacy and use of food labels. Hypotheses were tested using Hayes’s (2013) PROCESS macro for SPSS. Findings The results show that nutritional knowledge and attitude toward food label use positively predict food label use through self-efficacy and trust. However, these mediation effects are moderated by gender such that the indirect relationship is stronger among men than women. Practical implications Food marketers and government agencies engaged in nutrition education campaigns should aim to increase patients’ confidence in comprehending food label information. Social implications Since food labels can be a valuable tool to help patients with chronic diseases to make informed decisions about their diet and lifestyle, regulators may consider mandating nutritional labels on foods to help them improve their food or dietary choices. Originality/value This study uniquely applies Fisher and Fisher’s (1992) information–motivation–behavioral skills model as a theoretical framework to examine the influence of nutrition knowledge and attitude toward food label use on food label usage of Indian patients with multiple chronic diseases.

scholarly journals Applying Behavioral Nudges in a Dietary Comparator for Surgical Trials: Developing the MediDiet

2021 ◽  
Author(s):  
Irene Y. Zhang ◽  
Daniel Norwitz ◽  
Adam Drewnowski ◽  
Nidhi Agrawal ◽  
David R. Flum ◽  
...  
Keyword(s):  
Pilot Study ◽  
Positive Affect ◽  
Mediterranean Diet ◽  
Dietary Intervention ◽  
Behavioral Science ◽  
Negative Emotions ◽  
Dietary Change ◽  
Validated Questionnaire ◽  
The Mediterranean ◽  
Dietary Feedback

Introduction: The Mediterranean diet is being studied as an alternative to surgery for common gastrointestinal conditions. However, dietary change can be challenging. "Nudges" - behavioral science strategies seeking to influence cognitive processes to promote good behaviors - may help. We conducted a pilot study evaluating the acceptability of the MediDiet, a behaviorally designed dietary intervention incorporating nudges and recommendations based on the Mediterranean Diet. Methods: We conducted a three-phase pilot study involving parallel randomized surveys of U.S. adults. After completing a validated questionnaire assessing dietary consistency with a Mediterranean diet, participants were randomized to feedback containing no nudge versus nudge: peer comparison; peer comparison + positive affect induction; or default. Participants then rated their positive and negative emotions, motivation for dietary change, and interest in recipes. Responses were analyzed using baseline covariate-adjusted regression. Results: Among 1,709 participants, 56% were men, 73% were White, and the mean age was 38. In response to dietary feedback, participants reported low negative emotions, high positive emotions, moderate motivation for dietary change and high interest in recipes. Nudges did not affect the extent of negative (p=0.104) or positive (p=0.34) emotions, motivation (p=0.139), or interest (p=0.86). In exploratory analyses, those with moderate and high consistency with the Mediterranean diet, with or without nudges, reported lower negative affect, greater positive affect, greater motivation, and greater interest in recipes, than the minimally consistent, no nudge group. Conclusion: Delivering dietary feedback based on the Mediterranean diet using behavioral nudges was acceptable among U.S. adults, rousing positive reactions without triggering negative ones. As early evidence, this pilot study provides the basis for testing nudge-based dietary guidance among individuals with symptomatic gallstones, diverticulitis, and other gastrointestinal diseases.

Exploring Factors Associated with Physical Activity in Latino Immigrants

2020 ◽  
Vol 42 (9) ◽  
pp. 680-689
Author(s):  
Martin Mikell ◽  
Julia Snethen ◽  
Sheryl T. Kelber
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Self Efficacy ◽  
Chronic Conditions ◽  
Community Perceptions ◽  
Cross Sectional ◽  
Factors Associated ◽  
Latino Community ◽  
Increased Risk

Latinos are at increased risk for developing chronic conditions. Regular physical activity (PA) assists in protecting adults from developing type 2 diabetes, excess weight, and heart disease, making PA important for health promotion. This cross-sectional, descriptive investigation was conducted with adults 18 years of age and older in a predominately Latino community. Perceptions of factors which influenced PA were examined. Descriptive statistics and multiple regression analysis were performed. Immigrant Latino males engaged in PA significantly more often than female participants. In Latino participants, those who engaged in walking activities were more likely to engage in both vigorous ( r = .341, p<.005) and moderate PA ( r = .317, p <.001). Self-efficacy and acculturation were significant predictors of PA. Acculturation was associated with physical activity, even after adjusting for perceived stress. Findings highlight the continued importance of self-efficacy to foster health promotion in Latino communities.

scholarly journals The Acceptability of Technology in Health Care Among Older Korean Adults With Multiple Chronic Conditions

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 223-223
Author(s):  
Ji Yeon Ha ◽  
Hyeyoung Park
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Technology Acceptance ◽  
Cognitive Ability ◽  
Self Efficacy ◽  
Chronic Conditions ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Korean Adults ◽  
Facilitating Conditions

Abstract Background: Although there are benefits in utilizing ICT in health care, older adults have challenges in employ technologies in their health care management due to the changes in cognitive and physical functions, low motivation to use technology, and low computer/internet literacy (Adebayo et al, 2017; Wildenbos et al, 2018). The purpose of this study is to investigate the acceptance of technology among older Korean adults with multiple chronic conditions and examine factors associating with the acceptance of the technology. Method: The participants were 226 community-dwelling older adults who have more than two chronic conditions. Directed by the senior technology acceptance model (Chen & Chan, 2014), demographics, gerontechnology self-efficacy, gerontechnology anxiety, facilitating conditions, self-reported health conditions, cognitive ability, social relationship, attitude to life and satisfaction, physical functioning, and acceptance of technology were surveyed using a self-reported questionnaire. Findings: Older Korean adults with multiple chronic conditions showed a moderately high technology acceptance score (M = 25.35, SD = 5.28). There were significant differences in the acceptance of technology depending on age (r=-0.241, p&lt;.01), cognitive ability (r=0.225, p&lt;.01), gerontechnology self-efficacy (r=0.323, p&lt;.0001), and facilitating conditions (r=0.288, p&lt;.0001). Conclusion: While older age were associated to the acceptance of technology, gerontechnology self-efficacy which is one’s judgment of their ability to perform a task successfully using gerontechnology and facilitating conditions which are environmental factors that help older adults use gerontechnology easier were positively associated with the acceptance of technology among older Korean adults with multiple chronic conditions.

scholarly journals Health Self-Efficacy Among Populations with Multiple Chronic Conditions: the Value of Patient-Centered Communication

2016 ◽  
Vol 33 (8) ◽  
pp. 1440-1451 ◽  
Author(s):  
Lila J. Finney Rutten ◽  
Bradford W. Hesse ◽  
Jennifer L. St. Sauver ◽  
Patrick Wilson ◽  
Neetu Chawla ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Patient Centered

Factors associated with tobacco use among patients with multiple chronic conditions

2016 ◽  
Vol 221 ◽  
pp. 1004-1007 ◽  
Author(s):  
Arise Garcia de Siqueira Galil ◽  
Ana Paula Cupertino ◽  
Eliane F.C. Banhato ◽  
Tatiane S. Campos ◽  
Fernando A.B. Colugnati ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Factors Associated

scholarly journals Web-Based Intervention for Family Carers of Persons with Dementia and Multiple Chronic Conditions (My Tools 4 Care): Pragmatic Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Wendy Duggleby ◽  
Jenny Ploeg ◽  
Carrie McAiney ◽  
Shelley Peacock ◽  
Kathryn Fisher ◽  
...  
Keyword(s):  
Treatment Group ◽  
Social Services ◽  
Self Efficacy ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Mental Component Summary Score ◽  
Outcome Variable ◽  
Group Differences ◽  
Control Group ◽  
Multiple Chronic Conditions

BACKGROUND My Tools 4 Care (MT4C) is a Web-based intervention that was developed based on the transitions theory. It is an interactive, self-administered, and portable toolkit containing six main sections intended to support carers of community-living persons with Alzheimer’s disease and related dementia and multiple chronic conditions through their transition experiences. OBJECTIVE The objective of our study was to evaluate the effectiveness of MT4C with respect to increasing hope, self-efficacy, and health-related quality of life in carers of community-living older persons with Alzheimer’s disease and related dementia and multiple chronic conditions. METHODS A multisite, pragmatic, mixed methods, longitudinal, repeated-measures, randomized controlled trial was conducted between June 2015 and April 2017. Eligible participants were randomized into either treatment (MT4C) or educational control groups. Following baseline measures, carers in the treatment group received 3 months of password-protected access to MT4C. Trained research assistants collected data from participants via phone on hope (Herth Hope Index [HHI]), self-efficacy (General Self-Efficacy Scale), and health-related quality of life (Short Form-12 item [version 2] health survey; SF-12v2) at baseline, 1, 3, and 6 months. The use and cost of health and social services (Health and Social Services Utilization Inventory) among participants were measured at baseline, 3, and 6 months. Analysis of covariance was used to identify group differences at 3 months, and generalized estimating equations were used to identify group differences over time. RESULTS A total of 199 carers participated in this study, with 101 participants in the treatment group and 98 in the educational control group. Of all, 23% (45/199) participants withdrew during the study for various reasons, including institutionalization or death of the person with dementia and lack of time from the carer. In the treatment group, 73% (74/101) carers used MT4C at least once over the 3-month period. No significant differences in the primary outcome measure (mental component summary score from the SF-12v2) by group or time were noted at 3 months; however, significant differences were evident for HHI-factor 2 (P=.01), with higher hope scores in the treatment group than in the control group. General estimating equations showed no statistically significant group differences in terms of mental component summary score at all time points. Attrition and the fact that not all carers in the treatment group used MT4C may explain the absence of statistically significant results for the main outcome variable. CONCLUSIONS Despite no significant differences between groups in terms of the primary outcome variable (mental component score), the significant differences in terms of one of the hope factors suggest that MT4C had a positive influence on the lives of participants. CLINICALTRIAL ClinicalTrials.gov NCT02428387; https://clinicaltrials.gov/ct2/show/NCT02428387 (Archived by Webcite at http://www.webcitation.org/708oFCR8h).

Factors associated with oral chemotherapy adherence in specialty pharmacies.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19137-e19137
Author(s):  
Shanada Monestime ◽  
Ray D. Page ◽  
William M. Jordan ◽  
Subhash Aryal ◽  
Rafia Rasu
Keyword(s):  
Health Care Providers ◽  
Chronic Conditions ◽  
Care Patient ◽  
Oral Chemotherapy ◽  
Multiple Chronic Conditions ◽  
Care Providers ◽  
Factors Associated ◽  
Specialty Pharmacy ◽  
The Mean ◽  
The Impact

e19137 Background: Specialty pharmacies are expanding in the oncology setting and often favored by payors because of economic and operational benefits. However, challenges exist in coordination of care, patient safety, cost/reimbursement, and operational efficiency. While in-house specialty pharmacies mitigate these challenges due to close proximity of health care providers, these challenges can impact medication adherence. To date, limited data are available on adherence rates and factors associated with oral chemotherapy (OC) adherence in specialty pharmacy settings. Methods: Adult cancer patients who received their first OC between Aug.-Oct. 2018 were analyzed. Pharmacies were contacted to obtain OC pick-up dates over 6 months or until treatment completion. Patients were adherent if the proportion of days covered (PDC) was ≥90%. Descriptive and bivariate logistic regression models were performed to examine demographics, specialty pharmacy type (external vs. internal), distance from pharmacy to home, and chronic comorbidities. Results: Of the 80 patients analyzed, the mean age was 63.59 (SD ±11.8), 51.21% were female, 68.75% were white, 61.25% were married, 82.50% were smokers, 53.75% were on government insurance, 73.75% were using an internal pharmacy, and the mean distance traveled to pharmacy was 17.06 miles (SD±22.66). Thirty-five patients (43.75%) were adherent (mean PDC = 78%, range, 17-100%). Patients who went to an internal pharmacy were 1.81 times likely to be adherent than those who went to an external pharmacy [OR: 1.81, 95% CI (0.64- 5.11)]. We found that males were 1.21 times more likely to be adherent than females [OR: 1.21, 95% CI (0.50- 2.93)] and smokers were 2.21 times more likely to be adherent than non-smokers [OR: 2.21, 95% CI (0.63-7.78)]. Multiple chronic conditions were significantly associated with a decrease in OC adherence, even after controlling for covariates [OR: 0.66, 95% CI (0.66- 0.95); p = 0.02]. Conclusions: Patients with fewer comorbidities receiving OC from specialty pharmacies were significantly more adherent than those with multiple comorbidities. Further studies examining the impact financial toxicity has on adherence for patients with chronic conditions are warranted.

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