Resources for health: A primary-care-based diet and physical activity intervention targeting urban Latinos with multiple chronic conditions.

Background: Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental wellbeing after a motivational interviewing (MI) community-based PA intervention and the impact of signposting [SP] and Social Action [SA] (i.e. weekly group support) pathways. Methods: Participants (n=2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental wellbeing data were collected at baseline (following an initial 30-minute MI appointment), 12-weeks, six-months, and 12-months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models were used to derive point estimates and 95%CIs for outcomes at each time point and change scores. Results: Participants increased PA and mental wellbeing at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12-weeks, but the SP pathway retained more participants at six-months and 12-months. Conclusions: Both pathways produced similar improvements in PA and mental wellbeing, suggesting the effectiveness of MI based PA interventions. However, due to lower resources required yet similar effects, SP pathways are recommended over SA to support PA in primary care settings.

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¡Mi Vida Saludable! A randomized, controlled, 2 × 2 factorial trial of a diet and physical activity intervention among Latina breast cancer survivors: Study design and methods

Contemporary Clinical Trials ◽

10.1016/j.cct.2021.106524 ◽

2021 ◽

pp. 106524

Author(s):

Margarita Santiago-Torres ◽

Isobel Contento ◽

Pamela Koch ◽

Wei-Yann Tsai ◽

Adam M. Brickman ◽

...

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Cancer Survivors ◽

Study Design ◽

Breast Cancer Survivors ◽

Physical Activity Intervention ◽

Randomized Controlled ◽

Diet And Physical Activity ◽

Factorial Trial ◽

Design And Methods

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HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

Innovation in Aging ◽

10.1093/geroni/igz038.1160 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S317-S318

Author(s):

Jenny Ploeg ◽

Marie-Lee Yous ◽

Kimberly Fraser ◽

Sinéad Dufour ◽

Sharon Kaasalainen ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Home Care ◽

Family Caregivers ◽

Chronic Conditions ◽

Care Delivery ◽

Healthcare Providers ◽

Multiple Chronic Conditions ◽

Team Approach ◽

Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

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Should Physical Activity Intervention Efforts Take a Whole Population, High-Risk, or Middle Road Strategy?

Journal of Physical Activity and Health ◽

10.1123/jpah.2012-0275 ◽

2014 ◽

Vol 11 (5) ◽

pp. 966-970 ◽

Cited By ~ 4

Author(s):

Geeske Peeters ◽

Richard Hockey ◽

Wendy Brown

Keyword(s):

Physical Activity ◽

Heart Disease ◽

Longitudinal Study ◽

High Risk ◽

Chronic Conditions ◽

Physical Activity Intervention ◽

Incidence Rates ◽

Theoretical Modeling ◽

Actual Distribution ◽

Mail Surveys

Purpose:This study was designed to compare theoretical strategies for changing physical activity (PA) in terms of their potential to reduce the incidence of chronic conditions in midage women: (1) whole population: +30 minutes/week in all, (2) high-risk: +60 minutes/week in the lowest 25% of the PA distribution, and (3) middle road: shift all those not meeting guidelines to a level commensurate with meeting guidelines.Methods:10,854 participants (50–55 years in 2001) in the Australian Longitudinal Study of Women’s Health completed mail surveys in 2001, 2004, 2007, and 2010. PA was calculated as MET·minutes/week spent in walking, moderate and vigorous PA in the previous week. Incidence rates per 1000 person-years for diabetes, heart disease, hypertension, cancer, and depression were calculated for the actual distribution and after modeled shifts in PA.Results:The incidence rates were 10.6 for diabetes, 7.0 for heart disease, 30.7 for hypertension, 8.0 for cancer, and 28.4 for depression. Greater reductions in incidence were found for the middle road strategy than for the whole population and high-risk strategies, with reductions ranging from –6.3% for cancer to –12.3% for diabetes.Discussion:This theoretical modeling showed that a middle road strategy to increasing PA was superior to the whole population and high-risk strategies, in terms of reducing incidence rates of chronic conditions in middle-aged women.

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Primary care oncology model (PCOM): Implementation of a model integrating primary and oncology care for patients taking oral anticancer agents.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.tps1587 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. TPS1587-TPS1587

Author(s):

Emily R. Mackler ◽

Karen B. Farris ◽

Katie S. Gatwood ◽

Amna Rizvi-Toner ◽

Alex Wallace ◽

...

Keyword(s):

Primary Care ◽

Anticancer Agents ◽

Chronic Conditions ◽

Lymphocytic Leukemia ◽

Chronic Obstructive ◽

Multiple Chronic Conditions ◽

Hiv Intervention ◽

Patient Reported ◽

Chronic Medications ◽

Oral Anticancer Agents

TPS1587 Background: Non-adherence to oral anticancer agents (OAA) has been reported among 30% of individuals. Often, individuals with cancer are not just managing their new OAA but also medications to treat multiple chronic conditions (MCC). Multiple factors contribute to the extent patients on OAAs and MCC medications adhere to therapy. The objective of this study is to improve medication, symptom, and disease management of patients with hematological malignancies and MCC through care coordination between pharmacists. Methods: Design. This is a multi-center prospective single arm pilot study at two academic medical centers in Michigan and Tennessee. Subjects. Ninety participants will be recruited, 60 from site 1 and 30 from site 2. Inclusion criteria are: adults > 18 years, diagnosed with and initiating oral treatment for chronic myeloid leukemia, chronic lymphocytic leukemia, or multiple myeloma, diagnoses of at least 2 chronic conditions, where one is type 2 diabetes, hypertension, congestive heart failure, depression/anxiety, gastroesophageal reflux disease, hyperlipidemia, or chronic obstructive pulmonary disease, taking at least two chronic medications, and able to provide electronic consent. Exclusion criteria are: inability to speak English, and diagnosis of type 1 diabetes or HIV. Intervention. Participants will complete two Patient Reported Outcome Measures (PROMs) for their OAA that will be reviewed by the oncology pharmacist, with follow-up to the care team if needed. Participants will be scheduled for a Comprehensive Medication Review with a primary care pharmacist for up to two visits for their chronic medications. The intervention over 2 months, and the oncology and primary care pharmacists communicate via electronic health record about medications, symptoms, and disease control. Outcomes. The primary endpoints are (a) dose-adjusted adherence by proportion days covered (PDC) for the OAA and (b) PDC for chronic condition medications, assessed using 6 months of prescription claims. Data will be collected from patients using REDCap surveys and abstracted data will be entered into REDCap. Implementation by pharmacists and patient acceptability will be examined. Analysis. The association of OAA and chronic medication adherence (PDC) will be examined via correlation. Participant demographics,clinical characteristics, and the symptom experience from the PROM will be described. Using CMR results, medication problems, recommendations, and changes will be provided. Program implementation will be assessed and patient perceptions obtained from post-CMR interviews. A joint display for the quantitative and qualitative data for feasibility, appropriateness, and acceptability from pharmacists will be completed. Results: Screening and recruitment has begun. Clinical trial information: NCT04595851 and NCT04663100.

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