scholarly journals Self-Management of Diabetes in Black Men: The Flint MANUP Intervention Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 399-400
Author(s):  
Dana Carthron ◽  
Wayne McCullough ◽  
Samir Chatterjee ◽  
Kent Key ◽  
Kelsey Lemke ◽  
...  
Keyword(s):  
Physical Activity ◽  
Black Men ◽  
Repeated Measures ◽  
Text Messaging ◽  
The United States ◽  
Active Coping ◽  
Blood Glucose Monitoring ◽  
Self Management ◽  
Moderate Physical Activity ◽  
High Effort

Abstract The story of John Henry, the “steel-drivin’ man”, is well known to Black men in the United States. John Henry is considered a hero because he demonstrated tremendous strength and self-determination. The MANUP diabetes program used the John Henryism, defined as high-effort active coping in the face of adversity, as the basis of a diabetes intervention for Black men. MANUP conducted four community-based focus groups identifying topics of concern to Black men with type 2 diabetes (T2D). Interestingly, the men reported that high-effort active coping was crucial for successful diabetes self-management. MANUP then developed and implemented a longitudinal culturally targeted self-management program for 33 Black men with T2D in Flint, Michigan. MANUP included discussion groups, physical activity, and an app incorporating text-messaging, group-chat, and a blood glucose monitoring dashboard to improve glycemic control (A1c). This single-group, repeated measures intervention assessed A1c three times over a six-month period. Improvements in A1c were observed at: baseline – time 2: 8.9% vs 8.6%, p=0.14; time 2 – time 3: 8.6% vs 8.1%, p=0.21; and baseline – time 3: 8.9% vs 8.1%, p=0.005. After controlling for age and insulin use, the significant reduction in A1c over 6 months remained (p=0.01). These findings demonstrate that combining mobile health technology and moderate physical activity with culturally targeted discussion topics can improve T2D self-management and reduce A1c in Black men. More community-driven longitudinal intervention studies that improve diabetes self-management among Black men are needed to achieve gender and racial health equity.

scholarly journals The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomised Controlled Trial

2019 ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Repeated Measures ◽  
Patient Adherence ◽  
Intervention Group ◽  
Public Hospitals ◽  
Self Management ◽  
Control Group ◽  
Management Application

Abstract Background : Self-management of blood pressure is of great significance given the increasing incidence of hypertension and associated disabilities. With the increased use of mobile health in medicine, the present study evaluated the effect of the self-management application on patient adherence to hypertension treatment. Methods : This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up to 24 th weeks. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model). Results : The treatment adherence score increased by an average of 5.9 (95%CI: 5.0-6.7) in the intervention group compared to the control group. Scores of adherence to the low-fat and low-salt diet plans were 1.7 (95%CI: 1.3-2.1) and 1.5 (95%CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95%CI: 61.7-138.3) per week in the intervention group. Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones , mhealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries. Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on 1 January 2016.

Examining the Association between Item Specific Treatment Burden and Adherence in People Living with HIV

2019 ◽  
Vol 42 (7) ◽  
pp. 495-502 ◽  
Author(s):  
Nathanial Schreiner ◽  
Joseph Perazzo ◽  
Sarah Digenarro ◽  
Jackson Currie ◽  
Barbara Daly ◽  
...  
Keyword(s):  
Physical Activity ◽  
Specific Treatment ◽  
The United States ◽  
Healthy Eating Index ◽  
Healthy Diet ◽  
Self Management ◽  
People Living With Hiv ◽  
Treatment Burden ◽  
Medication Regimen ◽  
Optimal Health

For the 1.1 million people with HIV (PWH) in the United States, adherence to a HIV anti-retroviral medication regimen, engagement in regular physical activity, and eating a healthy diet are essential for maintaining optimal health. However, treatment burden can increase the risk for self-management non-adherence. We analyzed data of 103 men and women diagnosed with HIV to examine the relationship between medication, physical activity, and diet-related treatment burden to corresponding measures of self-management adherence. Multivariate analysis demonstrated that one medication treatment burden item explained 11% (p=.01) of self-reported 30-day HIV anti-retroviral medication adherence; physical activity treatment burden, along with physical functioning, explained 25% (p<.001) of physical activity, measured by daily average steps; and diet-specific treatment burden was non-significant in maintaining a healthy diet, measured by a total Healthy Eating Index-2010 score. Findings demonstrate that specific treatment burden items can predict specific self-management outcome behavior in PWH.

scholarly journals The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Repeated Measures ◽  
Patient Adherence ◽  
Intervention Group ◽  
Public Hospitals ◽  
Self Management ◽  
Control Group ◽  
Management Application

Abstract Background: Self-management of hypertension is of great significance given its increasing incidence and its associated disabilities. In view of the increased use of mobile health in medicine, the present study evaluated the effect of a self-management application on patient adherence to hypertension treatment.Methods: This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up until the 24th week. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model).Results: The treatment adherence score increased by an average of 5.9 (95% CI: 5.0-6.7) in the intervention group compared to the control group. Scores of 'adherence to the low-fat and low-salt diet plans' were 1.7 (95% CI: 1.3-2.1) and 1.5 (95% CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95% CI: 61.7-138.3) per week in the intervention group.Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones, mHealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries.Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on January 1st 2016.

scholarly journals The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Repeated Measures ◽  
Patient Adherence ◽  
Intervention Group ◽  
Public Hospitals ◽  
Self Management ◽  
Control Group ◽  
Management Application

Abstract Background: Self-management of hypertension is of great significance given its increasing incidence and its associated disabilities. In view of the increased use of mobile health in medicine, the present study evaluated the effect of a self-management application on patient adherence to hypertension treatment. Methods: This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up until the 24th week. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model). Results: The treatment adherence score increased by an average of 5.9 (95% CI: 5.0-6.7) in the intervention group compared to the control group. Scores of 'adherence to the low-fat and low-salt diet plans' were 1.7 (95% CI: 1.3-2.1) and 1.5 (95% CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95% CI: 61.7-138.3) per week in the intervention group. Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones, mHealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries. Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on January 1st 2016.

scholarly journals The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Repeated Measures ◽  
Patient Adherence ◽  
Intervention Group ◽  
Public Hospitals ◽  
Self Management ◽  
Control Group ◽  
Management Application

Abstract Background: Self-management of hypertension is of great significance given its increasing incidence and its associated disabilities. With the increased use of mobile health in medicine, the present study evaluated the effect of a self-management application on patient adherence to hypertension treatment. Methods: This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up until the24th week. Data on the primary outcome (adherence to treatment) and secondary outcomes(adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model). Results: The treatment adherence score increased by an average of 5.9 (95% CI: 5.0-6.7) in the intervention group compared to the control group. Scores of 'adherence to the low-fat and low-salt diet plans' were 1.7 (95% CI: 1.3-2.1) and 1.5 (95% CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95% CI: 61.7-138.3) per week in the intervention group. Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones, mHealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries. Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on January 1st2016.

Abstract P126: Self-management Program And Black Women With Hypertension

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Willie M Abel
Keyword(s):  
Black Women ◽  
Repeated Measures ◽  
Care Management ◽  
Self Care ◽  
The United States ◽  
Management Program ◽  
Lifestyle Changes ◽  
Community Dwelling ◽  
Self Management ◽  
Effective Interventions

Introduction: Prevalence rates of hypertension (HTN) among Black adults (males 58.3% and females 57.6%) in the United States is among the highest in the world. Black females (46%) experience a higher incidence of Stage 2 HTN than Black males (42%) contributing to a greater risk of heart failure, stroke, and kidney disease. Levels of awareness, treatment, and control of HTN among Black women are decreasing. Effective strategies to combat these trends are imperative. Lifestyle changes and medication adherence are proven strategies to facilitate blood pressure (BP) control. Getting individuals with HTN to incorporate these strategies into the context of their everyday physical and social environments where they can be performed independently requires active individual engagement in healthcare behaviors and self-care activities. Aim: This study examined the effects of the Chronic Disease Self-Management Program (CDSMP) on self-care (maintenance, management, and confidence) and BP control in Black women with HTN at baseline and then 3-, 6-, and 9-months post CDSMP. Methods: The current study used data from the Interactive Technology Enhanced Coaching Intervention RCT for Black Women with HTN study. All participants completed a 6-week CDSMP at the beginning of the study. Self-care data were collected using the Self-Care of HTN Inventory along with manual BP readings at baseline, and repeated measures at 3-, 6-, and 9-months. Results: Of the 90 community-dwelling Black women enrolled in the study, 83 completed the CDSMP and 69 completed the study. The mean age was 53.57 ( SD = 10.07) years and the average number of years diagnosed with HTN was 11.06 ( SD = 8.47). All participants had BP readings greater than 130/80 mmHg at baseline and 44.92% (31 of 69) moved to less than 130/80 mmHg at 9-months. A weak negative correlation occurred at 9-months between systolic BP and self-care management, r (67) = -.26, p = .029, and confidence, r (67) = -.25, p = .035; and diastolic BP and self-care management, r (67) = -.31, p = .009, and confidence, r (67) = -.28, p = .018. Conclusion: The CDSMP was feasible, successfully delivered, and well-received by those enrolled in the study. Future studies should evaluate effective interventions for self-care strategies to improve long-term BP control.

scholarly journals Alternative Wear-Time Estimation Methods Compared to Traditional Diary Logs for Wrist-Worn ActiGraph Accelerometers in Pregnant Women

2020 ◽  
Vol 3 (2) ◽  
pp. 110-117
Author(s):  
Samantha F. Ehrlich ◽  
Amanda J. Casteel ◽  
Scott E. Crouter ◽  
Paul R. Hibbing ◽  
Monique M. Hedderson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pregnant Women ◽  
Repeated Measures ◽  
Vigorous Physical Activity ◽  
Time Estimation ◽  
Estimation Methods ◽  
Moderate Physical Activity ◽  
Wear Time ◽  
Time Estimates ◽  
Efficient Alternative

Background: This study sought to compare three sensor-based wear-time estimation methods to conventional diaries for ActiGraph wGT3X-BT accelerometers worn on the non-dominant wrist in early pregnancy. Methods: Pregnant women (n = 108) wore ActiGraph wGT3X-BT accelerometers for seven days and recorded their device on and off times in a diary (criterion). Average daily wear-time estimates from the Troiano and Choi algorithms and the wGT3X-BT accelerometer wear sensor were compared against the diary. The Hibbing 2-regression model was used to estimate time spent in activity (during periods of device wear) for each method. Wear-time and time spent in activity were compared with multiple repeated measures ANOVAs. Bland Altman plots assessed agreement between methods. Results: Compared to the diary (825.5 minutes [795.1, 856.0]), the Choi (843.0 [95% CI: 812.6, 873.5]) and Troiano (839.1 [808.7, 869.6]) algorithms slightly overestimated wear-time, whereas the sensor (774.4 [743.9, 804.9]) underestimated it, although only the sensor differed significantly from the diary (p < .0001). Upon adjustment for average daily wear-time, there were no statistically significant differences between the wear-time methods in regards to minutes per day of moderate-to-vigorous physical activity (MVPA), vigorous physical activity, and moderate physical activity. Bland Altman plots indicated the Troiano and Choi algorithms were similar to the diary and within ≤0.5% of each other for wear-time and MVPA. Conclusions: The Choi or Troiano algorithms offer a valid and efficient alternative to diaries for the estimation of daily wear-time in larger-scale studies of MVPA during pregnancy, and reduce burden for study participants and research staff.

scholarly journals Improvements in physical activity and some dietary behaviors in a community health worker-led diabetes self-management intervention for adults with low incomes: results from a randomized controlled trial

2021 ◽  
Author(s):  
Kristen E Gray ◽  
Katherine D Hoerster ◽  
Leslie Taylor ◽  
James Krieger ◽  
Karin M Nelson
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Community Health ◽  
Self Efficacy ◽  
Lifestyle Changes ◽  
Dietary Behaviors ◽  
Blood Glucose Monitoring ◽  
Self Management ◽  
Diabetes Distress ◽  
Low Incomes

Abstract People with low incomes have a disproportionate prevalence of diabetes and its complications and experience many barriers to self-management, which community health workers (CHWs) may help address. We sought to examine the effects of an in-home CHW-led intervention for adults with diabetes and incomes &lt;250% of the federal poverty line on self-management behaviors and test mediators and moderators. From 2010 to 2013, we randomized participants from three Washington State health systems with type 2 diabetes and hemoglobin A1c (HbA1c) ≥ 8% to the CHW intervention (N = 145) or usual care control (N = 142) arms. We examined effects on 12-month self-management: physical activity, dietary behaviors, medication taking, blood glucose monitoring, foot care, and tobacco use. For behaviors with significant intervention-control group differences, we tested mediation by self-efficacy and social support. We also investigated whether intervention-associated changes in behaviors varied by race/ethnicity, gender, and baseline values of HbA1c, diabetes distress, depression, and food insecurity (moderators). Compared to controls, intervention participants engaged in more physical activity and reported better dietary behaviors for some measures (general diet, frequency of skipping meals, and frequency of eating out) at 12-months, but there was no evidence of mediation by self-efficacy or social support. Evidence of moderation was limited: improvements in the frequency of skipping meals were restricted to participants with baseline HbA1c &lt; 10%. Study findings suggest CHWs could be integrated into diabetes care to effectively support lifestyle changes around physical activity and some eating behaviors among adults with low incomes. More research is needed to understand mechanisms of change.

Abstract P257: The Association of Metabolic Risk and Physical Activity Trajectories: CARDIA

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Sarah M Camhi ◽  
Peter T Katzmarzyk ◽  
Stephanie Broyles ◽  
Timothy S Church ◽  
Arlene L Hankinson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Young Adults ◽  
Black Women ◽  
Black Men ◽  
Repeated Measures ◽  
White Women ◽  
Smoking Status ◽  
White Men ◽  
Metabolic Risk ◽  
Linear Modeling

Purpose: To determine whether baseline metabolic risk in young adults is associated with physical activity (PA) trajectories over 20 years. Methods: The sample included young adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study, baseline ages 18–30 years (n= 4161). PA was determined from self-reported questionnaire at baseline and at years 2,5,7,10,15 and 20 of follow-up. Baseline metabolic risk was calculated using age-adjusted principal components analysis (elevated=top 10% of first factor), within sex-by-race groups, from mean arterial pressure (1/3(SBP-DBP)+DBP), glucose, waist circumference, triglycerides, and high-density lipoprotein cholesterol. Repeated measures general linear modeling was used to generate PA trajectories over 20 years, separately in black men, white men, black women and white women, adjusting for age and smoking status. Time by metabolic risk interaction terms did not contribute significantly to any model for any sex-by-race group and were therefore not included in final models. Results: In black men, white men, and white women, PA (in exercise units) at baseline was significantly lower among those with elevated metabolic risk (elevated risk vs. normal risk: black men 473.0 ± 27.0 vs. 572.0 ± 22.7; white men: 498.0 ±20.6 vs. 568.7 ± 17.3; white women: 402.4 ± 17.0 vs. 481.1 ± 14.3), and these differences persisted over 20 years (black men: −98.9 ± 16.4, white men: −70.8 ± 12.5 , white women: −78.7 ± 10.2; all p<0.0001). There were no significant differences in PA by metabolic risk in black women (307.2 ± 15.5 vs. 317.4 ± 13.1, difference: −10.1 ± 9.3, p =0.27). Conclusion: Elevated metabolic risk is associated with lower levels of PA in early adulthood, and these differences persist over 20 years. Despite these lower levels at baseline, the PA trajectory declines at similar rates for those with and without elevated metabolic risk. Young adults with elevated metabolic risk are important to identify early, in order to prevent PA level gap which remains over 20 years between those with and without elevated metabolic risk.

BE-PALS: An Innovative Theory-Based Intervention to Promote Moderate Physical Activity Among Adult Lesbians

2014 ◽  
Vol 22 (2) ◽  
pp. 71-75 ◽  
Author(s):  
Danielle R. Brittain ◽  
Mary K. Dinger
Keyword(s):  
Physical Activity ◽  
Repeated Measures ◽  
Coping Skills ◽  
Effect Sizes ◽  
Group Differences ◽  
Moderate Physical Activity ◽  
Small Effect Size ◽  
Moderate Effect ◽  
Pilot Intervention ◽  
And Task

Adult lesbians are insufficiently active to achieve health benefits. An 8-week pilot intervention targeting coping skills to overcome barriers, was designed to increase moderate physical activity (MPA) among adult lesbians. Sixteen lesbians aged 29 to 55 years (experimental condition [EC] [n = 10]; control condition [CC] [n = 6] completed measures at baseline and end-program. Mixed repeated-measures ANOVAs used to examine between-group differences in average daily: (a) MPA, (b) task self-efficacy (TSE), and (c) self-regulatory efficacy (SRE) from baseline to end-program, were not significant. Two data trends with moderate effect sizes were identified: (1) the EC maintained 24 minutes/d of MPA (P = .10; d = .43); and (2) TSE was maintained among the EC but decreased for the CC (P = .09; d=.44). Only a small effect size was found (P = .56; d = .16) for SRE. The intervention appears to stem declines in MPA and task-related efficacy beliefs.

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