scholarly journals Influencing cardiovascular health habits in the rural, deep south: results of a cluster randomized trial

2019 ◽  
Vol 34 (2) ◽  
pp. 200-208
Author(s):  
Laurie S Abbott ◽  
Elizabeth H Slate ◽  
Jennifer L Lemacks

Abstract Cardiovascular disease (CVD) is a major cause of death among people living in the United States. Populations, especially minorities, living in the rural South are disproportionately affected by CVD and have greater CVD risk, morbidity and mortality. Culturally relevant cardiovascular health programs implemented in rural community settings can potentially reduce CVD risk and facilitate health behavior modification. The purpose of this study was to examine the effects of a cardiovascular health promotion intervention on the health habits of a group of rural African American adults. The study had a cluster randomized controlled trial design involving 12 rural churches that served as statistical clusters. From the churches (n = 6) randomized to the intervention group, 115 participants were enrolled, received the 6-week health program and completed pretest–posttest measures. The 114 participants from the control group churches (n = 6) did not receive the health program and completed the same pretest–posttest measures. The linear mixed model was used to compare group differences from pretest to posttest. The educational health intervention positively influenced select dietary and confidence factors that may contribute toward CVD risk reduction.

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Nicolaas P. Pronk ◽  
A. Lauren Crain ◽  
Jeffrey J. VanWormer ◽  
Brian C. Martinson ◽  
Jackie L. Boucher ◽  
...  

Objective.To determine the accuracy of self-reported body weight prior to and following a weight loss intervention including daily self-weighing among obese employees.Methods.As part of a 6-month randomized controlled trial including a no-treatment control group, an intervention group received a series of coaching calls, daily self-weighing, and interactive telemonitoring. The primary outcome variable was the absolute discrepancy between self-reported and measured body weight at baseline and at 6 months. We used general linear mixed model regression to estimate changes and differences between study groups over time.Results.At baseline, study participants underreported their weight by an average of 2.06 (se=0.33) lbs. The intervention group self-reported a smaller absolute body weight discrepancy at followup than the control group.Conclusions.The discrepancy between self-reported and measured body weight appears to be relatively small, may be improved through daily self-monitoring using immediate-feedback telehealth technology, and negligibly impacts change in body weight.


2020 ◽  
Vol 30 (1) ◽  
pp. 1-14
Author(s):  
Ayun Sriatmi ◽  
Sri Suwitri ◽  
Zahroh Shaluhiyah ◽  
Sri Achadi Nugraheni

Abstract The inability of pregnant women to identify and recognize danger signs of pregnancy indicates the lack of knowledge, attitudes and perceptions of mothers about healthy pregnancies which has an impact on the low practices of prevention of high risk of pregnancy. Pregnant Women Class Program (KIH) which is held is not optimal because of the low presence of pregnant women for various reasons. The aim of study to determine the effect of the KIH-Virtual model on the practice of preventing high risk of pregnancy. This is a quasi-experimental study with case-control approach. The population is pregnant women in Semarang City. The total sample was 60 mothers for the intervention group and 61 mothers for control group. The independent variable is KIH-Virtual intervention and dependent variable is the practice of preventing high risk pregnancy (covering 7 dimensions). Data collection through interviews and observations with four times measurements (pretest, posttest 1,2,3). Partial analysis using independent-T test and Paired test. Simultaneous analysis with Linear-Mixed-Model. Statistically, there were differences in the practice of preventing high risk pregnancy between intervention groups and control at the last measurement (p<0.05). Although both groups experienced an increase in scores at each measurement stage, it was evident in the intervention group that the increase was higher for all dimensions of practice. The highest increase in the effect of interventions on communication and collaboration practices was followed by health status monitoring practices. Daily self-care practices and lifestyle practices are the dimensions with the lowest intervention effect. Virtual-KIH influences the practice of pregnant women in the prevention of high risk of pregnancy and is able to improve the practice better than conventional models that have been underway. Abstrak  Ketidakmampuan ibu hamil mengidentifikasi dan mengenali tanda bahaya kehamilan mengindikasikan rendahnya pengetahuan, sikap dan persepsi ibu tentang kehamilan sehat, yang berdampak pada rendahnya praktik pencegahan risiko tinggi kehamilan. Program Kelas Ibu Hamil (KIH) yang diselenggarakan belum optimal karena terkendala rendahnya kehadiran ibu hamil dengan berbagai alasannya. Tujuan penelitian menganalisis pengaruh model KIH Virtual terhadap praktik pencegahan risiko tinggi kehamilan. Penelitian ini merupakan penelitian quasi experimental dengan pendekatan kasus-kontrol. Populasi adalah ibu hamil di Kota Semarang. Jumlah sampel 60 ibu untuk kelompok intervensi dan 61 ibu untuk kelompok kontrol. Variabel bebas yaitu intervensi KIH Virtual dan variabel terikatnya yaitu praktik pencegahan risiko tinggi kehamilan (meliputi 7 dimensi). Pengumpulan data melalui wawancara dan observasi dengan 4 kali pengukuran (pretest, posttest-1,2,3). Analisis parsial menggunakan uji beda independen dan berpasangan. Analisis simultan dengan Linear-Mixed-Model. Secara statistik ada perbedaan praktik pencegahan risiko tinggi kehamilan antara kelompok intervensi dengan kontrol pada pengukuran terakhir (p<0,05). Meski kedua kelompok mengalami peningkatan skor pada setiap tahap pengukuran, namun terbukti pada kelompok intervensi peningkatannya lebih tinggi untuk semua dimensi praktik. Peningkatan tertinggi efek intervensi pada praktik komunikasi dan kerjasama, diikuti praktik pemantauan status kesehatan. Praktik perawatan diri sehari-hari dan praktik gaya hidup merupakan dimensi praktik dengan efek intervensi terendah. KIH Virtual memengaruhi praktik ibu hamil dalam pencegahan risiko tinggi kehamilan dan mampu meningkatkan praktik tersebut dengan lebih baik dibandingkan model konvensional yang selama ini berlangsung.  


Author(s):  
Ilona van de Kolk ◽  
Sanne M. P. L. Gerards ◽  
Lisa S. E. Harms ◽  
Stef P. J. Kremers ◽  
Jessica S. Gubbels

SuperFIT is a comprehensive, integrated intervention approach aimed at promoting healthy energy balance-related behaviors in 2- to 4-year-old children in the preschool and home settings. A quasi-experimental research design was adopted to evaluate the effects of SuperFIT on physical activity (PA), sedentary behavior (SB) and Body Mass Index (BMI) z-score. Children could participate in the preschool-based and family-based component (full intervention) or only in the preschool-based component (partial intervention). Children’s PA levels and SB were assessed with accelerometers and observations, and height and weight were measured for the BMI z-score. Measurements were performed at baseline and two follow-up time points. Effectiveness was evaluated using linear mixed-model analyses, correcting for relevant covariates. Healthy changes in PA levels occurred within all study groups over time. No significant differences were found in overall PA levels between the intervention groups and control group at both follow-ups. Nevertheless, sedentary behavior decreased more in the full intervention group (effect size (ES): −0.62), and moderate-to-vigorous PA (ES: 0.85) and counts per minute (ES: 0.45) increased more compared to the control group on preschool days at the first follow-up. No effects were found for BMI z-score. The integrated approach of SuperFIT may induce changes in PA of young children, although the effects were small.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028369 ◽  
Author(s):  
Sarah J Hardcastle ◽  
Dana Hince ◽  
Ruth Jiménez-Castuera ◽  
Terry Boyle ◽  
Vinicius Cavalheri ◽  
...  

IntroductionPhysically active cancer survivors have substantially less cancer recurrence and improved survival compared with those who are inactive. However, the majority of survivors (70%–90%) are not meeting the physical activity (PA) guidelines. There are also significant geographic inequalities in cancer survival with poorer survival rates for the third of Australians who live in non-metropolitan areas compared with those living in major cities. The primary objective of the trial is to increase moderate-to-vigorous PA (MVPA) among cancer survivors living in regional and remote Western Australia. Secondary objectives are to reduce sedentary behaviour and in conjunction with increased PA, improve quality of life (QoL) in non-metropolitan survivors. Tertiary objectives are to assess the effectiveness of the health action process approach (HAPA) model variables, on which the intervention is based, to predict change in MVPA.Methods and analysisEighty-six cancer survivors will be randomised into either the intervention or control group. Intervention group participants will receive a Fitbit and up to six telephone health-coaching sessions. MVPA (using Actigraph), QoL and psychological variables (based on the HAPA model via questionnaire) will be assessed at baseline, 12 weeks (end of intervention) and 24 weeks (end of follow-up). A general linear mixed model will be used to assess the effectiveness of the intervention.Ethics and disseminationEthics approval has been obtained from St John of God Hospital Subiaco (HREC/#1201). We plan to submit a manuscript of the results to a peer-reviewed journal. Results will be presented at conferences, community and consumer forums and hospital research conferences.Trial registration numberACTRN12618001743257; pre-results, U1111-1222-5698


2018 ◽  
Author(s):  
Musheer Abdulwahid Al-Jaberi ◽  
Muhamad Hanafiah Juni ◽  
Hayati Kadir Shahar ◽  
Siti Irma Fadhilah Ismail ◽  
Murad Abdu Saeed ◽  
...  

BACKGROUND Universities around the world, including Malaysia, have attracted many international students from different countries. Research has reported that acculturative stress resulting from international students’ attempts to adjust to the cultures of host countries is one of the most challenging issues that affects their lives in general and academic lives in particular. OBJECTIVE This study aims to examine the effectiveness of an educational intervention on acculturative stress among new postgraduate international students joining Malaysian public universities. METHODS A cluster randomized controlled trial design with Malaysian public universities as the unit of randomization will be used in this study. Public universities will be randomized in a 1:1 ratio to be either in the intervention (educational program) or control group (waiting list). Participants in the intervention group will receive 7 sessions in 9 hours delivered by an expert in psychology and the researcher. The control group will receive the intervention once the 3-month follow-up evaluation is completed. RESULTS The data will be analyzed using the generalized estimation equation with a confidence interval value of 95%; significant differences between and within groups are determined as <i>P</i>&lt;.05. The results of the study underlie the effectiveness of educational program in decreasing acculturative stress of new international students and enabling them to cope with a new environment. The results of this study will contribute to previous knowledge of acculturative stress, acculturation, and adjustment of international students. Furthermore, such results are expected to play a role in raising university policy makers’ awareness of their postgraduate international students’ acculturative stress issues and how they can help them avoid such stress and perform well in their academic life. CONCLUSIONS We expect that the intervention group will score significantly lower than the wait-list group on the immediate and 3-month postintervention evaluation of acculturative stress and achieve a higher level of adjustment. Results will have implications for international students, policy makers at universities, the Malaysian Ministry of Higher Education, and future research. CLINICALTRIAL Clinical Trials Registry India CTRI/2018/01/011223; http://ctri.nic.in/Clinicaltrials/showallp.php?mid1= 21978&amp;amp;EncHid=&amp;amp;userName=Muhamad%20Hanafiah%20Juni INTERNATIONAL REGISTERED REPORT PRR1-10.2196/12950


Author(s):  
Miriam Romero-López ◽  
María Carmen Pichardo ◽  
Ana Justicia-Arráez ◽  
Judit Bembibre-Serrano

The objective of this study is to measure the effectiveness of a program on improving inhibitory and emotional control among children. In addition, it is assessed whether the improvement of these skills has an effect on the reduction of aggressive behavior in pre-school children. The participants were 100 children, 50 belonging to the control group and 50 to the experimental group, aged between 5 and 6 years. Pre-intervention and post-intervention measures of inhibitory and emotional control (BRIEF-P) and aggression (BASC) were taken. A Generalized Linear Mixed Model analysis (GLMM) was performed and found that children in the experimental group scored higher on inhibitory and emotional control compared to their peers in the control group. In addition, these improvements have an effect on the decrease in aggressiveness. In conclusion, preventive research should have among its priorities the design of such program given their implications for psychosocial development.


2021 ◽  
pp. 019394592110207
Author(s):  
Min Wen ◽  
Yaqin Liang ◽  
Qianqian Shen ◽  
Juping Yu ◽  
Pingping He ◽  
...  

This cluster randomized controlled trial aimed to investigate the effects of an intervention to teach resourcefulness on depression and coping style of patients with coronary heart disease (CHD). A convenience sample of 72 patients in community settings took part. Participants in the intervention group (n = 36) received an 8-week intervention based on the concept of resourcefulness, plus routine health education. Participants in the control group (n = 36) received routine health education only. After the intervention, participants in the intervention group had significantly higher scores on resourcefulness and coping styles, and lower scores on depression than those in the control group (both ps < .001). The findings suggest that a well-developed intervention to teach resourcefulness could help patients with CHD to be more resourceful, improve their level of depression, and choose more effective strategies to cope with stress.


2021 ◽  
pp. 019459982199474
Author(s):  
Maggie Xing ◽  
Dorina Kallogjeri ◽  
Jay F. Piccirillo

Objective To evaluate the effectiveness of cognitive training in improving tinnitus bother and to identify predictors of patient response. Study Design Prospective open-label randomized controlled trial. Setting Online. Methods Participants were adults with subjective idiopathic nonpulsatile tinnitus causing significant tinnitus-related distress. The intervention group trained by using auditory-intensive exercises for 20 minutes per day, 5 days per week, for 8 weeks. The active control group trained on the same schedule with non–auditory intensive games. Surveys were completed at baseline, 8 weeks, and 12 weeks. Results A total of 64 participants completed the study. The median age was 63 years (range, 25-69) in the intervention group and 61 years (34-68) in the control group. Mixed model analysis revealed that within-subject change in Tinnitus Functional Index in the intervention group was not different than the control group, with marginal mean differences (95% CI): 0.24 (–11.20 to 10.7) and 2.17 (–8.50 to 12.83) at 8 weeks and 2.33 (–8.6 to 13.3) and 3.36 (–7.91 to 14.6) at 12 weeks, respectively. When the 2 study groups were compared, the control group had higher Tinnitus Functional Index scores than the intervention group by 10.5 points at baseline (95% CI, –0.92 to 29.89), 8.1 at 8 weeks (95% CI, –3.27 to 19.42), and 9.4 at 12 weeks (95% CI, –2.45 to 21.34). Conclusion Auditory-intensive cognitive training was not associated with changes in self-reported tinnitus bother. Given the potential for neuroplasticity to affect tinnitus, we believe that future studies on cognitive training for tinnitus remain relevant.


2021 ◽  
Vol 10 (10) ◽  
pp. 2215
Author(s):  
Karina Limburg ◽  
Katharina Radziej ◽  
Heribert Sattel ◽  
Peter Henningsen ◽  
Marianne Dieterich ◽  
...  

We tested the efficacy of an integrative psychotherapeutic group treatment (IPGT) in reducing vertigo/dizziness-related impairment along with depression, anxiety, and somatization by conducting a randomized controlled superiority trial comparing IPGT to self-help groups moderated by a clinical psychologist (SHG). Adult patients with functional vertigo and dizziness symptoms were randomly allocated to either the IPGT or SHG as active control group. Outcomes were assessed at baseline (t0), after treatment lasting 16 weeks (t1), and 12 months after treatment (t2). A total of 81 patients were assigned to IPGT and 78 patients were assigned to SHG. Vertigo-related impairment was reduced in both conditions (IPGT: t0–t1: d = 1.10, t0–t2: d = 1.06; SHG: t0–t1: d = 0.86, t0–t2: d = 1.29), showing the efficiency of both IPGT and SHG. Clinically relevant improvements were also obtained for depression in both groups. Linear mixed model analyses revealed no differences between groups for all outcomes (effect of group for the primary outcome: b = −1.15, SE = 2.13, t = −0.54, p = 0.59). Attrition rates were higher in SHG (52.6%) than in IPGT (28.4%). Both conditions improved primary and secondary outcomes while IPGT was better accepted by patients than SHG. Trial registration: ClinicalTrials.gov, Identifier: NCT02320851.


2019 ◽  
Vol 14 (2) ◽  
pp. 240-249
Author(s):  
Lutz Heinemann ◽  
Wendelin Schramm ◽  
Helena Koenig ◽  
Annette Moritz ◽  
Iris Vesper ◽  
...  

Background: Integrated personalized diabetes management (iPDM) is a digitally supported therapeutic concept to improve patient-physician interaction to overcome the aspects of clinical inertia. Integrated personalized diabetes management can support decision making and improve therapeutic outcomes of suboptimally controlled persons with insulin-treated type 2 diabetes (T2D). In this paper, we report the results of an analysis of the PDM-ProValue study program on the effectiveness and perceived benefit of this approach, with a focus on how physicians used and assessed the digital tools provided for the iPDM process. Materials and Methods: The study program included two 12-month, prospective, controlled, cluster-randomized multicenter trials. A total of 101 practices participated with 907 patients. Practices were cluster-randomized to an intervention group and a control group. Digital tools for data visualization and analysis applied were used. HCP were asked to assess the use, relevance, and usefulness of the tools. Results: A clear preference was stated for the visual overview over more statistically complex analyses. A total of 83% of the participants rated a high relevance of the “daily profile,” 81% of the “total profile,” and 68% the “risk illustrated by traffic light symbols” for the therapy decision. The overall iPDM process was very favorably rated with respect to structuredness and potential for personalized treatment and well accepted among health care professionals (HCP). Conclusions: Embedding digital tools in a structured process (iPDM) were proved to provide a benefit for insulin-treated T2D patients and their physicians. These results offer insight for further development and improvement of the tools and add information on how to overcome clinical inertia.


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