Volunteers: An Effective Medium for Delivering Therapeutic Lifestyle Interventions

2021 ◽  
pp. 089011712110625
Author(s):  
Lillian M. Kent ◽  
Paul M. Rankin ◽  
Darren P. Morton ◽  
Rebekah M. Rankin ◽  
Roger L. Greenlaw ◽  
...  
Keyword(s):  
United States ◽  
Chronic Disease ◽  
Lifestyle Modification ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
The United States ◽  
Analysis Of Covariance ◽  
Health Improvement ◽  
Improvement Program ◽  
Blood Lipid Profile

Purpose Lifestyle modification programs have been shown to effectively treat chronic disease. The Coronary Health Improvement Program has been delivered by both paid professional and unpaid volunteer facilitators. This study compared participant outcomes of each mode in the United States. Design Pre-/post-analysis of CHIP interventions delivered between 1999 and 2012. Setting Professional-delivered programs in Rockford Illinois 1999-2004 and volunteer-delivered programs across North America 2005-2012. Subjects Adults ≥21 years (professional programs N = 3158 34.3% men, mean age = 54.0 ± 11.4 years; volunteer programs N = 7115 33.4% men, mean age = 57.4 ± 13.0 years). Measures Body mass index, blood pressure (systolic and diastolic), blood lipid profile (total cholesterol, high-density lipoprotein, triglycerides, low-density lipoprotein), and fasting plasma glucose. Analysis Analysis of Covariance, with adjustment for age, gender, BMI change and baseline biometric and effect sizes. Results The professional-delivered programs achieved significantly greater reductions in BMI (.4%, P < .001) and HDL (1.9%, P < .001) and the volunteer-delivered programs achieved greater reductions in SBP (1.4%, P < .001), DBP (1.1%, P < .001), TC (1.4%, P = .004), LDL (2.3%, P < .001), TG (4.0%, P = .006), and FPG (2.7%, P < .001). However, the effect size differences between the groups were minimal (Cohen’s d .1-.2). Conclusions Lifestyle modification programs have been shown to effectively treat chronic disease. The Complete Health Improvement Program (CHIP) lifestyle intervention has been delivered by both paid professional and unpaid volunteer facilitators. This study compared selected chronic disease biometric outcomes of participants in each mode in the United States. It found volunteer-delivered programs do not appear to be any less effective than programs delivered by paid professionals, which is noteworthy as volunteers may provide important social capital in the combat of chronic disease.

Effectiveness of the Complete Health Improvement Program in a Geriatric Population

2021 ◽  
pp. 155982762110493
Author(s):  
Emily Scriven ◽  
Bhakti Chavan ◽  
David Drozek
Keyword(s):  
Risk Factors ◽  
Lifestyle Modification ◽  
Density Lipoprotein ◽  
The Elderly ◽  
Lipoprotein Cholesterol ◽  
Health Improvement ◽  
Cvd Risk ◽  
Improvement Program ◽  
Geriatric Population ◽  
Complete Health

The Complete Health Improvement Program (CHIP) is an intensive therapeutic lifestyle modification program (ITLMP) with well-documented success in decreasing risk factors for cardiovascular disease (CVD). Plant-based diets and physical activity are components of the program that contribute to these improvements. Yet, there are few studies on how ITLMPs affect risk factors specifically for the geriatric population. The goal of this study was to examine results of CHIP participants with a focus on the older (greater than 65 years) population in Athens, Ohio. Retrospective data from 2011 to 2017 were analyzed for 26 CHIP classes. Recorded variables included body mass index (BMI), blood pressure (BP), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), blood glucose (BG), and exercise level. Among geriatric participants, significant changes were found in BMI, BP, TC, LDL, HDL, BG, and exercise level ( P < .001). As compared to the younger population, changes in variables were equivalent in the geriatric population in all variables ( P > .05). These improvements in CVD risk factors among the elderly support the hypothesis that CHIP should be considered for CVD prevention and treatment in the geriatric population.

scholarly journals Body Mass Index Change as a Predictor of Biometric Changes following an Intensive Lifestyle Modification Program

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
David Drozek ◽  
Alexandria DeFabio ◽  
Randi Amstadt ◽  
Godwin Y. Dogbey
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Body Mass ◽  
Lifestyle Modification ◽  
Density Lipoprotein ◽  
Health Improvement ◽  
Blood Levels ◽  
Improvement Program ◽  
Positive Effects ◽  
Lifestyle Modification Program

The initial benefits of lifestyle modification programs such as reduction in chronic and cardiovascular diseases (CVD) risk factors have been well documented. However, such positive effects may deteriorate over time following relapse into inactivity. Timely detection of weight regain leading to the deterioration of the accrued benefits could trigger early resumption of intensive lifestyle intervention. To date, no known cost-effective, noninvasive approach for monitoring long-term outcomes has yet been established. The purpose of this study was to determine if body mass index (BMI) change predicted changes in other CVD biometric markers during an intensive lifestyle modification program. This study was an observational, retrospective review of records of participants from the Complete Health Improvement Program (CHIP). Biomarker changes of participants in this community-based Intensive Therapeutic Lifestyle Modification Program (ITLMP) offered in Athens, Ohio, a rural Appalachian college town, between April 2011 and June 2017 were reviewed retrospectively. BMI, heart rate (Pulse), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), and glucose (FBS) were monitored before and after program completion. Data were analyzed using a multivariate general linear model. The sample analyzed consisted of 620 participants (mean age of 52.3±13.0 years, 74.5% female). Controlling for age and gender, BMI change significantly predicted 5 out of the 8 biomarker changes measured [Wilk’s λ = 0.939, F(8,526) = 4.29, p <.0001]. Specifically, a 1-point BMI decrease was associated with 4.4 units decrease in TC, 3.2 units in LDL, 5.3 units in TG, 2 units in SBP, and 1 unit in DBP (all p values < .05). These results suggest that change in BMI may be a useful predictor of change in other CVD biomarkers’ outcomes during and after an ITLMP participation. Tracking BMI, therefore, could serve as a proxy measure for identifying regressing biomarker changes following participation in an ITLMP leading to a timelier reassessment and intervention. Future studies evaluating the value of BMI as a surrogate for highlighting overall cardiovascular health are warranted.

scholarly journals Short-Term Effectiveness of a Lifestyle Intervention Program for Reducing Selected Chronic Disease Risk Factors in Individuals Living in Rural Appalachia: A Pilot Cohort Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
David Drozek ◽  
Hans Diehl ◽  
Masato Nakazawa ◽  
Tom Kostohryz ◽  
Darren Morton ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Intervention Program ◽  
Lifestyle Modification ◽  
Disease Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Health Improvement ◽  
Blood Levels ◽  
Lifestyle Behaviors ◽  
Improvement Program

Most Western chronic diseases are closely tied to lifestyle behaviors, and many are preventable. Despite the well-distributed knowledge of these detrimental behaviors, effective efforts in disease prevention have been lacking. Many of these chronic diseases are related to obesity and type 2 diabetes, which have doubled in incidence during the last 35 years. The Complete Health Improvement Program (CHIP) is a community-based, comprehensive lifestyle modification approach to health that has shown success in addressing this problem. This pilot study demonstrates the effectiveness of CHIP in an underserved, rural, and vulnerable Appalachian population. Two hundred fourteen participants in CHIP collectively demonstrated significant reductions in body mass index, systolic and diastolic blood pressure, and fasting blood levels of total cholesterol, low-density lipoprotein, and glucose. If these results can be repeated in other at-risk populations, CHIP has the potential to help reduce the burden of preventable and treatable chronic diseases efficiently and cost-effectively.

Racial and Sex Disparities in Trauma Outcomes Based on Geographical Region

2020 ◽  
pp. 000313482096006
Author(s):  
William Q. Duong ◽  
Areg Grigorian ◽  
Cyrus Farzaneh ◽  
Jeffry Nahmias ◽  
Theresa Chin ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Trauma Patients ◽  
Improvement Program ◽  
Trauma Outcomes ◽  
Risk Of Death ◽  
Hospital Access ◽  
Risk Of Mortality ◽  
Sex Disparities ◽  
Male Patients

Objectives Disparities in outcomes among trauma patients have been shown to be associated with race and sex. The purpose of this study was to analyze racial and sex mortality disparities in different regions of the United States, hypothesizing that the risk of mortality among black and Asian trauma patients, compared to white trauma patients, will be similar within all regions in the United States. Methods The Trauma Quality Improvement Program (2010-2016) was queried for adult trauma patients, separating by U.S. Census regions. Multivariable logistic regression analyses were performed for each region, controlling for known predictors of morbidity and mortality in trauma. Results Most trauma patients were treated in the South (n = 522 388, 40.7%). After risk adjustment, black trauma patients had a higher associated risk of death in all regions, except the Northeast, compared to white trauma patients. The highest associated risk of death for blacks (vs. whites) was in the Midwest (odds ratio [OR] 1.30, P < .001). Asian trauma patients only had a higher associated risk of death in the West (OR 1.39, P < .001). Male trauma patients, compared to women, had an increased associated risk of mortality in all four regions. Discussion This study found major differences in outcomes among different races within different regions of the United States. There was also both an increased rate and associated risk of mortality for male patients in all regions. Future prospective studies are needed to identify what regional differences in trauma systems including population density, transport times, hospital access, and other trauma resources explain these findings.

scholarly journals Patterns and correlates of mis-implementation in state chronic disease public health practice in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Margaret M. Padek ◽  
Stephanie Mazzucca ◽  
Peg Allen ◽  
Emily Rodriguez Weno ◽  
Edward Tsai ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
Chronic Disease ◽  
Multinomial Logistic Regression ◽  
Public Health Practice ◽  
State Level ◽  
The United States ◽  
Organizational Level ◽  
Effective Programs

Abstract Background Much of the disease burden in the United States is preventable through application of existing knowledge. State-level public health practitioners are in ideal positions to affect programs and policies related to chronic disease, but the extent to which mis-implementation occurring with these programs is largely unknown. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Methods A 2018 comprehensive survey assessing the extent of mis-implementation and multi-level influences on mis-implementation was reported by state health departments (SHDs). Questions were developed from previous literature. Surveys were emailed to randomly selected SHD employees across the Unites States. Spearman’s correlation and multinomial logistic regression were used to assess factors in mis-implementation. Results Half (50.7%) of respondents were chronic disease program managers or unit directors. Forty nine percent reported that programs their SHD oversees sometimes, often or always continued ineffective programs. Over 50% also reported that their SHD sometimes or often ended effective programs. The data suggest the strongest correlates and predictors of mis-implementation were at the organizational level. For example, the number of organizational layers impeded decision-making was significant for both continuing ineffective programs (OR=4.70; 95% CI=2.20, 10.04) and ending effective programs (OR=3.23; 95% CI=1.61, 7.40). Conclusion The data suggest that changing certain agency practices may help in minimizing the occurrence of mis-implementation. Further research should focus on adding context to these issues and helping agencies engage in appropriate decision-making. Greater attention to mis-implementation should lead to greater use of effective interventions and more efficient expenditure of resources, ultimately to improve health outcomes.

scholarly journals Dropping out of school and chronic disease in the United States

2014 ◽  
Vol 22 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Michael G. Vaughn ◽  
Christopher P. Salas-Wright ◽  
Brandy R. Maynard
Keyword(s):  
United States ◽  
Chronic Disease ◽  
The United States ◽  
Dropping Out ◽  
Out Of School

scholarly journals ASSOCIATION BETWEEN BLOOD LIPID PROFILE AND BLOOD GLUCOSE LEVELS IN MEN WITH CORONARY HEART DISEASE, METABOLIC SYNDROME, AND TYPE 2 DIABETES MELLITUS

2013 ◽  
Vol 12 (5) ◽  
pp. 29-33
Author(s):  
S. A. Matveeva
Keyword(s):  
Blood Glucose ◽  
Lipid Profile ◽  
Low Density Lipoprotein ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Lipoprotein Cholesterol ◽  
Blood Lipid Profile ◽  
Glucose Levels ◽  
Blood Glucose Levels

Aim.To study the associations between blood lipid profile and blood glucose levels in men with coronary heart disease (CHD), stable effort angina (SEA), metabolic syndrome (MS), and Type 2 diabetes mellitus (DM-2).Material and methods.The study included 82 men (mean age 50,5±0,9 years) with CHD, Functional Class I–III SEA, MS, and DM-2. The following lipid profile parameters were assessed: total cholesterol (TCH), triglycerides (TG), low-density lipoprotein cholesterol (LDL–CH), very low-density lipoprotein cholesterol (VLDL–CH), high-density lipoprotein cholesterol (HDL–CH), atherogenic index (AI), and triglyceride index (TGI), together with fasting blood glucose.Results.There were positive (direct) associations between higher levels (>90th percentile) of lipid profile parameters (TCH, TG, LDL–CH, VLDL– CH, HDL–CH, AI, TGI) and blood glucose, as well as between lower levels (≤10th percentile) of lipid profile parameters (TCH, TG, LDL–CH, VLDL– CH, AI, TGI) and blood glucose. At the same time, there were negative (inverse) associations between lower lipid levels (≤10th percentile of TCH, TG, LDL–CH, VLDL–CH, HDL–CH, AI, TGI) and higher glucose levels (>90th percentile), as well as between higher lipid levels (>90th percentile of TCH, TG, LDL–CH, VLDL–CH, HDL–CH, AI, TGI) and lower glucose levels (≤10th percentile).Conclusion.Dyslipidemia and hyperglycemia demonstrate synergetic proatherogenic effects in patients with CHD, SEA, MS, and DM-2, as suggested by significant heterogeneous (direct and inverse) associations between lipid profile parameters and fasting blood glucose. The results obtained provide an opportunity for the assessment of risk levels, prognosis, and need for pharmacological prevention and treatment in patients with combined cardiovascular pathology. 

scholarly journals Patterns and Correlates of Mis-implementation in State Chronic Disease Public Health Practice in the United States

2021 ◽  
Author(s):  
Margaret Padek ◽  
Stephanie Mazzucca ◽  
Peg Allen ◽  
Emily Rodriguez Weno ◽  
Edward Tsai ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
Chronic Disease ◽  
Multinomial Logistic Regression ◽  
Public Health Practice ◽  
State Level ◽  
The United States ◽  
Organizational Level ◽  
Effective Programs

Abstract Background: Much of the disease burden in the United States is preventable through application of existing knowledge. State-level public health practitioners are in ideal positions to affect programs and policies related to chronic disease, but the extent to which mis-implementation occurring with these programs is largely unknown. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Methods: A 2018 comprehensive survey assessing the extent of mis-implementation and multi-level influences on mis-implementation was reported by state health departments (SHDs). Questions were developed from previous literature. Surveys were emailed to randomly selected SHD employees across the Unites States. Spearman’s correlation and multinomial logistic regression were used to assess factors in mis-implementation. Results: Half (50.7%) of respondents were chronic disease program managers or unit directors. Forty nine percent reported that programs their SHD oversees sometimes, often or always continued ineffective programs. Over 50% also reported that their SHD sometimes or often ended effective programs. The data suggest the strongest correlates and predictors of mis-implementation were at the organizational level. For example, the number of organizational layers impeded decision-making was significant for both continuing ineffective programs (OR=4.70; 95% CI=2.20, 10.04) and ending effective programs (OR=3.23; 95% CI=1.61, 7.40). Conclusion: The data suggest that changing certain agency practices may help in minimizing the occurrence of mis-implementation. Further research should focus on adding context to these issues and helping agencies engage in appropriate decision-making. Greater attention to mis-implementation should lead to greater use of effective interventions and more efficient expenditure of resources, ultimately to improve health outcomes.

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