Living Labs for a Mobile App-Based Health Program: Effectiveness of a 24-Week Walking Intervention for Cardiovascular Disease Risk Reduction Among Female Korean-Chinese Migrant Workers: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Youlim Kim ◽  
Hyeonkyeong Lee ◽  
Misook Lee Chung
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Migrant Workers ◽  
Health Program ◽  
Density Lipoprotein ◽  
Mobile App ◽  
Cvd Risk ◽  
Walking Intervention ◽  
Korean Chinese ◽  
Chinese Migrant Workers

BACKGROUND Cardiovascular disease (CVD) accounts for one-third of the causes of death in women, and migrants are relatively more likely to be exposed to CVD risk owing to social and environmental factors. OBJECTIVE This study aimed to examine the effectiveness of a 24-week app-based walking program, using Fitbit, for CVD risk reduction among female Korean-Chinese middle-aged workers. METHODS Participants were recruited between April 11 and July 11, 2018 through distributing posters and flyers. They were randomly assigned to either the standard treatment (ST; n = 22) or enhanced treatment (ET; n = 28) group. All participants were provided with a mobile app linked to Fitbit Alta for 24 weeks and instructed to walk for more than 30 minutes five times a week and moderate intensity physical activity. During the 12-week adaptation period, the ET group also received a mobile app-based health program applying socio-cognitive strategies to increase walking adherence. All participants were guided to voluntary physical activity without researchers' intervention during the 12-week maintenance period. Data were analyzed by the Mann Whitney U-test and a generalized estimating equation. RESULTS There were significant between-group differences regarding the number of steps (B = 1.295, P < .001).and moderate physical activity time (OR = 6.396, P = .030) at week 12. ET group had significant changes in high-density lipoprotein cholesterol (B = 10.522, P = .007), low-density lipoprotein cholesterol ( B = -16.178, P = .024), total cholesterol (B = -20.325, P = .039), fasting blood sugar (B = -8.138, P = -.046) over 12 weeks compared to the ST group. In addition, there was a significant reduction CVD risk for the ET group over 12 weeks compared to the ST group (B = -0.521, P <. 001). CONCLUSIONS The app-based walking intervention was effective in reducing CVD risk among female Korean-Chinese migrant workers during the 12-week period. In future studies, long-term studies are needed to reduce the risk of cardiovascular disease in large-scale migrant workers, and it is necessary to confirm the direct and indirect effects of various socio-cognitive factors on health outcomes.

scholarly journals Cardiovascular disease risk factors among undergraduate medical students in a tertiary care centre of eastern India: a pilot study

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Somnath Mukhopadhay ◽  
Anindya Mukherjee ◽  
Dibbendhu Khanra ◽  
Biaus Samanta ◽  
Avik Karak ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Medical Students ◽  
Risk Ratio ◽  
Tertiary Care ◽  
Density Lipoprotein ◽  
Eastern India ◽  
Cvd Risk Factors ◽  
Cvd Risk

Abstract Background Handful studies report the prevalence of cardiovascular disease (CVD) risk factors among medical students from India and none from the eastern part of the country. Aim To estimate the prevalence of risk factors of CVD and their correlation with CVD risk ratio among the MBBS students from eastern India. Methods 433 students were studied. International Physical Activity Questionnaire-long form was used for assessment of physical activity and Perceived Stress Scale (PSS) to elicit psychological stress levels. Waist-to-height ratio (WHtR) was calculated. Total cholesterol to high-density lipoprotein ratio was calculated as the CVD risk ratio. Results 39.3% were women and 68.6% of the subjects were in junior classes. 22.4% subjects had high PSS while 30% performed low physical activity. Tobacco and alcohol intake was prevalent in 29.3% and 21.0% respectively. High CVD risk ratio was found in 14.3%. Most risk factors were more prevalent among juniors except diabetes. Among the non-overweight and non-obese subjects there was a significant positive correlation between WHtR and CVD risk score (R = 0.33, p < 0.001). 82.7% of the variance in CVD risk ratio could be explained by WHtR, Body mass index, Triglycerides and Low-density lipoprotein (F(7, 425) = 296.085), of which LDL (β = 0.755) contributed the most. Conclusions High prevalence of different modifiable CVD risk factors revealed among the subjects in this study is concerning. WHtR appears promising as an independent early predictor of CVD risk in Indian population. A dedicated CVD risk assessment tool for the young population is necessary.

scholarly journals Development of a Living Lab for a Mobile-Based Health Program for Korean-Chinese Working Women in South Korea: Mixed Methods Study

10.2196/15359 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e15359
Author(s):  
Youlim Kim ◽  
Hyeonkyeong Lee ◽  
Mi Kyung Lee ◽  
Hyeyeon Lee ◽  
Hyoeun Jang
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Women Workers ◽  
Needs Assessment ◽  
Program Development ◽  
Health Program ◽  
Mobile App ◽  
Middle Aged ◽  
Living Lab ◽  
Korean Chinese

Background Korean-Chinese (KC) women make up the largest group of female migrants in South Korea. To prevent and manage chronic diseases in middle-aged KC women working full time, it is necessary to develop health promotion programs that utilize an online platform because such a platform would allow individuals to participate in health promotion interventions at their convenience. Objective This study aimed to develop a living lab for a mobile-based health (LLm Health) program focused on improving the physical activity and cultural adaptation of KC women workers. Methods We used a mixed methods design. Living lab principles were factored into the LLm Health program, including the use of multiple methods, user engagement, multistakeholder participants, real-life settings, and cocreation. The program was developed using the 4 steps of the intervention mapping method: needs assessment, setting of objectives, identification of intervention strategies, and intervention design. Needs assessment was conducted through a literature review, focus group interviews with a total of 16 middle-aged KC women, and an online survey related to health promotion of migrant workers given to 38 stakeholders. KC middle-aged women participated in the early stages of program development and provided the idea of developing programs and mobile apps to enhance physical activity and acculturation. The mobile app developed in the program was validated with the help of 12 KC women and 4 experts, including 3 nursing professors and a professor of physical education. They were asked to rate each item based on content, interface design, and technology on a 4-point scale using a 23-item Smartphone App Evaluation Tool for Health Care. Results The LLm Health program comprised a 24-week walking program using Fitbit devices, the mobile app, and social cognitive interventions. The mobile app contained 6 components: a step counter, an exercise timer, an online chat function, health information, level of cardiovascular risk, and health status. The cultural aspects and lifestyles of KC women were accommodated in the entire process of program development. The content validity of the mobile app was found to be 0.90 and 0.96 according to the 12 KC women and 4 experts, respectively. Conclusions The mobile app was found to be valid and acceptable for KC women. The living lab approach was a useful strategy for developing a culturally adaptive LLm Health program for KC women workers, leading to their active participation in the overall research process, including needs assessment, program composition, and pre-evaluation.

Effects of culturally adaptive walking intervention on cardiovascular disease risks for middle-aged Korean-Chinese female migrant workers

2017 ◽  
Vol 72 (6) ◽  
pp. 317-327 ◽  
Author(s):  
Hyeonkyeong Lee ◽  
Sunghye Cho ◽  
JoEllen Wilbur ◽  
Junghee Kim ◽  
Chang-gi Park ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Migrant Workers ◽  
Middle Aged ◽  
Walking Intervention ◽  
Disease Risks ◽  
Korean Chinese ◽  
Female Migrant

scholarly journals Development of a Living Lab for a Mobile-Based Health Program for Korean-Chinese Working Women in South Korea: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Youlim Kim ◽  
Hyeonkyeong Lee ◽  
Mi Kyung Lee ◽  
Hyeyeon Lee ◽  
Hyoeun Jang
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Women Workers ◽  
Needs Assessment ◽  
Program Development ◽  
Health Program ◽  
Mobile App ◽  
Middle Aged ◽  
Living Lab ◽  
Korean Chinese

BACKGROUND Korean-Chinese (KC) women make up the largest group of female migrants in South Korea. To prevent and manage chronic diseases in middle-aged KC women working full time, it is necessary to develop health promotion programs that utilize an online platform because such a platform would allow individuals to participate in health promotion interventions at their convenience. OBJECTIVE This study aimed to develop a living lab for a mobile-based health (LLm Health) program focused on improving the physical activity and cultural adaptation of KC women workers. METHODS We used a mixed methods design. Living lab principles were factored into the LLm Health program, including the use of multiple methods, user engagement, multistakeholder participants, real-life settings, and cocreation. The program was developed using the 4 steps of the intervention mapping method: needs assessment, setting of objectives, identification of intervention strategies, and intervention design. Needs assessment was conducted through a literature review, focus group interviews with a total of 16 middle-aged KC women, and an online survey related to health promotion of migrant workers given to 38 stakeholders. KC middle-aged women participated in the early stages of program development and provided the idea of developing programs and mobile apps to enhance physical activity and acculturation. The mobile app developed in the program was validated with the help of 12 KC women and 4 experts, including 3 nursing professors and a professor of physical education. They were asked to rate each item based on content, interface design, and technology on a 4-point scale using a 23-item Smartphone App Evaluation Tool for Health Care. RESULTS The LLm Health program comprised a 24-week walking program using Fitbit devices, the mobile app, and social cognitive interventions. The mobile app contained 6 components: a step counter, an exercise timer, an online chat function, health information, level of cardiovascular risk, and health status. The cultural aspects and lifestyles of KC women were accommodated in the entire process of program development. The content validity of the mobile app was found to be 0.90 and 0.96 according to the 12 KC women and 4 experts, respectively. CONCLUSIONS The mobile app was found to be valid and acceptable for KC women. The living lab approach was a useful strategy for developing a culturally adaptive LLm Health program for KC women workers, leading to their active participation in the overall research process, including needs assessment, program composition, and pre-evaluation.

Prevalence of traditional and novel markers of cardiovascular disease risk in Scottish adolescents: socioeconomic effects

2012 ◽  
Vol 37 (5) ◽  
pp. 829-839 ◽  
Author(s):  
Duncan S. Buchan ◽  
Stewart Ollis ◽  
Non-Eleri Thomas ◽  
Alan Simpson ◽  
John D. Young ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Density Lipoprotein ◽  
Cvd Risk Factors ◽  
Plasminogen Activator Inhibitor 1 ◽  
Cvd Risk ◽  
Pai 1

Information on the health status and physical activity of Scottish adolescents is limited. This study examines the prevalence of cardiovascular disease (CVD) risk in Scottish adolescents by socioeconomic status (SES). Participants were recruited from two high schools that differed in the SES of the students in attendance. The sample included 73 boys and 34 girls (16.4 ± 0.6 years). Variables included anthropometry, physical activity, physical fitness, blood pressure, diet, and 11 metabolic markers of CVD risk. Significant sex differences (P ≤ 0.01) were noted for stature, waist circumference, waist–hip ratio, physical activity, cardiorespiratory fitness, muscular power, sprint speed, and several CVD risk factors: high-density lipoprotein (HDL), low-density lipoprotein (LDL), interleukin-6 (IL-6), and C-reactive protein (CRP) levels. Boys from a lower SES had significantly higher levels of glucose and plasminogen activator inhibitor-1 (PAI-1) but lower levels of adiponectin compared with boys from a higher SES. Girls from a lower SES had significantly (P ≤ 0.01) higher glucose and PAI-1 levels but lower levels of insulin and adiponectin than girls from a higher SES. High fat diets, low physical activity levels, and elevated CRP and total cholesterol levels were the CVD risk factors most commonly identified as being at-risk levels in this cohort, regardless of sex or SES. SES differences were not consistently apparent, but several CVD risk factors were identified as elevated in this sample of adolescents, regardless of sex or SES.

scholarly journals Reducing cardiovascular disease risk among families with familial hypercholesterolaemia by improving diet and physical activity: a randomised controlled feasibility trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044200
Author(s):  
Fiona Jane Kinnear ◽  
Fiona E Lithander ◽  
Aidan Searle ◽  
Graham Bayly ◽  
Christina Wei ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Familial Hypercholesterolaemia ◽  
Disease Risk ◽  
Pilot Trial ◽  
Feasibility Trial ◽  
Cvd Risk ◽  
Sedentary Behaviours ◽  
Diet And Physical Activity ◽  
Randomised Controlled

ObjectiveFamilial hypercholesterolaemia (FH) elevates low-density lipoprotein cholesterol (LDL-C) and increases cardiovascular disease (CVD) risk. This study aimed to provide evidence for the feasibility of conducting a randomised controlled trial to evaluate the efficacy of an intervention designed to improve diet and physical activity in families with FH.DesignA parallel, randomised, waitlist-controlled, feasibility pilot trial.SettingThree outpatient lipid clinics in the UK.ParticipantsFamilies that comprised children (aged 10–18 years) and their parent with genetically diagnosed FH.InterventionFamilies were randomised to either 12-week usual care or intervention. The behavioural change intervention aimed to improve dietary, physical activity and sedentary behaviours. It was delivered to families by dietitians initially via a single face-to-face session and then by four telephone or email follow-up sessions.Outcome measuresFeasibility was assessed via measures related to recruitment, retention and intervention fidelity. Postintervention qualitative interviews were conducted to explore intervention acceptability. Behavioural (dietary intake, physical activity and sedentary time) and clinical (blood pressure, body composition and blood lipids) outcomes were collected at baseline and endpoint assessments to evaluate the intervention’s potential benefit.ResultsTwenty-one families (38% of those approached) were recruited which comprised 22 children and 17 adults with FH, and 97% of families completed the study. The intervention was implemented with high fidelity and the qualitative data revealed it was well accepted. Between-group differences at the endpoint assessment were indicative of the intervention’s potential for improving diet in children and adults. Evidence for potential benefits on physical activity and sedentary behaviours was less apparent. However, the intervention was associated with improvements in several CVD risk factors including LDL-C, with a within-group mean decrease of 8% (children) and 10% (adults).ConclusionsThe study’s recruitment, retention, acceptability and potential efficacy support the development of a definitive trial, subject to identified refinements.Trial registration numberISRCTN24880714.

scholarly journals Multi-trajectories of lipid indices with incident cardiovascular disease, heart failure, and all-cause mortality: 23 years follow-up of two US cohort studies

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Fatemeh Koohi ◽  
Davood Khalili ◽  
Mohammad Ali Mansournia ◽  
Farzad Hadaegh ◽  
Hamid Soori
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Significant Risk ◽  
Density Lipoprotein ◽  
Lipid Levels ◽  
Cvd Risk ◽  
All Cause Mortality ◽  
Over Time

Abstract Background Understanding the distinct patterns (trajectories) of variation in blood lipid levels before diagnosing cardiovascular disease (CVD) might carry important implications for improving disease prevention or treatment. Methods We investigated 14,373 participants (45.5% men) aged 45–84 from two large US prospective cohort studies with a median of 23 years follow-up. First, we jointly estimated developmental trajectories of lipid indices, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) concentrations using group-based multi-trajectory modeling. Then, the association of identified multi-trajectories with incident CVD, heart failure, and all-cause mortality were examined using Cox proportional hazard model. Results Seven distinct multi-trajectories were identified. The majority of participants (approximately 80%) exhibited decreasing LDL-C but rising TG levels and relatively stable HDL-C levels. Compared to the individuals with healthy and stable LDL-C, HDL-C, and TG levels, those in other groups were at significant risk of incident CVD after adjusting for other conventional risk factors. Individuals with the highest but decreasing LDL-C and borderline high and rising TG levels over time were at the highest risk than those in other groups with a 2.22-fold risk of CVD. Also, those with the highest and increased triglyceride levels over time, over optimal and decreasing LDL-C levels, and the lowest HDL-C profile had a nearly 1.84 times CVD risk. Even individuals in the multi-trajectory group with the highest HDL-C, optimal LDL-C, and optimal TG levels had a significant risk (HR, 1.45; 95% CI 1.02–2.08). Furthermore, only those with the highest HDL-C profile increased the risk of heart failure by 1.5-fold (95% CI 1.07–2.06). Conclusions The trajectories and risk of CVD identified in this study demonstrated that despite a decline in LDL-C over time, a significant amount of residual risk for CVD remains. These findings suggest the impact of the increasing trend of TG on CVD risk and emphasize the importance of assessing the lipid levels at each visit and undertaking potential interventions that lower triglyceride concentrations to reduce the residual risk of CVD, even among those with the optimal LDL-C level.

Physical activity less than the recommended amount may prevent the onset of major biological risk factors for cardiovascular disease: a cohort study of 198 919 adults

2018 ◽  
Vol 54 (4) ◽  
pp. 238-244 ◽  
Author(s):  
David Martinez-Gomez ◽  
Irene Esteban-Cornejo ◽  
Esther Lopez-Garcia ◽  
Esther García-Esquinas ◽  
Kabir P Sadarangani ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Highly Active ◽  
Atherogenic Dyslipidaemia

ObjectivesWe examined the dose–response relationship between physical activity (PA) and incidence of cardiovascular disease (CVD) risk factors in adults in Taiwan.MethodsThis study included 1 98 919 participants, aged 18–97 years, free of CVD, cancer and diabetes at baseline (1997–2013), who were followed until 2016. At baseline, participants were classified into five PA levels: inactive’ (0 metabolic equivalent of task (MET)-h/week), ‘lower insufficiently active’ (0.1–3.75 MET-h/week), ‘upper insufficiently active’ (3.75–7.49 MET-h/week), ‘active’ (7.5–14.99 MET-h/week) and ‘highly active’ (≥15 MET-h/week]. CVD risk factors were assessed at baseline and at follow-up by physical examination and laboratory tests. Analyses were performed with Cox regression and adjusted for the main confounders.ResultsDuring a mean follow-up of 6.0±4.5 years (range 0.5–19 years), 20 447 individuals developed obesity, 19 619 hypertension, 21 592 hypercholesterolaemia, 14 164 atherogenic dyslipidaemia, 24 275 metabolic syndrome and 8548 type 2 diabetes. Compared with inactive participants, those in the upper insufficiently active (but not active) category had a lower risk of obesity (HR 0.92; 95% CI 0.88 to 0.95), atherogenic dyslipidaemia (0.96; 0.90 to 0.99), metabolic syndrome (0.95; 0.92 to 0.99) and type 2 diabetes (0.91; 0.86 to 0.97). Only highly active individuals showed a lower incidence of CVD risk factors than their upper insufficiently active counterparts.ConclusionCompared with being inactive, doing half the recommended amount of PA is associated with a lower incidence of several common biological CVD risk factors. Given these benefits, half the recommended amount of PA is an evidence based target for inactive adults.

scholarly journals Evaluating the effects of alcohol and tobacco use on cardiovascular disease using multivariable Mendelian randomization

2019 ◽  
Author(s):  
Daniel B. Rosoff ◽  
George Davey Smith ◽  
Nehal Mehta ◽  
Toni-Kim Clarke ◽  
Falk W. Lohoff
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Alcohol Use ◽  
Tobacco Use ◽  
Mendelian Randomization ◽  
Association Studies ◽  
Density Lipoprotein ◽  
Genome Wide Association Studies ◽  
Cvd Risk ◽  
Increased Risk

ABSTRACTAlcohol and tobacco use, two major modifiable risk factors for cardiovascular disease (CVD), are often consumed together. Using large publicly available genome-wide association studies (results from > 940,000 participants), we conducted two-sample multivariable Mendelian randomization (MR) to simultaneously assess the independent effects of alcohol and tobacco use on CVD risk factors and events. We found genetic instruments associated with increased alcohol use, controlling for tobacco use, associated with increased high-density-lipoprotein-cholesterol (HDL-C), decreased triglycerides, but not with coronary heart disease (CHD), myocardial infarction (MI), nor stroke; and instruments for increased tobacco use, controlling for alcohol use, associated with decreased HDL-C, increased triglycerides, and increased risk of CHD and MI. Exploratory analysis found associations with HDL-C, LDL-C, and intermediate-density-lipoprotein metabolites. Consistency of results across complementary methods accommodating different MR assumptions strengthened causal inference, providing strong genetic evidence for the causal effects of modifiable lifestyle risk factors on CVD risk.

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