Technology-Delivered Adaptations of Motivational Interviewing (TAMI) Interventions for the Prevention and Management of Chronic Disease: Narrative Review (Preprint)

2021 ◽  
Author(s):  
Havisha Pedamallu ◽  
Matthew J. Ehrhardt ◽  
Julia Maki ◽  
April Idalski Carcone ◽  
Melissa M. Hudson ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Motivational Interviewing ◽  
Text Messaging ◽  
Disease Risk ◽  
Behavioral Outcomes ◽  
Narrative Review ◽  
Population Characteristics ◽  
Web Based

BACKGROUND Motivational interviewing is an effective strategy to mitigate chronic disease risk through promotion of health behavior changes. However, multiple barriers impede its delivery to and uptake by patients. mHealth-based versions of motivational interviewing interventions, or technology-delivered adaptations of motivational interviewing (TAMIs), might increase reach, but their effectiveness is less well-understood. OBJECTIVE The purpose of this narrative review was to characterize the extent to which TAMIs: (1) affect behavioral outcomes, (2) have included individuals from populations that have been marginalized, and (3) have addressed socio-contextual influences on health. METHODS We identified studies indexed in PubMed that described interventions incorporating motivational interviewing techniques into a mobile or electronic health platform. Data were abstracted from eligible studies, including target population characteristics, study design and eligibility criteria, theoretical/conceptual models utilized, mHealth tool details, and effects on behavioral outcomes. RESULTS Thirty-three studies reported the use of TAMIs. Sample sizes ranged from 10 to 2,069 participants ages 13 to 70 years. Most studies (n=24) directed interventions towards individuals engaging in behaviors that increased the risk of chronic disease. Most studies oversampled (n=18) individuals from marginalized socio-demographic groups, but few were designed specifically with marginalized groups in mind (n=3). TAMIs utilized text messaging (n=7), web-based (n=19), app + text messaging (n=1), and web-based + text messaging (n=3) delivery platforms. Twenty-seven (90%) included randomized controlled trials reporting behavioral and health-related outcomes, 21 of which reported statistically significant improvements in targeted behaviors with the use of TAMIs. TAMIs improved targeted health behaviors in the remaining 3 studies. Nine of 30 (30%) assessed TAMI feasibility, acceptability, and/or satisfaction, all of which rated TAMIs highly in this regard. Among 18 studies comprised of a disproportionately high number of racial or ethnic minorities, 15 (83%) reported increased engagement in health behaviors and/or better health outcomes. CONCLUSIONS TAMIs can improve health promotion and disease management behaviors for people from a variety of socio-demographic backgrounds. Future studies are needed to determine the contribution of TAMIs on individual health outcomes, and to determine best practices for implementing TAMIs into clinical practice.

scholarly journals Sleep and inflammation in resilient aging

2014 ◽  
Vol 4 (5) ◽  
pp. 20140009 ◽  
Author(s):  
Michael R. Irwin
Keyword(s):  
Chronic Disease ◽  
Sleep Quality ◽  
Health Outcomes ◽  
Physical Health ◽  
Disease Risk ◽  
Biological Pathway ◽  
Chronic Disease Risk ◽  
Physical Health Outcomes ◽  
Mental And Physical Health

Sleep quality is important to health, and increasingly viewed as critical in promoting successful, resilient aging. In this review, the interplay between sleep and mental and physical health is considered with a focus on the role of inflammation as a biological pathway that translates the effects of sleep on risk of depression, pain and chronic disease risk in aging. Given that sleep regulates inflammatory biologic mechanisms with effects on mental and physical health outcomes, the potential of interventions that target sleep to reduce inflammation and promote health in aging is also discussed.

scholarly journals A Web-Based Intervention to Prevent Multiple Chronic Disease Risk Factors Among Adolescents: Co-Design and User Testing of the Health4Life School-Based Program (Preprint)

2020 ◽  
Author(s):  
Katrina Elizabeth Champion ◽  
Lauren Anne Gardner ◽  
Cyanna McGowan ◽  
Cath Chapman ◽  
Louise Thornton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Disease ◽  
Disease Risk ◽  
Physical And Mental Health ◽  
User Testing ◽  
School Students ◽  
Web Based ◽  
Chronic Disease Risk ◽  
School Based ◽  
Lifestyle Risk

BACKGROUND Chronic diseases are the leading cause of death worldwide. Addressing key lifestyle risk factors during adolescence is critical for improving physical and mental health outcomes and reducing chronic disease risk. Schools are ideal intervention settings, and electronic health (eHealth) interventions afford several advantages, including increased student engagement, scalability, and sustainability. Although lifestyle risk behaviors tend to co-occur, few school-based eHealth interventions have targeted multiple behaviors concurrently. OBJECTIVE This study aims to summarize the co-design and user testing of the Health4Life school-based program, a web-based cartoon intervention developed to concurrently prevent 6 key lifestyle risk factors for chronic disease among secondary school students: alcohol use, smoking, poor diet, physical inactivity, sedentary recreational screen time, and poor sleep (the <i>Big 6</i>). METHODS The development of the Health4Life program was conducted over 18 months in collaboration with students, teachers, and researchers with expertise relevant to the Big 6. The iterative process involved (1) scoping of evidence and systematic literature review; (2) consultation with adolescents (N=815) via a cross-sectional web-based survey to identify knowledge gaps, attitudes, barriers, and facilitators in relation to the Big 6; (3) content and web development; and (4) user testing of the web-based program with students (n=41) and teachers (n=8) to evaluate its acceptability, relevance, and appeal to the target audience. RESULTS The co-design process resulted in a six-module, evidence-informed program that uses interactive cartoon storylines and web-based delivery to engage students. Student and teacher feedback collected during user testing was positive in terms of acceptability and relevance. Commonly identified areas for improvement concerned the length of modules, age appropriateness of language and alcohol storyline, the need for character backstories and links to syllabus information, and feasibility of implementation. Modifications were made to address these issues. CONCLUSIONS The Health4Life school-based program is the first universal, web-based program to concurrently address 6 important chronic disease risk factors among secondary school students. By adopting a multiple health behavior change approach, it has the potential to efficiently modify the Big 6 risk factors within one program and to equip young people with the skills and knowledge needed to achieve and maintain good physical and mental health throughout adolescence and into adulthood.

scholarly journals Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1873 ◽  
Author(s):  
Catherine M. Phillips ◽  
Ling-Wei Chen ◽  
Barbara Heude ◽  
Jonathan Y. Bernard ◽  
Nicholas C. Harvey ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Disease Risk ◽  
Narrative Review ◽  
Mental Health Outcomes ◽  
Low Grade ◽  
Dietary Inflammatory Index ◽  
Inflammatory Index ◽  
Inflammatory Status ◽  
Wide Range

There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed to characterize the inflammatory potential of habitual diet. Subsequently, a large and rapidly growing body of research investigating associations between dietary inflammatory potential, determined by the DII, and risk of a wide range of NCDs has emerged. In this narrative review, we examine the current state of the science regarding relationships between the DII and cancer, cardiometabolic, respiratory and musculoskeletal diseases, neurodevelopment, and adverse mental health outcomes. We synthesize the findings from recent studies, discuss potential underlying mechanisms, and look to the future regarding novel applications of the adult and children’s DII (C-DII) scores and new avenues of investigation in this field of nutritional research.

scholarly journals Non-Pharmacological Interventions to Improve Chronic Disease Risk Factors and Sleep in Shift Workers: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 3 (1) ◽  
pp. 132-178
Author(s):  
Meagan E Crowther ◽  
Sally A Ferguson ◽  
Grace E Vincent ◽  
Amy C Reynolds
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Chronic Disease ◽  
Health Outcomes ◽  
Disease Risk ◽  
Meta Analysis ◽  
Perceived Health Status ◽  
Pharmacological Interventions ◽  
Shift Workers ◽  
Chronic Disease Risk

Shift work is associated with adverse chronic health outcomes. Addressing chronic disease risk factors including biomedical risk factors, behavioural risk factors, as well as sleep and perceived health status, affords an opportunity to improve health outcomes in shift workers. The present study aimed to conduct a systematic review, qualitative synthesis, and meta-analysis of non-pharmacological interventions targeting chronic disease risk factors, including sleep, in shift workers. A total of 8465 records were retrieved; 65 publications were eligible for inclusion in qualitative analysis. Random-effects meta-analysis were conducted for eight eligible health outcomes, including a total of thirty-nine studies. Interventions resulted in increased objective sleep duration (Hedges’ g = 0.73; CI: 0.36, 1.10, k = 16), improved objective sleep efficiency (Hedges’ g = 0.48; CI: 0.20, 0.76, k = 10) and a small increase in both subjective sleep duration (Hedges’ g = 0.11; CI: −0.04, 0.27, k = 19) and sleep quality (Hedges’ g = 0.11; CI: −0.11, 0.33, k = 21). Interventions also improved perceived health status (Hedges’ g = 0.20; CI: −0.05, 0.46, k = 8), decreased systolic (Hedges’ g = 0.26; CI: −0.54, 0.02, k = 7) and diastolic (Hedges’ g = 0.06; CI: −0.23, 0.36, k = 7) blood pressure, and reduced body mass index (Hedges’ g = −0.04; CI: −0.37, 0.29, k = 9). The current study suggests interventions may improve chronic disease risk factors and sleep in shift workers; however, this could only be objectively assessed for a limited number of risk factor endpoints. Future interventions could explore the impact of non-pharmacological interventions on a broader range of chronic disease risk factors to better characterise targets for improved health outcomes in shift workers.

Predicting Hawaiian Youth’s Physical Activity and Fruit and Vegetable Consumption Behaviors: A 10-Year Cohort Study

2019 ◽  
Vol 16 (8) ◽  
pp. 644-646
Author(s):  
Sasha A. Fleary ◽  
Robin Mehl ◽  
Claudio Nigg
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Health Behaviors ◽  
Disease Risk ◽  
Vegetable Consumption ◽  
Fruit And Vegetable Consumption ◽  
Fruit And Vegetable ◽  
Chronic Disease Risk ◽  
Childhood Physical Activity

Background: Health behaviors in childhood and adolescence are implicated in health behaviors and chronic disease risk in adulthood for the majority of the US population. However, little is known about these relationships in Hawaiian youth. This study investigated the extent to which childhood physical activity (PA) and fruit and vegetable consumption behaviors predicted later behaviors across a 10-year period in Hawaiian youth. Methods: Three cohorts of fourth- to sixth-grade students who participated in an elementary after-school program (Fun 5) provided baseline data (Y1—data collected between 2003 and 2007), 5-year (Y5—data collected between 2008 and 2012), and 10-year (Y10—data collected between 2013 and 2017) follow-up surveys. Demographic, PA, and fruit and vegetable consumption measures were completed at all 3 time points. Bivariate and multiple regressions were computed in 2018. Results: Y1 and Y5 behavior predicted PA in young adulthood. For fruit and vegetable consumption, Y1 behavior predicted Y5 behavior but not Y10 behavior, and Y5 behavior predicted Y10 behaviors. Conclusions: Similar to mainland US youth, it is important to address PA and nutrition early in the life span for Hawaiian youth to increase long-term preventive health behaviors and reduce long-term chronic disease risk.

scholarly journals Occupational Therapy in Primary Care -- Barriers, Pivots, and Outcomes: A pilot study

2021 ◽  
Author(s):  
Sue Dahl-Popolizio ◽  
Gretchen Anne Roman ◽  
Felicia Trembath ◽  
Bradley Doebbeling ◽  
Alyssa Concha-Chavez
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Lifestyle Modification ◽  
Care Team ◽  
Primary Care Team ◽  
Interprofessional Team ◽  
Patients With Diabetes ◽  
Lifestyle Modification Program

Purpose: Habits, roles, and routines are important behaviors that affect lifestyle and can lead to the development of chronic disease such as diabetes mellitus. Primary care physicians (PCPs) have limited time, suggesting an interprofessional team approach would be beneficial in helping patients modify behaviors for the prevention and treatment of chronic disease. Occupational therapists (OTs) specialize in addressing health behaviors, and literature supports including OTs on the primary care team to improve the self-management techniques of patients with chronic disease. This study was guided by Lifestyle Redesign®, an evidence-based program that addresses the health behaviors of patients with diabetes in primary care. We aimed to improve health outcomes by combining an OT-led lifestyle modification program with patient-centered treatment recommendations from an external interprofessional team. We hypothesized that the health outcomes of patients with diabetes in primary care would improve after participating in an OT-led interprofessional lifestyle modification program, and that reimbursement for services would be obtainable. Method: Two PCPs in community practice initially agreed to involve an OT on their primary care team. Due to reimbursement concerns, the PCPs later preferred to refer patients to receive the OT-led intervention at an offsite clinic, rather than onsite at the primary care practice. Health outcomes were measured pre- and post-intervention using industry standard assessments and biometrics. Descriptive and non-parametric statistics were used to evaluate change. Results: Thirty-one patients with diabetes were referred, and three (9.7%) participated in the offsite lifestyle modification program. While statistical significance was not achieved (p≥0.10), trends toward individual improvement were noted for occupational performance and satisfaction and empowerment, and reimbursement was received from the third-party payers. Conclusions: Patient participation in this study was consistent with participation rates for offsite behavioral health referrals. An offsite OT-led interprofessional lifestyle modification program demonstrated potential for meaningful change and services were reimbursed. These findings support practice redesign efforts to include OTs as part of an integrated primary care model. Offering onsite services will increase patient accessibility to care and improve referral completion rates, thus providing OTs the opportunity to further demonstrate the efficacy of delivering chronic disease management in primary care.

scholarly journals A Web-Based Intervention to Prevent Multiple Chronic Disease Risk Factors Among Adolescents: Co-Design and User Testing of the Health4Life School-Based Program

10.2196/19485 ◽  
2020 ◽  
Vol 4 (7) ◽  
pp. e19485 ◽  
Author(s):  
Katrina Elizabeth Champion ◽  
Lauren Anne Gardner ◽  
Cyanna McGowan ◽  
Cath Chapman ◽  
Louise Thornton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Disease ◽  
Disease Risk ◽  
Physical And Mental Health ◽  
User Testing ◽  
School Students ◽  
Web Based ◽  
Chronic Disease Risk ◽  
School Based ◽  
Lifestyle Risk

Background Chronic diseases are the leading cause of death worldwide. Addressing key lifestyle risk factors during adolescence is critical for improving physical and mental health outcomes and reducing chronic disease risk. Schools are ideal intervention settings, and electronic health (eHealth) interventions afford several advantages, including increased student engagement, scalability, and sustainability. Although lifestyle risk behaviors tend to co-occur, few school-based eHealth interventions have targeted multiple behaviors concurrently. Objective This study aims to summarize the co-design and user testing of the Health4Life school-based program, a web-based cartoon intervention developed to concurrently prevent 6 key lifestyle risk factors for chronic disease among secondary school students: alcohol use, smoking, poor diet, physical inactivity, sedentary recreational screen time, and poor sleep (the Big 6). Methods The development of the Health4Life program was conducted over 18 months in collaboration with students, teachers, and researchers with expertise relevant to the Big 6. The iterative process involved (1) scoping of evidence and systematic literature review; (2) consultation with adolescents (N=815) via a cross-sectional web-based survey to identify knowledge gaps, attitudes, barriers, and facilitators in relation to the Big 6; (3) content and web development; and (4) user testing of the web-based program with students (n=41) and teachers (n=8) to evaluate its acceptability, relevance, and appeal to the target audience. Results The co-design process resulted in a six-module, evidence-informed program that uses interactive cartoon storylines and web-based delivery to engage students. Student and teacher feedback collected during user testing was positive in terms of acceptability and relevance. Commonly identified areas for improvement concerned the length of modules, age appropriateness of language and alcohol storyline, the need for character backstories and links to syllabus information, and feasibility of implementation. Modifications were made to address these issues. Conclusions The Health4Life school-based program is the first universal, web-based program to concurrently address 6 important chronic disease risk factors among secondary school students. By adopting a multiple health behavior change approach, it has the potential to efficiently modify the Big 6 risk factors within one program and to equip young people with the skills and knowledge needed to achieve and maintain good physical and mental health throughout adolescence and into adulthood.

scholarly journals Effectiveness of motivational interviewing at improving oral health: a systematic review

2014 ◽  
Vol 48 (1) ◽  
pp. 142-153 ◽  
Author(s):  
Andreia Morales Cascaes ◽  
Renata Moraes Bielemann ◽  
Valerie Lyn Clark ◽  
Aluísio J D Barros
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Motivational Interviewing ◽  
Clinical Outcomes ◽  
Dental Plaque ◽  
Oral Health Behaviors ◽  
The Impact ◽  
Oral Health Outcomes

OBJECTIVE : To analyze the effectiveness of motivational interviewing (MI) at improving oral health behaviors (oral hygiene habits, sugar consumption, dental services utilization or use of fluoride) and dental clinical outcomes (dental plaque, dental caries and periodontal status). METHODS : A systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google Scholar bibliographic databases was conducted looking for intervention studies that investigated MI as the main approach to improving the oral health outcomes investigated. RESULTS : Of the 78 articles found, ten met the inclusion criteria, all based on randomized controlled trials. Most studies (n = 8) assessed multiple outcomes. Five interventions assessed the impact of MI on oral health behaviors and nine on clinical outcomes (three on dental caries, six on dental plaque, four on gingivitis and three on periodontal pockets). Better quality of evidence was provided by studies that investigated dental caries, which also had the largest population samples. The evidence of the effect of MI on improving oral health outcomes is conflicting. Four studies reported positive effects of MI on oral health outcomes whereas another four showed null effect. In two interventions, the actual difference between groups was not reported or able to be recalculated. CONCLUSIONS : We found inconclusive effectiveness for most oral health outcomes. We need more and better designed and reported interventions to fully assess the impact of MI on oral health and understand the appropriate dosage for the counseling interventions.

scholarly journals Adverse Childhood Experiences Negatively Impact Health Behaviors and Chronic Disease Risk Among Adults Residing in Delaware

2016 ◽  
Vol 2 (5) ◽  
pp. 68-69
Author(s):  
Caprice A. Torrance ◽  
Kimberly Williams ◽  
Elizabeth Brown ◽  
Kirsten Olson ◽  
Andrea Miller ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Health Behaviors ◽  
Adverse Childhood Experiences ◽  
Disease Risk ◽  
Childhood Experiences ◽  
Chronic Disease Risk ◽  
Adverse Childhood
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