scholarly journals Engagement in Everyday Activities for Prevention of Stroke: Feasibility of an mHealth-Supported Program for People with TIA

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 968
Author(s):  
Ann-Helen Patomella ◽  
Lisette Farias ◽  
Christina Eriksson ◽  
Susanne Guidetti ◽  
Eric Asaba
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Healthy Lifestyle ◽  
Self Management ◽  
Post Intervention ◽  
Lifestyle Habits ◽  
Mobile Phone Application ◽  
Everyday Activities ◽  
Lifestyle Program ◽  
Ischemic Attack

Most of the risk factors for stroke are modifiable, yet incorporating and sustaining healthy lifestyle habits in daily life that reduce these risk factors is a major challenge. Engaging everyday activities (EEAs) are meaningful activities that are regularly performed that have the potential to contribute to the sustainability of healthy lifestyle habits and reduce risk factors for stroke. The aims of this study were (1) to investigate the feasibility and acceptability of a digitally supported lifestyle program called “Make My Day” (MMD) for people at risk for stroke following a transient ischemic attack, and (2) to describe participants’ stroke risk and lifestyle habits pre- and post-intervention. A multiple case study design using mixed methods was utilized (n = 6). Qualitative and self-reported quantitative data were gathered at baseline, post-intervention, and 12 months post-baseline. The results indicate that MMD can support lifestyle change and self-management for persons at risk for stroke following a TIA. The findings indicate a high acceptability and usability of MMD, as well as a demand for digital support provided via a mobile phone application. Self-management with digital support has the potential to increase participation in EEAs for persons at risk for stroke following a TIA.

scholarly journals EXPRESS: Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach

2021 ◽  
pp. 174749302110176
Author(s):  
Brodie M Sakakibara ◽  
Scott A Lear ◽  
Susan I Barr ◽  
Charles Goldsmith ◽  
Amy Schneeberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Controlled Trial ◽  
Cognitive Status ◽  
Self Management ◽  
Community Living ◽  
Memory Training ◽  
Stroke Survivors ◽  
Post Intervention ◽  
Lifestyle Behaviour ◽  
Mild Stroke

Background: Stroke Coach is a lifestyle coaching telehealth program to improve self-management of stroke risk factors. Aims: To examine the efficacy of Stroke Coach on lifestyle behaviour and risk factor control among community-living stroke survivors within one-year post stroke. Methods: Participants were randomized to Stroke Coach or an attention control Memory Training group. Lifestyle behaviour was measured using the Health Promoting Lifestyle Profile II. Secondary outcomes included specific behavioural and cardiometabolic risk factors, health-related quality of life (HRQoL), cognitive status, and depressive symptoms. Measurements were taken at baseline, post-intervention (6 months), and retention (12 month). Linear mixed-effects models were used to test the study hypotheses (p<0.05). All analyses were intention-to-treat. Results: The mean age of the Stroke Coach (n=64) and Memory Training (n=62) groups was 67.2 and 69.1 years, respectively. The majority of participants (n = 100) had mild stroke (modified Rankin Scale = 1 or 2), were active, with controlled blood pressure (mean = 129/79 mmHg) at baseline. At post-intervention, there were no significant differences in lifestyle (b = -2.87; 95%CI -8.03 to 2.29; p=0.28). Glucose control, as measured by HbA1c (b = 0.17; 95%CI 0.17 to 0.32; p=0.03), and HRQoL, measured using SF-36 Physical Component Summary (b = -3.05; 95%CI -5.88 to -0.21; p=0.04), were significantly improved in Stroke Coach compared to Memory Training, and the improvements were maintained at retention. Conclusion: Stroke Coach did not improve lifestyle behaviour, however, there were improvements to HbA1c and HRQoL among community-living stroke survivors with mild stroke-related disability. (ClinicalTrials.gov identifier: NCT02207023)

scholarly journals Parental Participation in a Healthy Lifestyle Program for Middle Schoolers Improves Their Family Meal Patterns and Social Support and Self-Regulation for Healthy Eating (P16-041-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Henna Muzaffar ◽  
Cassandra Nikolaus ◽  
Sharon Nickols-Richardson
Keyword(s):  
Social Support ◽  
Healthy Lifestyle ◽  
Self Regulation ◽  
Parental Participation ◽  
Post Intervention ◽  
Meal Patterns ◽  
Family Meal ◽  
Lifestyle Program ◽  
Post Assessment ◽  
Healthy Lifestyle Program

Abstract Objectives The development and dissemination of appropriate integrated curricula for parents represent a critical need and a novel approach in the obesity prevention field. Our objective was to assess if parental participation in a healthy lifestyle program (PAWS [Peer-education About Weight Steadiness] Club) for middle school students would improve parental anthropometrics, social cognitive theory (SCT) mediators of dietary behavior, and family mealtime frequency and environment. Methods A total of 42 parents participated in five weekly 1.5-hour sessions, delivered four times from 2015–2017. The sessions were led by a trained research assistant; focused on family fitness, meal planning, family mealtimes, label reading, energy balance, making healthy choices and simple recipes, self-reflection and goal setting. Data on anthropometrics, blood pressure (BP), SCT mediators (social/family support, self-efficacy, self-regulation, and outcome expectations) of eating, and family meal patterns (frequency and environment) was collected from the parents at pre-and post-intervention. Wilcoxon Signed Rank test was used to determine any changes from baseline to post assessment for SCT mediators of dietary behavior and family meal patterns. Paired t-test was used to determine any changes from pre-to post-intervention for anthropometric and BP measurements. Significance was set at P < 0.05. Results Of the 42 participants, 67% were females (mothers); 33% self-reported White and 33% self-reported African American race/ethnicity. Participants significantly improved in their self-regulation for reducing unhealthy foods (P = 0.011), social support for balancing calories (P = 0.007), and family mealtime patterns (P = 0.003) from pre- to post-assessment. No significant changes were observed for anthropometric and BP measures. Conclusions Parental participation in a healthy lifestyle program can potentially improve family mealtime environment and frequency and increase self-regulation and social support for dietary behaviors of the family. These results have implications for planning future health programs with adolescents in schools. Funding Sources Supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2012-68001-22032.

scholarly journals 3086 Virtual World-based Cardiac Rehabilitation to Promote Healthy Lifestyle Among Cardiac Patients

2019 ◽  
Vol 3 (s1) ◽  
pp. 61-62
Author(s):  
LaPrincess Brewer ◽  
Brian Kaihoi ◽  
Shawn Leth ◽  
Ray Squires ◽  
Randal Thomas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Behaviors ◽  
Cardiac Rehabilitation ◽  
Fruits And Vegetables ◽  
Health Knowledge ◽  
Healthy Lifestyle ◽  
Cardiac Patients ◽  
Annual Household Income ◽  
Post Intervention ◽  
Coronary Syndrome

OBJECTIVES/SPECIFIC AIMS: Our aim was to assess the feasibility and acceptability of a VW-based cardiac rehabilitation (CR) program (Destination Rehab) as an extension of a face-to-face conventional CR program. We hypothesized that a VW-based CR program could be successfully implemented as an extension of conventional CR and would have high acceptability among cardiac patients. METHODS/STUDY POPULATION: We recruited 30 adult cardiac patients (10/site) hospitalized at Mayo Clinic Hospitals in Rochester, MN, Jacksonville, FL or Scottsdale, AZ with a diagnosis for CR (eg, acute coronary syndrome (ACS), heart failure, elective percutaneous coronary intervention (PCI)). Other inclusion criteria included at least 1 modifiable, lifestyle risk factor target: sedentary lifestyle (< 3 hours physical activity (PA)/week), unhealthy diet (< 5 servings fruits and vegetables/day) or current smoking (>1 year). Patients participated in an 8-week, health education program using a VW platform from a prior proof-of-concept study and provided intervention usability, usefulness and satisfaction feedback. We assessed cardiovascular (CV) health behaviors (diet, PA) and risk factors (eg, blood pressure (BP), lipids) at baseline and immediate post-intervention. RESULTS/ANTICIPATED RESULTS: Among 30 patients enrolled (mean age; 59 years; 50% women; 65% <college graduate; 32% annual household income <$50,000), 28 (98%) completed the study. The majority (64%) were enrolled in conventional CR with a high session completion rate (median 36 sessions, interquartile range 8-36). The most common CR indication was PCI (68%). There were statistically significant improvements in PA from baseline to post-intervention: vigorous PA, +10.7 (SD 11.7) minutes/day (p = 0.05) and flexibility exercises +0.9 (SD 0.9) days/week for men (p=0.05). There were favorable trends in risk factors: systolic BP (−6.8 mmHg, SD 29.8), total cholesterol (−31.6 mg/dL, SD 46.2) and LDL (−26 mg/dL, SD 44.8) from baseline to post-intervention, although not statistically significant. The majority reported that they would continue to use VW as a resource (76%) and agreed/strongly agreed that the program improved their heart health knowledge (86%) and assisted with adapting healthier lifestyle (100%). Overall, the VW CR program received a rating of 8 (scale 0-10). DISCUSSION/SIGNIFICANCE OF IMPACT: VW-based CR program is a feasible, highly acceptable and innovative platform to influence health behaviors and CV risk and can increase accessibility to disadvantaged populations with higher CVD burdens.

scholarly journals Primary prevention of stroke: randomised controlled pilot trial protocol on engaging everyday activities promoting health

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031984
Author(s):  
Ann-Helen Patomella ◽  
Susanne Guidetti ◽  
Emelie Mälstam ◽  
Christina Eriksson ◽  
Aileen Bergström ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Pilot Study ◽  
Activity Patterns ◽  
Pilot Trial ◽  
Lifestyle Change ◽  
Prevention Programme ◽  
Everyday Activities ◽  
Study Results ◽  
Healthy Activity

IntroductionStroke is a globally common disease that has detrimental effects on the individual and, more broadly, on society. Lifestyle change can contribute to reducing risk factors for stroke. Although a healthy lifestyle has direct benefits, sustaining and incorporating healthy activities into everyday life is a challenge. Engaging everyday activities have the potential to support lifestyle change and to promote sustainable activity patterns. Current healthcare is failing to reduce modifiable risk factors in people at risk, and in addition to current practice, there is a need for systematic and efficient non-pharmacological and non-surgical stroke-prevention strategies. The aim of the pilot study was to increase knowledge about the effects of a prevention programme and its feasibility to promote sustainable and healthy activity patterns among persons at risk of stroke.Methods and analysisThe proposed pilot study will be a two-armed randomised, assessor-blinded, parallel pilot trial. The study will include feasibility data, investigating acceptability and delivery of the intervention. Persons at risk of stroke (n=60) will be included in a mobile phone-supported prevention programme. The 10-week programme will be conducted at primary healthcare clinics, combining group meetings and online resources to support self-management of lifestyle change. Main outcomes are stroke risk, lifestyle habits and healthy activity patterns. Assessments will be performed at baseline and at follow-up (immediately following the end of the programme and at 6 and 12 months). Effects of the programme will be analysed using inferential statistics. Feasibility will be analysed using both qualitative and quantitative methods.Ethics and disseminationThe study has been approved by the Regional Ethical Review Board in Stockholm, Sweden, being granted reference numbers 2015/834-31, 2016/2203-32 and 2019/01444. Study results will be disseminated through peer-review journals and presentations to mixed audiences at regional and international conferences.Trial registration numberNCT03730701.

scholarly journals 107 Using Brief Motivational Interviewing to Increase Healthy Lifestyle Habits in Overweight and Obese Adults in a Rural Family Practice Setting

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 69-70
Author(s):  
Amanda McNulty
Keyword(s):  
Motivational Interviewing ◽  
Healthy Lifestyle ◽  
Readiness To Change ◽  
College Education ◽  
The United States ◽  
Care Practice ◽  
Post Intervention ◽  
Lifestyle Habits ◽  
Lifestyle Choices ◽  
Significant Difference

AbstractObesity is a rapidly growing epidemic in the United States of America resulting in a multitude of comorbid conditions. Individuals living in rural areas have a higher prevalence of obesity than in urban settings. Effective treatment of obesity is needed to decrease the morbidity and mortality of this chronic disease. Using motivational interviewing (MI) techniques to address unhealthy lifestyle habits has previously proven to be effective in aiding individuals to achieve a healthier lifestyle.ObjectivesThe main objective is to determine the effectiveness of brief MI used during regular office visits and with phone follow-ups on body mass index (BMI) at the initiation of the project, as well as at the 3-month follow-up. Secondary objectives are to determine the effect brief MI has on the amount of weekly physical activity, advancing the individual to the next stage on the Transtheoretical Model of Change (TTM) continuum and determining common barriers to leading a healthy lifestyle in a rural adult population.MethodParticipants (n=15) were recruited using a convenience sampling method from the primary care practice. Using a pretest/posttest design, individuals were asked to complete a survey regarding their amount of weekly exercise, their perceived stage of change and their barriers to healthy lifestyle choices. A pre- and post-intervention BMI was collected. One in-office brief MI session and two monthly phone sessions were conducted, each lasting not longer than ten minutes.ResultsA total of 14 participants, mostly female (67%), aged 36 to 45 years old (33%), Caucasian (73.3%), and had some college education (40%), completed the study. It was hypothesized that brief MI would result in decreased BMI, increased exercise and advancement along the TTM continuum. No significant difference in the pre-and post -intervention BMI ([M=37.88, SD=9.15] vs [M=37.01, SD=9.37]); t (27)=0.25, p=0.801 was found. Many participants (n=10), however, had a decrease in BMI. The difference in weekly activity (M=644.2 min vs M=268.57 min) was not found to be statistically significant; t (27)=1.40, p=0.17. An increase in readiness to change was noted, but, was not significant (p =0.52). Of 34 responses, chronic pain or health conditions (n=10) and scheduling conflicts (n=7) were the two top cited reasons for not practicing a healthylifestyle.ConclusionsThis QI project did not demonstrate statistically significant improvement in BMI, weekly exercise or readiness to change after three months of brief MI. It is important to note, however, that many individuals did experience an overall decrease in BMI. It is also promising to note that more individuals were participating in healthylifestyle activities more frequently post-intervention when analyzed on the TTM continuum. Further studies are needed to analyze the most effective strategies to assist individuals in rural settings to make healthier lifestyle choices.Funding AcknowledgementsNo funding.

scholarly journals Changes in Health Behaviours in Adults At-Risk of Chronic Disease: Primary Outcomes From The My Health for Life Program

2021 ◽  
Author(s):  
Charrlotte Seib ◽  
Stephanie Moriarty ◽  
Nicole McDonald ◽  
Debra Anderson ◽  
Joy Parkinson
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
At Risk ◽  
Chronic Disease ◽  
Waist Circumference ◽  
Healthy Lifestyle ◽  
Disease Risk ◽  
Vegetable Consumption ◽  
Health Behaviours ◽  
Fruit And Vegetable

Abstract Background Chronic disease is the leading cause of premature death globally, and many of these deaths are preventable by modifying some key behavioural and metabolic risk factors. This secondary data analysis examines changes in health behaviours among men and women at risk of diabetes or cardiovascular disease (CVD) who participated in a 6-month lifestyle intervention called the My health for life program. Methods My health for life is a government-funded multi-component program designed to reduce chronic disease risk factors amongst at-risk adults. The intervention comprises six sessions over a 6-month period, delivered by a trained facilitator or telephone health coach. The analysis presented in this paper stems from 9,372 participants who participated in the program between July 2017 and December 2019. Primary outcomes included fruit and vegetable intake, consumption of sugar-sweetened drinks and take-away, alcohol and tobacco smoking, physical activity, body mass index (BMI), and waist circumference (WC). Variables were summed to form a single Healthy Lifestyle Index (HLI) ranging from 0 to 18, with higher scores denoting healthier behaviours. Longitudinal associations between lifestyle indices, assessed using Gaussian Generalized Estimating Equations (GEE) models with an identity link and robust standard errors. Results Improvements in HLI scores were noted between baseline (Md = 10.0; IQR = 8.3, 11.7] and 26-weeks (Md = 11.7; IQR = 10.0, 13.2] which corresponded with increases in fruit and vegetable consumption and decreases in takeaway frequency, and weight indices (p < .01 for all) but not risky alcohol intake. Modelling showed higher average HLI among those aged 45 or older (β = 0.97, 95% CI = 0.81, 1.13, p < .01) with vocational educational qualifications (certificate/diploma: β = 0.47, 95% CI = 0.19, 0.76, p < .01; bachelor/post-graduate degree β = 1.05, 95% CI = 0.76, 1.34, p < .01) while being male, Aboriginal or Torres Strait Islander background, or not currently working conferred lower average HLI scores (p < .01 for all). Conclusions While participants showed improvements in many healthy lifestyle indices including BMI, waist circumference, physical activity, and dietary indicators, changes in alcohol consumption were less amenable to the program. There is a need for additional research to understand the multi-level barriers and facilitators of behaviour change in this context to tailor the intervention for more-difficult-to-treat groups.

Program of Rehabilitative Exercise and Education to Avert Vascular Events After Non-Disabling Stroke or Transient Ischemic Attack (PREVENT Trial): A Randomized Controlled Trial

2021 ◽  
pp. 154596832110603
Author(s):  
MacKay-Lyons Marilyn ◽  
Gubitz Gordon ◽  
Phillips Stephen ◽  
Giacomantonio Nicholas ◽  
Firth Wanda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Density Lipoprotein ◽  
Post Intervention ◽  
Vascular Events ◽  
Randomized Controlled ◽  
Ischemic Attack

Background Non-disabling stroke (NDS) and transient ischemic attack (TIA) herald the possibility of future, more debilitating vascular events. Evidence is conflicting about potency of exercise and education in reducing risk factors for second stroke. Methods Three-site, single-blinded, randomized controlled trial with 184 participants <3 months of NDS or TIA (mean age, 65 years; 66% male) randomized to usual care (UC) or UC + 12-week program of exercise and education (PREVENT). Primary (resting systolic blood pressure) and secondary outcomes (diastolic blood pressure [DBPrest], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC], TC/HDL, triglycerides, fasting glucose, and body mass index) were assessed at baseline, post-intervention, and 6- and 12-month follow-up. Peak oxygen consumption (VO2peak) was measured at baseline, post-intervention, 12-month assessments. Results Significant between-group differences at post-intervention favored PREVENT group over UC: DBPrest (mean difference [MD]: −3.2 mmHg, 95% confidence interval [CI]: −6.3, −.2, P = .04) and LDL-C (MD: −.31 mmol/L, 95% CI: −.42, −.20, P = .02). Trends of improvement in PREVENT group were noted in several variables between baseline and 6-month follow-up but not sustained at 12-month follow-up. Of note, VO2 peak did not change over time in either group. Conclusion Impact of PREVENT on vascular risk factor reduction was more modest than anticipated, possibly because several outcome variables approximated normative values at baseline and training intensity may have been sub-optimal. Further investigation is warranted to determine when exercise and education programs are viable adjuncts to pharmaceutical management for reduction of risk factors for second stroke. Clinical Trial Registration-URL: http://www.clinicaltrials.gov . Unique identifier: #NCT00885456

Individual and Combined Association Between Healthy Lifestyle Habits With Muscle Strength According to Cardiovascular Health Status in Adults and Older Adults

2021 ◽  
pp. 1-8
Author(s):  
Tiago R. de Lima ◽  
David A. González-Chica ◽  
Eleonora D’Orsi ◽  
Xuemei Sui ◽  
Diego A.S. Silva
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Health Status ◽  
Muscle Strength ◽  
Healthy Lifestyle ◽  
Handgrip Strength ◽  
Activity Levels ◽  
Healthy Individuals ◽  
Lifestyle Habits

Background: The authors aimed to identify the effect of adherence to healthy lifestyle habits on muscle strength (MS) according to a distinct health status. Methods: Longitudinal analysis using data from 2 population-based cohorts in Brazil (EpiFloripa adult, n = 862, 38.8 [11.4] y—6 y of follow-up length; EpiFloripa Aging, n = 1197, 69.7 [7.1] y—5 y of follow-up length). MS was assessed by handgrip strength (kgf). Information assessed by questionnaire regarding adequate physical activity levels, regular consumption of fruit and vegetables, low alcohol consumption, and nonsmoking habits were analyzed in the relationship with MS according to the health status. The participants were grouped into 3 health status categories: (1) with cardiovascular disease (CVD); (2) at risk of CVD (abdominal obesity or overweight/obesity, high blood pressure, hyperglycemia, and dyslipidemia); and (3) healthy individuals (without CVD and risk of CVD). Results: Simultaneous adherence of 4 healthy lifestyle habits was directly associated with MS among healthy individuals (β = 10.0, 95% CI, 2.0–18.0, SE = 4.0), at risk of CVD (β = 5.5, 95% CI, 0.3–12.6, SE = 3.6), and those with CVD (β = 11.4, 95% CI, 5.8–16.7, SE = 2.8). Conclusions: Adopting a healthy lifestyle can contribute to increased MS in adults and older adults, regardless of health status.

scholarly journals A Targeted Self-Management Approach for Reducing Stroke Risk Factors in African American Men Who Have Had a Stroke or Transient Ischemic Attack

2017 ◽  
Vol 32 (2) ◽  
pp. 282-293 ◽  
Author(s):  
Martha Sajatovic ◽  
Curtis Tatsuoka ◽  
Elisabeth Welter ◽  
Kari Colon-Zimmermann ◽  
Carol Blixen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
African American ◽  
Health Behaviors ◽  
Transient Ischemic Attack ◽  
Stroke Risk ◽  
African American Men ◽  
Self Management ◽  
Positive Effects ◽  
Ischemic Attack

Purpose: This study compared a novel self-management (TargetEd MAnageMent Intervention [TEAM]) versus treatment as usual (TAU) to reduce stroke risk in African American (AA) men. Design: Six-month prospective randomized controlled trial with outcomes evaluated at baseline, 3 months, and 6 months. Setting: Academic health center. Participants: Thirty-eight (age < 65) AA men who had a stroke or transient ischemic attack and a Barthel index score of >60 were randomly assigned to TEAM (n = 19) or TAU (n = 19). Intervention: Self-management training, delivered in 1 individual and 4 group sessions (over 3 months). Measures: Blood pressure, glycosylated hemoglobin (HbA1c), lipids, medication adherence, weight, and standardized measures of health behaviors (diet, exercise, smoking, substances), depression, and quality of life. Qualitative assessments evaluated the perspectives of TEAM participants. Analysis: T tests for paired differences and nonparametric tests. Thematic content qualitative analysis. Results: Mean age was 52.1 (standard deviation [SD] = 7.4) and mean body mass index was 31.4 (SD = 7.4). Compared to TAU, TEAM participants had significantly lower mean systolic blood pressure by 24 weeks, and there was also improvement in HbA1c and high-density lipoprotein cholesterol ( P = .03). Other biomarker and health behaviors were similar between groups. Qualitative results suggested improved awareness of risk factors as well as positive effects of group support.

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