scholarly journals A Process Evaluation of a Multi-Component Intervention in Dutch Dietetic Treatment to Improve Portion Control Behavior and Decrease Body Mass Index in Overweight and Obese Patients

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1717 ◽  
Author(s):  
Willemieke Kroeze ◽  
Frédérique Rongen ◽  
Michelle Eykelenboom ◽  
Wieke Heideman ◽  
Claudia Bolleurs ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Self Efficacy ◽  
Control Strategies ◽  
Real Life ◽  
Implementation Process ◽  
Evidence Based ◽  
Highly Educated ◽  
Portion Control ◽  
Control Intervention

The SMARTsize intervention embeds an evidence-based portion control intervention in regular dietetic care. This intervention was evaluated to explore (1) which patients participated, (2) the implementation process, and (3) the outcomes of the intervention. The intervention was evaluated with an observational study design including measures at baseline, and three, six, and nine months after the start of the program. Data concerning the process (participation, dose delivered, dose received, satisfaction) and the outcomes (self-efficacy, intention, portion control strategies, and Body Mass Index (BMI) were collected with forms and questionnaires filled out by dietitians and patients. Descriptive analyses, comparison analyses, and cluster analyses were performed. Patients were mainly obese, moderately to highly educated women of Dutch ethnicity. Use of the intervention components varied from 50% to 100% and satisfaction with the SMARTsize intervention was sufficient to good (grades 7.2–8.0). Statistically significant (p < 0.001) improvements were observed for self-efficacy (+0.5), portion control strategies (+0.7), and BMI (−2.2 kg/m2), with no significant differences between patients with or without counselling. Three clusters of patients with different levels of success were identified. To conclude, implementing an evidence-based portion control intervention in real-life dietetic practice is feasible and likely to result in weight loss.

Evidence-based eHealth interventions for caregivers of people with dementia (Myinlife and Partner in Balance): Evaluation of implementations in municipality contexts (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
Marjolein Elizabeth de Vugt
Keyword(s):  
Self Efficacy ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Successful Implementation ◽  
Evidence Based ◽  
Multiple Sources ◽  
Target Groups ◽  
Face To Face ◽  
People With Dementia ◽  
Implementation Context

BACKGROUND Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context to implement these interventions, due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in eight municipalities in the Euregion Meuse-Rhine. OBJECTIVE This study’s objectives were to (1.) evaluate this implementation and (2.) investigate determinants of successful implementation. METHODS This study collected eHealth usage data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials, based on the Measurement Instrument for Determinants of Implementation (MIDI). This data from multiple sources and perspectives was integrated and analysed to form a total picture of the municipality implementation process. RESULTS The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, three municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The two Partner in Balance municipalities that did not consider the implementation to be successful, viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and the target groups. Successful implementations were linked to implementer self-efficacy CONCLUSIONS The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols, as part of standard implementation materials for municipalities and organisations implementing Myinlife and Partner in Balance.

scholarly journals Evaluation and management of the patient with a failed midurethral synthetic sling

2012 ◽  
Vol 6 (5-S2) ◽  
pp. 123
Author(s):  
E. Ann Gormley
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Body Mass ◽  
Midurethral Sling ◽  
Patient Characteristics ◽  
Evidence Based ◽  
Careful Evaluation ◽  
Mixed Incontinence ◽  
Surgical Failure ◽  
Sphincter Deficiency

While most women will do well following placement of a midurethral sling (MUS), a substantial minority do experience surgical failure. There are several risk factors that can help identify a patient at higher risk for failure, including body mass index greater than 25 kg/m2, mixed incontinence, previous continence surgery, intrinsic sphincter deficiency, and diabetes. At the present time, there is no evidence-based guidance for which intervention to use following failure. Careful evaluation of patient characteristics will help guide subsequent management.

scholarly journals Self-efficacy among patients with chronic diseases and its associated factors

2018 ◽  
Vol 7 (3) ◽  
pp. 82-88
Author(s):  
Dayana Shakya
Keyword(s):  
Health Care ◽  
Body Mass Index ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Body Mass ◽  
Health Care Providers ◽  
Self Efficacy ◽  
Care Providers ◽  
Modifiable Factors ◽  
Significant Difference

Background: Chronic diseases are in an increasing trend worldwide. Although, this rise may be due to a number of factors, one reason for the worldwide increase is due to better treatment protocols and higher awareness among patients. The management of chronic disease depends on the patient’s ability to alter the modifi able risk factors. The burden of disease can be decreased with better self- efficacy. Objectives: To assess the self-efficacy among patients with chronic diseases Methodology: In this descriptive, cross sectional study, data was collected purposively from 329 patients with chronic diseases presenting in the Medical outpatient department of Kathmandu Medical College. Face to face interview method was used to collect data using Chronic Disease Self-efficacy Scale and Patient Assessment Chronic Illness Care Questionnaire. Association with selected socio demographic variables were computed with Mann Whitney U and Kruskal Wallis H tests. Results: The mean age of the patients was 62±13 years. Males, those earning, those never admitted in the hospital for their disease and those who exercised were found to have better self-efficacy. There was significant difference in self-efficacy in terms of age, education, marital status, caregivers and body mass index. Self-efficacy showed significant positive correlation with monthly family income and health care provider score whereas significant negative correlation with age and monthly cost of treatment. Conclusion: Self-efficacy of patients with chronic disease can be improved with certain modifiable factors like daily exercise and appropriate body mass index. Younger patients, males, educated, employed and married patients were found to have better self-efficacy. Proper counselling by health care providers also improves self-efficacy.

Associations between depressive symptoms, self-efficacy, eating styles, exercise and body mass index in women

2013 ◽  
Vol 37 (4) ◽  
pp. 577-586 ◽  
Author(s):  
Gretchen A. Clum ◽  
Janet C. Rice ◽  
Marsha Broussard ◽  
Carolyn C. Johnson ◽  
Larry S. Webber
Keyword(s):  
Body Mass Index ◽  
Depressive Symptoms ◽  
Body Mass ◽  
Self Efficacy ◽  
Eating Styles

scholarly journals Effects of implementing evidence-based appropriateness guidelines for epidural steroid injection in chronic low back pain: the EAGER (Esi Appropriateness GuidElines pRotocol) study

2019 ◽  
Vol 8 (4) ◽  
pp. e000772
Author(s):  
Scott M Johnson ◽  
Troy Hutchins ◽  
Miriam Peckham ◽  
Yoshimi Anzai ◽  
Elizabeth Ryals ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Low Back Pain ◽  
Back Pain ◽  
Body Mass ◽  
Chronic Low Back Pain ◽  
Evidence Based ◽  
Low Back ◽  
Patient Level ◽  
Epidural Steroid ◽  
Evidence Based Guidelines

ObjectiveChronic low back pain is very common and often treated with epidural steroid injections (ESIs). As ESI referrals had been rapidly increasing at our Veterans’ Administration hospital, we were concerned that they were supplanting more comprehensive care. The objective was to determine how referral patterns and multidisciplinary care might change with the implementation of evidence-based guidelines.MethodsIn this retrospective observational study, multidisciplinary evidence-based guidelines were implemented in 2014 (EAGER: Esi Appropriateness GuidElines pRotocol) as part of the ordering process for an ESI. Time series analysis was performed to assess the primary outcome of subspecialty referral pattern, that is, the number of patients receiving referrals to ancillary services which might serve to provide a more comprehensive approach to their back pain. Secondary outcomes included patient-level changes (ie, body mass index, number of injections, opioid use), which were compared before and after protocol implementation.ResultsComparing preimplementation and postimplementation protocol periods, referrals to physical medicine/rehabilitation increased 11.7% (p=0.003) per year and integrative health increased 2.1% (p<0.001) per year among the 2294 individual patients who received ESI through the neurointerventional radiology service. Of 100 randomly selected patients for patient-level analysis, the median body mass index decreased from 31.57 to 30.22 (p=<0.001) and the mean number of injections decreased from 1.76 to 0.73 (p<0.001). The percentage of patients using oral opioid analgesics decreased from 72% to 49% (p=<0.001).ConclusionImplementation of evidence-based guidelines for ESI referral helps guide patients into a more comprehensive care pathway for chronic low back pain and is correlated with patient-level changes such as decreased body mass index and decreased opioid usage.

scholarly journals Establishing the Link Between Lean Mass and Grip Strength Cut Points With Mobility Disability and Other Health Outcomes: Proceedings of the Sarcopenia Definition and Outcomes Consortium Conference

2019 ◽  
Vol 75 (7) ◽  
pp. 1317-1323 ◽  
Author(s):  
Peggy M Cawthon ◽  
Thomas G Travison ◽  
Todd M Manini ◽  
Sheena Patel ◽  
Karol M Pencina ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Grip Strength ◽  
Body Mass ◽  
Lean Mass ◽  
Risk Model ◽  
Evidence Based ◽  
Mobility Disability ◽  
Cut Points ◽  
Increased Risk ◽  
Definition Of

Abstract Background Lack of consensus on how to diagnose sarcopenia has limited the ability to diagnose this condition and hindered drug development. The Sarcopenia Definitions and Outcomes Consortium (SDOC) was formed to develop evidence-based diagnostic cut points for lean mass and/or muscle strength that identify people at increased risk of mobility disability. We describe here the proceedings of a meeting of SDOC and other experts to discuss strategic considerations in the development of evidence-based sarcopenia definition. Methods Presentations and panel discussions reviewed the usefulness of sarcopenia as a biomarker, the analytical approach used by SDOC to establish cut points, and preliminary findings, and provided strategic direction to develop an evidence-based definition of sarcopenia. Results The SDOC assembled data from eight epidemiological cohorts consisting of 18,831 participants, clinical populations from 10 randomized trials and observational studies, and 2 nationally representative cohorts. In preliminary assessments, grip strength or grip strength divided by body mass index was identified as discriminators of risk for mobility disability (walking speed &lt;0.8 m/s), whereas dual-energy X-ray absorptiometry-derived lean mass measures were not good discriminators of mobility disability. Candidate definitions based on grip strength variables were associated with increased risk of mortality, falls, mobility disability, and instrumental activities of daily living disability. The prevalence of low grip strength increased with age. The attendees recommended the establishment of an International Expert Panel to review a series of position statements on sarcopenia definition that are informed by the findings of the SDOC analyses and synthesis of literature. Conclusions International consensus on an evidence-based definition of sarcopenia is needed. Grip strength—absolute or adjusted for body mass index—is an important discriminator of mobility disability and other endpoints. Additional research is needed to develop a predictive risk model that takes into account sarcopenia components as well as age, sex, race, and comorbidities.

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