ORCID Profile
0000-0002-7712-5413
Current Organisation
Baker Heart and Diabetes Institute
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Public Health and Health Services | Public Health And Health Services Not Elsewhere Classified | Developmental Psychology And Ageing | Policy and Administration | Social Policy And Planning | Policy And Administration Not Elsewhere Classified | Preventive Medicine | Health Promotion | Social Policy | Community Child Health | Health Promotion |
ANZSRC Socio-Economic Objective (SEO)
Education and training not elsewhere classified | Youth/child development and welfare | Child health | Health policy evaluation | Social Structure and Health | Public health not elsewhere classified | Preventive medicine | Health Inequalities
Related Links
Publications
Sexual behaviour in aids‐related research: Reliability and validity of recall and diary measures
Publisher: Informa UK Limited
Date: 05-1990
Educational achievement and fracture risk: Response to Clark and Tobias
Publisher: Springer Science and Business Media LLC
Date: 09-12-2010
Type 2 Diabetes Prevention in the Real World
Publisher: American Diabetes Association
Date: 22-06-2007
DOI: 10.2337/DC09-0039
Abstract: We study the effectiveness of the GOAL Lifestyle Implementation Trial at the 36-month follow-up. Participants (n = 352, type 2 diabetes risk score FINDRISC = 16.2 ± 3.3, BMI 32.6 ± 5.0 kg/m2) received six lifestyle counseling sessions over 8 months. Measurements were at baseline, 12 months (88.6%), and 36 months (77.0%). Statistically significant risk reduction at 12 months was maintained at 36 months in weight (−1.0 ± 5.6 kg), BMI (−0.5 ± 2.1 kg/m2), and serum total cholesterol (−0.4 ± 1.1 mmol/l). Maintenance of risk reduction in this “real world” trial proves the intervention's potential for significant public health impact.
Quality, Functionality, and Features of Chinese Mobile Apps for Diabetes Self-Management: Systematic Search and Evaluation of Mobile Apps
Publisher: JMIR Publications Inc.
Date: 07-04-2020
DOI: 10.2196/14836
Abstract: The emergence and advancement of mobile technologies offer a promising opportunity for people with diabetes to improve their self-management. Despite the proliferation of mobile apps, few studies have evaluated the apps that are available to the millions of people with diabetes in China. This study aimed to conduct a systematic search of Chinese mobile apps for diabetes self-management and to evaluate their quality, functionality, and features by using validated rating scales. A systematic search was conducted to identify Chinese apps for diabetes self-management in the four most popular Chinese language mobile app stores. Apps were included if they were designed for diabetes self-management and contained at least one of the following components: blood glucose management, dietary and physical activity management, medication taking, and prevention of diabetes-related comorbidities. Apps were excluded if they were unrelated to health, not in Chinese, or the targeted users are health care professionals. Apps meeting the identified inclusion criteria were downloaded and evaluated by a team of 5 raters. The quality, functionalities, and features of these apps were assessed by using the Mobile App Rating Scale (MARS), the IMS Institute for Healthcare Informatics Functionality score, and a checklist of self-management activities developed based on the Chinese diabetes self-management guideline, respectively. Among 2072 apps searched, 199 were eligible based on the inclusion criteria, and 67 apps were successfully downloaded for rating. These 67 apps had an average MARS score of 3.42 out of 5, and 76% (51/67) of the apps achieved an acceptable quality (MARS score .0). The scores for the four subdomains of MARS were 3.97 for functionality, 3.45 for aesthetics, 3.21 for information, and 3.07 for engagement. On average, reviewed apps applied five out of the 19 examined behavior change techniques, whereas the average score on the subjective quality for the potential impact on behavior change is 3 out of 5. In addition, the average score on IMS functionality was 6 out of 11. Functionalities in collecting, recording, and displaying data were mostly presented in the reviewed apps. Most of the apps were multifeatured with monitoring blood glucose and tracking lifestyle behaviors as common features, but some key self-management activities recommended by clinical guidelines, such as stress and emotional management, were rarely presented in these apps. The general quality of the reviewed apps for diabetes self-management is suboptimal, although the potential for improvement is significant. More attention needs to be paid to the engagement and information quality of these apps through co-design with researchers, public health practitioners, and consumers. There is also a need to promote the awareness of the public on the benefit and potential risks of utilizing health apps for self-management.
The Australian national workplace health project: Design and baseline findings
Publisher: Elsevier BV
Date: 09-2000
Acceptability of an Embodied Conversational Agent for Type 2 Diabetes Self-Management Education and Support via a Smartphone App: Mixed Methods Study
Publisher: JMIR Publications Inc.
Date: 22-07-2020
DOI: 10.2196/17038
Abstract: Embodied conversational agents (ECAs) are increasingly used in health care apps however, their acceptability in type 2 diabetes (T2D) self-management apps has not yet been investigated. This study aimed to evaluate the acceptability of the ECA (Laura) used to deliver diabetes self-management education and support in the My Diabetes Coach (MDC) app. A sequential mixed methods design was applied. Adults with T2D allocated to the intervention arm of the MDC trial used the MDC app over a period of 12 months. At 6 months, they completed questions assessing their interaction with, and attitudes toward, the ECA. In-depth qualitative interviews were conducted with a subs le of the participants from the intervention arm to explore their experiences of using the ECA. The interview questions included the participants’ perceptions of Laura, including their initial impression of her (and how this changed over time), her personality, and human character. The quantitative and qualitative data were interpreted using integrated synthesis. Of the 93 intervention participants, 44 (47%) were women the mean (SD) age of the participants was 55 (SD 10) years and the baseline glycated hemoglobin A1c level was 7.3% (SD 1.5%). Overall, 66 of the 93 participants (71%) provided survey responses. Of these, most described Laura as being helpful (57/66, 86%), friendly (57/66, 86%), competent (56/66, 85%), trustworthy (48/66, 73%), and likable (40/66, 61%). Some described Laura as not real (18/66, 27%), boring (26/66, 39%), and annoying (20/66, 30%). Participants reported that interacting with Laura made them feel more motivated (29/66, 44%), comfortable (24/66, 36%), confident (14/66, 21%), happy (11/66, 17%), and hopeful (8/66, 12%). Furthermore, 20% (13/66) of the participants were frustrated by their interaction with Laura, and 17% (11/66) of the participants reported that interacting with Laura made them feel guilty. A total of 4 themes emerged from the qualitative data (N=19): (1) perceived role: a friendly coach rather than a health professional (2) perceived support: emotional and motivational support (3) embodiment preference acceptability of a human-like character and (4) room for improvement: need for greater congruence between Laura’s words and actions. These findings suggest that an ECA is an acceptable means to deliver T2D self-management education and support. A human-like character providing ongoing, friendly, nonjudgmental, emotional, and motivational support is well received. Nevertheless, the ECA can be improved by increasing congruence between its verbal and nonverbal communication and accommodating user preferences. Australian New Zealand Clinical Trials Registry CTRN12614001229662 xshn6pd
Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD): A large, nationally representative survey in the Australian population
Publisher: Springer Science and Business Media LLC
Date: 18-01-2012
A Smart and Multifaceted Mobile Health System for Delivering Evidence-Based Secondary Prevention of Stroke in Rural China: Design, Development, and Feasibility Study
Publisher: No publisher found
Date: 2019
DOI: 10.2196/13503
Trends and Inequalities in the Health Care and Hypertension Outcomes in China, 2011 to 2015
Publisher: MDPI AG
Date: 19-11-2019
Abstract: Background: Hypertension is one of the most significant and common risk factors for cardiovascular disease, yet it remains poorly controlled in China. This study aims to examine trends and socioeconomic inequalities in the management of hypertension between 2011 and 2015 in China and to investigate the association between antihypertensive medication treatment and reduction of blood pressure, using nationally representative data. Methods: Concentration curve and concentration index were used to assess socioeconomic-related inequalities in hypertension care and health service utilisation. The fixed-effects analysis was performed to measure the impact of medication treatment on reduction of blood pressure among people with hypertension by using linear regression models. Results: Among hypertensive in iduals, there were growing trends in the rates of awareness and treatment from 55.87% and 48.44% in 2011, to 68.31% in 2013 and 61.97% in 2015, respectively. The proportion of hypertension control was still below 30%. The fixed-effects models indicated that medication treatment was statistically significant and associated with the patients’ systolic blood pressure (β: −13.483 95% CI: −15.672, −11.293) and diastolic blood pressure (β: −5.367 95% CI: −6.390, −4.344). Conclusions: China has made good progress in the hypertension diagnosis, medication treatment and coverage of health services over the last 10 years however, pro-rich inequalities in hypertension care still exist, and there is considerable progress to be made in the prevention, treatment and effective control of hypertension.
Long-term effectiveness of a lifestyle intervention on the prevention of type 2 diabetes in a middle-income country.
Publisher: Springer Science and Business Media LLC
Date: 25-08-2020
DOI: 10.1038/S41598-020-71119-2
Abstract: This study aims to assess the effects of a community-based lifestyle intervention program on the incidence of type 2 diabetes (T2D). For this purpose, three communities in Tehran were chosen one community received a face-to-face educational session embedded in a long-term community-wide lifestyle intervention aimed at supporting lifestyle changes. We followed up 9,204 participants (control: 5,739, intervention: 3,465) triennially from 1999 to 2015 (Waves 1–5). After a median follow-up of 3.5 years (wave 2), the risk of T2D was 30% lower in the intervention community as compared with two control communities by (Hazard-ratio: 0.70 [95% CI 0.53 0.91]) however, the difference was not statistically significant in the following waves. After a median follow-up of 11.9 years (wave 5), there was a non-significant 6% reduction in the incidence of T2D in the intervention group as compared to the control group (Hazard-ratio: 0.94 [0.81, 1.08]). Moreover, after 11.9 years of follow-up, the intervention significantly improved the diet quality measured by the Dietary Approaches to Stop Hypertension concordance (DASH) score. Mean difference in DASH score in the intervention group versus control group was 0.2 [95% CI 0.1 0.3]. In conclusion, the intervention prevented T2D by 30% in the short-term (3.5 years) but not long-term however, effects on improvement of the diet maintained in the long-term. Registration: This study is registered at IRCT, a WHO primary registry ( irct.ir ). The registration date 39 is 2008-10-29 and the IRCT registration number is IRCT138705301058N1.
The health-related quality of life burden of co-morbid cardiovascular disease and major depressive disorder in Australia: findings from a population-based, cross-sectional study
Publisher: Springer Science and Business Media LLC
Date: 10-02-2012
Would general practitioners support a population-based colorectal cancer screening programme of faecal-occult blood testing?
Publisher: Wiley
Date: 09-2004
DOI: 10.1111/J.1445-5994.2004.00652.X
Abstract: Background: The success of a population‐based screening for colorectal cancer (CRC) is determined to a large extent by general practitioner (GP) attitudes, beliefs and support. The extent to which GPs support population‐based CRC screening remains unclear. Aims: To assess the knowledge, attitudes and practices of GPs in relation to CRC screening, and to identify the determinants of GP support for population‐based faecal‐occult blood testing (FOBT). Methods: A cross‐sectional postal survey was conducted with a random s le of 692 GPs in Queensland, Australia. We assessed GP knowledge, attitudes and practices concerning CRC screening in relation to their stance on population‐based FOBT screening. Results: Although the response rate was low (41%), participants were representative of Queensland GPs in general. Of 284 participating GPs, 143 (50.5%) indicated that they would support a population‐based FOBT screening programme, 42 (14.8%) would not and 98 (34.6%) were unsure. Belief in FOBT test efficacy ( P 0.001), possession of CRC guidelines ( P 0.05) and belief in earlier stage detection ( P 0.05) were major determinants of support for population‐based FOBT screening. No significant association was observed for doctor's sex, location of practice, age, year completed medical training, membership of a Division of General Practice, number of weekly consultations, number of patients investigated for CRC per month, size of practice, own family history of CRC, interest in further information on CRC screening or treatment, and current use of FOBT with asymptomatic patients aged ≥40 years. Conclusions: GP support for FOBT population‐based screening appears to have increased over recent years. The knowledge and attitudes/beliefs of GPs are key determinants of their support. (Intern Med J 2004 34: 532−538)
The Logan Healthy Living Program: A cluster randomized trial of a telephone-delivered physical activity and dietary behavior intervention for primary care patients with type 2 diabetes or hypertension from a socially disadvantaged community - Rationale, design and recruitment
Publisher: Elsevier BV
Date: 05-2008
DOI: 10.1016/J.CCT.2007.10.005
Abstract: Physical activity and dietary behavior changes are important to both the primary prevention and secondary management of the majority of our most prevalent chronic conditions (i.e., cardiovascular disease, hypertension, type 2 diabetes, breast and colon cancer). With over 85% of Australian adults visiting a general practitioner each year, the general practice setting has enormous potential to facilitate wide scale delivery of health behaviour interventions. However, there are also many barriers to delivery in such settings, including lack of time, training, resources and remuneration. Thus there is an important need to evaluate other feasible and effective means of delivering evidence-based physical activity and dietary behaviour programs to patients in primary care, including telephone counseling interventions. Using a cluster randomized design with practice as the unit of randomization, this study evaluated a telephone-delivered intervention for physical activity and dietary change targeting patients with chronic conditions (type 2 diabetes or hypertension) recruited from primary care practices in a socially disadvantaged community in Queensland, Australia. Ten practices were randomly assigned to the telephone intervention or to usual care, and 434 patients were recruited. Patients in intervention practices received a workbook and 18 calls over 12 months. Assessment at baseline, 4-, 12- and 18-months allows for assessment of initial change and maintenance of primary outcomes (physical activity and dietary behavior change) and secondary outcomes (quality of life, cost-effectiveness, support for health behavior change). This effectiveness trial adds to the currently limited number of telephone-delivered intervention studies targeting both physical activity and dietary change. It also addresses some of the shortcomings of previous trials by targeting patients from a disadvantaged community, and by including detailed reporting on participant representativeness, intervention implementation and cost-effectiveness, as well as an evaluation of maintenance of health behavior change.
Assessment of cardiovascular disease risk in South Asian populations
Publisher: Hindawi Limited
Date: 2013
DOI: 10.1155/2013/786801
Abstract: Although South Asian populations have high cardiovascular disease (CVD) burden in the world, their patterns of in idual CVD risk factors have not been fully studied. None of the available algorithms/scores to assess CVD risk have originated from these populations. To explore the relevance of CVD risk scores for these populations, literature search and qualitative synthesis of available evidence were performed. South Asians usually have higher levels of both “classical” and nontraditional CVD risk factors and experience these at a younger age. There are marked variations in risk profiles between South Asian populations. More than 100 risk algorithms are currently available, with varying risk factors. However, no available algorithm has included all important risk factors that underlie CVD in these populations. The future challenge is either to appropriately calibrate current risk algorithms or ideally to develop new risk algorithms that include variables that provide an accurate estimate of CVD risk.
Population Prevalence and Correlates of Stages of Change in Physical Activity
Publisher: SAGE Publications
Date: 10-1993
DOI: 10.1177/109019819302000312
Abstract: Stages of change for exercise, sociodemographic variables, and beliefs about the health benefits of exercise were obtained for a representative s le of Australian adults (N = 4404). Logistic regression analysis was used to examine the relationship between exercise stage of change and sociodemographic variables and beliefs about the benefits of exercise. Thirteen percent of respondents stated that they did not exercise and did not intend to start 10% stated that they did not exercise but were thinking of starting 16% stated that they exercise occasionally and were not thinking of doing more 23% stated that they exercised occasionally and were thinking of doing more and 38% stated that they exercised regularly and intended to continue. Intention to do more exercise generally decreased with increasing age, but increased with level of education. An increased frequency of exercise and an intention to do more exercise was associated with the belief that exercise would help to prevent heart disease and with a higher level of education. The results provide a useful profile of the exercise habits (and intention to change those habits) of population subgroups. Public communication c aigns on the benefits of physical activity should focus particularly on those who do not intend to exercise, older adults, and the less well educated.
Lifestyle change in Kerala, India: needs assessment and planning for a community-based diabetes prevention trial
Publisher: Springer Science and Business Media LLC
Date: 02-2013
Who comes to a workplace health risk assessment?
Publisher: Springer Science and Business Media LLC
Date: 12-1998
DOI: 10.1207/S15327558IJBM0504_6
Abstract: Workplace health promotion initiatives have proliferated, but there are difficulties in recruiting employees of lower socioeconomic status and at higher risk of disease. A survey of health behaviors and attitudes was administered in 20 worksites and the opportunity to attend a health risk assessment promoted. Those more likely to attend were women, those of higher occupational prestige, and those from a non-English-speaking background. After adjustment for these variables, the only health behavior associated with attendance was smoking status. Perceived risk of lung cancer was significant, even after adjustment for smoking status. Stage of readiness to change health behaviors was associated with attendance, with those in the preparation stage being more likely to attend than those in the precontemplation stage. However, this association was statistically significant only for fruit and vegetable consumption. There was no relation between attendance and support for health promotion, perceived general health, or other perceived risk of disease. These findings suggest that additional risk communication strategies and environmental support are required to involve those with less prestigious occupations.
The cost-effectiveness of a cardiovascular risk reduction program in general practice
Publisher: Elsevier BV
Date: 08-1997
DOI: 10.1016/S0168-8510(97)00015-8
Abstract: An economic evaluation was conducted alongside a randomised controlled trial of two lifestyle interventions and a routine care (control) group to assess the cost-effectiveness of a general practice-based lifestyle change program for patients with risk factors for cardiovascular disease. Routine care was the base case comparator because it represents 'current therapy' for cardiovascular disease (CVD). A 'no care' control group was not considered a clinically acceptable alternative to lifestyle interventions. The interventions consisted of an education guide and video for GPs to assess in idual patient risk factors and plan a program for risk factor behavior change. Each patient received a risk factor assessment, education materials, a series of videos to watch on lifestyle behaviors and some patients received a self-help booklet. Eighty-two general practitioners were randomised from 75 general practices in Sydney's Western Metropolitan Region to (i) routine care (n = 25), (ii) video group (n = 29) or (iii) video + self help group (n = 28). GPs enrolled patients into the trial who met selection criteria for being at risk of CVD. There were 255 patients in the routine care (control) group, 270 in the video (intervention) group and 232 in the video + self help (intervention) group enrolled in the trial. Outcome measures included patient risk factor status: blood pressure, body mass index, cholesterol and smoking status at entry to trial and after 1 year. Changes in risk factors were used to estimate quality adjusted life years (QALYs) gained. One hundred and thirty patients in the routine care group, 199 in the video group and 155 in the video + self help group remained in the trial at the 12-month review and had complete data. The cost per QALY for males ranged from $AUD152,000 to 204,000. Further analysis suggests that a program targeted at 'high risk' males would cost approximately $30,000 per QALY. The lifestyle interventions had no significant effect on cardiovascular risk factors when compared to routine patient care. There remains insufficient evidence that lifestyle programs conducted in general practices are effective. Resources for general practice-based lifestyle programs may be better spent on high risk patients who are contemplating changes in risk factor behaviours.
Burnout in Relation to Specific Contributing Factors and Health Outcomes among Nurses: A Systematic Review
Publisher: MDPI AG
Date: 31-05-2013
Type 2 diabetes after gestational diabetes: Greater than fourfold risk among Indigenous compared with non-Indigenous Australian women
Publisher: Wiley
Date: 22-10-2016
DOI: 10.1002/DMRR.2715
Abstract: Gestational diabetes is associated with a high risk of type 2 diabetes. However, progression rates among Indigenous women in Australia who experience high prevalence of gestational diabetes are unknown. This retrospective cohort study includes all births to women at a regional hospital in Far North Queensland, Australia, coded as having 'gestational diabetes' from 1 January 2004 to 31 December 2010 (1098 births) and receiving laboratory postpartum screening from 1 January 2004 to 31 December 2011 (n = 483 births). Women who did not receive postpartum screening were excluded from the denominator. Data were linked between hospital electronic records, routinely collected birth data and laboratories, with s le validation by reviews of medical records. Analysis was conducted using Cox-proportional regression models. Indigenous women had a greater than fourfold risk of developing type 2 diabetes within 8 years of having gestational diabetes, compared with non-Indigenous women (hazards ratio 4.55, 95% confidence interval 2.63-7.88, p < 0.0001). Among women receiving postpartum screening tests, by 3, 5 and 7 years postpartum, 21.9% (15.8-30.0%), 25.5% (18.6-34.3%) and 42.4% (29.6-58.0%) Indigenous women were diagnosed with type 2 diabetes after gestational diabetes, respectively, compared with 4.2% (2.5-7.2%), 5.7% (3.3-9.5%) and 13.5% (7.3-24.2%) non-Indigenous women. Multivariate analysis showed an increased risk of developing type 2 diabetes among women with an early pregnancy body mass index ≥25 kg/m(2) , only partially breastfeeding at hospital discharge and gestational diabetes diagnosis prior to 17 weeks gestation. This study demonstrates that, compared with non-Indigenous women, Indigenous Australian women have a greater than fourfold risk of developing type 2 diabetes after gestational diabetes. Strategies are urgently needed to reduce rates of type 2 diabetes by supporting a healthy weight and breastfeeding and to improve postpartum screening among Indigenous women with gestational diabetes. Copyright © 2015 John Wiley & Sons, Ltd.
User Experiences With a Type 2 Diabetes Coaching App: Qualitative Study.
Publisher: JMIR Publications Inc.
Date: 17-07-2020
DOI: 10.2196/16692
Abstract: Diabetes self-management apps have the potential to improve self-management in people with type 2 diabetes (T2D). Although efficacy trials provide evidence of health benefits, premature disengagement from apps is common. Therefore, it is important to understand the factors that influence engagement in real-world settings. This study aims to explore users’ real-world experiences with the My Diabetes Coach (MDC) self-management app. We conducted telephone-based interviews with participants who had accessed the MDC self-management app via their smartphone for up to 12 months. Interviews focused on user characteristics the context within which the app was used barriers and facilitators of app use and the design, content, and delivery of support within the app. A total of 19 adults with T2D (8/19, 42% women mean age 60, SD 14 years) were interviewed. Of the 19 interviewees, 8 (42%) had T2D for years, 42% (n=8) had T2D for 5-10 years, and 16% (n=3) had T2D for years. In total, 2 themes were constructed from interview data: (1) the moderating effect of diabetes self-management styles on needs, preferences, and expectations and (2) factors influencing users’ engagement with the app: one size does not fit all. User characteristics, the context of use, and features of the app interact and influence engagement. Promoting engagement is vital if diabetes self-management apps are to become a useful complement to clinical care in supporting optimal self-management. Australia New Zealand Clinical Trials Registry CTRN126140012296 URL www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366925& isReview=true
My Diabetes Coach, a Mobile App–Based Interactive Conversational Agent to Support Type 2 Diabetes Self-Management: Randomized Effectiveness-Implementation Trial
Publisher: JMIR Publications Inc.
Date: 05-11-2020
DOI: 10.2196/20322
Abstract: Delivering self-management support to people with type 2 diabetes mellitus is essential to reduce the health system burden and to empower people with the skills, knowledge, and confidence needed to take an active role in managing their own health. This study aims to evaluate the adoption, use, and effectiveness of the My Diabetes Coach (MDC) program, an app-based interactive embodied conversational agent, Laura, designed to support diabetes self-management in the home setting over 12 months. This randomized controlled trial evaluated both the implementation and effectiveness of the MDC program. Adults with type 2 diabetes in Australia were recruited and randomized to the intervention arm (MDC) or the control arm (usual care). Program use was tracked over 12 months. Coprimary outcomes included changes in glycated hemoglobin (HbA1c) and health-related quality of life (HRQoL). Data were assessed at baseline and at 6 and 12 months, and analyzed using linear mixed-effects regression models. A total of 187 adults with type 2 diabetes (mean 57 years, SD 10 years 41.7% women) were recruited and randomly allocated to the intervention (n=93) and control (n=94) arms. MDC program users (92/93 participants) completed 1942 chats with Laura, averaging 243 min (SD 212) per person over 12 months. Compared with baseline, the mean estimated HbA1c decreased in both arms at 12 months (intervention: 0.33% and control: 0.20%), but the net differences between the two arms in change of HbA1c (−0.04%, 95% CI −0.45 to 0.36 P=.83) was not statistically significant. At 12 months, HRQoL utility scores improved in the intervention arm, compared with the control arm (between-arm difference: 0.04, 95% CI 0.00 to 0.07 P=.04). The MDC program was successfully adopted and used by in iduals with type 2 diabetes and significantly improved the users’ HRQoL. These findings suggest the potential for wider implementation of technology-enabled conversation-based programs for supporting diabetes self-management. Future studies should focus on strategies to maintain program usage and HbA1c improvement. Australia New Zealand Clinical Trials Registry (ACTRN) 12614001229662 anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614001229662
Determinants of intention to quit smoking among Dutch employees: The influence of the social environment
Publisher: Elsevier BV
Date: 04-1996
Abstract: This study examines the influence of the social environment in worksites on employees' intention to quit smoking by applying the attitude-social influence-efficacy model. Regression analyses were conducted with 509 smoking employees from eight Dutch worksites. Variables of interest were attitudes toward smoking, perceived social pressure to quit, perceived smoking behavior of others, self-efficacy, demographics, smoking history variables, company type, and smoking tolerance. Attitude, social pressure from people out-side the worksetting (partner, children), and self-efficacy explained 23% of the variance for intention. Past behavior increased the adjusted R2 from 0.23 to 0.29. Social influences in the worksite were unrelated to employees' intention to quit smoking. It was concluded that, in Dutch work-sites, social influences stemming from people at work have less influence on employees' intention to quit smoking than other important people outside the work situation. Implications for smoking control strategies in worksites are briefly discussed.
Health, work, and the workplace: Introduction
Publisher: Springer Science and Business Media LLC
Date: 12-1998
Area-level socioeconomic status and incidence of abnormal glucose metabolism: , The Australian Diabetes, Obesity and Lifestyle (AusDiab) study.
Publisher: American Diabetes Association
Date: 12-06-2012
DOI: 10.2337/DC11-1410
Abstract: To examine the role of area-level socioeconomic status (SES) on the development of abnormal glucose metabolism (AGM) using national, population-based data. The Australian Diabetes, Obesity and Lifestyle (AusDiab) study is a national, population-based, longitudinal study of adults aged ≥25 years. A s le of 4,572 people provided complete baseline (1999 to 2000) and 5-year follow-up (2004 to 2005) data relevant for these analyses. Incident AGM was assessed using fasting plasma glucose and 2-h plasma glucose from oral glucose tolerance tests, and demographic, socioeconomic, and behavioral data were collected by interview and questionnaire. Area SES was defined using the Index of Relative Socioeconomic Disadvantage. Generalized linear mixed models were used to examine the relationship between area SES and incident AGM, with adjustment for covariates and correction for cluster design effects. Area SES predicted the development of AGM, after adjustment for age, sex, and in idual SES. People living in areas with the most disadvantage were significantly more likely to develop AGM, compared with those living in the least deprived areas (odds ratio 1.53 95% CI 1.07–2.18). Health behaviors (in particular, physical activity) and central adiposity appeared to partially mediate this relationship. Our findings suggest that characteristics of the physical, social, and economic aspects of local areas influence diabetes risk. Future research should focus on identifying the aspects of local environment that are associated with diabetes risk and how they might be modified.
Long-term efficacy of a tele-health intervention for acute coronary syndrome patients with depression: 12-month results of the MoodCare randomized controlled trial
Publisher: Oxford University Press (OUP)
Date: 26-08-2015
Abstract: Depression is common after a cardiac event however it often remains untreated. Previously, we reported the efficacy and feasibility of a 6-month tele-health programme (MoodCare), which integrates depression management into a cardiovascular disease (CVD) risk reduction programme for Acute Coronary Syndrome (ACS) patients with low mood. Here, we evaluate the long-term efficacy of the programme at 12-month follow-up. A two-arm, parallel, randomized design to compare the long-term effects of 'MoodCare' (n = 61) to usual care (UC) (n = 60) at 12 months. 121 ACS patients recruited from six hospitals in Victoria and Brisbane, Australia were randomized to a telephone-delivered cognitive behavioural therapy and risk-reduction programme or usual medical care. Mixed-model repeated measurements (MMRM) analysis was applied with results expressed as estimated marginal mean changes in depression and health-related quality of life (HRQOL) outcomes by group. After 12 months, treatment effects were observed for those with major depressive disorder (MDD) for PHQ-9 depression (MoodCare: mean score: 6.5 95% CI: 4.9-8.0 versus UC: 9.3 95% CI: 7.7-10.9, p = 0.012)) and SF-12 mental health scores (MoodCare: 42.5 95% CI: 39.8-45.2 versus UC: 36.8 95% CI: 34.1-39.6, p = 0.005). No beneficial treatment effects were observed in those with no MDD at baseline. After 12 months, MoodCare was superior to UC for improving mental health outcomes for those with a clinical diagnosis of major depression. Our findings support the implementation of depression-based interventions for cardiac patients with a clinical diagnosis of depression and provide evidence of longer term efficacy to one year.
Teachers' knowledge of children's exposure to family risk factors: accuracy and usefulness
Publisher: Elsevier BV
Date: 2005
A scoping review of end user involvement in disability research
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.DHJO.2015.10.001
Abstract: Involving clients and consumers of health care in research, policy and health service development has been widely advocated for across a number of different fields and disciplines. Despite some promising evidence, 'end users' have not been meaningfully involved in all stages of the research process in the area of disability research. To conduct a scoping review on end user involvement in disability research, service and policy development. Literature was searched using electronic databases, hand searching reference lists of papers and grey literature. Electronic databases searched included the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, PsycINFO and Google Scholar. The search was restricted to articles published in English between January 2000 and April 2013. Two clear themes emerged from a review of twenty-seven articles. Firstly, end users can benefit research as 'experts of experience' through their role as a co-researcher. Secondly, evidence suggests end users add value at different stages of the research process in this role. However, less is understood about end user involvement in the latter stages of the research process. This review suggests that end users can meaningfully contribute to the quality of disability research. End users are likely to engage in research with differing perspectives, desires to be involved at distinct stages of the process, differing roles and different abilities to participate in the research. Academic rigor, however, must be maintained by the researcher.
Effects of interventions in health care settings on physical activity or cardiorespiratory fitness
Publisher: Elsevier BV
Date: 11-1998
DOI: 10.1016/S0749-3797(98)00078-6
Abstract: This paper reviews studies of physical activity interventions in health care settings to determine effects on physical activity and/or fitness and characteristics of successful interventions. Studies testing interventions to promote physical activity in health care settings for primary prevention (patients without disease) and secondary prevention (patients with cardiovascular disease [CVD]) were identified by computerized search methods and reference lists of reviews and articles. Inclusion criteria included assignment to intervention and control groups, physical activity or cardiorespiratory fitness outcome measures, and, for the secondary prevention studies, measurement 12 or more months after randomization. The number of studies with statistically significant effects was determined overall as well as for studies testing interventions with various characteristics. Twelve studies of primary prevention were identified, seven of which were randomized. Three of four randomized studies with short-term measurement (4 weeks to 3 months after randomization), and two of five randomized studies with long-term measurement (6 months after randomization) achieved significant effect on physical activity. Twenty-four randomized studies of CVD secondary prevention were identified 13 achieved significant effects on activity and/or fitness at twelve or more months. Studies with measurement at two time points showed decaying effects over time, particularly if the intervention were discontinued. Successful interventions contained multiple contacts, behavioral approaches, supervised exercise, provision of equipment, and/or continuing intervention. Many studies had methodologic problems such as low follow-up rates. Interventions in health care settings can increase physical activity for both primary and secondary prevention. Long-term effects are more likely with continuing intervention and multiple intervention components such as supervised exercise, provision of equipment, and behavioral approaches. Recommendations for additional research are given.
A cost-effectiveness analysis of a telephone-linked care intervention for individuals with Type 2 diabetes
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.DIABRES.2013.12.032
Abstract: To assess the cost-effectiveness of an automated telephone-linked care intervention, Australian TLC Diabetes, delivered over 6 months to patients with established Type 2 diabetes mellitus and high glycated haemoglobin level, compared to usual care. A Markov model was designed to synthesize data from a randomized controlled trial of TLC Diabetes (n=120) and other published evidence. The 5-year model consisted of three health states related to glycaemic control: 'sub-optimal' HbA1c ≥58mmol/mol (7.5%) 'average' ≥48-57mmol/mol (6.5-7.4%) and 'optimal' <48mmol/mol (6.5%) and a fourth state 'all-cause death'. Key outcomes of the model include discounted health system costs and quality-adjusted life years (QALYS) using SF-6D utility weights. Univariate and probabilistic sensitivity analyses were undertaken. Annual medication costs for the intervention group were lower than usual care [ £1076 (95%CI: £947, £1206) versus usual care £1271 (95%CI: £1115, £1428) p=0.052]. The estimated mean cost for intervention group participants over five years, including the intervention cost, was £17,152 versus £17,835 for the usual care group. The corresponding mean QALYs were 3.381 (SD 0.40) for the intervention group and 3.377 (SD 0.41) for the usual care group. Results were sensitive to the model duration, utility values and medication costs. The Australian TLC Diabetes intervention was a low-cost investment for in iduals with established diabetes and may result in medication cost-savings to the health system. Although QALYs were similar between groups, other benefits arising from the intervention should also be considered when determining the overall value of this strategy.
Functionality and Quality of Asthma mHealth Apps and Their Consistency With International Guidelines: Protocol for a Systematic Search and Evaluation of Mobile Apps
Publisher: JMIR Publications Inc.
Date: 09-02-2022
DOI: 10.2196/33103
Abstract: Asthma is a chronic respiratory disorder that requires long-term pharmacotherapy and patient empowerment to manage the condition and recognize and respond to asthma exacerbations. Mobile health (mHealth) apps represent a potential medium through which patients can improve their ability to self-manage their asthma. Few studies have conducted a systematic evaluation of asthma mobile apps for quality and functionality using a validated tool. None of these reviews have systematically assessed these apps for their content and evaluated them against the available international best practice guidelines. The objective of this study is to conduct a systematic search and evaluation of adult-targeted asthma mHealth apps. As part of this review, the potential of an mHealth app to improve asthma self-management and the overall quality of the app will be evaluated using the Mobile App Rating Scale framework, and the quality of the information within an app will be evaluated using the current Global Initiative for Asthma guidelines as a reference. A stepwise methodological approach was taken in creating this review. First, the most recent Global Initiative for Asthma guidelines were independently reviewed by 2 authors to identify key recommendations that could be feasibly incorporated into an mHealth app. A previously developed asthma assessment framework was identified and was modified to suit our research and ensure that all of these identified recommendations were included. In total, 2 popular app stores were reviewed to identify potential mHealth apps. These apps were screened based on predefined inclusion and exclusion criteria. Suitable apps were then evaluated. Technical information was obtained from publicly available information. The next step was to perform an app quality assessment using the validated Mobile App Rating Scale framework to objectively determine the quality of an app. App functionality was assessed using the Intercontinental Medical Statistics Institute for Health Informatics Functionality Scoring System. Finally, the mHealth apps were assessed using our developed checklist. Funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the apps. The results of this study are expected in 2022. To our knowledge, this review represents the first study to examine all mHealth apps available in Australia that are targeted to adults with asthma for their functionality, quality, and consistency with international best practice guidelines. Although this review will only be conducted on mHealth apps available in Australia, many apps are available worldwide thus, this study should be largely generalizable to other English-speaking regions and users. The results of this review will help to fill gaps in the literature and assist clinicians in providing evidence-based advice to patients wishing to use mHealth apps as part of their asthma self-management. PROSPERO 269894 www.crd.york.ac.uk rospero/display_record.php?RecordID=269894 PRR1-10.2196/33103
The Global Alliance for Chronic Diseases Supports 15 Major Studies in Hypertension Prevention and Control in Low‐ and Middle‐Income Countries
Publisher: Wiley
Date: 06-2016
DOI: 10.1111/JCH.12835
Psychosocial stress predicts abnormal glucose metabolism: the Australian diabetes, obesity and lifestyle (ausdiab) study
Publisher: Oxford University Press (OUP)
Date: 07-02-2013
DOI: 10.1007/S12160-013-9473-Y
Abstract: The evidence supporting a relationship between stress and diabetes has been inconsistent. This study examined the effects of stress on abnormal glucose metabolism, using a population-based s le of 3,759, with normoglycemia at baseline, from the Australian Diabetes, Obesity and Lifestyle study. Perceived stress and stressful life events were measured at baseline, with health behavior and anthropometric information also collected. Oral glucose tolerance tests were undertaken at baseline and 5-year follow-up. The primary outcome was the development of abnormal glucose metabolism (impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes), according to WHO 1999 criteria. Perceived stress predicted incident abnormal glucose metabolism in women but not men, after multivariate adjustment. Life events showed an inconsistent relationship with abnormal glucose metabolism. Perceived stress predicted abnormal glucose metabolism in women. Healthcare professionals should consider psychosocial adversity when assessing risk factor profiles for the development of diabetes.
Diabetes in pregnancy among indigenous women in australia, canada, new zealand and the united states: A systematic review of the evidence for screening in early pregnancy
Publisher: Wiley
Date: 05-2013
DOI: 10.1002/DMRR.2389
Hypertension in Rural India: The Contribution of Socioeconomic Position
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-04-2020
Abstract: Various indicators of socioeconomic position ( SEP ) may have opposing effects on the risk of hypertension in disadvantaged settings. For ex le, high income may reflect sedentary employment, whereas greater education may promote healthy lifestyle choices. We assessed whether education modifies the association between income and hypertension in 3 regions of South India at different stages of epidemiological transition. Using a cross‐sectional design, we randomly selected villages within each of rural Trivandrum, West Godavari, and Rishi Valley. S ling was stratified by age group and sex. We measured blood pressure and anthropometry and administered a questionnaire to identify lifestyle factors and SEP , including education, literacy, and income. Logistic regression was used to assess associations between various components of SEP and hypertension, and interaction analyses were used to determine whether educational attainment modified the association between income and hypertension. Trivandrum, the region of highest SEP , had the greatest prevalence of hypertension, whereas Rishi Valley, the lowest SEP region, had the least. Overall, greater income was associated with greater risk of hypertension. In interaction analyses, there was no evidence that educational attainment modified the association between income and hypertension. Education is widely considered to ameliorate the risk of hypertension in high‐income countries. Why this effect is absent in rural India merits investigation.
High seroprevalence of Helicobacter pylori in diabetes mellitus patients
Publisher: Springer Science and Business Media LLC
Date: 03-1996
DOI: 10.1007/BF02282318
Abstract: Nearly 1.5 billion people of an Asian country are living their lives without a country-specific over-the-counter (OTC) drug list. A study was planned to assess the understanding and practice of OTC medication consumption in the pregnant population. A questionnaire-based cross-sectional study evaluating different perspectives on OTC drug consumption was planned in around 500 pregnant women attending tertiary care outpatient antenatal clinics. The association of knowledge, attitude and practice versus indications, knowledge regarding harmful effects possible, reasons for choosing OTC medication, the practice of consulting nonmedical persons and drug interactions with the disease or prescription medications was determined. Regression analysis was performed in statistical software R. Seven percent (36/516) of pregnant women were found to consume oral antimicrobials without prescription. Local chemist consultation was the most common channel (72.48%) to procure the OTC medicines. Participants with good knowledge score showed an odds ratio (OR) of 1.87 (95% C.I. 1.28-2.73), 1.6 (95% C.I. 0.99-2.63), 1.66 (95% C.I. 1.14-2.42) and 2.66 (95% C.I. 1.49-4.89) for self-medication encouragement tendency possible, restricting sale of OTC medications, the habit of reading drug leaflets and understanding the potentially harmful effects, with OTC drugs, respectively. Right-attitude participants showed an OR of 1.89 (95% C.I. 1.29-2.80) and 1.8 (95% C.I. 1.19-2.76) for identifying knowledge of acetaminophen overdose and liver damage link as well as the disease symptom masking possibility with OTC, respectively. Participants with insufficient knowledge and attitude scores showed an association with more OTC antacid-antiemetics and analgesic use, respectively. Antenatal pregnant women need to be guided on avoiding OTC antimicrobial usage. Both obstetricians and regulators have to play an active role in educating pregnant women and contributing to developing country-specific OTC drug lists with the guidelines. The online version contains supplementary material available at 10.1007/s13224-021-01481-2.
Functionality and Quality of Asthma mHealth Apps and Their Consistency with International Guidelines: A Systematic Search and Evaluation of Mobile Apps (Preprint)
Publisher: JMIR Publications Inc.
Date: 14-03-2023
Abstract: sthma is a chronic respiratory disorder requiring long-term pharmacotherapy and judicious patient self-management. Asthma mobile health (mHealth) apps are widely available and represent a potential tool for assisting with asthma self-management. Few studies have conducted a systematic evaluation of asthma mobile apps for quality and functionality, and none have systematically assessed these apps for their content alignment with international best practice guidelines. o conduct a systematic search and evaluation of current mHealth apps for their functionality, quality and consistency with best practice guidelines. he most recent Global Initiative for Asthma (GINA) guidelines were reviewed to identify key recommendations that could be feasibly incorporated into an mHealth app. A checklist was developed from these recommendations and a modified previously developed asthma app assessment framework. Two popular app stores were reviewed to screen and identify potential mHealth apps based on predefined criteria. Evaluation of suitable apps included assessment of technical information, an app quality assessment using the validated Mobile App Rating Scale (MARS) framework, app functionality assessment using the Intercontinental Medical Statistics Institute for Health Informatics (IMS) Functionality Scoring System and finally, the mHealth apps were assessed for their content alignment with the GINA guidelines, using our developed checklist. f the 422 apps initially identified, 53 were suitable for further analysis based on the inclusion/exclusion criteria. The mean number of behavioural change techniques for a single app was 3.26. The mean MARS for all reviewed apps was 3.05. 27 of 53 apps (51%) achieved a total MARS score of 3 or above. On average reviewed apps achieved 5.1 out of 11 functionalities from the IMS functionality scale (SD 2.79). The median number of functionalities identified was 5 (IQR 2-7). 22.2-31.8% of apps provided knowledge regarding asthma in the different domains. Skill training in peak flow meters, inhaler devices, recognising/responding to exacerbations and non-pharmacological asthma management were identified in 8 (17.4%), 12 (24.5%), 11 (28.2%) and 14 (31.1%) apps, respectively. 19 (37.3%) apps had the ability to track or record ‘asthma symptoms’, the most common recorded metric. The most frequently identified prompt/reminder was for taking preventer medications, available for 9 apps (20%). 5 (9.6%) apps provided an area for patients to store or enter their asthma action plan. ood quality asthma apps aligned with international best practice asthma guidelines are lacking. This study used a unique checklist developed from the GINA guidelines to evaluate the content alignment of asthma apps. Future app development should target the key features identified in this study as currently lacking, including use of asthma action plans, and deployment of behavioural change techniques to engage and re-engage with users. This study has implications for clinicians navigating the ever-expanding mHealth app market for chronic diseases. R2-10.2196/33103
Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia
Publisher: Springer Science and Business Media LLC
Date: 12-2009
Health behaviours, socioeconomic status and diabetes incidence: The Australian Diabetes Obesity and Lifestyle Study (AusDiab)
Publisher: Springer Science and Business Media LLC
Date: 26-08-2010
DOI: 10.1007/S00125-010-1888-4
Abstract: To identify the impact of socioeconomic status on incident impaired glucose metabolism and type 2 diabetes and to investigate the mediating role of health behaviours on this relationship using national, population-based data. The Australian Diabetes Obesity and Lifestyle (AusDiab) Study is a national, population-based, longitudinal study of adults aged 25 years and above. A total s le of 4,405 people provided complete baseline (1999-2000) and 5 year follow-up (2004-2005) data relevant for these analyses. Fasting plasma glucose and 2 h plasma glucose were obtained from an OGTT, and demographic, socioeconomic and behavioural data were collected by interview and questionnaire. Multinomial logistic regression examined the role of socioeconomic position in the development of diabetes and mediation analyses tested the contribution of health behaviours in this relationship. Highest level of education was a stronger predictor of incident impaired glucose tolerance and type 2 diabetes (p = 0.002), compared with household income (p = 0.103), and occupational grade (p = 0.202). Education remained a significant independent predictor of diabetes in fully adjusted models. However, the relationship was attenuated by the health behaviours (smoking and physical activity). Mediation analyses indicated that these behaviours were partial mediators (explaining 27%) of the socioeconomic status-diabetes relationship. Smoking and physical activity partly mediate the relationship between low education and type 2 diabetes. Identification of these modifiable behavioural mediators should facilitate the development of effective health promotion c aigns to target those at high risk of developing type 2 diabetes.
Health Promotion and Disease Prevention in the Primary Health Care Setting: Setting the Scene
Publisher: Cambridge University Press (CUP)
Date: 09-1994
DOI: 10.1017/S0813483900005027
Abstract: Last (1983) defines public health as: the efforts organised by society to protect, promote and restore the public's health. It is the combination of sciences, skills and beliefs that are directed to the maintenance and improvement of the health of all people through collective or social actions. The programs, services and institutions involved emphasise the prevention of disease and the health needs of the population as a whole. Public health activities change with changing technology and values, but the goals remain the same: to reduce the amount of disease, premature death and disability in the population. (p.45) Recommended goals and targets for addressing national public health problems and directed at reducing the amount of death and premature death have been proposed in many countries over the past 10 years, including the United States of America (United States Department of Health and Human Services, 1990), the United Kingdom (Department of Health, 1992), Canada (Ontario Premiers' Council on Health, 1987) and Australia (Nutbeam, Wise, Bauman, Harris, & Leeder, 1993). In Australia for ex le, over the past 2 years, much attention has been directed at health outcomes related to cardiovascular disease, cancers, accidents and injuries and mental health. All of these reports have emphasised the importance of changing those lifestyle and related risk factors associated with preventable causes of death. Priority lifestyle areas that have been identified include physical inactivity, diet and nutrition, smoking, alcohol and other drug use, safety behaviours, sun protective behaviours, appropriate use of medicines, immunisation, sexuality and reproductive health, oral hygiene, and mental health. Priority populations and appropriate settings for intervening in these areas have also been identified.
Prevalence and Correlates of Prehypertension among Adults in Urban South India
Publisher: SAGE Publications
Date: 22-11-2016
Abstract: Prehypertension is one of the most common conditions affecting human beings worldwide. It is associated with several complications including hypertension. The blood pressure between normal and hypertension is prehypertension as per the Seventh Report Joint National Committee (JNC-7) classification. The current study was done to measure the magnitude of prehypertension and to study their sociodemographic correlates in the urban field practice area of Kasturba Medical College, Mangalore, India, among 624 people aged ≥20 years. The measurements of blood pressure were done (JNC 7 criteria) with the anthropometric measurements and lifestyle factors. Data analysis was done using Statistical Package for Social Sciences version 16. Adjusted odds ratios were calculated. Overall, 55% subjects had prehypertension and 30% had hypertension. Prehypertension was higher among males. Those from the higher age groups, those from upper socioeconomic status, obese in iduals, and those with lesser physical activity had significantly higher association with prehypertension, and it was least among those who never used tobacco and alcohol.
Mental health in the workplace: Using the ICF to model the prospective associations between symptoms, activities, participation and environmental factors
Publisher: Informa UK Limited
Date: 2008
DOI: 10.1080/09638280701654690
Abstract: This prospective study used the framework of ICF components to investigate the magnitude and direction of association between body functions (depression/anxiety symptoms), activity (limitations in work activities), participation (sickness absence), and environment (psychosocial aspects) in the workplace setting. A cohort of employees completed a self-report survey at baseline and 6 months follow-up, with analysis restricted to those with at least one health condition (n = 204). Self-report measures of depression/anxiety symptoms, limitations in work activities, sickness absences, and psychosocial work environment were mapped to the corresponding ICF component. The prospective association between these components was modelled using relative risks (RR) estimated from log-binomial regression. Depression/anxiety symptoms were more likely to be an outcome of other ICF components, rather than a risk factor. Sickness absence, limitations in work activities, and work environment all conferred a greater than two-fold risk of depression/anxiety symptoms 6 months later. The ICF offers a valuable approach to understanding the contextual influences on employee mental health and work disability. Further application of the ICF framework to mental health should improve the environmental components and encourage a wider adoption of the ICF by mental health researchers and practitioners.
Sex-Specific Differences in Percutaneous Coronary Intervention Outcomes After a Cardiac Event: A Cohort Study Examining the Role of Depression, Worry and Autonomic Function
Publisher: Elsevier BV
Date: 10-2020
Web-based interventions for the management of type 2 diabetes mellitus: A systematic review of recent evidence
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.IJMEDINF.2011.02.002
Abstract: The Internet has emerged as a potentially effective medium for information exchange. The Internet's potential has been recognised and web-based education programmes have been steadily adopted in recent years in preventing and managing chronic diseases such as diabetes mellitus. This review provides a descriptive discussion of web-based behavioural interventions for the management of type 2 diabetes mellitus. Systematic literature searches were performed using MEDLINE, EMBASE, PUBMED, PsycINFO, Web of Science and Cochrane Library to retrieve articles published between 2000 and June 2010 which fulfilled all inclusion criteria. Methodological quality assessment and data synthesis were then performed. Twenty articles representing 13 different studies were reviewed. None of the studies were ranked as low in the methodological quality. Goal-setting, personalised coaching, interactive feedback and online peer support groups were some of the successful approaches which were applied in e-interventions to manage type 2 diabetes mellitus. Strong theoretical background, use of other technologies and longer duration of intervention were proven to be successful strategies as well. The web-based interventions have demonstrated some level of favourable outcomes, provided they are further enhanced with proper e-research strategies.
Psychosocial considerations in the european guidelines for prevention of cardiovascular diseases in clinical practice: third joint task force
Publisher: Springer Science and Business Media LLC
Date: 09-2005
DOI: 10.1207/S15327558IJBM1203_2
Abstract: The International Society of Behavioral Medicine (ISBM) was one of eight societies that comprised the Third Task Force of European and Other Societies on Prevention of Cardiovascular Disease in Clinical Practice (2003-2004). This task force considered published knowledge from erse fields related to preventive cardiology including behavioral medicine to improve risk estimation and risk factor management. The scientific evidence supporting the guidelines included findings on low socioeconomic status, social isolation, psychosocial stress, hostility, depression and negative affect, the clustering of psychosocial and lifestyle risk factors, and lifestyle psychosocial interventions. Recommendations for promoting behavior change and management of psychosocial and lifestyle factors in clinical practice include strategies for promoting healthy lifestyle, improving health care provider-patient interactions, implementing multimodal interventions, and managing psychosocial risk factors.
Socioeconomic differences in food purchasing behaviour and suggested implications for diet-related health promotion
Publisher: Wiley
Date: 10-2002
DOI: 10.1046/J.1365-277X.2002.00384.X
Abstract: The relationship between socioeconomic position (SEP) and diet has been examined mainly on the basis of food and nutrient intake. As a complement to this work, we focused on the socioeconomic patterning of food purchasing, as many educational dietary messages emphasize behaviours such as food choice when shopping. Also, the type of food people buy influences the quality of their nutrient intake. A probability s le of households in Brisbane City, Australia (n = 1003, 66.4% response rate). Data were collected using face-to-face interviews. SEP was measured using education, occupation and household income. Food purchasing was examined on the basis of grocery items (including meat and chicken) and fruit and vegetables. Significant associations were found between each socioeconomic indicator and food purchasing. Persons from socioeconomically disadvantaged backgrounds were less likely to purchase grocery foods that were comparatively high in fibre and low in fat, salt and sugar. The least educated, those employed in blue-collar (manual) occupations and residents of low income households purchased fewer types of fruit and vegetables, and less regularly, than their higher status counterparts. Health promotion efforts aimed at narrowing socioeconomic differences in food purchasing need to be designed and implemented with an understanding of, and a sensitivity to, the barriers to nutritional improvement that difficult life circumstances can impose.
Association of technologically assisted integrated care with clinical outcomes in type 2 diabetes in Hong Kong using the prospective JADE Program: A retrospective cohort analysis
Publisher: Public Library of Science (PLoS)
Date: 02-10-2020
Predictors of long term outcome following a bladder re-training programme
Publisher: Elsevier BV
Date: 1986
DOI: 10.1016/0022-3999(86)90103-0
Abstract: A total of fifty-three female patients suffering from urinary urgency and urge incontinence completed a bladder re-training programme which comprised behavioural and biofeedback treatment components. The psychological status of patients prior to treatment and at eighteen-month follow-up was compared. The role of clinical and psychological factors was examined in relation to treatment outcome (immediately following treatment and at eighteen-month follow-up). Compared to pre-treatment, patients at the eighteen-month follow-up were experiencing fewer psychological symptoms and were more internal with respect to their locus of control, irrespective of urological response to the programme. Poor treatment compliance predicted a poor treatment response both in the short- and long-term. Excessive worrying about, and preoccupation with, the urinary symptoms, previous surgery, and chronic urinary symptoms were all good predictors of a poor treatment response in the long term.
Is There a Link Between Components of Health-Related Functioning and Incident Impaired Glucose Metabolism and Type 2 Diabetes?
Publisher: American Diabetes Association
Date: 10-12-2009
DOI: 10.2337/DC09-1107
Abstract: To determine the longitudinal association of components of health-related functioning (HRF) with incident impaired glucose metabolism and type 2 diabetes. The Australian Diabetes Obesity and Lifestyle (AusDiab) study is a national, longitudinal study of adults aged ≥25 years from 42 randomly selected areas of Australia. Diabetes status was defined using the World Health Organization criteria, and HRF was assessed using the SF-36 questionnaire in 1999–2000 and 2004–2005. Incident impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and newly diagnosed type 2 diabetes were associated with increased bodily pain at baseline compared with those with normal glucose tolerance (NGT) (IFG P = 0.005, IGT P & 0.004, and newly diagnosed type 2 diabetes P = 0.005), after adjustment. In addition, those with incident IGT and newly diagnosed type 2 diabetes had significantly reduced physical functioning, general health, mental health, and vitality at baseline compared with those with NGT. After we controlled for factors associated with incident diabetes, those in the lowest quartile of the physical component summary scale at baseline had at least a 50% higher risk of progression to impaired glucose metabolism and diabetes 5 years later. These findings show that incident IFG, IGT, and newly diagnosed type 2 diabetes are associated with reduced HRF independent of cardiovascular disease and that this is evident before the onset of these conditions. If future health promotion c aigns are to effectively target those at high risk of developing diabetes, an understanding of the process of declining health before onset of the disease is essential.
Conceptual perspectives on the co-occurrence of mental and physical disease: Diabetes and depression as a model
Publisher: S. Karger AG
Date: 26-11-2015
DOI: 10.1159/000365522
Bone Density Testing: An Under-Utilised and Under-Researched Health Education Tool for Osteoporosis Prevention?
Publisher: MDPI AG
Date: 16-09-2010
DOI: 10.3390/NU2090985
Preventive care in general practice in Australia: a public health perspective
Publisher: Elsevier BV
Date: 07-1995
DOI: 10.1016/0738-3991(95)00809-E
Abstract: There is considerable potential in Australia for implementing effective preventive care strategies in the general practice setting, especially in the context of Australia's new health goals and targets towards the year 2000. There is a clear need for the clinical paradigm, which focuses on developing efficacious, intensive, practitioner-delivered lifestyle change interventions, to be integrated within a broader public health approach. However, while there has been considerable growth in the breath and variety of health promotion research and activity being carried out in general practice in Australia, the evidence supportive of the efficacy and effectiveness of physician-based interventions (except in the case of smoking cessation) has been less than compelling, and a number of problems still remain. These include: health promotion still remains a minor component of the great majority of consultations there are many potential interventions which are possible, but little evidence that they will be used appropriately there is little evidence that patients who are most in need are receiving appropriate services there is generally a poor linkage between research and practice and there are real doubts about the ability of the system to sustain preventive care in general practice.
Health psychology in australia
Publisher: Informa UK Limited
Date: 1990
Benchmarking life quality support interventions in long‐term care using the Long‐Term Care Quality of Life scale
Publisher: Wiley
Date: 10-12-2018
DOI: 10.1111/NHS.12588
Abstract: We aimed to develop a graphical procedure for benchmarking quality of life care results using the Long-Term Care Quality of Life (LTC-QoL) scale. While clinical care quality benchmarking is now well established, similar research for quality of life (QOL) aged care benchmarking has received scant attention. Data from 10 facilities utilizing the LTC-QoL scale were analysed to establish baseline statistics for developing a graphical procedure for QOL benchmarking. Client LTC-QoL records were tested with varimax rotation factor analysis revealing three viable benchmarking themes: B1 (Self-efficacy), B2 (supporting relationships), and B3 (outlook on life) were selected for benchmark development utilizing Analysis of Means to generate graphical outputs using Minitab version 17.3.1. In this way, in the absence of verified industry standards, it is possible to compare organizations providing similar services using the same indicators, against group averages. In conclusion, the benchmarking protocol produced comparative information on three benchmarks for 10 facilities. Similar analysis is feasible for a single facility over time. The results of these analyses provide evidence for on-site discussion of quality of life care quality performance.
An Economic Evaluation of Four Work Site Based Cardiovascular Risk Factor Interventions
Publisher: SAGE Publications
Date: 02-1995
DOI: 10.1177/109019819502200103
Abstract: We used outcome data from a randomized work site intervention trial to examine the cost-effectiveness of four cardiovascular disease (CVD) risk reduction programs: health risk assessment (HRA), risk factor education (RFE), behavioral counseling (BC), and behavioral counseling plus incentives (BCI). Composite CVD risk scores were derived from measures of serum total cholesterol, blood pressure, number of cigarettes smoked, body mass index, and aerobic capacity. The economic evaluation of the programs focused on the subset of costs most sensitive to the differences between the interventions, and a sensitivity analysis examined some of the relevant cost variations. At the 6-month follow-up (i.e., the "action" or initiation stage of lifestyle change), the RFE, BC, and BCI interventions produced a significant reduction in cardiovascular risk. Incremental analyses demonstrated RFE to be more cost-effective, but not as clinically effective as BC BC was more cost-effective than RFE when assessment costs were included, and BCI was judged to be the least cost-effective. At the 12-month follow-up (i.e., the "maintenance" stage of lifestyle of change), BC was the only program found to produce a significant reduction in CVD risk. In idualized behavioral counseling was found to be a cost-effective strategy for the initiation and maintenance of CVD risk factor reduction.
Quality improvement and paramedic care
Publisher: Emerald
Date: 24-07-2007
DOI: 10.1108/09526860710763325
Abstract: The purpose of this article to review the literature relating to improving paramedic care in an Australian context. The paper presents changes and challenges that have occurred in the ambulance services in terms of improving care and measuring performance, exploring the literature on quality improvement initiatives and their application to pre‐hospital care. While hospitals and health services have moved well down the quality improvement pathway, the application of these processes to pre‐hospital care has been a relatively recent phenomenon. Ambulance services have taken a variety of approaches to measuring and improving pre‐hospital care. This article questions the transferability of lessons learned in hospitals to ambulance services. Arguably, the quality improvement approach is dependent upon health control and funding models and where ambulance is categorised in terms of health or emergency services. The quality improvement approach by Australian paramedics and ambulance services is in its infancy. This article provides insights into the quality improvement approach taken by ambulance staff in Australia compared to other countries, as well as highlighting useful information on the future direction and research into the area.
A Web-Based Dietary Intervention for People with Type 2 Diabetes: Development, Implementation, and Evaluation
Publisher: Springer Science and Business Media LLC
Date: 02-10-2014
The Functionality, Quality and Consistency with International Guidelines of Asthma Mobile Health Applications: Protocol for a Systematic Review. (Preprint)
Publisher: JMIR Publications Inc.
Date: 04-08-2021
Abstract: sthma is a chronic respiratory disorder defined clinically as a combination of typical respiratory symptoms, and significant variable reversible airflow limitation. In addition to pharmacotherapy, a key aspect of asthma management is empowering patients to manage their condition and recognise and respond to asthma exacerbations. Mobile health applications (mHealth apps) represent a potential medium through which patients could improve the ability to self-manage their asthma. Few studies have conducted a systematic evaluation of both free and paid asthma mobile applications for the quality and functionality of the apps using a validated tool and to our knowledge none have systematically assessed these applications for the quality of information that they provide compared to available international best practice guidelines. This represents the first study that will undertake both of these evaluations for all available mHealth Apps in Australia targeted towards adult asthmatics. The Global Initiative for Asthma (GINA) guidelines represent a regularly updated guideline based on reviews of the available scientific literature by an international panel of experts. This review will examine the functionality and quality of available asthma mobile health applications and the consistency of these available applications with recommendations from the GINA guidelines. he objective of this study is to conduct a systematic review of adult-targeted asthma mobile health applications on the Australian market. As part of this review the potential for an mHealth app to improve asthma self-management and the overall quality of the application will be evaluated, using the Mobile App Rating Scale (MARS) framework, and the quality of the information within an app, using the current GINA guidelines as a reference, will be assessed. methodological stepwise approach was taken in creating this review. First the most recent GINA guidelines were independently reviewed by two authors to identify key recommendations that could feasibly be incorporated into a mHealth app. These identified recommendations were then compared to a previously developed asthma application assessment framework. A modified assessment framework was created, ensuring all of these identified recommendations were included. Two popular App stores were then reviewed to identify potential mHealth Apps and then a screening process based on pre-defined inclusion and exclusion criteria occurred to establish what mHealth Apps would be evaluated. Application evaluation then occurred. Technical information was obtained from publicly available information on the application store or within the app itself. The next step was to perform an application quality assessment using the validated MARS framework to objectively determine the quality of the application. Application functionality was then assessed using the IMS Institute for Health Informatics Functionality Scoring system. Finally, the mHealth applications will be assessed using a checklist that we have developed based on what was identified from the international GINA guidelines. o date, funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the applications. Results for this study are expected by the end of this year. il as protocol ROSPERO 269894
Smartphone Cardiac Rehabilitation, Assisted Self-Management Versus Usual Care: Protocol for a Multicenter Randomized Controlled Trial to Compare Effects and Costs Among People With Coronary Heart Disease
Publisher: JMIR Publications Inc.
Date: 27-01-2020
DOI: 10.2196/15022
Abstract: Alternative evidence-based cardiac rehabilitation (CR) delivery models that overcome significant barriers to access and delivery are needed to address persistent low utilization. Models utilizing contemporary digital technologies could significantly improve reach and fidelity as complementary alternatives to traditional center-based programs. The aim of this study is to compare the effects and costs of the innovative Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) intervention with usual care CR. In this investigator-, assessor-, and statistician-blinded parallel 2-arm randomized controlled trial, 220 adults (18+ years) with coronary heart disease are being recruited from 3 hospitals in metropolitan and regional Victoria, Australia. Participants are randomized (1:1) to receive advice to engage with usual care CR or the SCRAM intervention. SCRAM is a 24-week dual-phase intervention that includes 12 weeks of real-time remote exercise supervision and coaching from exercise physiologists, which is followed by 12 weeks of data-driven nonreal-time remote coaching via telephone. Both intervention phases include evidence- and theory-based multifactorial behavior change support delivered via smartphone push notifications. Outcomes assessed at baseline, 12 weeks, and 24 weeks include maximal aerobic exercise capacity (primary outcome at 24 weeks), modifiable cardiovascular risk factors, exercise adherence, secondary prevention self-management behaviors, health-related quality of life, and adverse events. Economic and process evaluations will determine cost-effectiveness and participant perceptions of the treatment arms, respectively. The trial was funded in November 2017 and received ethical approval in June 2018. Recruitment began in November 2018. As of September 2019, 54 participants have been randomized into the trial. The innovative multiphase SCRAM intervention delivers real-time remote exercise supervision and evidence-based self-management behavioral support to participants, regardless of their geographic proximity to traditional center-based CR facilities. Our trial will provide unique and valuable information about effects of SCRAM on outcomes associated with cardiac and all-cause mortality, as well as acceptability and cost-effectiveness. These findings will be important to inform health care providers about the potential for innovative program delivery models, such as SCRAM, to be implemented at scale, as a complement to existing CR programs. The inclusion of a cohort comprising metropolitan-, regional-, and rural-dwelling participants will help to understand the role of this delivery model across health care contexts with erse needs. Australian New Zealand Clinical Trials Registry (ACTRN): 12618001458224 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374508. DERR1-10.2196/15022
The Effectiveness of a General-Practice-Based Physical Activity Intervention on Patient Physical Activity Status
Publisher: Cambridge University Press (CUP)
Date: 09-1994
DOI: 10.1017/S0813483900005039
Abstract: Physical inactivity is a risk factor for a number of chronic diseases, including cardiovascular disease. Interventions designed to reduce the prevalence of physical inactivity have focused primarily on either adoption of physical activity or noncompliance and relapse, and no interventions have been reported which cover adoption, compliance, maintenance, and relapse, particularly within the clinical setting. The Fresh Start program, a multiple risk factor intervention program for the reduction of cardiovascular disease risk factors in general practice patients, was developed to cover all aspects of the adoption and maintenance of habitual physical activity, using Prochaska and DiClemente's Transtheoretical model. The evaluation of the program on cardiovascular disease risk factors and behaviours provided the opportunity to evaluate the impact of a staged program on patient physical activity behaviour. The program was evaluated in a randomised controlled trial in Sydney's Western, South-western, and Wentworth regions with 80 volunteer general practitioners and 758 volunteer patients between January 1991 and January 1993. Self-reported physical activity data were used as the basis for estimating energy expenditure due to leisure-time physical activity. The results failed to show any differences between groups over time, as a function of patients' baseline stages of change, and as a function of baseline activity levels. There were some indications, however, that the least active would respond to doctor-based advice to increase their physical activity, and that doctor advice would lead to a progression in intention to change in approximately 20% of patients. Limitations of the study, the program, and physical activity intervention in the clinical setting are discussed.
Cluster randomized controlled trial of a peer support program for people with diabetes: Study protocol for the Australasian peers for progress study
Publisher: Springer Science and Business Media LLC
Date: 04-10-2012
Randomised controlled trial of an automated, interactive telephone intervention (TLC Diabetes) to improve type 2 diabetes management: Baseline findings and six-month outcomes
Publisher: Springer Science and Business Media LLC
Date: 03-08-2012
PEAPS-Q: A Questionnaire to measure the Psychosocial Effects of Having an Abnormal Pap Smear
Publisher: Elsevier BV
Date: 10-1995
DOI: 10.1016/0895-4356(95)00015-V
Abstract: We have developed the Psychosocial Effects of Abnormal Pap Smears Questionnaire (PEAPS-Q) which measures distress experienced by women undergoing follow-up investigation after an abnormal Pap smear result. A thorough literature review and qualitative research resulted in the development of a questionnaire which was tested on 350 women attending a Family Planning New South Wales (FPNSW) clinic. This s le included women at different stages of management after detection of a cervical abnormality: 93 first colposcopy clients and 257 follow-up colposcopy clients. Factor analysis identified four dimensions of distress: experience of medical procedures, beliefs/feelings about cervical abnormality and changes in perception of oneself, worry about infectivity and effect on sexual relationships. Repeatability of the PEAPS-Q was indicated by intra-class correlations of 0.88 overall and at least 0.60 for each scale. Internal consistency was shown by Cronbach's alpha of 0.84 overall and at least 0.72 for each scale. Validity was demonstrated by the correlation of scale scores with the 12-item General Health Questionnaire (GHQ) score of 0.32 (95% CI 0.22-0.41). The PEAPS-Q is a valid, reliable and multidimensional instrument for quantifying distress experienced by women with abnormal Pap smears.
The effect on behavior and bone mineral density of individualized bone mineral density feedback and educational interventions in premenopausal women: a randomized controlled trial [NCT00273260]
Publisher: Springer Science and Business Media LLC
Date: 23-01-2006
Abstract: Limited information is available on ways to influence osteoporosis risk in premenopausal women. This study tested four hypotheses regarding the effects of in idualized bone density (BMD) feedback and different educational interventions on osteoporosis preventive behavior and BMD in pre-menopausal women, namely: that women are more likely to change calcium intake and physical activity if their BMD is low that group education will be more efficacious at changing behavior than an information leaflet that BMD feedback and group education have independent effects on behavior and BMD and, that women who improve their physical activity or calcium intake will have a change in bone mass over 2 years that is better than those who do not alter their behavior. We performed a 2-year randomized controlled trial of BMD feedback according to T-score and either an osteoporosis information leaflet or small group education in a population-based random s le of 470 healthy women aged 25–44 years (response rate 64%). Main outcome measures were dietary calcium intake, calcium supplement use, smoking behavior, physical activity, endurance fitness, lower limb strength and BMD. We used paired t-tests, one-way ANOVA and linear regression techniques for data analysis. Women who had feedback of low BMD had a greater increase in femoral neck BMD than those with normal BMD (1.6% p.a. vs. 0.7% p.a., p = 0.0001), but there was no difference in lumbar spine BMD change between these groups (0.1% p.a. vs. 0.08% p.a., p = 0.9). Both educational interventions had similar increases in femoral neck BMD (Leaflet = +1.0% p.a., Osteoporosis self-management course = + 1.3% p.a., p = 0.4). Femoral neck BMD change was only significantly associated with starting calcium supplements (1.3 % p.a, 95%CI +0.49, +2.17) and persistent self-reported change in physical activity levels (0.7% p.a., 95%CI +0.22, +1.22). In idualized BMD feedback combined with a minimal educational intervention is effective at increasing hip but not spine bone density in premenopausal women. The changes in behavior through which this was mediated are potentially important in the prevention of other diseases, thus measuring BMD at a young age may have substantial public health benefits, particularly if these changes are sustained.
HABITAT: A longitudinal multilevel study of physical activity change in mid-aged adults
Publisher: Springer Science and Business Media LLC
Date: 05-03-2009
A multilevel analysis of socioeconomic (small area) differences in household food purchasing behaviour
Publisher: BMJ
Date: 03-2004
Abstract: To examine the association between area and in idual level socioeconomic status (SES) and food purchasing behaviour. The s le comprised 1000 households and 50 small areas. Data were collected by face to face interview (66.4% response rate). SES was measured using a composite area index of disadvantage (mean 1026.8, SD = 95.2) and household income. Purchasing behaviour was scored as continuous indices ranging from 0 to 100 for three food types: fruits (mean 50.5, SD = 17.8), vegetables (61.8, 15.2), and grocery items (51.4, 17.6), with higher scores indicating purchasing patterns more consistent with dietary guideline recommendations. Brisbane, Australia, 2000. Persons responsible for their household's food purchasing. Controlling for age, gender, and household income, a two standard deviation increase on the area SES measure was associated with a 2.01 unit increase on the fruit purchasing index (95% CI -0.49 to 4.50). The corresponding associations for vegetables and grocery foods were 0.60 (-1.36 to 2.56) and 0.94 (-1.35 to 3.23). Before controlling for household income, significant area level differences were found for each food, suggesting that clustering of household income within areas (a composition effect) accounted for the purchasing variability between them. Living in a socioeconomically advantaged area was associated with a tendency to purchase healthier food, however, the association was small in magnitude and the 95% CI for area SES included the null. Although urban areas in Brisbane are differentiated on the basis of their socioeconomic characteristics, it seems unlikely that where you live shapes your procurement of food over and above your personal characteristics.
Co-morbid cardiovascular disease and depression: sequence of disease onset is linked to mental but not physical self-rated health. Results from a cross-sectional, population-based study
Publisher: Springer Science and Business Media LLC
Date: 10-08-2012
DOI: 10.1007/S00127-011-0421-5
Abstract: Self-rated health has been linked to important health and survival outcomes in in iduals with co-morbid depression and cardiovascular disease (CVD). It is not clear how the timing of depression onset relative to CVD onset affects this relationship. We aimed to first identify the prevalence of major depressive disorder (MDD) preceding CVD and secondly determine whether sequence of disease onset is associated with mental and physical self-rated health. This study utilised cross-sectional, population-based data from 224 respondents of the 2007 Australian National Survey of Mental Health and Wellbeing (NSMHWB). Participants were those diagnosed with MDD and reported ever having a heart/circulatory condition over their lifetime. Age of onset was reported for each condition. Logistic regression was used to explore differences in self-rated mental and physical health for those reporting pre-cardiac and post-cardiac depression. The proportion of in iduals in whom MDD preceded CVD was 80.36% (CI: 72.57-88.15). One-fifth (19.64%, CI: 11.85-27.42) reported MDD onset at the time of, or following, CVD. After controlling for covariates, the final model demonstrated that those reporting post-cardiac depression were significantly less likely to report poor self-rated mental health (OR:0.36, CI: 0.14-0.93) than those with pre-existing depression. No significant differences were found in self-rated physical health between groups (OR:0.90 CI: 0.38-2.14). MDD is most common prior to the onset of CVD. Further, there is an association between pre-morbid MDD and poorer self-rated mental health. To our knowledge, this is the first time this has been demonstrated in a national, population-based survey. As self-rated health has been shown to predict important outcomes such as survival, we recommend that those with MDD be identified as vulnerable to CVD onset and poorer health outcomes.
Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes mellitus: Study protocol of myDIDeA
Publisher: Springer Science and Business Media LLC
Date: 21-05-2011
Engagement with Conversational Agent-Enabled Interventions in Cardiometabolic Disease Management: A Systematic Review Protocol (Preprint)
Publisher: JMIR Publications Inc.
Date: 20-09-2013
Stressful life events and the onset of chronic diseases among Australian adults: findings from a longitudinal survey
Publisher: Oxford University Press (OUP)
Date: 07-02-2013
Abstract: This article examines the link between stressful life events and illness by considering both onset and reoccurrence of chronic illnesses. Using longitudinal data, we estimate the extent to which life events increase the likelihood of depression or anxiety, type 2 diabetes, cancer, coronary heart disease, circulatory disease, asthma and emphysema among Australian adults aged ≥21 years. Longitudinal data were obtained from the nationally representative Household, Income and Labour Dynamics in Australia panel survey collected at waves 3 (2003), 7 (2007) and 9 (2009). Participants (N = 9222) answered life events questions relating to the preceding 12 months and chronic illnesses lasting (or expected to last for) 6 months. Weighted pooled and random effects logistic regressions were performed, controlling for confounders and previous illness, and also performed on subs les delineated by reported illnesses in wave 3. Work-related stress [odds ratio (OR) = 1.54, P < 0.001] was positively associated with the onset of depression or anxiety. Personal stress increased the likelihood of the onset of depression or anxiety (OR = 1.70, P < 0.001), type 2 diabetes (OR = 1.47, P < 0.05) and circulatory diseases (OR = 1.72, P < 0.05), while family-related stress increased the likelihood of the onset of heart (OR = 1.32, P < 0.01) and circulatory diseases (OR = 1.32, P < 0.05). Independent of personal characteristics and key health measures (body mass index, hypertension and disability), these findings suggest that work-related, personal and family-related stressful life events contribute to the development and/or course of chronic diseases.
Gender differences in health-related quality of life following ST-elevation myocardial infarction: women and men do not benefit from primary percutaneous coronary intervention to the same degree
Publisher: Oxford University Press (OUP)
Date: 02-2007
Response to “Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS)”
Publisher: JMIR Publications Inc.
Date: 09-06-2017
DOI: 10.2196/MHEALTH.6419
The spread and uptake of diabetes prevention programs around the world: A case study from Finland and Australia
Publisher: Oxford University Press (OUP)
Date: 06-2011
Planning of a community-based approach to injury control and safety promotion in a rural community.
Publisher: Wiley
Date: 10-2001
DOI: 10.1046/J.1440-1584.2001.00399.X
Abstract: This paper describes the planning of a community-based approach to injury control and safety promotion, the Kolan Injury Prevention Program. The process involved the establishment of a local steering committee, 11 months of injury surveillance, a critical review of the evidence base, community consultations and assessment of community resources. There were 412 recorded injury cases during the surveillance period, with higher rates among men, manual workers, those aged 15-34 years, sport/leisure activities and around the home and farm. Salient issues for residents included a lack of access to safety information and skills, particularly with regard to first aid and bush fire for isolated residents and rurally inexperienced new residents. While injury prevention was identified as an important issue for the community, the rapidly changing size and nature of the community and its infrastructure made this a particularly challenging issue. Challenges included limited availability of volunteers from key sectors, lack of formal data collection systems, difficulties in mobilising support for a broad issue like injury, limited communication networks and the negative impact of distance and role uncertainty on community ownership of the program. This case study illustrates the steps involved in an effective community-based needs assessment addressing injury prevention. Such an approach, if carried out systematically, will help ensure that the strategies and programs developed will be both appropriate and likely to obtain the support of the local community.
Rainfall, mosquito density and the transmission of Ross River virus: A time-series forecasting model
Publisher: Elsevier BV
Date: 07-2006
Using Digital Technology to Reduce the Prevalence of Mental Health Disorders in Populations: Time for a New Approach (Preprint)
Publisher: JMIR Publications Inc.
Date: 16-12-2019
Abstract: igital technology, which includes the collection, analysis, and use of data from a variety of digital devices, has the potential to reduce the prevalence of disorders and improve mental health in populations. Among the many advantages of digital technology is that it allows preventive and clinical interventions, both of which are needed to reduce the prevalence of mental health disorders, to be feasibly integrated into health care and community delivery systems and delivered at scale. However, the use of digital technology also presents several challenges, including how systems can manage and implement interventions in a rapidly changing digital environment and handle critical issues that affect population-wide outcomes, including reaching the targeted population, obtaining meaningful levels of uptake and use of interventions, and achieving significant outcomes. We describe a possible solution, which is to have an outcome optimization team that focuses on the dynamic use of data to adapt interventions for populations, while at the same time, addressing the complex relationships among reach, uptake, use, and outcome. We use the ex le of eating disorders in young people to illustrate how this solution could be implemented at scale. We also discuss system, practitioner-related, and other issues related to the adaptation of such an approach. Digital technology has great potential for facilitating the reduction of mental illness rates in populations. However, achieving this goal will require the implementation of new approaches. As a solution, we argue for the need to create outcome optimization teams, tasked with integrating data from various sources and using advanced data analytics and new designs to develop interventions/strategies to increase reach, uptake, use/engagement, and outcomes for both preventive and treatment interventions. R2-10.2196/none
Utilisation of general practitioner services and achievement of guideline targets by people with diabetes who joined a peer-support program in Victoria, Australia
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/PY13178
Abstract: This paper describes the use of general practitioner (GP) services and achievement of guideline targets by 285 adults with type 2 diabetes in urban and regional areas of Victoria, Australia. Anthropometric and biomedical measures and responses to a self-administered questionnaire were collected. Findings indicate that almost all participants had visited a GP and had had their hypoglycated haemoglobin (HbA1c) measured in the past 6 months less than one-third had visited a practice nurse. Fifty per cent achieved a HbA1c target of ≤7.0% 40%, a total cholesterol ≤4.00 mmol/L 39%, BP Systolic ≤130 mmHg 51%, BP Diastolic ≤80 mmHg 15%, body mass index ≤25 kg/m2 and 34% reported a moderately intense level of physical activity, that is, ≥30 min, 5 days a week. However, 39% of in iduals achieved at least two targets and 18% achieved at least three of these guideline targets. Regional participants were more likely to report having a management plan and having visited a practice nurse, but they were less likely to have visited other health professionals. Therefore, a more sustained effort that also includes collaborative care approaches is required to improve the management of diabetes in Australia.
Age-related changes relevant to health in women: Design, recruitment, and retention strategies for the Longitudinal Assessment of Women (LAW) study
Publisher: Mary Ann Liebert Inc
Date: 2008
Abstract: The primary aim was to assess the age-related changes that occur in older women. This paper describes the study rationale and methods, recruitment, and retention strategies. The Longitudinal Assessment of Women (LAW) Study was a longitudinal, observational, and multidisciplinary evaluation of a population-based cohort of urban-living women, aged between 40 and 80 years at recruitment and randomly invited from a district in Brisbane (a city in Australia) via the electoral roll. Five hundred eleven women were recruited and stratified into four age groups (40-49, 50-59, 60-69, 70-79 years) and were assessed on three or four occasions each year, using interviews and diagnostic instruments (echocardiography, applination tonometry, dual-energy x-ray absorptiometry [DEXA]) Retention strategies included flexibility, accessibility, personalized attention, and feedback. From a s le frame of 1598 names, there were 1082 respondents, of whom 511 (47%) were successfully recruited from those eligible to participate. Recruitment was quickest for the oldest age group, 70-79 years, and slowest for the age group 40-49 years all age groups achieved their required quota. A scheduling program was developed to minimize the number of visits and maximize the use of allocated time. The largest dropout was seen in year 1 of the study, with very few thereafter. Of the 9 deaths, cancer was the cause in 7. The retention rate after 5 years was 95.5%. The design of the present study, with careful attention to coordination and a personal approach, facilitated the completion of a 5-year study, enabling a collection of a set of wide-ranging data from almost all the women recruited. The information thus collected will form the basis of cross-linking analysis of the risk factors associated with health problems in aging women.
Clinical and social determinants of diarrhoeal disease in a rural HIV/AIDS clinic, South Africa: a case-control study
Publisher: SAGE Publications
Date: 05-2012
Abstract: Diarrhoeal diseases are a common cause of morbidity and are associated with mortality in HIV-infected populations. Little is known about the contribution of clinical and socio-environmental factors to the risk of diarrhoea in these populations in rural sub-Saharan Africa. We conducted a case-control study of people attending a rural HIV clinic with an episode of diarrhoea in Bushbuckridge, South Africa. Cases were defined as HIV-positive adults with symptoms of diarrhoea before or after initiation of antiretroviral therapy (ART). Controls without diarrhoea were randomly selected from clinic attendees. Structured questionnaires and case-file reviews were undertaken to describe clinical and socioenvironmental risk factors. We recruited 103 cases of diarrhoea from 121 patients meeting case definitions. Cases were more likely to be women ( P = 0.013), aged over 45 years ( P = 0.002), orced or separated ( P = 0.006), have limited formal education ( P = 0.003), have inadequate access to sanitation facilities ( P = 0.045), have water access limited to less than three days per week ( P = 0.032) and not yet initiated on ART ( P 0.001). In multivariate analysis, diarrhoea remained associated with female gender (adjusted odds ratio [aOR]: 2.02, 95% CI 1.10–3.73), older age (aOR: 6.31, 95% CI 1.50–26.50), limited access to water (aOR: 2.66, 95% CI 1.32–5.35) and pre-ART status (aOR: 5.87, 95% CI 3.05–11.27). Clinical and socio-environmental factors are associated with occurrence of diarrhoeal disease among rural HIV patients in South Africa. Further intervention research is urgently needed, combining community- and clinic-based approaches, to improve access to water, sanitation and ART for rural areas with high HIV prevalence, along with structural interventions to address gender inequities.
Randomised trial of an asthma self-management programme for adults
Publisher: BMJ
Date: 07-1995
DOI: 10.1136/THX.50.7.731
Cluster randomised controlled trial of a peer-led lifestyle intervention program: study protocol for the Kerala diabetes prevention program
Publisher: Springer Science and Business Media LLC
Date: 04-11-2013
Perceptions of benefit of complementary therapy use among people with diabetes and cardiovascular disease
Publisher: S. Karger AG
Date: 2014
DOI: 10.1159/000358725
Abstract: b i Background: /i /b Little is known about why and how people with type 2 diabetes and cardiovascular disease (CVD) use CAM, or of the perceived benefits of CAM use. The CAMELOT study explored care-seeking, self-management, costs, barriers and benefits of CAM use among this population. We report here on CAM used for treatment of diabetes and CVD, and non-clinical outcomes of CAM use. b i Methods: /i /b Data were collected in 2009-2010 via in-depth interviews (n = 69) and a self-report questionnaire (n = 2,915) among people with diabetes and/or CVD, throughout an Australian state. Analysis included contingency tables, chi-square analysis and thematic coding of interview and long answer survey data. b i Results: /i /b CAM use was generally part of a multi-component approach to chronic condition management. Choice of CAM practitioners and products varied and included CAM not usually associated with diabetes or CVD treatment, such as massage or manipulative therapies (44%). Most survey respondents perceived that CAM consultations resulted in symptom relief, improved general health and increased knowledge, understanding and confidence in condition management. Few people reported that they experienced any side effects from CAM. Economic barriers were significant in limiting access to CAM. b i Conclusion: /i /b More research is required to understand how the appropriate use and perceived benefits of CAM can be reinforced by stronger interaction or integration with mainstream health service delivery for chronic condition management and illness prevention.
A systematic review of the clustering and correlates of physical activity and sedentary behavior among boys and girls
Publisher: Springer Science and Business Media LLC
Date: 21-02-2023
DOI: 10.1186/S12889-022-14869-0
Abstract: Identifying the clustering and correlates of physical activity (PA) and sedentary behavior (SB) is very important for developing appropriate lifestyle interventions for children and adolescents. This systematic review (Prospero CRD42018094826) aimed to identify PA and SB cluster patterns and their correlates among boys and girls (0–19 years). The search was carried out in five electronic databases. Cluster characteristics were extracted in accordance with authors’ descriptions by two independent reviewers and a third resolved any disagreements. Seventeen studies met the inclusion criteria and the population age ranged from six to 18 years old. Nine, twelve, and ten cluster types were identified for mixed-sex s les, boys, and girls, respectively. While girls were in clusters characterized by “Low PA Low SB” and “Low PA High SB”, the majority of boys were in clusters defined by “High PA High SB” and “High PA Low SB”. Few associations were found between sociodemographic variables and all cluster types. Boys and girls in “High PA High SB” clusters had higher BMI and obesity in most of the tested associations. In contrast, those in the “High PA Low SB” clusters presented lower BMI, waist circumference, and overweight and obesity. Different cluster patterns of PA and SB were observed in boys and girls. However, in both sexes, a better adiposity profile was found among children and adolescents in “High PA Low SB” clusters. Our results suggest that it is not enough to increase PA to manage the adiposity correlates, it is also necessary to reduce SB in this population.
Risk of cardiovascular and all-cause mortality: Impact of impaired health-related functioning and diabetes - The Australian Diabetes, Obesity and Lifestyle (AusDiab) study
Publisher: American Diabetes Association
Date: 11-04-2012
DOI: 10.2337/DC11-1288
Abstract: There is an established link between health-related functioning (HRF) and cardiovascular disease (CVD) mortality, and it is known that those with diabetes predominantly die of CVD. However, few studies have determined the combined impact of diabetes and impaired HRF on CVD mortality. We investigated whether this combination carries a higher CVD risk than either component alone. The Australian Diabetes, Obesity and Lifestyle (AusDiab) study included 11,247 adults aged ≥25 years from 42 randomly selected areas of Australia. At baseline (1999–2000), diabetes status was defined using the World Health Organization criteria and HRF was assessed using the SF-36 questionnaire. Overall, after 7.4 years of follow-up, 57 persons with diabetes and 105 without diabetes had died from CVD. In in iduals with and without diabetes, HRF measures were significant predictors of increased CVD mortality. The CVD mortality risks among those with diabetes or impaired physical health component summary (PCS) alone were similar (diabetes only: hazard ratio 1.4 [95% CI 0.7–2.7] impaired PCS alone: 1.5 [1.0–2.4]), while those with both diabetes and impaired PCS had a much higher CVD mortality (2.8 [1.6–4.7]) compared with those without diabetes and normal PCS (after adjustment for multiple covariates). Similar results were found for the mental health component summary. This study demonstrates that the combination of diabetes and impaired HRF is associated with substantially higher CVD mortality. This suggests that, among those with diabetes, impaired HRF is likely to be important in the identification of in iduals at increased risk of CVD mortality.
The association between socioeconomic status and osteoporotic fracture in population-based adults: a systematic review
Publisher: Springer Science and Business Media LLC
Date: 24-12-2009
DOI: 10.1007/S00198-008-0822-9
Abstract: Although socioeconomic status (SES) is inversely related to most diseases, this systematic review showed a paucity of good quality data examining influences of SES on osteoporotic fracture to confirm this relationship. Further research is required to elucidate the issue and any underlying mechanisms as a necessary precursor to considering intervention implications. The association between socioeconomic status (SES) and musculoskeletal disease is little understood, despite there being an inverse relationship between SES and most causes of morbidity. We evaluated evidence of SES as a risk factor for osteoporotic fracture in population-based adults. Computer-aided search of Medline, EMBASE, CINAHL, and PsychINFO from January 1966 until November 2007 was conducted. Identified studies investigated the relationship between SES parameters of income, education, occupation, type of residence and marital status, and occurrence of osteoporotic fracture. A best-evidence synthesis was used to summarize the results. Eleven studies were identified for inclusion, which suggested a lack of literature in the field. Best evidence analysis identified strong evidence for an association between being married/living with someone and reduced risk of osteoporotic fracture. Limited evidence exists of the relationship between occupation type or employment status and fracture, or for type of residence and fracture. Conflicting evidence exists for the relationship between osteoporotic fracture and level of income and education. Limited good quality evidence exists of the role SES might play in osteoporotic fracture. Further research is required to identify whether a relationship exists, and to elucidate underlying mechanisms, as a necessary precursor to considering intervention implications.
Lost in translation: overcoming the barriers to global implementation and exchange of behavioral medicine evidence
Publisher: Oxford University Press (OUP)
Date: 06-2011
Editorial: Health Psychology and Public Health—Bridging the Gap
Publisher: SAGE Publications
Date: 2004
Validation of WHOQOL-BREF in Malayalam and Determinants of Quality of Life among People with Type 2 Diabetes in Kerala, India
Publisher: SAGE Publications
Date: 29-09-2016
Abstract: Quality of life (QOL) is an important health outcome in people with chronic conditions like diabetes and WHOQOL-BREF is a popular instrument used worldwide to assess QOL. However, QOL varies considerably from society to society depending on the culture of the person. Hence, the WHOQOL-BREF was translated to the local language, Malayalam. This article attempts to establish reliability, construct and discriminant validity of the translated WHOQOL-BREF, and determinants of QOL among people with type 2 diabetes. A cross-sectional study was undertaken among 200 patients with diabetes attending a primary care center in a rural area of Kerala, India. The translated version of WHOQOL-BREF was found to be internally consistent (Cronbach’s α = .86) and demonstrated discriminant and construct validity. Education was found to be an independent determinant of QOL in the physical, psychological, and environmental domains. Thus, the translated version had good psychometric properties and education was an independent determinant of QOL in 3 of 4 domains.
Low Rates of Postpartum Glucose Screening Among Indigenous and non-Indigenous Women in Australia with Gestational Diabetes
Publisher: Springer Science and Business Media LLC
Date: 07-2014
DOI: 10.1007/S10995-014-1555-3
Abstract: Women with gestational diabetes have a high risk of type 2 diabetes postpartum, with Indigenous women particularly affected. This study reports postpartum diabetes screening rates among Indigenous and non-Indigenous women with gestational diabetes, in Far North Queensland, Australia. Retrospective study including 1,012 women with gestational diabetes giving birth at a regional hospital from 1/1/2004 to 31/12/2010. Data were linked between hospital records, midwives perinatal data, and laboratory results, then analysed using survival analysis and logistic regression. Indigenous women had significantly longer times to first oral glucose tolerance test (OGTT) [hazards ratio (HR) 0.62, 95 % confidence interval (CI) 0.48-0.79, p < 0.0001) and 'any' postpartum glucose test (HR 0.81, 95 % CI 0.67-0.98, p = 0.03], compared to non-Indigenous women. Postpartum screening rates among all women were low. However, early OGTT screening rates (<6 months) were significantly lower among Indigenous women (13.6 vs. 28.3 %, p < 0.0001), leading to a persistent gap in cumulative postpartum screening rates. By 3 years postpartum, cumulative rates of receiving an OGTT, were 24.6 % (95 % CI 19.9-30.2 %) and 34.1 % (95 % CI 30.6-38.0 %) among Indigenous and non-Indigenous women, respectively. Excluding OGTTs in previous periods, few women received OGTTs at 6-24 months (7.8 vs. 6.7 %) or 2-4 years (5.2 vs. 6.5 %), among Indigenous and non-Indigenous women, respectively. Low rates of postpartum diabetes screening demonstrate that essential 'ongoing management' and 'equity' criteria for population-based screening for gestational diabetes are not being met particularly among Indigenous women, for whom recent guideline changes have specific implications. Strategies to improve postpartum screening after gestational diabetes are urgently needed.
Measuring psychological, social, and environmental influences on leisure-time physical activity among adults
Publisher: Elsevier BV
Date: 02-2007
DOI: 10.1111/J.1753-6405.2007.00008.X
Abstract: Many of the self-administered scales for measuring physical activity (PA) influences were originally developed for vigorous-intensity exercise, focus on only one domain of influence, and have not been evaluated for both reliability and validity using population-based s les. This study describes the factorial validity and internal reliability of scales for measuring in idual-level psychological, social, and environmental influences on leisure-time PA among adults in the general population. Constructs were identified from a literature review and formative research with a socio-economically erse s le. Items were generated using previously developed scales and interview data. New items were pre-tested using reliability and principal components analyses, with data collected from a mail survey sent to a randomly selected population-based s le. Qualitative feedback was obtained from a convenience s le and expert panel. A second mail survey provided data for principal components and reliability analyses. Twenty-eight scales were factorially derived and 24 had acceptable or marginally acceptable levels of internal consistency with Cronbach's alpha values ranging from 0.65 to 0.91. The 24 scales are suitable for researchers and practitioners interested in measuring in idual-level influences on PA that are consistent with Social Cognitive Theory. More research is required to assess predictive validity, sensitivity to change and test/re-test reliability.
Associations with low rates of postpartum glucose screening after gestational diabetes among Indigenous and non‐Indigenous Australian women
Publisher: Elsevier BV
Date: 02-2015
Abstract: To explore factors associated with postpartum glucose screening among women with Gestational Diabetes Mellitus (GDM). A retrospective study using linked records from women with GDM who gave birth at Cairns Hospital in Far North Queensland, Australia, from 1 January 2004 to 31 December 2010. The rates of postpartum Oral Glucose Tolerance Test (OGTT) screening, while having increased significantly among both Indigenous* and non-Indigenous women from 2004 to 2010 (HR 1.15 per year, 95%CI 1.08-1.22, p<0.0001), remain low, particularly among Indigenous women (10% versus 27%, respectively at six months postpartum). Indigenous women in Cairns had a longer time to postpartum OGTT than Indigenous women in remote areas (HR 0.58, 0.38-0.71, p=0.01). Non-Indigenous women had a longer time to postpartum OGTT if they: were born in Australia (HR 0.76, 0.59-1.00, 0.05) were aged 5 (HR 0.33, 0.12-0.90, p=0.03) smoked (HR 0.48, 0.31-0.76, p=0.001) and did not breastfeed (HR 0.09, 0.01-0.64, p=0.02). Postpartum diabetes screening rates following GDM in Far North Queensland are low, particularly among Indigenous women, with lower rates seen in the regional centre and among non-Indigenous women with indicators of low socioeconomic status. Strategies are urgently needed to improve postpartum diabetes screening after GDM that reach women most at risk.
Effects of Individualized Bone Density Feedback and Educational Interventions on Osteoporosis Knowledge and Self-Efficacy: A 12-Yr Prospective Study
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.JOCD.2014.07.008
Abstract: This is 12-yr follow-up of a randomized controlled trial aimed to evaluate the long-term effects of bone density feedback and osteoporosis education on osteoporosis knowledge and self-efficacy. We examined the effects of feedback of bone density-defined fracture risk (high [T-score <0] vs normal [T-score ≥0] risk) and 2 different educational interventions (the group-based Osteoporosis Prevention and Self-Management Course [OPSMC] vs an osteoporosis leaflet) on osteoporosis knowledge and self-efficacy in women aged 25-44. Seventy-four percent (N = 347) of 470 participants at baseline participated at 12 yr. Overall, the scores were higher for osteoporosis knowledge but lower for self-efficacy at 12 yr. However, neither intervention had an effect on the change in knowledge (T-score, β = 0.4, 95% confidence interval [CI] = -0.3 to 1.1 OPSMC, β = 0.2, 95% CI = -0.5 to 0.9) or self-efficacy (T-score, β = -1.1, 95% CI = -2.5 to 0.4 OPSMC, β = -0.2, 95% CI = -1.6 to 1.3). Women in households with an unemployed main financial provider had a decrease in knowledge at 12 yr compared with those in households with an employed main financial provider in whom knowledge increased (β = -1.95, 95% CI = -3.40 to -0.50), but there were no other predictors of change identified for knowledge or self-efficacy. In conclusion, beneficial effects of both OPSMC and feedback of high fracture risk on osteoporosis knowledge seen previously at 2 yr were not sustained after 12 yr although overall knowledge was still significantly higher than at baseline. Neither intervention improved osteoporosis self-efficacy. More frequent osteoporosis education and bone density feedback may be required to maintain knowledge, and other approaches to improve self-efficacy are necessary.
Acceptability of an Embodied Conversational Agent for Type 2 Diabetes Self-Management Education and Support via a Smartphone App: Mixed Methods Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 17-11-2019
Abstract: mbodied conversational agents (ECAs) are increasingly used in health care apps however, their acceptability in type 2 diabetes (T2D) self-management apps has not yet been investigated. his study aimed to evaluate the acceptability of the ECA (Laura) used to deliver diabetes self-management education and support in the My Diabetes Coach (MDC) app. sequential mixed methods design was applied. Adults with T2D allocated to the intervention arm of the MDC trial used the MDC app over a period of 12 months. At 6 months, they completed questions assessing their interaction with, and attitudes toward, the ECA. In-depth qualitative interviews were conducted with a subs le of the participants from the intervention arm to explore their experiences of using the ECA. The interview questions included the participants’ perceptions of Laura, including their initial impression of her (and how this changed over time), her personality, and human character. The quantitative and qualitative data were interpreted using integrated synthesis. f the 93 intervention participants, 44 (47%) were women the mean (SD) age of the participants was 55 (SD 10) years and the baseline glycated hemoglobin A1c level was 7.3% (SD 1.5%). Overall, 66 of the 93 participants (71%) provided survey responses. Of these, most described Laura as being helpful (57/66, 86%), friendly (57/66, 86%), competent (56/66, 85%), trustworthy (48/66, 73%), and likable (40/66, 61%). Some described Laura as not real (18/66, 27%), boring (26/66, 39%), and annoying (20/66, 30%). Participants reported that interacting with Laura made them feel more motivated (29/66, 44%), comfortable (24/66, 36%), confident (14/66, 21%), happy (11/66, 17%), and hopeful (8/66, 12%). Furthermore, 20% (13/66) of the participants were frustrated by their interaction with Laura, and 17% (11/66) of the participants reported that interacting with Laura made them feel guilty. A total of 4 themes emerged from the qualitative data (N=19): (1) perceived role: a friendly coach rather than a health professional (2) perceived support: emotional and motivational support (3) embodiment preference acceptability of a human-like character and (4) room for improvement: need for greater congruence between Laura’s words and actions. hese findings suggest that an ECA is an acceptable means to deliver T2D self-management education and support. A human-like character providing ongoing, friendly, nonjudgmental, emotional, and motivational support is well received. Nevertheless, the ECA can be improved by increasing congruence between its verbal and nonverbal communication and accommodating user preferences. ustralian New Zealand Clinical Trials Registry CTRN12614001229662 xshn6pd
Pilot study of the effects of a workplace smoking ban on indices of smoking, cigarette craving, stress and other health behaviours
Publisher: Informa UK Limited
Date: 05-1993
Effectiveness of a primary care-based integrated mobile health intervention for stroke management in rural China (SINEMA): A cluster-randomized controlled trial
Publisher: Public Library of Science (PLoS)
Date: 28-04-2021
DOI: 10.1371/JOURNAL.PMED.1003582
Abstract: Managing noncommunicable diseases through primary healthcare has been identified as the key strategy to achieve universal health coverage but is challenging in most low- and middle-income countries. Stroke is the leading cause of death and disability in rural China. This study aims to determine whether a primary care-based integrated mobile health intervention (SINEMA intervention) could improve stroke management in rural China. Based on extensive barrier analyses, contextual research, and feasibility studies, we conducted a community-based, two-arm cluster-randomized controlled trial with blinded outcome assessment in Hebei Province, rural Northern China including 1,299 stroke patients (mean age: 65.7 [SD:8.2], 42.6% females, 71.2% received education below primary school) recruited from 50 villages between June 23 and July 21, 2017. Villages were randomly assigned (1:1) to either the intervention or control arm (usual care). In the intervention arm, village doctors who were government-sponsored primary healthcare providers received training, conducted monthly follow-up visits supported by an Android-based mobile application, and received performance-based payments. Participants received monthly doctor visits and automatically dispatched daily voice messages. The primary outcome was the 12-month change in systolic blood pressure (BP). Secondary outcomes were predefined, including diastolic BP, health-related quality of life, physical activity level, self-reported medication adherence (antiplatelet, statin, and antihypertensive), and performance in “timed up and go” test. Analyses were conducted in the intention-to-treat framework at the in idual level with clusters and stratified design accounted for by following the prepublished statistical analysis plan. All villages completed the 12-month follow-up, and 611 (intervention) and 615 (control) patients were successfully followed (3.4% lost to follow-up among survivors). The program was implemented with high fidelity, and the annual program delivery cost per capita was US$24.3. There was a significant reduction in systolic BP in the intervention as compared with the control group with an adjusted mean difference: −2.8 mm Hg (95% CI −4.8, −0.9 p = 0.005). The intervention was significantly associated with improvements in 6 out of 7 secondary outcomes in diastolic BP reduction ( p 0.001), health-related quality of life ( p = 0.008), physical activity level ( p 0.001), adherence in statin ( p = 0.003) and antihypertensive medicines ( p = 0.039), and performance in “timed up and go” test ( p = 0.022). We observed reductions in all exploratory outcomes, including stroke recurrence (4.4% versus 9.3% risk ratio [RR] = 0.46, 95% CI 0.32, 0.66 risk difference [RD] = 4.9 percentage points [pp]), hospitalization (4.4% versus 9.3% RR = 0.45, 95% CI 0.32, 0.62 RD = 4.9 pp), disability (20.9% versus 30.2% RR = 0.65, 95% CI 0.53, 0.79 RD = 9.3 pp), and death (1.8% versus 3.1% RR = 0.52, 95% CI 0.28, 0.96 RD = 1.3 pp). Limitations include the relatively short study duration of only 1 year and the generalizability of our findings beyond the study setting. In this study, a primary care-based mobile health intervention integrating provider-centered and patient-facing technology was effective in reducing BP and improving stroke secondary prevention in a resource-limited rural setting in China. ClinicalTrials.gov NCT03185858 .
Behavioral medicine and prevention of non-communicable diseases in china: Current challenges and future directions
Publisher: Springer Science and Business Media LLC
Date: 03-2014
DOI: 10.1007/S12529-014-9393-7
Abstract: We describe the emergence of recent public health challenges in China, particularly those regarding lifestyle-related non-communicable diseases (NCDs). We also summarize some recent ex les of behavioral medicine research and practice in relation to the prevention and control of NCDs in China. Finally, we describe recent changes in the public health system in China and how behavioral medicine research and practice can be incorporated into this system to address these public health challenges. We considered research and policy literature from both China and Western countries in order to evaluate the relevance of the field of behavioral medicine for addressing the rising NCDs in China. Rapid economic development and related social and environmental changes have brought about increasing wealth and lifestyle changes in China, along with new public health challenges related to the prevention and control of NCDs. The field of behavioral medicine has much to offer China in addressing these public health challenges. Although behavioral medicine research and practice are still at an early stage in China, there are encouraging signs of its development, particularly resulting from international collaborations with researchers from Western countries. The next stage of this field's development in China will involve increased integration of behavioral medicine into public health education, training, and the health system. However, this process of integration will need to build on China's traditional approaches to public health training, research, and practice. Although the field of behavioral medicine in public health is still in its infancy in China, we argue that the practice and principles of behavioral medicine are important for successfully addressing the substantial burden of NCDs now and in the future.
Cardiovascular prevention model from Kenyan slums to migrants in the Netherlands
Publisher: Springer Science and Business Media LLC
Date: 2015
Behavioral medicine in China
Publisher: Springer Science and Business Media LLC
Date: 05-06-2014
Psychosoziale Faktoren bei koronarer Herzkrankheit - wissenschaftliche Evidenz und Empfehlungen für die klinische Praxis
Publisher: Georg Thieme Verlag KG
Date: 06-2025
Abstract: Psychosocial risk factors like low socio-economic status, lack of social support and social isolation, chronic work or family stress, as well as negative emotions, e. g. depression and hostility, contribute significantly to the development and adverse outcome of coronary heart disease (CHD). Negative effects of psychosocial risk factors are conveyed via behavioural pathways including unhealthy lifestyle, e. g. food choice, smoking, sedentary life, inadequate utilisation of medical resources, and psychobiological mechanisms like disturbed autonomic and hormonal regulation: all these factors contribute to metabolic dysfunction and inflammatory and haemostatic processes, which are directly involved in the pathogenesis of CHD. Interventions to improve pychosocial factors are available and have demonstrated positive effects on risk factors and - at least in part - on CHD morbidity and mortality. The prevention of CHD should therefore include screening for psychosocial risk factors and adequate interventions. Recommedations for the screening of risk factors, behavioural change and further management of psychosocial risk factors in clinical practice are pointed out.
A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare'): Study protocol
Publisher: Springer Science and Business Media LLC
Date: 25-02-2011
My Diabetes Coach, a Mobile App–Based Interactive Conversational Agent to Support Type 2 Diabetes Self-Management: Randomized Effectiveness-Implementation Trial (Preprint)
Publisher: JMIR Publications Inc.
Date: 17-05-2020
Abstract: elivering self-management support to people with type 2 diabetes mellitus is essential to reduce the health system burden and to empower people with the skills, knowledge, and confidence needed to take an active role in managing their own health. his study aims to evaluate the adoption, use, and effectiveness of the My Diabetes Coach (MDC) program, an app-based interactive embodied conversational agent, i Laura /i , designed to support diabetes self-management in the home setting over 12 months. his randomized controlled trial evaluated both the implementation and effectiveness of the MDC program. Adults with type 2 diabetes in Australia were recruited and randomized to the intervention arm (MDC) or the control arm (usual care). Program use was tracked over 12 months. Coprimary outcomes included changes in glycated hemoglobin (HbA sub c /sub ) and health-related quality of life (HRQoL). Data were assessed at baseline and at 6 and 12 months, and analyzed using linear mixed-effects regression models. total of 187 adults with type 2 diabetes (mean 57 years, SD 10 years 41.7% women) were recruited and randomly allocated to the intervention (n=93) and control (n=94) arms. MDC program users (92/93 participants) completed 1942 chats with i Laura /i , averaging 243 min (SD 212) per person over 12 months. Compared with baseline, the mean estimated HbA sub c /sub decreased in both arms at 12 months (intervention: 0.33% and control: 0.20%), but the net differences between the two arms in change of HbA sub c /sub (−0.04%, 95% CI −0.45 to 0.36 i P /i =.83) was not statistically significant. At 12 months, HRQoL utility scores improved in the intervention arm, compared with the control arm (between-arm difference: 0.04, 95% CI 0.00 to 0.07 i P /i =.04). he MDC program was successfully adopted and used by in iduals with type 2 diabetes and significantly improved the users’ HRQoL. These findings suggest the potential for wider implementation of technology-enabled conversation-based programs for supporting diabetes self-management. Future studies should focus on strategies to maintain program usage and HbA sub c /sub improvement. ustralia New Zealand Clinical Trials Registry (ACTRN) 12614001229662 anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614001229662
Which questionnaire to measure psychosocial effects of having an abnormal PAP smear? (multiple letters) [1]
Publisher: Elsevier BV
Date: 12-1996
DOI: 10.1016/S0895-4356(96)00193-X
Abstract: COVID-19 is a multisystem disease, and some patients suffer from physical or psychological symptoms for weeks or even months after infection, which is described as post-COVID syndrome. The goal of this study is evaluating the prevalence of post-COVID-19 symptoms among Egyptian patients and detecting the factors associated with the presence of these symptoms. An on-line cross-sectional survey using Google Forms was used to conduct the present study, which took place between June and August 2021. Three hundred and ninety-six participants filled in the survey. The mean age of participants was 41.4 years. Most participants had mild to moderate COVID-19 (81.31%). The prevalence of post-COVID-19 symptoms was 87.63%, where the most frequent symptom was fatigue (60.86%). Female sex, the presence of comorbidities, lower degree of education, longer disease duration, as well as severe and critical forms of the disease were significantly associated with the presence of post-COVID symptoms. Using regression analysis, the predictors of post-COVID symptoms were severe and critical forms of the disease and intake of antibiotics and corticosteroids for treatment of COVID-19. COVID-19 is followed by high prevalence of post-COVID symptoms. To the best of our knowledge, this is the first study to report the relationship between the use of antibiotics and the development of post-COVID symptoms. We recommend further studies to understand this relationship. We also recommend restricting the use of these drugs to indicated cases according to the international guidelines. More studies are needed to gain better understanding of post-COVID symptoms especially in females.
A Critical Review of Determinants of Smoking Cessation
Publisher: Cambridge University Press (CUP)
Date: 09-1990
DOI: 10.1017/S0813483900007075
Abstract: The problems of relapse and reci ism have received increasing attention in smoking research over the past ten years. Researchers and clinicians alike have come to understand smoking as a complex process consisting of a number of stages. This paper reviews recent models and theories of the change process as well as those studies which have examined the determinants of the quitting process. Finally, the implications of these developments for smoking cessation strategies directed at the prevention of relapse are discussed.
Advancing the Science of Dissemination and Implementation in Behavioral Medicine: Evidence and Progress
Publisher: Springer Science and Business Media LLC
Date: 22-05-2015
DOI: 10.1007/S12529-015-9490-2
Abstract: The enormous time lag between the discovery of new knowledge and its implementation poses a significant challenge to improving public health because of the very slow uptake into policy and practice. The field of dissemination and implementation research in behavioral medicine is receiving increased attention because of the keen interest in accelerating knowledge transfer from relevant research to improve the health and wellbeing of populations in many different settings, contexts, and countries around the world. This is particularly important in high-risk populations, resource-poor and developing regions of the world where the difference in health systems, languages, and cultures very significantly influences the translation of evidence into policy and practice. Moreover, demonstrating the broader societal and economic value of behavioral interventions in settings where they are implemented can further support the sustainability, uptake, and implementation of these findings in other settings and contexts. This special issue presents a series of empirical studies, reviews, and case studies that address dissemination, implementation, and translation issues in both developed and developing countries. Specifically, the learnings from the application of many and varied theories and research methodologies are very relevant for bridging the current ision between research findings and their translation and uptake into policy and practice.
Adapting and Developing A Diabetes Prevention Intervention Programme for South Africa: Curriculum and Tools
Publisher: MDPI AG
Date: 02-03-2023
Abstract: The South African Diabetes Prevention Programme (SA-DPP) is a lifestyle intervention targeting in iduals at high risk of developing type 2 diabetes mellitus (T2DM). In this paper we describe the mixed-method staged approach that was used to develop and refine the SA-DPP intervention curriculum and the appropriate tools for local resource-poor communities. During the preparation phase, existing evidence on similar DPP interventions was reviewed, focus group discussions with in iduals from the target population were conducted as part of a needs assessment, and experts were consulted. The curriculum booklet, a participant workbook and facilitator workbook were developed, and the content was evaluated by experts in the field. The design and layout of the booklet and workbooks needed to be culturally and contextually appropriate. The printed material was evaluated for readability and acceptability by participants of the target population based on their feedback, the design and layout were refined and the printed material was translated. The suitability of the intervention was tested in a pilot study based on feedback from the participants and facilitator, the curriculum was revised where needed and finalised. Through this process a context specific intervention and printed materials were developed. A complete evaluation of this culturally relevant model for T2DM prevention in South Africa is pending.
Depression as a predictor of work resumption following myocardial infarction (MI): a review of recent research evidence
Publisher: Springer Science and Business Media LLC
Date: 2010
Development of a Tool to Increase Physical Activity among People at Risk for Diabetes in Low-Resourced Communities in Cape Town
Publisher: MDPI AG
Date: 30-01-2020
Abstract: Targeted lifestyle interventions, including physical activity (PA), have been proven to prevent or delay the onset of diabetes. South Africa’s unique context, complex environment and varied cultures and ethnicities require tailored interventions. Our objective was to develop a context-appropriate tool for the South African Diabetes Prevention Programme’s PA lifestyle component in order to enable people at risk of developing diabetes to adopt PA. We used mixed methods to inform the development of the tool. Descriptive analyses of baseline survey data included socio-demographics, anthropometrics, blood pressure and biochemical measurements, reported medical history, PA behaviours, and built environment information. Focus group discussions assisted in understanding perceived challenges, barriers and facilitators/opportunities to PA. A literature search on successful South African PA interventions was done, and PA experts in Cape Town were consulted. Quantitative data were analysed using the software R, version 3.4.4 and qualitative data were thematically analysed. Participants (n = 316) recruited were mostly black (54.4%) and of mixed-ancestry (44.6%) they were mainly female (80.1%), obese (75.2%), and had an haemoglobin A1c (HbA1c) above 5.7% (65.5%), with 30% having hypertension and 87% (self-reported) meeting the World Health Organisation (WHO) PA recommendation. Main barriers to PA practice were safety, cost and accessibility of sports facilities, and laziness. We included practising moderate-intensity aerobic and resistance exercises and take-home self-help materials as recommended. By combining results, we produced a targeted, practical and promotional PA booklet.
The future of public health: The importance of workforce
Publisher: Springer Science and Business Media LLC
Date: 09-04-2009
Abstract: Health workforce has become a major concern and a significant health policy issue around the world in recent years. With recent international and national initiatives and models being developed and implemented in Australia and other countries, it is timely to understand the need and the rationale for a better trained and educated public health workforce for the future. Much more attention should also be given to evaluation and research in this field. Through this thematic series on Workforce and Public Health, we have drawn on the erse nature of public health, workforce implications, education and training and national and international case ex les of ongoing improvements and issues in this sector.
Evaluating the impact of depression, anxiety & autonomic function on health related quality of life, vocational functioning and health care utilisation in acute coronary syndrome patients: the ADV
Publisher: Springer Science and Business Media LLC
Date: 17-11-2013
Participation in recreational physical activity: Why do socioeconomic groups differ?
Publisher: SAGE Publications
Date: 04-2003
Abstract: This qualitative study explored how influences on recreational physical activity (RPA) were patterned by socioeconomic position. Face-to-face interviews were conducted with 10 males and 10 females in three socioeconomic groups ( N = 60). Influences salient across all groups included previous opportunities, physical health, social assistance, safety, environmental aesthetics and urban design, physical and health benefits, and barriers of self-consciousness, low skill, and weather/time of year. Influences more salient to the high socioeconomic group included social benefits, achieving a balanced lifestyle, and the barrier of an unpredictable lifestyle. Influences more salient to the high and mid socioeconomic groups included efficacy, perceived need, activity demands, affiliation, emotional benefits, and the barrier of competing demands. Influences more salient to the low socioeconomic group included poor health and barriers of inconvenient access and low personal functioning. Data suggest that efforts to increase RPA in the population should include both general and socioeconomically targeted strategies.
Putting non-communicable disease data to work in Vietnam: an investigation of community health surveillance capacity
Publisher: Springer Science and Business Media LLC
Date: 14-02-2023
DOI: 10.1186/S12889-023-14986-4
Abstract: Despite the public health system’s critical role in non-communicable disease (NCD) surveillance in Vietnam, limited evidence exists on the implementation of NCD surveillance activities within these systems and the need for capacity building across different system levels to meet expected NCD surveillance goals. This study aimed to evaluate the status of and describe factors affecting the implementation of NCD surveillance activities and to identify the NCD surveillance capacity building needs of the public health system in Vietnam. We used a mixed-methods approach in four provinces, conducting self-completed surveys of staff from six Preventive Medicine Institutes (PHI), 53 Centres for Disease Control (CDC) and 148 commune health stations (CHS), as well as 14 in-depth interviews and 22 focus group discussions at four PHI, four CDC, and eight district health centres and CHS. Study findings highlighted that although Vietnam has a well-functioning NCD surveillance system, a number of quality issues related to NCD surveillance data were salient. Multifactorial reasons were identified for incomplete, unconfirmed, and inaccurate mortality data and current disease surveillance data. Data on NCD management and treatment were reported to be of better quality than data for screening, targeted treatment, and counselling communication. Main factors affected the effective implementation of NCD surveillance, namely lack of complete and specific guidelines for NCD surveillance, limitations in human resource capacity within NCD departments, and shortage of funding for NCD surveillance activities. Study findings provide practical strategies for strengthening health system capacity for NCD surveillance through developing policies, guidelines, and standardised tools to guide NCD surveillance and a road map for integrated NCD surveillance, developing training packages and manuals for all levels of the health system, and conducting utilisation-focused surveillance training programs.
Association between socioeconomic status and bone mineral density in adults: a systematic review
Publisher: Springer Science and Business Media LLC
Date: 07-05-2010
DOI: 10.1007/S00198-010-1261-Y
Abstract: For most causes of mortality and morbidity, a socioeconomic gradient exists however, this systematic review identified limited evidence for the role of education on bone mineral density (BMD). Further research is required to build upon the current paucity of data examining influences of socioeconomic status (SES) on BMD, especially in men. For most causes of mortality and morbidity, a socioeconomic gradient exists, although little is understood of the relationship between BMD and SES. We systematically evaluated evidence of SES as a risk factor for low BMD at the clinically relevant sites of hip and spine in adults. We conducted a computer-aided search of Medline, EMBASE, CINAHL, and PsychINFO from January 1, 1966 until December 31, 2008. Reviewed studies investigated the relationship between SES parameters of income, education, and occupation, and the level of BMD. Studies were rated based on their methodological quality, and a best-evidence synthesis was used to summarise the results. One case-control and seven cross-sectional studies were identified for inclusion, of which four cross-sectional studies were high-quality. Best-evidence analysis identified consistent, yet limited, evidence for a positive association between educational attainment and BMD in women. No evidence was available regarding an association between income or occupation and BMD in either gender, or education and BMD in men. Limited good quality evidence exists for the role that education level may play in BMD levels. Cohort studies are required to examine the relationship between in idual SES parameters and BMD in order to identify potential intervention targets.
Depression in C hinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence
Publisher: Wiley
Date: 19-02-2015
Prediction of quality of life in a cohort of end-stage renal disease patients
Publisher: Elsevier BV
Date: 1988
DOI: 10.1016/0895-4356(88)90059-5
Abstract: In order to assess the physical, psychological and social impact of end-stage renal disease (ESRD) 102 patients on maintenance dialysis were assessed on standardized self-report measures, a structured interview schedule, a physician assessment and biochemical data. Patients were assessed on two occasions, 18 months apart. Principal components analysis was used to develop a small number of dimensions to characterize quality of life. Multiple regression analysis of patient variables on initial factor scores (cross-sectional analysis) showed that hospital dialysis and length of time on dialysis were predictive of more psychological distress males were less compliant than females patients on peritoneal dialysis made a poorer adjustment to their illness and, hospital dialysis was predictive of more social distress. As long term predictors (prospective analysis): initial level of psychological distress predicted long-term level of psychological, social distress and illness adjustment and initial level of compliance predicted long-term level of compliance.
A mother-based intervention trial for osteoporosis prevention in children
Publisher: Elsevier BV
Date: 2006
DOI: 10.1016/J.YPMED.2005.11.006
Abstract: To assess whether a lifestyle intervention delivered to mothers might impact on osteoporosis preventive behaviors in their children. We performed a 2-year randomized controlled trial of in idualized bone mineral density feedback with either an osteoporosis information leaflet, or small group education, in a population-based s le of 354 mothers from Southern Tasmania, Australia in 2000-02. Main outcomes were maternal report of calcium intake and physical activity change in their children. Receiving small group education was associated with mothers' report of increasing children's calcium intake (odds ratio 2.3, 95% confidence interval 1.4, 3.8), as was low t-score feedback (odds ratio 2.0, 95% confidence interval 1.2, 3.3). Mothers who increased their own physical activity were more often reported increasing both physical activity (odds ratio 2.7, 95% confidence interval 1.5, 5.0) and calcium intake in their children (odds ratio 2.2, 95% confidence interval 1.3, 3.7). Mothers who commenced calcium supplements more often reported increasing children's calcium intake (odds ratio 2.6, 95% confidence interval 1.0, 6.7) but not physical activity. Both bone mineral density feedback and small group education delivered to mothers are effective at inducing maternally reported osteoporosis preventive behavior change in their children. These results require confirmation by studies with objective outcome measures.
A Smart and Multifaceted Mobile Health System for Delivering Evidence-Based Secondary Prevention of Stroke in Rural China: Design, Development, and Feasibility Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 26-01-2019
Abstract: obile health (mHealth) technologies hold great promise in improving the delivery of high-quality health care services. Yet, there has been little research so far applying mHealth technologies in the context of delivering stroke care in resource-limited rural regions. his study aimed to introduce the design and development of an mHealth system targeting primary health care providers and to ascertain its feasibility in supporting the delivery of a System-Integrated techNology-Enabled Model of cAre (SINEMA) service for strengthening secondary prevention of stroke in rural China. he SINEMA mHealth system was designed by a multidisciplinary team comprising public health researchers, neurologists, and information and communication technology experts. The iterative co-design and development of the mHealth system involved the following 5 steps: (1) assessing the needs of relevant end users through in-depth interviews of stakeholders, (2) designing the functional modules and evidence-based care content, (3) designing and building the system and user interface, (4) improving and enhancing the system through a 3-month pilot test in 4 villages, and (5) finalizing the system and deploying it in field trial, and finally, evaluating its feasibility through a survey of the dominant user group. rom the in-depth interviews of 49 relevant stakeholders, we found that village doctors had limited capacity in caring for village-dwelling stroke patients in rural areas. Primary health care workers demonstrated real needs in receiving appropriate training and support from the mHealth system as well as great interests in using the mHealth technologies and tools. Using these findings, we designed a multifaceted mHealth system with 7 functional modules by following the iterative user-centered design and software development approach. The mHealth system, aimed at 3 different types of users (village doctors, town physicians, and county managers), was developed and utilized in a cluster-randomized controlled trial by 25 village doctors in a resource-limited county in rural China to manage 637 stroke patients between July 2017 and July 2018. In the end, a survey on the usability and functions of the mHealth system among village doctors (the dominant group of users, response rate=96%, 24/25) revealed that most of them were satisfied with the essential functions provided (71%) and were keen to continue using it (92%) after the study. he mHealth system was feasible for assisting primary health care providers in rural China in delivering the SINEMA service on the secondary prevention of stroke. Further research and initiatives in scaling up the SINEMA approach and this mHealth system to other resource-limited regions in China and beyond will likely enhance the quality and accessibility of essential secondary prevention among stroke patients. linicalTrials.gov NCT03185858 t2/show/NCT03185858 R2-10.1016/j.ahj.2018.08.015
Outcome Assessment for Intermittent Claudication
Publisher: Elsevier BV
Date: 2006
Diabetes prevalence and determinants in adults in China mainland from 2000 to 2010: A systematic review
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.DIABRES.2012.05.010
Abstract: To systematically review trends in diabetes mellitus (DM) prevalence in adults in China over the last 10 years and to identify the determinants of these trends. A systematic search was conducted for studies published between 2000 and 2010. Studies reporting DM prevalence were included if they met the pre-determined criteria. The prevalence estimates and reported determinants of these studies were compared. Twenty-five manuscripts, reporting on 22 studies, were selected for inclusion in the review. There has been an increase in DM prevalence from 2.6% to 9.7% in China over the past decade. DM prevalence is strongly associated with age and is higher in urban residents compared with rural populations. Some studies found a difference in DM prevalence between males and females, but this finding was not consistent. Other commonly reported associations with DM included family history, obesity and hypertension. Over the period of 2000-2010, we identify a significant increase in DM prevalence at the national level. It is important for all levels of government to develop more effective strategies to prevent and manage this rising diabetes epidemic. There is also an important need for more large-scale studies of diabetes in the western and central regions of China.
User Experiences With a Type 2 Diabetes Coaching App: Qualitative Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 31-10-2019
Abstract: iabetes self-management apps have the potential to improve self-management in people with type 2 diabetes (T2D). Although efficacy trials provide evidence of health benefits, premature disengagement from apps is common. Therefore, it is important to understand the factors that influence engagement in real-world settings. his study aims to explore users’ real-world experiences with the i My Diabetes Coach /i (MDC) self-management app. e conducted telephone-based interviews with participants who had accessed the MDC self-management app via their smartphone for up to 12 months. Interviews focused on user characteristics the context within which the app was used barriers and facilitators of app use and the design, content, and delivery of support within the app. total of 19 adults with T2D (8/19, 42% women mean age 60, SD 14 years) were interviewed. Of the 19 interviewees, 8 (42%) had T2D for & years, 42% (n=8) had T2D for 5-10 years, and 16% (n=3) had T2D for & years. In total, 2 themes were constructed from interview data: (1) the moderating effect of diabetes self-management styles on needs, preferences, and expectations and (2) factors influencing users’ engagement with the app: one size does not fit all. ser characteristics, the context of use, and features of the app interact and influence engagement. Promoting engagement is vital if diabetes self-management apps are to become a useful complement to clinical care in supporting optimal self-management. ustralia New Zealand Clinical Trials Registry CTRN126140012296 URL www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366925& isReview=true
Type 2 Diabetes Prevention in the “Real World”
Publisher: American Diabetes Association
Date: 10-2007
DOI: 10.2337/DC07-0171
Abstract: OBJECTIVE—“Real-world” implementation of lifestyle interventions is a challenge. The Good Ageing in Lahti Region (GOAL) Lifestyle Implementation Trial was designed for the primary health care setting, with lifestyle and risk reduction objectives derived from the major diabetes prevention efficacy trials. We report on the program's effectiveness as well as findings related to the program's reach, adoption, and implementation. RESEARCH DESIGN AND METHODS—A total of 352 middle-aged participants with elevated type 2 diabetes risk were recruited from the health care centers in Päijät-Häme Province in Finland. The intervention included six group counseling sessions, delivered by trained public health nurses. Measurement was conducted at baseline and 12 months. Clinical risk factors were measured by study nurses, and lifestyle outcomes were analyzed from self-reports. Lifestyle outcomes were compared with the outcomes achieved in relevant efficacy trials, and within-subject changes were tested for risk reduction. RESULTS—At baseline, mean BMI was & kg/m2, and 25% of the participants had impaired glucose tolerance. At 12 months, 20% of participants achieved at least four of five key lifestyle outcomes, with these results being comparable with the reference trials. However, physical activity and weight loss goals were achieved significantly less frequently (65 vs. 86% and 12 vs. 43%, respectively). Several clinical risk factors decreased, more so among men than women. CONCLUSIONS—This trial demonstrates that lifestyle counseling can be effective and is feasible in real-world settings for in iduals with elevated risk of type 2 diabetes. To increase program impact, program exposure and treatment intensity need to be increased.
Building Noncommunicable Disease Research Capacity in the South Asian Region
Publisher: SAGE Publications
Date: 2016
Behavioural Treatment of Compulsive Polydipsia: Two Case Studies
Publisher: Cambridge University Press (CUP)
Date: 12-1987
DOI: 10.1017/S0813483900008299
Abstract: Two case studies are described where behavioural strategies, including response prevention and controlled drinking, were used to successfully treat chronic compulsive polydipsia where traditional medical management had failed. The improvement during treatment and at the 3-month follow-up was reflected not only in reduced fluid intake but also in the reduction of associated thirst symptoms and psychological distress. The implications of these results for treatment of polydipsia and non-compliance with fluid restrictions, particularly among dialysis patients, are discussed.
Colorectal cancer screening with faecal occult blood testing: Community intention, knowledge, beliefs and behaviour
Publisher: SAGE Publications
Date: 03-2006
DOI: 10.1177/10105395060180010401
Abstract: The objective of this study was to examine the current community intention, knowledge, beliefs and behaviour regarding colorectal cancer (CRC) screening with faecal occult blood testing (FOBT). A cross sectional telephone survey of the general population was conducted in Queensland, Australia. A random s le of 1,136 residents aged 40-80 years were invited to participate in the survey with a response rate of 77.8%. 77.5% (95% confidence interval [95% CI]: 74.0 to 80.7%) of respondents reported that they would participate in CRC screening by FOBT if recommended to do so by doctors or health authorities. Screening intention was significantly associated with interest in further information concerning CRC or CRC screening (odds ratio: 6.7 95% CI: 3.4 - 13.1), belief that CRC screening is necessary for persons without symptoms (5.0 95% CI: 1.5 -17.1), and belief that treating bowel cancer in the early stages increases a person's chance of survival (5.1 95% CI: 2.6 - 9.9). Knowledge of seeking medical advice (2.8 95% CI: 0.9 - 8.7) and diarrhoea/constipation as a symptom of CRC (1.7 95% CI: 0.9 - 3.2), self-initiated screening behaviour (1.5 95% CI: 0.8 -2.9), and medical check a couple of times a year or more (2.4 95% CI: 0.9 - 6.5) were also marginally significantly associated with screening intention. Community intention to screen for CRC with FOBT may have increased over recent years. Screening intention is associated with community knowledge, attitudes/beliefs and behaviour.
Getting a Grip on NCDs in China: an Evaluation of the Implementation of the Dutch-China Cardiovascular Prevention Program
Publisher: Springer Science and Business Media LLC
Date: 04-12-2014
An early-stage epidemic: A systematic review of correlates of smoking among Chinese women
Publisher: Springer Science and Business Media LLC
Date: 13-11-2014
Effect of Conventional Lifestyle Interventions on Type 2 Diabetes Incidence by Glucose-Defined Prediabetes Phenotype: An Individual Participant Data Meta-analysis of Randomized Controlled Trials
Publisher: American Diabetes Association
Date: 31-08-2023
DOI: 10.2337/DC23-0696
Abstract: To examine whether the effect of conventional lifestyle interventions on type 2 diabetes incidence differs by glucose-defined prediabetes phenotype. We searched multiple databases until 1 April 2023 for randomized controlled trials that recruited people with isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), and impaired fasting glucose plus impaired glucose tolerance (IFG+IGT). In idual-participant data were pooled from relevant trials and analyzed through random-effects models with use of the within-trial interactions approach. Four trials with 2,794 participants (mean age 53.0 years, 60.7% men) were included: 1,240 (44.4%), 796 (28.5%), and 758 (27.1%) had i-IFG, i-IGT, and IFG+IGT, respectively. After a median of 2.5 years, the pooled hazard ratio for diabetes incidence in i-IFG was 0.97 (95% CI 0.66, 1.44), i-IGT 0.65 (0.44, 0.96), and IFG+IGT 0.51 (0.38, 0.68 Pinteraction = 0.01). Conventional lifestyle interventions reduced diabetes incidence in people with IGT (with or without IFG) but not in those with i-IFG.
Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses
Publisher: MDPI AG
Date: 12-01-2015
Effects of a national mass-media campaign on physical activity participation
Publisher: Oxford University Press (OUP)
Date: 1992
No bias of ignored bilaterality when analysing the revision risk of knee prostheses: Analysis of a population based sample of 44,590 patients with 55,298 knee prostheses from the national Swedish Knee
Publisher: Springer Science and Business Media LLC
Date: 05-02-2003
Abstract: The current practice of the Swedish Knee Register is not to take into consideration if one or both knees in a patient are subject to surgery when evaluating risk of revision after arthroplasty. Risk calculations are typically done by statistical methods, such as Kaplan-Meier analyses and Cox's proportional hazards models, that are based on the assumption that observed events are independent, and this is rarely appreciated. The purpose of this study was to investigate if ignoring bilateral operations when using these methods biases the results. The bias of not taking bilateral operations into account was investigated by statistically analysing 55 298 prostheses in 44 590 patients, undergoing knee arthroplasty surgery in Sweden during 1985-1999, using traditional proportional hazards analysis, which assumes that all observations are independent, and a shared gamma frailty model, which allows patients to contribute repeated observations. The effect of neglecting bilateral prostheses is minute, possibly because bilateral prosthesis failure is a rare event. We conclude that the revision risk of knee prostheses in general can be analysed without consideration for subject dependency, at least in study populations with a relatively low proportion of subjects having experienced bilateral revisions.
Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand, and the United States: A method for systematic review of studies with different designs
Publisher: Springer Science and Business Media LLC
Date: 12-2011
Determinants of smoking and cessation during and after pregnancy
Publisher: Oxford University Press (OUP)
Date: 12-2001
Abstract: Smoking during pregnancy is harmful to both the foetus and the woman herself. However, in spite of educational efforts, a substantial proportion of pregnant women continue to smoke and many women who do stop smoking during pregnancy resume smoking following childbirth. To foster successful maternal smoking cessation, public health professionals need to focus on the major determinants of smoking and cessation during and after pregnancy, and then to address these with their intervention efforts. It is important to review contemporary epidemiological evidence on this significant public health issue. We have identified nine cohort studies, published in international peer-reviewed journals, that have examined determinants of smoking and cessation in pregnant women. The results indicate that the determinants of pregnant smoking and cessation include maternal age, dose and duration of smoking, partner's smoking habit, socioeconomic status, level of education, age to start smoking, level of addiction, parity and passive smoking. However, many other psychosocial factors, which may affect smoking status among pregnant women, remain to be identified. Evidence reviewed here suggests that a more focused, integrated approach and a more comprehensive assessment of major determinants of smoking and cessation during pregnancy will be required as part of any future intervention effort.
Effects of Telephone-Based Peer Support in Patients With Type 2 Diabetes Mellitus Receiving Integrated Care
Publisher: American Medical Association (AMA)
Date: 06-2014
DOI: 10.1001/JAMAINTERNMED.2014.655
Abstract: In type 2 diabetes mellitus (T2DM), team management using protocols with regular feedback improves clinical outcomes, although suboptimal self-management and psychological distress remain significant challenges. To investigate if frequent contacts through a telephone-based peer support program (Peer Support, Empowerment, and Remote Communication Linked by Information Technology [PEARL]) would improve cardiometabolic risk and health outcomes by enhancing psychological well-being and self-care in patients receiving integrated care implemented through a web-based multicomponent quality improvement program (JADE [Joint Asia Diabetes Evaluation]). Between 2009 and 2010, 628 of 2766 Hong Kong Chinese patients with T2DM from 3 publicly funded hospital-based diabetes centers were randomized to the JADE + PEARL (n = 312) or JADE (n = 316) groups, with comprehensive assessment at 0 and 12 months. Thirty-three motivated patients with well-controlled T2DM received 32 hours of training (four 8-hour workshops) to become peer supporters, with 10 patients assigned to each. Peer supporters called their peers at least 12 times, guided by a checklist. Changes in hemoglobin A(1c) (HbA(1c)) level (primary), proportions of patients with attained treatment targets (HbA(1c) <7% blood pressure <130/80 mm Hg low-density lipoprotein cholesterol <2.6 mmol/L [to convert to milligrams per deciliter, ide by 0.0256]) (secondary), and other health outcomes at month 12. Both groups had similar baseline characteristics (mean [SD] age, 54.7 [9.3] years 57% men disease duration, 9.4 [7.7] years HbA(1c) level, 8.2% [1.6%] systolic blood pressure, 136 [19] mm Hg low-density lipoprotein cholesterol level, 2.89 [0.82] mmol/L 17.4% cardiovascular-renal complications and 34.9% insulin treated). After a mean (SD) follow-up period of 414 (55) days, 5 patients had died, 144 had at least 1 hospitalization, and 586 had repeated comprehensive assessments. On intention-to-treat analysis, both groups had similar reductions in HbA(1c) (JADE + PEARL, 0.30% [95% CI, 0.12%-0.47%], vs JADE, 0.29% [95% CI, 0.12%-0.47%] [P = .97]) and improvements in treatment targets and psychological-behavioral measures. In the JADE + PEARL group, 90% of patients maintained contacts with their peer supporters, with a median of 20 calls per patient. Most of the discussion items were related to self-management. In patients with T2DM receiving integrated care, peer support did not improve cardiometabolic risks or psychological well-being. clinicaltrials.gov Identifier: NCT00950716.
Telephone counselling for physical activity and diet in primary care patients
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.AMEPRE.2008.09.042
Abstract: The delivery of effective interventions to assist patients to improve their physical activity and dietary behaviors is a challenge in the busy primary care setting. Cluster RCT with practices randomized to telephone counseling intervention or usual care. Data collection took place from February 2005 to November 2007, with analysis from December 2007 to April 2008. Four-hundred thirty-four adult patients with type 2 diabetes or hypertension (mean age=58.2 [SD=11.8] 61% female mean BMI=31.1 [SD=6.8]) from a disadvantaged community were recruited from ten primary care practices. Twelve-month telephone counseling intervention. Physical activity and dietary intake were assessed by self-report at baseline, 4, and 12 months. At 12 months, patients in both groups increased moderate-to-vigorous physical activity by a mean of 78 minutes per week (SE=10). Significant intervention effects (telephone counseling minus usual care) were observed for: calories from total fat (decrease of 1.17% p<0.007), energy from saturated fat (decrease of 0.97% p<0.007), vegetable intake (increase of 0.71 servings p<0.039), fruit intake (increase of 0.30 servings p<0.001), and grams of fiber (increase of 2.23 g p<0.001). The study targeted a challenging primary care patient s le and, using a telephone-delivered intervention, demonstrated modest improvements in diet and in physical activity. Results suggest that telephone counseling is a feasible means of delivering lifestyle intervention to primary care patients with chronic conditions-patients whose need for ongoing support for lifestyle change is often beyond the capacity of primary healthcare practitioners.
Using Digital Technology to Reduce the Prevalence of Mental Health Disorders in Populations: Time for a New Approach
Publisher: JMIR Publications Inc.
Date: 24-07-2020
DOI: 10.2196/17493
Abstract: Digital technology, which includes the collection, analysis, and use of data from a variety of digital devices, has the potential to reduce the prevalence of disorders and improve mental health in populations. Among the many advantages of digital technology is that it allows preventive and clinical interventions, both of which are needed to reduce the prevalence of mental health disorders, to be feasibly integrated into health care and community delivery systems and delivered at scale. However, the use of digital technology also presents several challenges, including how systems can manage and implement interventions in a rapidly changing digital environment and handle critical issues that affect population-wide outcomes, including reaching the targeted population, obtaining meaningful levels of uptake and use of interventions, and achieving significant outcomes. We describe a possible solution, which is to have an outcome optimization team that focuses on the dynamic use of data to adapt interventions for populations, while at the same time, addressing the complex relationships among reach, uptake, use, and outcome. We use the ex le of eating disorders in young people to illustrate how this solution could be implemented at scale. We also discuss system, practitioner-related, and other issues related to the adaptation of such an approach. Digital technology has great potential for facilitating the reduction of mental illness rates in populations. However, achieving this goal will require the implementation of new approaches. As a solution, we argue for the need to create outcome optimization teams, tasked with integrating data from various sources and using advanced data analytics and new designs to develop interventions/strategies to increase reach, uptake, use/engagement, and outcomes for both preventive and treatment interventions.
The association between urban or rural locality and hip fracture in community-based adults: A systematic review
Publisher: BMJ
Date: 19-08-2010
Abstract: Urban or rural locality has been suggested to influence musculoskeletal health, with lower bone mineral density (BMD) and greater prevalence of fracture identified in urban residents. A computer-aided search of Medline, EMBASE, CINAHL and PsychINFO, January 1966 to November 2007 was conducted to identify studies investigating the relationship between urban or rural locality and the occurrence of hip fracture. The methodological quality of studies was assessed, and a best-evidence synthesis was used to summarise the results. Fourteen cohort studies and one case-control study were identified for inclusion in this review, indicating a lack of literature in the field. Best-evidence analysis identified moderate evidence for residents of rural regions to have lower risk of hip fracture compared to urban residents. Examining principal mechanisms for the observed relationship between urban/rural locality and hip fracture, such as factors at the person or area level, may help to identify modifiable risk factors and inform appropriate prevention strategies.
Controlled trial of enalapril in patients with chronic fluid overload undergoing dialysis
Publisher: BMJ
Date: 16-04-1988
DOI: 10.1136/BMJ.296.6629.1089
Abstract: About one third of patients receiving dialysis for end stage renal failure have chronic fluid overload despite advice to restrict their oral fluid intake. To investigate the potential of an angiotensin converting enzyme inhibitor in reducing the urge to drink and consequent gain in weight, a double blind, placebo controlled crossover trial of enalapril was conducted in 25 patients receiving dialysis who had fluid overload. The trial comprised a baseline period of four weeks two periods of treatment, each of four weeks, during which patients received either placebo or enalapril 5 mg twice each week and a follow up period of four weeks. Five patients withdrew from the trial, one because of an adverse drug reaction to enalapril. A range of biochemical and behavioural variables was measured during the baseline period, at the completion of periods 1 and 2, and during follow up. These variables included gain in weight between dialysis sessions blood pressure plasma concentrations of sodium, angiotensin II, and vasopressin plasma renin and angiotensin converting enzyme activities osmolality and estimations of thirst, intake of fluid, and control of drinking. Enalapril caused a significant reduction in gain in weight between dialysis sessions, thirst, and oral intake of fluid in parallel with significantly increased renin activity, significantly decreased angiotensin converting enzyme activity, and decreased concentrations of angiotensin II. Gain in weight and angiotensin converting enzyme activity returned to baseline values once patients stopped taking enalapril. These results suggest that enalapril may act on the renin-angiotensin system and reduce intake of fluid by inhibiting angiotensin converting enzyme.
Effectiveness of a scalable group-based education and monitoring program, delivered by health workers, to improve control of hypertension in rural India: A cluster randomised controlled trial
Publisher: Public Library of Science (PLoS)
Date: 02-01-2020
Co-occurrence of diabetes and depression: Conceptual considerations for an emerging global health challenge
Publisher: Elsevier BV
Date: 10-2012
Controlled Trial of Psychological Intervention in Myocardial Infarction
Publisher: American Psychological Association (APA)
Date: 1985
Work related stress, burnout, job satisfaction and general health of nurses: A follow‐up study
Publisher: Wiley
Date: 30-05-2016
DOI: 10.1111/IJN.12455
Abstract: Nurses experience high levels of work related stress and burnout as well as low job satisfaction and poor general health owing to the nature of their work. This paper seeks to provide a better understanding of the nature of relationships between work related stress, burnout, job satisfaction and general health of nurses over one year. This study involved a longitudinal design. Two hundred and seventy seven nurses from four hospitals completed a follow up survey consisting of five questionnaires. Data were collected between 2013 and 2014. The data were analysed using generalized estimation equation analysis. Lack of support was associated with burnout, patient care was associated with job satisfaction and staff issues were associated with general health of nurses. Burnout is more strongly related to job satisfaction than general health. The findings of this study could inform evidence based policy and practice through interventions aimed at improving job satisfaction and reducing the impact of burnout on general health of nurses.
Functionality and Quality of Asthma mHealth Apps and Their Consistency With International Guidelines: Protocol for a Systematic Search and Evaluation of Mobile Apps (Preprint)
Publisher: JMIR Publications Inc.
Date: 24-08-2021
Abstract: sthma is a chronic respiratory disorder that requires long-term pharmacotherapy and patient empowerment to manage the condition and recognize and respond to asthma exacerbations. Mobile health (mHealth) apps represent a potential medium through which patients can improve their ability to self-manage their asthma. Few studies have conducted a systematic evaluation of asthma mobile apps for quality and functionality using a validated tool. None of these reviews have systematically assessed these apps for their content and evaluated them against the available international best practice guidelines. he objective of this study is to conduct a systematic search and evaluation of adult-targeted asthma mHealth apps. As part of this review, the potential of an mHealth app to improve asthma self-management and the overall quality of the app will be evaluated using the Mobile App Rating Scale framework, and the quality of the information within an app will be evaluated using the current Global Initiative for Asthma guidelines as a reference. stepwise methodological approach was taken in creating this review. First, the most recent Global Initiative for Asthma guidelines were independently reviewed by 2 authors to identify key recommendations that could be feasibly incorporated into an mHealth app. A previously developed asthma assessment framework was identified and was modified to suit our research and ensure that all of these identified recommendations were included. In total, 2 popular app stores were reviewed to identify potential mHealth apps. These apps were screened based on predefined inclusion and exclusion criteria. Suitable apps were then evaluated. Technical information was obtained from publicly available information. The next step was to perform an app quality assessment using the validated Mobile App Rating Scale framework to objectively determine the quality of an app. App functionality was assessed using the Intercontinental Medical Statistics Institute for Health Informatics Functionality Scoring System. Finally, the mHealth apps were assessed using our developed checklist. unding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the apps. The results of this study are expected in 2022. o our knowledge, this review represents the first study to examine all mHealth apps available in Australia that are targeted to adults with asthma for their functionality, quality, and consistency with international best practice guidelines. Although this review will only be conducted on mHealth apps available in Australia, many apps are available worldwide thus, this study should be largely generalizable to other English-speaking regions and users. The results of this review will help to fill gaps in the literature and assist clinicians in providing evidence-based advice to patients wishing to use mHealth apps as part of their asthma self-management. ROSPERO 269894 www.crd.york.ac.uk rospero/display_record.php?RecordID=269894 RR1-10.2196/33103
Cost-effectiveness of a coronary heart disease secondary prevention program in patients with myocardial infarction: results from a randomised controlled trial (ProActive Heart)
Publisher: Springer Science and Business Media LLC
Date: 05-2013
Impact of depression treatment on mental and physical health-related quality of life of cardiac patients: A meta-analysis
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2011
Sociodemographic factors associated with calcium intake in premenopausal women: a cross-sectional study
Publisher: Springer Science and Business Media LLC
Date: 19-01-2005
Abstract: To describe associations between sociodemographic factors and calcium intake in premenopausal women. Cross-sectional study. Population-based. A total of 467 randomly selected, predominantly Caucasian Tasmanian women aged 25-44 y, response rate 63%. calcium intake, sociodemographic factors, anthropometrics, osteoporosis knowledge and self-efficacy. Education level, calcium-specific osteoporosis knowledge and self-efficacy were all independently associated with calcium intake (P<0.05). The odds of achieving the recommended dietary intake for calcium increased with higher levels of calcium-specific self-efficacy and knowledge, and decreased in smokers or if the household's main financial provider was unemployed (P<0.05). Women who have lower levels of education, who are in households where the main financial provider is unemployed, who are smokers, and those with low levels of calcium-specific self-efficacy and knowledge are at risk of not achieving adequate calcium intake. This information will assist targeting of public health strategies aimed at improving the calcium intake of premenopausal women.
Mediators of change in physical activity following an intervention in primary care: PACE
Publisher: Elsevier BV
Date: 05-1997
Abstract: The current study evaluated the construct validity of a physical activity intervention in primary care by testing whether the intervention changed hypothesized mediators and whether changes in the mediators were associated with behavior change. Matched physician offices were nonrandomly assigned to intervention or control. Apparently healthy, sedentary, adult patients (N = 255) were recruited from physician offices. The intervention was brief, behaviorally based counseling by physicians, plus a telephone follow-up 2 weeks later. Assessments of physical activity and mediators were collected at baseline and at 4- to 6-week follow-up. Hypothesized mediators were processes of change, self-efficacy, and social support for exercise. Patients who were counseled improved significantly more than those in the control group on behavioral and cognitive processes of change. Other changes in mediators were nonsignificant. Behavioral processes of change and self-efficacy made significant contributions to the multiple regression model explaining self-report and objective measures of physical activity. The intervention affected some of the targeted mediators of physical activity change. Two of three mediator variables were associated with changes in physical activity regardless of experimental condition and other variables. The construct validity of the intervention was partially supported.
Prevention of chronic disease and the promotion of health. The contribution of behavioral medicine | Prävention chronischer krankheiten und gesundheitsförderung. Der beitrag der verhaltensmedizin
Publisher: Springer Science and Business Media LLC
Date: 12-2003
Prevention of type 2 diabetes and its complications in developing countries: A review
Publisher: Springer Science and Business Media LLC
Date: 18-05-2012
Neighborhood Disadvantage and Physical Activity: Baseline Results from the HABITAT Multilevel Longitudinal Study
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.ANNEPIDEM.2009.11.004
Abstract: To examine the association between neighborhood disadvantage and physical activity (PA). We use data from the HABITAT multilevel longitudinal study of PA among middle-aged (40-65 years) men and women (N = 11,037, 68.5% response rate) living in 200 neighborhoods in Brisbane, Australia. PA was measured using three questions from the Active Australia Survey (general walking, moderate, and vigorous activity), one indicator of total activity, and two questions about walking and cycling for transport. The PA measures were operationalized by using multiple categories based on time and estimated energy expenditure that were interpretable with reference to the latest PA recommendations. The association between neighborhood disadvantage and PA was examined with the use of multilevel multinomial logistic regression and Markov chain Monte Carlo simulation. The contribution of neighborhood disadvantage to between-neighborhood variation in PA was assessed using the 80% interval odds ratio. After adjustment for sex, age, living arrangement, education, occupation, and household income, reported participation in all measures and levels of PA varied significantly across Brisbane's neighborhoods, and neighborhood disadvantage accounted for some of this variation. Residents of advantaged neighborhoods reported significantly higher levels of total activity, general walking, moderate, and vigorous activity however, they were less likely to walk for transport. There was no statistically significant association between neighborhood disadvantage and cycling for transport. In terms of total PA, residents of advantaged neighborhoods were more likely to exceed PA recommendations. Neighborhoods may exert a contextual effect on the likelihood of residents participating in PA. The greater propensity of residents in advantaged neighborhoods to do high levels of total PA may contribute to lower rates of cardiovascular disease and obesity in these areas.
Randomised controlled trial of an automated, interactive telephone intervention to improve type 2 diabetes self-management (Telephone-Linked Care Diabetes Project): study protocol
Publisher: Springer Science and Business Media LLC
Date: 12-10-2010
Which presenteeism measures are more sensitive to depression and anxiety?
Publisher: Elsevier BV
Date: 08-2007
DOI: 10.1016/J.JAD.2006.10.024
Abstract: Lost productivity from attending work when unwell, or "presenteeism", is a largely hidden cost of mental disorders in the workplace. Sensitive measures are needed for clinical and policy applications, however there is no consensus on the optimal self-report measure to use. This paper examines the sensitivity of four alternative measures of presenteeism to depression and anxiety in an Australian employed cohort. A prospective single-group study in ten call centres examined the association of presenteeism (presenteeism days, inefficiency days, Work Limitations Questionnaire, Stanford Presenteeism Scale) with Patient Health Questionnaire depression and anxiety syndromes. At baseline, all presenteeism measures were sensitive to differences between those with (N=69) and without (N=363) depression/anxiety. Only the Work Limitations Questionnaire consistently showed worse productivity as depression severity increased, and sensitivity to remission and onset of depression/anxiety over the 6-month follow-up (N=231). There was some evidence of in idual depressive symptoms having a differential association with different types of job demands. The study findings may not generalise to other occupational settings with different job demands. We were unable to compare responders with non-responders at baseline due to anonymity. In this community s le the Work Limitations Questionnaire offered additional sensitivity to depression severity, change over time, and in idual symptoms. The comprehensive assessment of work performance offers significant advantages in demonstrating both the in idual and economic burden of common mental disorders, and the potential gains from early intervention and treatment.
Randomised controlled trial of a secondary prevention program for myocardial infarction patients ('ProActive Heart'): Study protocol. Secondary prevention program for myocardial infarction patients
Publisher: Springer Science and Business Media LLC
Date: 09-05-2009
Worksite physical activity interventions
Publisher: Elsevier BV
Date: 11-1998
DOI: 10.1016/S0749-3797(98)00077-4
Abstract: National objectives for public health have targeted worksite as important settings for interventions to increase physical activity. However, expert reviews reveal no scientific consensus about the effectiveness of worksite interventions for increasing physical activity or fitness. We judged the quantity and quality of existing evidence against scientific standards for the internal and external validity of the research design and the validity of measurements. Meta-analytic methods were used to quantify the size of effects expressed as Pearson correlation coefficients (r). Variation in effect was examined in relation to several features of the studies deemed important for implementing successful worksite interventions. Pre-experimental cohort studies were excluded because they are sensitive to secular trends in physical activity. Twenty-six studies involving nearly 9,000 subjects yielded 45 effects. The mean effect was heterogeneous and small, r = 0.11 (95% CI, -0.20 to 0.40), approximating 1/4 S.D., or an increase in binomial success rate from 50% to 56%. Although effects varied slightly according to some of the study features we examined, effects were heterogeneous within levels of these features. Hence, the moderating variables examined did not explain variation in the effects (P > 0.05). The exception was that effects were smaller in randomized studies compared with studies using quasi-experimental designs (P < 0.05). Our results indicate that the typical worksite intervention has yet to demonstrate a statistically significant increase in physical activity or fitness. The few studies that have used an exemplary s le, research design, and outcome measure have also yielded small or no effects. The generally poor scientific quality of the literature on this topic precludes the judgment that interventions at worksites cannot increase physical activity or fitness, but such an increase remains to be demonstrated by studies using valid research designs and measures.
Health promotion research and the diffusion and institutionalization of interventions
Publisher: Oxford University Press (OUP)
Date: 02-1999
DOI: 10.1093/HER/14.1.121
Abstract: To examine the extent to which health promotion research is providing an empirical basis for the diffusion and institutionalization of effective interventions, we conducted a systematic audit of all articles in 12 public health and health promotion journals for the 1994 calendar year. We identified empirical/non-empirical and health promotion/non-health promotion articles. For each study, the health behaviours or outcomes studied, the target group, gender and setting were categorized. Each study was also categorized as belonging to one of four stages: basic research and development, innovation development, diffusion research, and research into institutionalization or policy implementation. Of all articles coded (n = 1210), 33.9% were identified as non-research, 39.5% were health promotion research and 26.6% were non-health promotion research. The vast majority of studies fell within the basic research and development stage (89.6%), with less than 1% categorized as diffusion research and only 5% as institutionalization or policy implementation research. The published studies reviewed provide a limited empirical basis for diffusion and institutionalization of health promotion programs. These findings suggest a need to more systematically monitor research input (funding) and research output (publications), and to develop a more explicit focus on the relevance of the stages of research innovation and development, the issues and/or behaviours addressed, the target population, and the research setting.
Efficacy and feasibility of a tele-health intervention for acute coronary syndrome patients with depression: results of the MoodCare randomized controlled trial
Publisher: Oxford University Press (OUP)
Date: 26-02-2014
DOI: 10.1007/S12160-014-9592-0
Abstract: Depression is common after a cardiac event, yet there remain few approaches to management that are both effective and scalable. We aimed to evaluate the 6-month efficacy and feasibility of a tele-health program (MoodCare) that integrates depression management into a cardiovascular disease risk reduction program for acute coronary syndrome patients with low mood. A two-arm, parallel, randomized design was used comprising 121 patients admitted to one of six hospitals for acute coronary syndrome. Significant treatment effects were observed for Patient Health Questionnaire 9 (PHQ9) depression (mean difference [change] = -1.8 p = 0.025 effect size: d = 0.36) for the overall s le, when compared with usual medical care. Results were more pronounced effects for those with a history of depression (mean difference [change] = -2.7 p = 0.043 effect size: d = 0.65). MoodCare was effective for improving depression in acute coronary syndrome patients, producing effect sizes exceeding those of some face-to-face psychotherapeutic interventions and pharmacotherapy. ( ACTRN1260900038623.).
The socio-economic patterning of survey participation and non-response error in a multilevel study of food purchasing behaviour: Area- and individual-level characteristics
Publisher: Cambridge University Press (CUP)
Date: 04-2003
DOI: 10.1079/PHN2002415
Abstract: To undertake an assessment of survey participation and non-response error in a population-based study that examined the relationship between socio-economic position and food purchasing behaviour. The study was conducted in Brisbane City (Australia) in 2000. The s le was selected using a stratified two-stage cluster design. Respondents were recruited using a range of strategies that attempted to maximise the involvement of persons from disadvantaged backgrounds: respondents were contacted by personal visit and data were collected using home-based face-to-face interviews multiple call-backs on different days and at different times were used and a financial gratuity was provided. Non-institutionalised residents of private dwellings ( n = 1003), located in 50 small areas that differed in their socio-economic characteristics. Rates of survey participation – measured by non-contacts, exclusions, dropped cases, response rates and completions – were similar across areas, suggesting that residents of socio-economically advantaged and disadvantaged areas were equally likely to be recruited. In idual-level analysis, however, showed that respondents and non-respondents differed significantly in their sociodemographic and food purchasing characteristics: non-respondents were older, less educated and exhibited different purchasing behaviours. Misclassification bias probably accounted for the inconsistent pattern of association between the area- and in idual-level results. Estimates of bias due to non-response indicated that although respondents and non-respondents were qualitatively different, the magnitude of error associated with this differential was minimal. Socio-economic position measured at the in idual level is a strong and consistent predictor of survey non-participation. Future studies that set out to examine the relationship between socio-economic position and diet need to adopt s ling strategies and data collection methods that maximise the likelihood of recruiting participants from all points on the socio-economic spectrum, and particularly persons from disadvantaged backgrounds. Study designs that are not sensitive to the difficulties associated with recruiting a socio-economically representative s le are likely to produce biased estimates (underestimates) of socio-economic differences in the dietary outcome being investigated.
Resting Heart Rate and Heart Rate Variability in the Year Following Acute Coronary Syndrome: How Do Women Fare?
Publisher: Elsevier BV
Date: 2021
Measuring socio-economic position in dietary research: Is choice of socio-economic indicator important?
Publisher: Cambridge University Press (CUP)
Date: 04-2003
DOI: 10.1079/PHN2002416
Abstract: To examine the association between socio-economic position (SEP) and diet, by assessing the unadjusted and simultaneously adjusted (independent) contributions of education, occupation and household income to food purchasing behaviour The s le was randomly selected using a stratified two-stage cluster design, and the response rate was 66.4%. Data were collected by face-to-face interview. Food purchasing was examined on the basis of three composite indices that reflected a household's choice of grocery items (including meat and chicken), fruit and vegetables Brisbane City, Australia, 2000 Non-institutionalised residents of private dwellings ( n = 1003), located in 50 small areas (Census Collectors Districts) When shopping, respondents in lower socio-economic groups were less likely to purchase grocery foods that were high in fibre and low in fat, salt and sugar. Disadvantaged groups purchased fewer types of fresh fruits and vegetables, and less often, than their counterparts from more advantaged backgrounds. When the relationship between SEP and food purchasing was examined using each indicator separately, education and household income made an unadjusted contribution to purchasing behaviour for all three food indices however, occupation was significantly related only with the purchase of grocery foods. When education and occupation were simultaneously adjusted for each other, the socio-economic patterning with food purchase remained largely unchanged, although the strength of the associations was attenuated. When household income was introduced into the analysis, the association between education, occupation and food purchasing behaviour was diminished or became non-significant income, however, showed a strong, graded association with food choice The food purchasing behaviours of socio-economically disadvantaged groups were least in accord with dietary guideline recommendations, and hence are more consistent with greater risk for the development of diet-related disease. The use of separate indicators for education, occupation and household income each adds something unique to our understanding of how socio-economic position is related to diet: each indicator reflects a different underlying social process and hence they are not interchangeable, and do not serve as adequate proxies for one another
A systematic review of real-world diabetes prevention programs: learnings from the last 15 years
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Smartphone Cardiac Rehabilitation, Assisted Self-Management Versus Usual Care: Protocol for a Multicenter Randomized Controlled Trial to Compare Effects and Costs Among People With Coronary Heart Disease (Preprint)
Publisher: JMIR Publications Inc.
Date: 13-06-2019
Abstract: lternative evidence-based cardiac rehabilitation (CR) delivery models that overcome significant barriers to access and delivery are needed to address persistent low utilization. Models utilizing contemporary digital technologies could significantly improve reach and fidelity as complementary alternatives to traditional center-based programs. he aim of this study is to compare the effects and costs of the innovative i Smartphone Cardiac Rehabilitation, Assisted self-Management /i (SCRAM) intervention with usual care CR. n this investigator-, assessor-, and statistician-blinded parallel 2-arm randomized controlled trial, 220 adults (18+ years) with coronary heart disease are being recruited from 3 hospitals in metropolitan and regional Victoria, Australia. Participants are randomized (1:1) to receive advice to engage with usual care CR or the SCRAM intervention. SCRAM is a 24-week dual-phase intervention that includes 12 weeks of real-time remote exercise supervision and coaching from exercise physiologists, which is followed by 12 weeks of data-driven nonreal-time remote coaching via telephone. Both intervention phases include evidence- and theory-based multifactorial behavior change support delivered via smartphone push notifications. Outcomes assessed at baseline, 12 weeks, and 24 weeks include maximal aerobic exercise capacity (primary outcome at 24 weeks), modifiable cardiovascular risk factors, exercise adherence, secondary prevention self-management behaviors, health-related quality of life, and adverse events. Economic and process evaluations will determine cost-effectiveness and participant perceptions of the treatment arms, respectively. he trial was funded in November 2017 and received ethical approval in June 2018. Recruitment began in November 2018. As of September 2019, 54 participants have been randomized into the trial. he innovative multiphase SCRAM intervention delivers real-time remote exercise supervision and evidence-based self-management behavioral support to participants, regardless of their geographic proximity to traditional center-based CR facilities. Our trial will provide unique and valuable information about effects of SCRAM on outcomes associated with cardiac and all-cause mortality, as well as acceptability and cost-effectiveness. These findings will be important to inform health care providers about the potential for innovative program delivery models, such as SCRAM, to be implemented at scale, as a complement to existing CR programs. The inclusion of a cohort comprising metropolitan-, regional-, and rural-dwelling participants will help to understand the role of this delivery model across health care contexts with erse needs. ustralian New Zealand Clinical Trials Registry (ACTRN): 12618001458224 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374508. ERR1-10.2196/15022
Ethnic and socio-economic disparities in oral health outcomes and quality of life among Sri Lankan preschoolers: a cross-sectional study
Publisher: Springer Science and Business Media LLC
Date: 2013
A systematic review of the impact of work environment on smoking cessation, relapse and amount smoked
Publisher: Elsevier BV
Date: 10-2006
DOI: 10.1016/J.YPMED.2006.05.001
Abstract: Smoking is an important issue for the majority of the world's working population. It is important to explore in which ways the workplace might contribute to changes in smoking status and smoking behavior. The present article provides a systematic review and quality assessment of studies that have addressed the impact of factors in the work environment on smoking behavior. An evaluation of the methodological quality of 22 prospective studies was based on 14 explicit criteria, which included features of study design, statistical analysis, s ling issues and measurement. The level of scientific evidence was evaluated for each study. There was strong evidence for an effect of the work environment on the amount smoked, but insufficient or mixed evidence regarding cessation and relapse. Summarizing the results, high job demands were associated with higher amount smoked and with increased likelihood of cessation. Resources at work and social support were positively associated with cessation and negatively associated with relapse and the amount smoked. The results supported the overall hypothesis that the work environment influences aspects of smoking behavior. Recommendations are made for more intervention studies where changes in work environment are carried out in combination with health promotion interventions.
Effects of Bone Density Feedback and Group Education on Osteoporosis Knowledge and Osteoporosis Self-Efficacy in Premenopausal Women
Publisher: Elsevier BV
Date: 03-2005
DOI: 10.1385/JCD:8:1:095
Abstract: In this 2-yr randomized controlled trial, we examined the effect of bone mineral density feedback and two different educational interventions (an osteoporosis information leaflet and group-based behavioral education [OPSMC]) on osteoporosis knowledge and self-efficacy in 470 women aged 25-44 yr. Osteoporosis knowledge increased across all intervention groups. Women receiving the OPSMC had a greater increase in both short (beta = +1.33, 95% confidence interval [CI] = 0.72-1.94) and long-term (beta = +0.64, 95% CI = 0.0034-1.25) osteoporosis knowledge, compared to those receiving the leaflet. In contrast, a low T-score was associated with a significant increase in long-term (beta = +0.66, 95% CI = 0.0034-1.25) but not short-term (beta = +0.57, 95% CI = -0.036 to 1.17) osteoporosis knowledge, compared to a normal T-score. Changes in osteoporosis self-efficacy were not associated with either low bone mineral density or receiving the OPSMC but were negatively associated with number of children (beta = -0.9, 95% CI = - 1.4 to -0.3) and working more than 20 h per week (beta = -2.7, 95% CI = -4.6 to -0.8). In conclusion, both the OPSMC and bone density feedback increased osteoporosis knowledge but not self-efficacy over 2 yr. Women with children or who worked full time have decreased osteoporosis self-efficacy, suggesting that this group should be a specific target for future interventional strategies.
Health-related quality of life one month after thrombolysis or primary PCI in patients with ST-elevation infarction. A DANAMI-2 sub-study.
Publisher: Informa UK Limited
Date: 2005
DOI: 10.1080/14017430510035989
Abstract: To evaluate the health-related quality of life (HRQoL) following Primary percutaneous coronary intervention (PCI) or thrombolytic treatment for ST-elevation myocardial infarction (STEMI). A questionnaire based study on patients randomised in the DANAMI-2 study to Primary PCI or thrombolysis for STEMI. A total of 1 351 patients (93.2% response rate) randomised in the DANAMI-2 study completed the HRQoL questionnaire one month after the infarction. With respect to the primary end-points (SF-36 physical component score, angina pectoris, and dyspnoea), patients randomised to primary PCI scored better on the SF-36 physical component score (PCS) (p=0.007), and reported significantly less angina pectoris (p=0.010) and dyspnoea (p=0.010). Higher scores among PCI patients were also found on the SF-36 scales physical functioning (p=0.015), role-physical (p=0.017), and general health (p=0.009). The results in this study support the hypothesis that primary PCI is superior to thrombolysis in treating STEMI, not only in clinical outcome, but also in quality of life outcome.
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