The Breathe Easier through Weight Loss Lifestyle (BE WELL) Intervention: A randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Obesity and asthma have reached epidemic proportions in the US. Their concurrent rise over the last 30 years suggests that they may be connected. Numerous observational studies support a temporally-correct, dose-response relationship between body mass index (BMI) and incident asthma. Weight loss, either induced by surgery or caloric restriction, has been reported to improve asthma symptoms and lung function. Due to methodological shortcomings of previous studies, however, well-controlled trials are needed to investigate the efficacy of weight loss strategies to improve asthma control in obese individuals.</p> <p>Methods/Design</p> <p>BE WELL is a 2-arm parallel randomized clinical trial (RCT) of the efficacy of an evidence-based, comprehensive, behavioral weight loss intervention, focusing on diet, physical activity, and behavioral therapy, as adjunct therapy to usual care in the management of asthma in obese adults. Trial participants (n = 324) are patients aged 18 to 70 years who have suboptimally controlled, persistent asthma, BMI between 30.0 and 44.9 kg/m², and who do not have serious comorbidities (e.g., diabetes, heart disease, stroke). The 12-month weight loss intervention to be studied is based on the principles of the highly successful Diabetes Prevention Program lifestyle intervention. Intervention participants will attend 13 weekly group sessions over a four-month period, followed by two monthly individual sessions, and will then receive individualized counseling primarily by phone, at least bi-monthly, for the remainder of the intervention. Follow-up assessment will occur at six and 12 months. The primary outcome variable is the overall score on the Juniper Asthma Control Questionnaire measured at 12 months. Secondary outcomes include lung function, asthma-specific and general quality of life, asthma medication use, asthma-related and total health care utilization. Potential mediators (e.g., weight loss and change in physical activity level and nutrient intake) and moderators (e.g., socio-demographic characteristics and comorbidities) of the intervention effects also will be examined.</p> <p>Discussion</p> <p>This RCT holds considerable potential for illuminating the nature of the obesity-asthma relationship and advancing current guidelines for treating obese adults with asthma, which may lead to reduced morbidity and mortality related to the comorbidity of the two disorders.</p> <p>Trial registration</p> <p>NCT00901095</p

MHealth resources for asthma and pregnancy care: methodological issues and social media recruitment. A discussion paper

A discussion of methodological issues and social media recruitment to a feasibility study to investigate mHealth resources for asthma and pregnancy care

Overcoming barriers faced by smokers in quitting cigarettes & a portfolio of professional practice

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A good day's work : a guide for tobacco-free work sites in Arizona

abstract: For employers, employees and community support programs to implement tobacco-free work sites. Presents information on procedures and policies, and community, state, and national level programs

EXHALE : a technical package to control asthma (resource document)

The EXHALE technical package represents a group of strategies, which, based on the best available evidence, can improve asthma control and reduce health care costs. It is intended as a resource to inform decision-making in communities, organizations, and states.E - Education on asthma self-managementX - X-tinguishing smoking and secondhand smokeH - Home visits for trigger reduction and asthma self- management educationA - Achievement of guidelines-based medical managementL - Linkages and coordination of care across settingsE - Environmental policies or best practices to reduce asthma triggers from indoor, outdoor, and occupational sourceSuggested citation: Hsu J, Sircar K, Herman E, Garbe P. (2018). EXHALE: A Technical Package to Control Asthma. Atlanta, GA: National Center for Environmental Health, Centers for Disease Control and Prevention.EXHALE_technical_package-508.pdf2018702

Practice Characteristics That Matter In the Provision of Health Education Services By Primary Care Physicians

The onset of chronic disease is occurring earlier and more often in the lives of adult citizens of the United States. The literature has effectively demonstrated the efficacy that physician provision of health education services offers their patients and the positive effects it has for lowering risk factors for chronic disease. The literature has described the complexities physicians encounter in providing these services. The literature is not as plentiful in defining and describing the characteristics of physician practice that are associated with increased health education provision. This study is an analysis of the factors that are associated with provision of health education by primary care physicians in their offices. For this study, three years of the National Ambulatory Care Medical Care Survey, (NAMCS) are used for analysis. Selected factors germane to physician practice are analyzed for their effects on three risk factors for chronic disease; tobacco use, lack of exercise and obesity. The study findings show that use of electronic health record systems are associated with increased odds of providing health education services over non automated physician practices. Physicians of private group practices offer health education services less often than physicians in federally qualified health centers. Use of e mail, telephone conferences, and whether the physician received Allopathic or osteopathic training was not associated with provision of health education. The study is relevant because of the need for a re-engineering of the financial and structural systems of physician practice that pre-empt offering health education in physician practice. Factors identified in this study, should be important considerations in the design of a new physician payment system that will incentivize physicians to include evidenced based health education as essential component of primary care delivery

Health of children and young people in secure settings

This small-scale descriptive study was commissioned by the Children and Young People's Public Health team within the Department of Health, in partnership with Offender Health, in order to inform preparation and implementation of an Offender Health Strategy document for children and young people. The overall aim was to review what is currently known about healthcare for children and young people in the secure estate, covering all three types of settings (Young Offender Institution, Secure Training Centre and Secure Children's Home) and all aspects of health, but with a particular focus on physical health since more is already known about mental health and substance misuse among young people in secure settings