10 research outputs found
Preliminary effects and acceptability of a co-produced physical activity referral intervention
Objectives: To explore the preliminary effects and acceptability of a co-produced physical activity referral intervention.
Study Design: Longitudinal design with data collected at baseline and post a 12-week physical activity referral intervention.
Setting. Community leisure centre.
Methods: 32 adults with controlled lifestyle-related health conditions took part in a physical activity referral intervention (co-produced by a multidisciplinary stakeholder group) comprising 12 weeksâ subsidised fitness centre access plus four behaviour change consultations. A complete case analysis (t-tests and magnitude-based inferences) was conducted to assess baseline-to-12-week change in physical activity, cardiometabolic, and psychological measures. Semi-structured interviews were conducted (n=12) to explore experiences of the intervention.
Results: Mean improvements were observed in cardiorespiratory fitness-2 (3.6 ml.kg.-1min-1 (95% confidence interval 1.9 to 5.4) P<0.001) and moderate-to-vigorous physical activity (12.6 min.day (95% CI 4.3 to 29.6) P=0.013). Participants were positive about the support from exercise referral practitioners, but experienced some challenges in a busy and under staffed gym environment.
Conclusions: A co-produced physical activity referral intervention elicited short-term improvements in physical activity and cardiometabolic health. Further refinements may be required, via ongoing feedback between stakeholders, researchers and service users, to achieve the intended holistic physical activity focus of the intervention, prior to a definitive trial
Use of intervention mapping to adapt a health behavior change intervention for endometrial cancer survivors: The shape-up following cancer treatment program
Background: About 80% of endometrial cancer survivors (ECS) are overweight or obese and have sedentary behaviors. Lifestyle behavior interventions are promising for improving dietary and physical activity behaviors, but the constructs associated with their effectiveness are often inadequately reported. The aim of this study was to systematically adapt an evidence-based behavior change program to improve healthy lifestyle behaviors in ECS. Methods: Following a review of the literature, focus groups and interviews were conducted with ECS (n = 16). An intervention mapping protocol was used for the program adaptation, which consisted of six steps: a needs assessment, formulation of matrices of change objectives, selection of theoretical methods and practical applications, program production, adoption and implementation planning, and evaluation planning. Social Cognitive Theory and Control Theory guided the adaptation of the intervention. Results: The process consisted of eight 90-min group sessions focusing on shaping outcome expectations, knowledge, self-efficacy, and goals about healthy eating and physical activity. The adapted performance objectives included establishment of regular eating, balanced diet, and portion sizes, reduction in sedentary behaviors, increase in lifestyle and organized activities, formulation of a discrepancy-reducing feedback loop for all above behaviors, and trigger management. Information on managing fatigue and bowel issues unique to ECS were added. Conclusions: Systematic intervention mapping provided a framework to design a cancer survivor-centered lifestyle intervention. ECS welcomed the intervention and provided essential feedback for its adaptation. The program has been evaluated through a randomized controlled trial
The impact of buprenorphine and methadone on mortality:a primary care cohort study in the United Kingdom
AIMS: To estimate whether opioid substitution treatment (OST) with buprenorphine or methadone is associated with a greater reduction in the risk of all-cause mortality (ACM) and opioid drug-related poisoning (DRP) mortality.
DESIGN: Cohort study with linkage between clinical records from Clinical Practice Research Datalink and mortality register.
PARTICIPANTS: A total of 11â033 opioid-dependent patients in the UK who received OST from 1998 to 2014, followed-up for 30â410 person-years.
MEASUREMENTS: Exposure to methadone (17â373, 61%) OST episodes or buprenorphine (9173, 39%) OST episodes. ACM was available for all patients; information on cause of death and DRP was available for 5935 patients (54%) followed-up for 16â363 person-years. Poisson regression modelled mortality by treatment period with an interaction between OST type and treatment period (first 4Â weeks on OST, rest of time off OST, first 4Â weeks off OST, rest of time out of OST censored at 12Â months) to test whether ACM or DRP differed between methadone and buprenorphine. Inverse probability weights were included to adjust for confounding and balance characteristics of patients prescribed methadone or buprenorphine.
FINDINGS: ACM and DRP rates were 1.93 and 0.53 per 100 person-years, respectively. DRP was elevated during the first 4Â weeks of OST [incidence rate ratio (IRR)Â =Â 1.93 95% confidence interval (CI)Â =Â 0.97-3.82], the first 4Â weeks off OST (IRRÂ =Â 8.15, 95% CIÂ =Â 5.45-12.19) and the rest of time out of OST (IRRÂ =Â 2.13, 95% CIÂ =Â 1.47-3.09) compared with mortality risk from 4Â weeks to end of treatment. Patients on buprenorphine compared with methadone had lower ACM rates in each treatment period. After adjustment, there was evidence of a lower DRP risk for patients on buprenorphine compared with methadone at treatment initiation (IRRÂ =Â 0.08, 95% CIÂ =Â 0.01-0.48) and rest of time on treatment (IRRÂ =Â 0.37, 95% CIÂ =Â 0.17-0.79). Treatment duration (mean and median) was shorter on buprenorphine than methadone (173 and 40 versus 363 and 111, respectively). Model estimates suggest that there was a low probability that methadone or buprenorphine reduced the number of DRP in the population: 28 and 21%, respectively.
CONCLUSIONS: In UK general medical practice, opioid substitution treatment with buprenorphine is associated with a lower risk of all-cause and drug-related poisoning mortality than methadone. In the population, buprenorphine is unlikely to give greater overall protection because of the relatively shorter duration of treatment
Interdental cleaning and periodontal pocketing among finnish adults
Abstract
Aim: To investigate the relationship between frequency of interdental cleaning and 11âyear change in teeth with periodontal pocketing in Finnish adults.
Methods: Data from 1667 dentate adults, aged 30 to 82 years, who participated in the Health 2000 survey and were reâexamined in 2004 and/or 2011 were analysed. Participants reported their frequency of interdental cleaning (either dental floss or interdental brush) at baseline. Teeth with periodontal pocketing (PD) â„4 mm were counted in every survey and treated as a repeated outcome. The association between the frequency of interdental cleaning and the number of teeth with PD â„4 mm was evaluated in linear mixed effects models, controlling for demographic factors, socioeconomic position, diabetes, smoking status, toothbrushing frequency, dental attendance and number of teeth.
Results: Twelve per cent of adults reported daily interdental cleaning. Significant inverse linear trends in the number of teeth with PD â„4 mm were found in every survey according to the frequency of interdental cleaning. However, this association was completely attenuated after adjustment for the full set of confounders. Contrarily, toothbrushing frequency was negatively associated with the baseline number of teeth with PD â„4 mm and its rate of change over time.
Conclusion: Interdental cleaning was not associated with 11âyear change in periodontal pocketing after accounting for other established risk factors for periodontal disease