On preventive blood pressure self-monitoring at home

Self-monitoring activities are increasingly becoming part of people’s everyday lives. Some of these measurements are taken voluntarily rather than being referred by a physician and conducted because of either a preventive health interest or to better understand the body and its functions (the so-called Quantified Self). In this article, we explore socio-technical complexities that may occur when introducing preventive health-measurement technologies into older adults’ daily routines and everyday lives. In particular, the original study investigated blood pressure (BP) measurement in non-clinical settings, to understand existing challenges, and uncover opportunities for self-monitoring technologies to support preventive healthcare activities among older adults. From our study, several important aspects emerged to consider when designing preventive self-monitoring technology, such as the complexity of guidelines for self-measuring, the importance of interpretation, understanding and health awareness, sharing self-monitoring information for prevention, various motivational factors, the role of the doctor in prevention, and the home as a distributed information space. An awareness of these aspects can help designers to develop better tools to support people’s preventive self-monitoring needs, compared to existing solutions. Supporting the active and informed individual can help improve people’s self-care, awareness, and implementation of preventive care. Based on our study, we also reflect on the findings to illustrate how these aspects can both inform people engaged in Quantified Self activities and designers alike, and the tools and approaches that have sprung from the so-called Quantified Self movement

Social media for health promotion and weight management: A critical debate

© 2018 The Author(s). Background: In 2016 an estimated 1.9 billion adults world-wide were either overweight or obese. The health consequences of obesity are responsible for 2.8 million preventable deaths per year. The WHO now considers obesity as a global epidemic and recommends population-wide health promotion strategies to address this issue. Weight gain is caused by increased energy intake and physical inactivity, so treatment should focus on changes to behaviour regarding diet and physical activity. Discussion: The WHO has also recognised the importance of social resources as a valuable agent for behaviour change in health promotion. Social resources are translated at the community level as support provided by significant others such as family, partners and peers, in the form of information, material aid and encouragement. Social support has been shown to improve health and well-being, whereas social isolation has been shown to have a negative impact on health outcomes. Social support provided by peers has been shown to be a useful strategy to employ in weight management programmes. The documented increased use of ICT and social media has presented health promoters with a potentially useful medium to increase social support for weight management. Conclusion: While the use of social media for health promotion is an emerging field of investigation, preliminary research suggests that it increases participant engagement, and may provide a cost-effective tool to provide social support for individuals participating in weight management programmes. With stringent privacy protocols in place, social media may be a useful, cost-effective accompaniment to multifactorial weight management programmes. However more research is needed to identify how to make the best use of social media as health promotion tool

Physical activity levels in adults and older adults 3–4 years after pedometer-based walking interventions: Long-term follow-up of participants from two randomised controlled trials in UK primary care

Background Physical inactivity is an important cause of noncommunicable diseases. Interventions can increase short-term physical activity (PA), but health benefits require maintenance. Few interventions have evaluated PA objectively beyond 12 months. We followed up two pedometer interventions with positive 12-month effects to examine objective PA levels at 3–4 years. Methods and findings Long-term follow-up of two completed trials: Pedometer And Consultation Evaluation-UP (PACE-UP) 3-arm (postal, nurse support, control) at 3 years and Pedometer Accelerometer Consultation Evaluation-Lift (PACE-Lift) 2-arm (nurse support, control) at 4 years post-baseline. Randomly selected patients from 10 United Kingdom primary care practices were recruited (PACE-UP: 45–75 years, PACE-Lift: 60–75 years). Intervention arms received 12-week walking programmes (pedometer, handbooks, PA diaries) postally (PACE-UP) or with nurse support (PACE-UP, PACE-Lift). Main outcomes were changes in 7-day accelerometer average daily step counts and weekly time in moderate-to-vigorous PA (MVPA) in ≥10-minute bouts in intervention versus control groups, between baseline and 3 years (PACE-UP) and 4 years (PACE-Lift). PACE-UP 3-year follow-up was 67% (681/1,023) (mean age: 59, 64% female), and PACE-Lift 4-year follow-up was 76% (225/298) (mean age: 67, 53% female). PACE-UP 3-year intervention versus control comparisons were as follows: additional steps/day postal +627 (95% CI: 198–1,056), p = 0.004, nurse +670 (95% CI: 237–1,102), p = 0.002; total weekly MVPA in bouts (minutes/week) postal +28 (95% CI: 7–49), p = 0.009, nurse +24 (95% CI: 3–45), p = 0.03. PACE-Lift 4-year intervention versus control comparisons were: +407 (95% CI: −177–992), p = 0.17 steps/day, and +32 (95% CI: 5–60), p = 0.02 minutes/week MVPA in bouts. Neither trial showed sedentary or wear-time differences. Main study limitation was incomplete follow-up; however, results were robust to missing data sensitivity analyses. Conclusions Intervention participants followed up from both trials demonstrated higher levels of objectively measured PA at 3–4 years than controls, similar to previously reported 12-month trial effects. Pedometer interventions, delivered by post or with nurse support, can help address the public health physical inactivity challenge

Nutrient intake in the GEICO multicenter trial: The effects of a multicomponent worksite intervention

Background/objectives: To assess the effects on macro- and micronutrient intake of a nutrition intervention program in corporate settings across the United States. Subjects/methods: Two hundred and ninety-two individuals who were overweight or had type 2 diabetes were recruited from 10 sites of a US insurance company. Two hundred and seventy-one participants completed baseline diet recalls, and 183 participants completed dietary recalls at 18 weeks. Sites were randomly assigned to an intervention group (five sites) or to a control group (five sites) for 18 weeks. At intervention sites, participants were asked to follow a low-fat vegan diet and attend weekly group meetings. At control sites, participants continued their usual diets. At baseline and 18 weeks, participants completed 2-day diet recalls. Between-group differences in changes in nutrient intake were assessed using an analysis of covariance. Results: Compared with those in the control group, intervention-group participants significantly reduced the reported intake of total fat (P=0.02), saturated (P=0.006) and monounsaturated fats (P=0.01), cholesterol (P=0.009), protein (P=0.03) and calcium (P=0.02), and increased the intake of carbohydrate (P=0.006), fiber (P=0.002), β-carotene (P=0.01), vitamin C (P=0.003), magnesium (P=0.04) and potassium (P=0.002). Conclusions: An 18-week intervention program in a corporate setting reduces intake of total fat, saturated fat and cholesterol and increases the intake of protective nutrients, particularly fiber, β-carotene, vitamin C, magnesium and potassium. The reduction in calcium intake indicates the need for planning for this nutrient