The Use of Telehealth Technology in Assessing the Accuracy of Self-Reported Weight and the Impact of a Daily Immediate-Feedback Intervention among Obese Employees

Objective. To determine the accuracy of self-reported body weight prior to and following a weight loss intervention including daily self-weighing among obese employees. Methods. As part of a 6-month randomized controlled trial including a no-treatment control group, an intervention group received a series of coaching calls, daily self-weighing, and interactive telemonitoring. The primary outcome variable was the absolute discrepancy between self-reported and measured body weight at baseline and at 6 months. We used general linear mixed model regression to estimate changes and differences between study groups over time. Results. At baseline, study participants underreported their weight by an average of 2.06 (se = 0.33) lbs. The intervention group self-reported a smaller absolute body weight discrepancy at followup than the control group. Conclusions. The discrepancy between self-reported and measured body weight appears to be relatively small, may be improved through daily self-monitoring using immediate-feedback telehealth technology, and negligibly impacts change in body weight

Regional surveillance of medically-attended farm-related injuries in children and adolescents

PurposeDue to numerous environmental hazards such as heavy machinery and large livestock, youth who live and work on farms are at high risk of injury, disability, and death. This study described a regional surveillance system for monitoring farm-related injuries in children and adolescents. As the risk of farm-related injuries are not exclusive to farm residents, trends in farm-related injuries over the previous 5 years were reported and compared between children/adolescents who did and did not live on farms in north-central Wisconsin.MethodsA retrospective cohort of child and adolescent patients of the Marshfield Clinic Health System was assembled. Incident farm-related injuries, including from agricultural work or other activities in a farm environment, were extracted from medical records from 2017 through 2021. Generalized linear models were created to compare age- and sex-adjusted farm-related injury rates by year.ResultsThere were 4,730 (5%) in-farm and 93,420 (95%) out-farm children and adolescents in the cohort. There were 65 incident farm-related injury cases in the in-farm group and 412 in the out-farm group. The annual incidence rate of farm-related injuries was higher in the in-farm group, but changes during the 5-year timeframe were not significant in either group. In the in-farm group, rates ranged from a high of 61.8 [95% confidence interval (CI): 38.3, 94.5] incident farm-related injuries per 10,000 children/adolescents in 2017 to a low of 28.2 (13.5, 51.9) injuries per 10,000 children/adolescents in 2018. In the out-farm group, rates ranged from 10.7 (8.3, 13.6) to 16.8 (13.7, 20.5) incident farm-related injuries per 10,000 children/adolescents per year between 2017 and 2021. The in-farm group had a higher proportion of injured males and heavy machinery injuries, while the out-farm group had more all-terrain vehicle injuries and pesticide poisonings.ConclusionFarm residency remains hazardous for children and adolescents, as injury rates were three times higher in the in-farm group and remained stable over 5 years. All-terrain vehicle injuries were high in both groups, and should be a priority in rural safety interventions. With additional adaptations to other states, this surveillance model could be scaled across other healthcare systems

Trends in Incidence of Hospitalized Acute Myocardial Infarction in the Cardiovascular Research Network (CVRN)

Monitoring trends in cardiovascular events can provide key insights into the effectiveness of prevention efforts. Leveraging data from electronic health records provides a unique opportunity to examine contemporary, community-based trends in acute myocardial infarction hospitalizations

Physical activity, self-weighing, and absenteeism in a worksite weight physical activity, self-weighing, and absenteeism in a worksite weight gain prevention intervention: the healthWorks trial.

University of Minnesota Ph.D. dissertation. January 2011. Major: Epidemiology. Advisors: Jennifer A. Linde, PhD, & Robert W. Jeffery, PhD. 1 computer file (PDF); xi, 90 pages, appendix A.INTRODUCTION: Rising obesity rates are a threat to the American public's health. To date, however, few studies have used an environment focused weight gain prevention intervention approach, which is arguably more appropriate than individual weight loss counseling interventions. The HealthWorks trial recently implemented a worksite environment intervention (e.g., modifications to cafeterias/vending, activity social environment) aimed at reducing weight gain over two years among adults. METHODS: This dissertation includes three secondary data analyses from the broader HealthWorks trial in order to: (1) determine if baseline physical activity level is associated with enrollment in worksite walking club events, (2) assess if self-weighing frequency is associated with weight maintenance, and (3) assess if weight change is associated with workplace absenteeism. Physical activity and self-weighing were two of the key lifestyle changes targeted in the HealthWorks trial and reduced workplace absenteeism was one of the economic outcomes believed to result from a successful intervention. Six worksites (N=1,747 individuals) were randomized to either a treatment or control arm. Multivariate regression models were used for all analyses. RESULTS: In paper #1, baseline physical activity level was not a significant predictor of worksite walking club participation, but several covariates (i.e., age, sex, social support, worksite) remained in the final models as significant predictors. In paper #2, there was a significant interaction between follow-up self-weighing frequency and baseline BMI category. Specifically, adjusted weight change ranged from a mean±SE -4.5±0.8 kg among obese daily self-weighers to 2.2±0.4 kg for participants at a healthy BMI who reported self-weighing monthly or less. In paper #3, weight change was not a significant predictor of workplace absenteeism, but several covariates (i.e., sex, depression, smoking, BMI) remained in the final models as significant predictors of workplace absenteeism. CONCLUSIONS: The collective findings suggest that over two years: (1) worksite walking clubs are generally appealing across varying levels of physical activity, (2) self-weighing may be most beneficial for obese individuals who increase their self-weighing frequency over time, and (3) weight loss may not meaningfully decrease workplace illness absence days. More intense efforts on the primary prevention of weight gain that decreases the proportion of newly obese employees, perhaps via broad-based physical activity programs and stronger emphases on frequent self-weighing, may be necessary to achieve long-term weight change and economic benefits for employers

The Impact of Regular Self-weighing on Weight Management: A Systematic Literature Review

<p>Abstract</p> <p>Background</p> <p>Regular self-weighing has been a focus of attention recently in the obesity literature. It has received conflicting endorsement in that some researchers and practitioners recommend it as a key behavioral strategy for weight management, while others caution against its use due to its potential to cause negative psychological consequences associated with weight management failure. The evidence on frequent self-weighing, however, has not yet been synthesized. The purpose of this paper is to evaluate the evidence regarding the use of regular self-weighing for both weight loss and weight maintenance.</p> <p>Methods</p> <p>A systematic literature review was conducted using the MEDLINE, CINAHL, and PsycINFO online databases. Reviewed studies were broken down by sample characteristics, predictors/conditions, dependent measures, findings, and evidence grade.</p> <p>Results</p> <p>Twelve studies met the inclusion/exclusion criteria, but nearly half received low evidence grades in terms of methodological quality. Findings from 11 of the 12 reviewed studies indicated that more frequent self-weighing was associated with greater weight loss or weight gain prevention. Specifically, individuals who reported self-weighing weekly or daily, typically over a period of several months, held a 1 to 3 kg/m²(current) advantage over individuals who did not self-weigh frequently. The effects of self-weighing in experimental studies, especially those where self-weighing behaviors could be isolated, were less clear.</p> <p>Conclusion</p> <p>Based on the consistency of the evidence reviewed, frequent self-weighing, at the very least, seems to be a good predictor of moderate weight loss, less weight regain, or the avoidance of initial weight gain in adults. More targeted research is needed in this area to determine the causal role of frequent self-weighing in weight loss/weight gain prevention programs. Other open questions to be pursued include the optimal dose of self-weighing, as well as the risks posed for negative psychological consequences.</p

Accuracy of ICD-9-CM codes in identifying infections of pneumonia and herpes simplex virus in administrative data

Clinical epidemiology studies increasingly rely on electronic medical records data. The validity of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes is crucial as they are often used to identify conditions of interest. We evaluated the use of archived ICD-9-CM codes to identify two representative infection-related conditions, pneumonia and herpes simplex virus (HSV), in a defined health system. Records were obtained for a sample of 175 and 179 patients with ICD-9-CM codes for pneumonia and HSV, respectively. An adjudicated case status was assigned for each subject. The presence of a single ICD-9-CM code had a positive predictive value of 88% for pneumonia and 86% for HSV. False positives (noncases) accounted for less than 10% of records evaluated for each condition. Our study demonstrates that ICD-9-CM codes for pneumonia and HSV were valid markers of a true history of these conditions, suggesting that ICD-9-CM codes can be used to successfully identify infection-related conditions in epidemiologic studies. However, validation studies for individual conditions may help identify condition-specific strategies to improve the performance of diagnostic codes