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The Chronic Conditions Care Collaborative (4C Collaborative): A Platform for Improving Diabetes and Heart Disease Outcomes in Rural South Carolina 慢性病护理合作组织(4C 合作组织):改善南卡罗来纳州农村地区糖尿病和心脏病治疗效果的平台
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 DOI: 10.1177/15598276241268266
Brittney Grant, Jennifer Mandelbaum, Khristian Curry, Kristian Myers, Michele James, Courtney Brightharp, Shauna Hicks
Rural U.S. counties experience racial, geographic, and socioeconomic disparities in chronic diseases. Collaborations among stakeholders in rural areas are needed to make measurable changes in health care outcomes in South Carolina. The Chronic Conditions Care Collaborative (4C Collaborative) was developed to provide an opportunity for health care teams in medically underserved areas of South Carolina to convene to improve diabetes and heart disease outcomes. The 4C Collaborative was a quality improvement (QI) learning collaborative focused on the identification of patients with undiagnosed hypertension, team-based care through medication therapy management (MTM), and diabetes management. All QI work was approached through a health equity lens. Fifteen medical practices across two cohorts participated in the 4C Collaborative and gained access to more than 35 hours of educational content and guided action steps to create systemic changes specific to the needs of their patient population. Participation also conferred access to one-on-one technical assistance with faculty subject-matter experts. The activities within the 4C Collaborative allowed health care practices to identify areas of improvement within their practices and test improvement strategies through Plan-Do-Study-Act (PDSA) cycles. Best practices and lessons learned from learning collaborative participants were compiled into storyboards and presented during end of program celebrations.
美国农村地区在慢性疾病方面存在种族、地域和社会经济差异。要使南卡罗来纳州的医疗保健成果发生可衡量的变化,需要农村地区利益相关者之间的合作。慢性病护理合作组织(4C Collaborative)的成立,为南卡罗来纳州医疗服务不足地区的医疗团队提供了一个召开会议的机会,以改善糖尿病和心脏病的治疗效果。4C 协作组织是一个质量改进(QI)学习协作组织,重点关注未确诊高血压患者的识别、通过药物治疗管理(MTM)进行的团队护理以及糖尿病管理。所有质量改进工作都从健康公平的角度出发。两个组别的 15 家医疗机构参加了 4C 协作项目,并获得了超过 35 小时的教育内容和指导行动步骤,以针对其患者群体的需求进行系统性改革。参与活动还能获得教员主题专家提供的一对一技术援助。4C 协作计划中的活动使医疗实践得以确定其实践中需要改进的领域,并通过 "计划-实施-研究-行动"(PDSA)循环测试改进策略。学习合作计划参与者的最佳实践和经验教训被汇编成故事板,并在计划结束庆祝活动上进行展示。
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引用次数: 0
A Comparative Survey on Daily Health Habits Among iPhone and Android Smartphone Users iPhone 和 Android 智能手机用户日常健康习惯比较调查
IF 1.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-27 DOI: 10.1177/15598276241268195
Matthias N. Ungerer, Christoph Gumbinger
Background: With the increasing use of smartphone-based lifestyle interventions, it is important to understand whether people’s preferred operating system (iOS or Android) is linked to their lifestyle habits. Purpose: Our goal was to determine whether the choice of an iOS- or Android-powered smartphone independently affected daily health habits. Methods: We recruited participants for an online survey using the CloudResearch® Connect™ platform. The survey collected basic sociodemographic data, information on the participant’s primary smartphone operating system, and the HLPCQ to estimate daily health habits. Results: Of the 195 participants, 54.4% identified as Android users. We found that iOS users tended to be younger, had higher estimated annual household incomes, and had higher levels of education. However, we found no statistically significant link between the operating system and the HLPCQ total score or any of its subscales. Instead, age, employment status, and estimated annual household income were found to be more strongly associated with daily health habits. Conclusion: This study did not find a significant association between the smartphone operating system and daily health habits as measured by the HLPCQ. The findings suggest that future smartphone-based lifestyle interventions should instead focus on established sociodemographic factors linked to lifestyle habits.
背景:随着基于智能手机的生活方式干预措施的使用越来越多,了解人们偏好的操作系统(iOS 或 Android)是否与他们的生活习惯有关非常重要。目的:我们的目标是确定选择 iOS 或 Android 系统的智能手机是否会独立影响日常健康习惯。调查方法我们使用 CloudResearch® Connect™ 平台招募参与者进行在线调查。调查收集了基本社会人口学数据、参与者的主要智能手机操作系统信息以及用于评估日常健康习惯的 HLPCQ。调查结果显示在 195 名参与者中,54.4% 为安卓用户。我们发现,iOS 用户往往更年轻、家庭年收入更高、受教育程度更高。然而,我们发现操作系统与 HLPCQ 总分或其任何分量表之间没有统计学意义上的显著联系。相反,我们发现年龄、就业状况和估计家庭年收入与日常健康习惯的关系更为密切。结论本研究没有发现智能手机操作系统与 HLPCQ 测定的日常健康习惯之间有明显的关联。研究结果表明,未来基于智能手机的生活方式干预应侧重于与生活习惯相关的既定社会人口因素。
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引用次数: 0
Physical Activity Habits Among Physicians: Data From the Athens Medical Association 医生的体育锻炼习惯:来自雅典医学协会的数据
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-26 DOI: 10.1177/15598276241267213
Stamatios Lampsas, Georgios Marinos, Dimitrios Lambrinos, Panagiotis Theofilis, Ioannis Gialamas, Panteleimon Pantelidis, George E Zakynthinos, Vasiliki Kalogera, Sotirios Pililis, Emmanouil Korakas, Vaia Lambadiari, Kostas A. Papavassiliou, Evangelos Oikonomou, Gerasimos Siasos
Background: Physicians’ exercise habits vary across different medical specialties and health service infrastructure. We assessed physicians’ exercise performance according to the recommendations of the 2020 European Society of Cardiology Guidelines. Methods: This cross-sectional study comprised 742 physicians of the Athens Medical Association (AMA), Greece. Utilizing a self-administered questionnaire, physicians’ exercise habits, demographics, specialty, and infrastructure [Hellenic National Health care System (HNHS) or Private System (PS)] were assessed. Subjects were categorized: Moderate-intensity weekly exercise ≥150 min. (Group A); Moderate-intensity weekly exercise <150 min. (Group B). Results: 53.4% of AMA members met the recommended exercise criteria, averaging 240 ± 285 min./week. Significant differences were noted between Group A and B in male sex (58.3% vs 43.1%, P < 0.001), Body Mass Index (24.7 ± 3.8 kg/m2 vs 26.2 ± 4.7 kg/m2, P < 0.001), Smoking (17.4% vs 23.5%, P = 0.04), Diabetes Mellitus (6.6% vs 11.8%, P = 0.01), and activity monitoring wearables usage (45.2% vs 29.8%, P < 0.001). Significantly more doctors in the PS categorized in Group A ( P = 0.008). After adjustment for confounders, HNHS reported 33% decreased odds of achieving the exercise recommendations compared to PS (Odds Ratio: 0.676; 95% CI: 0.484-0.943, P = 0.03). Conclusion: Several factors affect adherence of AMA members to exercise goals. HNHS AMA doctors are less adherent to exercise recommendations, emphasizing the need to strengthen prevention strategies.
背景:在不同的医学专业和医疗服务基础设施中,医生的运动习惯各不相同。我们根据《2020 年欧洲心脏病学会指南》的建议对医生的运动表现进行了评估。研究方法这项横断面研究由希腊雅典医学协会 (AMA) 的 742 名医生组成。通过自填式问卷,对医生的运动习惯、人口统计学、专业和基础设施[希腊国家医疗保健系统(HNHS)或私人系统(PS)]进行了评估。受试者被分为每周中等强度运动≥150 分钟(A 组);每周中等强度运动 <150 分钟(B 组)。结果显示53.4%的AMA成员符合推荐的运动标准,平均每周运动时间为240±285分钟。A 组和 B 组在男性(58.3% vs 43.1%,P < 0.001)、体重指数(24.7 ± 3.8 kg/m2 vs 26.2 ± 4.7 kg/m2,P < 0.001)、吸烟(17.4% vs 23.5%,P = 0.04)、糖尿病(6.6% vs 11.8%,P = 0.01)和活动监测可穿戴设备使用率(45.2% vs 29.8%,P < 0.001)方面存在显著差异。在 PS 分类中,A 组的医生人数明显较多(P = 0.008)。在对混杂因素进行调整后,与 PS 相比,HNHS 实现运动建议的几率降低了 33%(Odds Ratio:0.676;95% CI:0.484-0.943,P = 0.03)。结论:有几个因素会影响亚美游会员对运动目标的坚持。HNHS 的全美医生对运动建议的坚持程度较低,这强调了加强预防策略的必要性。
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引用次数: 0
Safe-Guarding Youth from Online Sexual Exploitation in the Digital Era: A Role for Primary Care 在数字时代保护青少年免受网络性剥削:初级保健的作用
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-26 DOI: 10.1177/15598276241268236
Bree A. Zeyzus Johns, Allison R. Casola, Olivia Rea, Neil Skolnik, Susan K. Fidler
Online child sexual exploitation refers to the use of technology to sexually exploit or harm a person under age 18. In 2020, over 21.7 million reports of online child sexual enticement were filed with law enforcement, highlighting the alarming prevalence of this form of exploitation. This phenomenon has become increasingly prevalent in recent years due increased household internet access to the internet, the increased use of smartphones among children and teens, and the rapid expansion of new technological platforms such as live-streaming and gaming. Despite its risk and prevalence, this form of sexual abuse against children is largely underrepresented in the medical literature, with no formal screening or reporting guidelines for primary care physicians. This paper aims to define online child sexual exploitation, explore its health impacts, identify associated risk factors, and emphasize the pivotal role of primary care physicians in screening and counseling youth. By shedding light on this issue, we strive to address the critical need for safe-guarding the well-being of children and adolescents in an increasingly digital age.
网上儿童性剥削是指利用技术对 18 岁以下的人进行性剥削或伤害。2020 年,执法部门收到了超过 2170 万份关于网上儿童性诱骗的报告,凸显了这种剥削形式的惊人普遍性。近年来,由于家庭互联网接入的增加、儿童和青少年使用智能手机的增多,以及直播和游戏等新技术平台的迅速扩张,这种现象变得越来越普遍。尽管这种形式的儿童性虐待具有一定的风险性和普遍性,但医学文献中对这种形式的儿童性虐待的报道却很少,也没有针对初级保健医生的正式筛查或报告指南。本文旨在定义网络儿童性剥削,探讨其对健康的影响,识别相关风险因素,并强调初级保健医生在筛查和咨询青少年方面的关键作用。通过揭示这一问题,我们努力满足在日益数字化的时代保护儿童和青少年福祉的迫切需要。
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引用次数: 0
The Walking and Lifestyle Coaching (WALC) Program for University Students: A Pilot Study 大学生步行和生活方式指导 (WALC) 计划:试点研究
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-24 DOI: 10.1177/15598276241266783
Allyssa Cole, Francesca Corrales, Emily Stone, Duke Biber
Background: The purpose of this study was to evaluate the implementation of the 3-week Walking and Lifestyle Coaching (WALC) program with university college students to promote health behavior change and reduce chronic disease risk. Methods: During the 3-week WALC program, students received weekly peer health and wellness coaching while engaging in a 30-minute walk throughout campus. Each week, physical activity was directly measured using pedometers, and self-report physical activity behavior, steps, and daily reflections were reported using a self-monitoring journal. At baseline and follow-up, students completed biometrics screening, mental health questionnaires, and the Cooper 1.5 mile walk test to evaluate cardiovascular fitness. Results: A total of 35 college students participated in the WALC program. The mean daily steps number of steps during the WALC program was 6315 ( SD = 2073.16). Only 25/35 participants reported steps for the entire WALC program (71.43%). There was not a statistically significant difference in generalized anxiety, perceived stress, depression, quality of life, or self-compassion. There was a slight decline in body fat percentage, although not statistically significant. There was an average improvement of 89 seconds on the 1.5-mile walk/run test. Discussion: The WALC program was developed to be inclusive, feasible, and a mechanism to synergize campus resources to collaborate on behalf of student wellness. It is necessary for this program to be utilized on university campuses in diverse geographical regions (i.e., rural, urban, or suburban), with diverse students (i.e., racially, ethnically, gender-identity, and religious affiliation.), and with universities of all sizes and funding levels. Future research could consider the use of a control group as well as an online self-monitoring journal.
研究背景本研究旨在评估为期 3 周的 "步行和生活方式指导(WALC)"计划在大学生中的实施情况,以促进健康行为改变并降低慢性病风险。研究方法在为期 3 周的 WALC 计划中,学生们每周都会接受同伴健康和保健指导,同时在校园内进行 30 分钟的步行。每周使用计步器直接测量体力活动,并使用自我监测日记报告自我报告的体力活动行为、步数和每日反思。在基线和后续阶段,学生们完成了生物统计筛查、心理健康问卷调查以及库珀 1.5 英里步行测试,以评估心血管健康状况。结果共有 35 名大学生参加了 WALC 计划。在 WALC 计划期间,平均每日步数为 6315 步(标准差 = 2073.16)。在整个 WALC 计划期间,只有 25/35 的参与者报告了自己的步数(71.43%)。在普遍焦虑、感知压力、抑郁、生活质量或自我同情方面,没有统计学意义上的显著差异。体脂率略有下降,但无统计学意义。1.5 英里步行/跑步测试平均提高了 89 秒。讨论WALC 计划的制定具有包容性和可行性,是一种协同校园资源,共同促进学生健康的机制。该计划有必要在不同地理区域(如农村、城市或郊区)、不同学生(如种族、民族、性别认同和宗教信仰)以及不同规模和资金水平的大学校园中推广。未来的研究可以考虑使用对照组和在线自我监控日志。
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引用次数: 0
Barriers and Enablers to Maintaining Behaviour Changes Following a Lifestyle Intervention for Adults With Type 2 Diabetes 成人 2 型糖尿病患者在接受生活方式干预后保持行为改变的障碍和促进因素
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-23 DOI: 10.1177/15598276241262721
Genevieve N. Healy, Ana D. Goode, Lucy Campbell, Amit Sikder, Denis Giguere, Sjaan R. Gomersall
AimTo explore short-term barriers and enablers to maintaining behaviour changes in adults with type 2 diabetes who had completed a lifestyle behaviour change program.MethodsFocus groups with 44 participants identified barriers and enablers at the end-of-program (n = 8 groups: anticipated); and, 1-month post-program (n = 6 groups: experienced). Thematic inductive analysis was undertaken independently by two authors, discussed, then deductively grouped according to the Capability (physical, psychological), Opportunity (physical, social), Motivation (automatic, reflective) – Behaviour (COM-B) model.ResultsNine barriers were identified: two anticipated, one experienced, and six common to both timepoints. Key barriers related to physical capability (health ability), physical opportunity (difficulty accessing and using resources), social opportunity (unwillingness to invest in social networks), and reflective motivation (lack of internal drive). Eleven enablers were identified: all across both timepoints. Key enablers related to psychological capability (knowledge), physical opportunity (access and use of program resources), social opportunity (sense of belonging and safety within the program), automatic motivation (beliefs and awareness around perceived risk; monitoring of progress), and reflective motivation (committed to change).DiscussionFindings suggest diabetes management programs should enable ongoing access to their resources. Investing in mechanisms to scaffold program graduates into suitable community-based activities may also be beneficial.
目的 探讨已完成生活方式行为改变计划的 2 型糖尿病成人患者在保持行为改变方面的短期障碍和促进因素。方法 44 名参与者参加的焦点小组确定了计划结束时(8 组:预期)和计划结束后 1 个月(6 组:经历)的障碍和促进因素。两位作者独立进行了专题归纳分析、讨论,然后根据能力(身体、心理)、机会(身体、社会)、动机(自动、反思)-行为(COM-B)模型进行演绎分组。主要障碍涉及身体能力(健康能力)、物质机会(难以获得和使用资源)、社会机会(不愿投资于社会网络)和反思动机(缺乏内驱力)。在这两个时间点上共发现了 11 个促进因素。主要的促进因素涉及心理能力(知识)、实际机会(获取和使用项目资源)、社会机会(在项目中的归属感和安全感)、自动动机(关于感知风险的信念和意识;监测进展)和反思动机(致力于改变)。研究结果表明,糖尿病管理项目应能让患者持续获得其资源,投资建立机制以帮助项目毕业生参加合适的社区活动也可能是有益的。
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引用次数: 0
Prediabetes, Physical Activity, and Primary Care Providers 糖尿病前期、体育锻炼和初级保健提供者
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-22 DOI: 10.1177/15598276241264739
Bryant J. Webber
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引用次数: 0
Improving Medical Student Access to Nutrition During the Core Surgery Clerkship 改善医学生在核心外科实习期间获得营养的机会
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-20 DOI: 10.1177/15598276241261646
Blake M. Hauser, Matthew Parsons, Besmira Alija, Christine Kim, Andrew Nguyen, Joy Moses, Sierra Tseng, Christopher Alba, Kniya Dédé, Megan Gimmen, Evelyn Lemus Silva, Diviya Rajesh, Lily Mirfakhraie, Alan Z. Yang, Meghan Ariagno, Kelly Moutsioulis, Erin Reilly, Reza Askari, Nancy L. Cho, Amy Evenson, Arundhati Ghosh, Sophia McKinley, Roy Phitayakorn, Beth Frates
The rigorous demands of medical education create circumstances that can make it challenging to maintain a healthy diet. Evaluations from students at an urban medical school in the northeast U.S. regarding their surgery clerkship highlighted the difficulty of finding healthy snacks or meals between operations and patient care obligations. In response, we implemented the Nutritional Wellness Initiative, a pilot program designed to offer accessible, healthy snacks to medical students during their surgery clerkship. We conducted a 3-month pilot program at three hospital sites and surveyed participants. Responses were compared to controls who completed their surgery rotation before initiation of the pilot program. Both groups emphasized the importance of having access to food during the workday for student wellness, with less than 50% of students in either group eating lunch daily during the surgery rotation. Of students who participated in the pilot program, 63% used the provided snacks at least once per week. This model offers one approach to improving student access to nutritious snacks during the busy surgery workday. To improve our program going forward, we have engaged the Director of Lifestyle Medicine and Wellness in the Department of Surgery to help optimize nutritional delivery and to create student education resources regarding healthy snacking habits and choices.
医学教育的严格要求会给保持健康饮食带来挑战。美国东北部一所城市医学院的学生对外科实习的评价突出表明,在手术和病人护理之间很难找到健康的零食或正餐。为此,我们实施了 "营养健康计划"(Nutritional Wellness Initiative),该试点计划旨在为医学生在外科实习期间提供方便、健康的零食。我们在三家医院开展了为期 3 个月的试点计划,并对参与者进行了调查。我们将参与者的回答与在试点计划启动前完成外科轮转的对照组进行了比较。两组学生都强调了在工作日获得食物对学生健康的重要性,而在两组学生中,只有不到50%的学生在外科轮转期间每天吃午餐。在参与试点计划的学生中,63% 的学生每周至少使用一次提供的小吃。这种模式为改善学生在繁忙的外科工作日获得营养小吃提供了一种方法。为了改进我们的计划,我们已经聘请了外科部的生活方式医学和健康主任来帮助优化营养供应,并创建有关健康零食习惯和选择的学生教育资源。
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引用次数: 0
Prescribe Movement Outside 规定户外运动
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-19 DOI: 10.1177/15598276241265282
John La Puma
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引用次数: 0
Regular Physical Activity: A Key to Healthy Living and an Indispensable Pillar of Lifestyle Medicine 有规律的体育锻炼:健康生活的关键和生活方式医学不可或缺的支柱
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-19 DOI: 10.1177/15598276241263790
James M. Rippe
Individuals who choose to be inactive accept the same increased risk of heart disease as individuals who smoke a pack of cigarettes a day! Unfortunately, between 11%-15% of the adult population still smoke a pack of cigarettes a day, whereas, 60%-80% of adults are either not adequately active or completely inactive. Thus, inactivity carries the same risk as smoking a pack of cigarettes per day and is between 4-5 times more prevalent!
选择不运动的人与每天抽一包烟的人一样,都会增加患心脏病的风险!不幸的是,11%-15% 的成年人仍然每天抽一包烟,而 60%-80% 的成年人要么活动不足,要么完全不活动。因此,不运动所带来的风险与每天吸一包烟的风险相同,而且是吸烟风险的 4-5 倍!
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引用次数: 0
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American Journal of Lifestyle Medicine
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