Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 11 de 11
Filter
1.
Obes Sci Pract ; 10(2): e750, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38618520

ABSTRACT

Background: People with physical disabilities (PWD) have a higher prevalence of obesity than populations without disability, but most evidence-based weight loss programs have not included this population. The State of Slim (SOS) program is an evidence-based weight loss program that has demonstrated success in producing weight loss in populations without disability, but it has not been adapted for or evaluated in PWD. Methods: The SOS program was systematically adapted using the evidence-informed Guidelines, Recommendations, and Adaptations Including Disability (GRAIDs) framework. A total of 35 participants enrolled in the State of Slim Everybody program. The program was offered entirely online. Body weight, attendance, and food log completion were also tracked weekly. The program length was 16.5 h and included weekly group instruction, with optional one-on-one sessions provided upon request. Following completion, participants completed post-evaluation surveys on overall satisfaction with the program. The primary outcomes were program effectiveness (i.e., body weight), usability, and feasibility. Results: Thirty-two out of 35 participants completed the program, representing a retention rate of 91.4%. Average weight loss was 10.9% (9.9 ± 0.7 kg (t (31) = -13.3, p =< 0.0001)). On a 1 (dissatisfied/completely useless) to 5 (very satisfied/completely helpful) Likert scale, the average score for overall program satisfaction was 4.8 ± 0.1 and program helpfulness 4.6 ± 0.1. Conclusion: The State of Slim Everybody program demonstrated significant weight loss and good usability and feasibility in PWD. Existing adaptation frameworks can be used to create inclusive health promotion programs for adults with physical disabilities.

2.
Disabil Health J ; 17(2): 101577, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38184471

ABSTRACT

BACKGROUND: The Centers for Disease Control and Prevention (CDC) funds a quality improvement (QI) health promotion telewellness program for adults with physical disabilities. OBJECTIVE: The nutrition component of the parent program, Mindfulness, Exercise, and Nutrition to Optimize Resilience (MENTOR) program, from 2020 to 2021, was evaluated to assess changes in nutrition knowledge of people with physical disabilities. METHODS: This was a quasi-experimental program evaluation by pre-post survey of participating adults with physical disabilities. Participants attended weekly nutrition classes for eight weeks with optional one-on-one counseling with a Registered Dietitian. Participants completed pre-post General Nutrition Knowledge Questionnaire Revised (GNKQ-R) that were analyzed using paired t-tests. Participants were grouped into quartiles by pre-program GNKQ-R scores for additional comparisons. Program attendance and post-program feedback were also evaluated. RESULTS: A total of 286 participants completed the MENTOR program, and 31% (n = 89) completed pre-post questionnaires for data analysis. Mean pre-program GNKQ-R scores were 58.4 ± 15.1 and post scores were 64.4 ± 11.3, which demonstrated a statistically significant improvement in nutrition knowledge (p < .001). Ancillary analysis revealed that participants with the lowest quartile of pre-program nutrition knowledge had the greatest improvements in their post-GNKQ-R scores (Mean change 16.4 ± 13.9). Questionnaire data revealed participants' subjective knowledge changes and their feedback on the nutrition component of the program. CONCLUSIONS: The eight-week MENTOR program effectively improved nutrition knowledge among people with physical disabilities. This demonstrates the impact the program can have on individual knowledge levels. Additionally, these results support the implementation of the program to the broader population of people with disabilities.


Subject(s)
Disabled Persons , Mindfulness , Resilience, Psychological , Adult , Humans , Program Evaluation , Mentors
3.
Disabil Health J ; 16(3): 101447, 2023 07.
Article in English | MEDLINE | ID: mdl-36841678

ABSTRACT

BACKGROUND: Practitioners and researchers often adapt tools, practices, and programs to meet the needs of culturally diverse population groups, but do not consider populations with disability. While there is some research on guidelines for adapting evidence-based programs, there is no systematic process for adapting survey instruments. Rather than creating separate instruments for people with physical disabilities (PWD), it is critical that instruments are designed to capture data on people with and without disabilities for comparison purposes. Given the disproportionately high rates of physical inactivity and obesity in PWD, we developed a methodology to adapt an evidence-based physical activity instrument. OBJECTIVE: To create a methodology to adapt surveys to be inclusive of PWD and use the methodology to adapt an evidence-based physical activity survey. METHODS: A framework was developed to adapt a physical activity survey instrument (International Physical Activity Questionnaire, IPAQ) to be inclusive of PWD. The framework, referred to as SAVe-IT, includes five steps: Step 1) Select survey instrument to adapt; Step 2) Adapt the survey instrument; Step 3) Verify adaptations with experts; Step 4) Implement pilot test; Step 5) Test the tool to confirm reliability. RESULTS: The adapted IPAQ passed review by the expert panels and the pilot test (n = 20). Assessment of test-retest reliability (n = 30) yielded strong intraclass correlation coefficients of 0.950 for the total score for the whole sample, 0.950 for PWD (n = 15) and 0.952 for people without disability (n = 15). CONCLUSIONS: The SAVe-IT framework resulted in the successful adaptation of the IPAQ and can be used in populations with and without physical disabilities.


Subject(s)
Disabled Persons , Humans , Reproducibility of Results , Exercise , Surveys and Questionnaires , Obesity
4.
J Appl Gerontol ; 42(1): 131-140, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36062816

ABSTRACT

Objectives: The purpose of this qualitative study was to explore factors associated with the ability of people with PD to perform food-related activities (FRAs). Methods: Eleven dyads, older adults with Parkinson disease (PD) and their care-partners (n = 22), completed virtual semi-structured interviews guided by the Social Cognitive Theory (SCT) that were independently analyzed by two coders via directed content analysis. Results: The following themes were identified-(1) Personal: perception of a healthy diet, perception of how nutrition influences PD, confidence in following a healthy diet, and barriers to performing FRA; (2) Environmental: previous sources of nutrition information and willingness to changing their diet with a registered dietitian; and (3) Behavioral: modifications to FRA due to food-medication interactions, and skills necessary to maintain a healthy diet. Discussion: Findings from this study highlight the need for nutrition intervention research to inform evidence-based guidelines in order to provide tailored education for people with PD and care-partners.


Subject(s)
Parkinson Disease , Humans , Aged , Parkinson Disease/psychology , Qualitative Research , Diet , Diet, Healthy , Nutritional Status
5.
Article in English | MEDLINE | ID: mdl-36142014

ABSTRACT

OBJECTIVE: The purpose of this mixed methods study was to explore the impact of COVID-19 on the ability of people with Parkinson disease (PwPs) and their care-partners to perform food-related activities (FRA) and PwPs' overall diet quality. METHODS: Using a convergent parallel mixed methods design, PwPs and their care-partners completed virtual dyadic semi-structured interviews about their FRA during the COVID-19 pandemic. PwPs completed Food Frequency Questionnaires (FFQ) to quantify their dietary intake in the previous 12 months. Qualitative data were analyzed by two coders using thematic analysis, and quantitative data from FFQs were descriptively analyzed to calculate diet quality scores. RESULTS: Eleven dyadic interviews revealed the following key themes: cooking more at home; changes with grocery shopping; less meals with non-household members. These changes were described to increase the care-partners' responsibilities and overall burden. Diet scores among PwPs were 73.0 ± 6.3 for the Healthy Eating Index 2015 (scale of 0-100), 29.2 ± 6.6 for the Mediterranean diet (scale of 0-55), and 10.4 ± 1.8 for the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet (scale 0-15). CONCLUSIONS: Diet scores revealed that PwPs consumed a high-quality diet during the pandemic. Findings from this study highlight the need for tailored nutrition education to support PwPs' care-partners.


Subject(s)
COVID-19 , Diet, Mediterranean , Parkinson Disease , COVID-19/epidemiology , Diet , Feeding Behavior , Humans , Meals , Pandemics , Parkinson Disease/epidemiology
6.
Clin Nutr ; 40(6): 4085-4089, 2021 06.
Article in English | MEDLINE | ID: mdl-33640204

ABSTRACT

BACKGROUND & AIMS: The visceral adiposity index (VAI) has been shown to be a reliable estimate of visceral adiposity, but little is known about its association with specific dietary patterns such as the Dietary Approaches to Stop Hypertension (DASH) diet, particularly in older adults. Many studies have shown the DASH diet to be beneficial for cardiometabolic health. The purpose of this study was to investigate the relationship between DASH diet scores and the VAI in older adults using a nationally representative dataset. METHODS: Using the National Health and Nutrition Examination Surveys (NHANES) from 2011 to 2014, data from 508 community-dwelling older adults were examined, and dietary intake was evaluated using the Dixon's DASH diet index. Using multiple linear regression analysis, the relationship between VAI and DASH diet score was assessed while controlling for demographic variables. RESULTS: Participants' average DASH diet score was 2.41 (SE = 0.07), and the average VAI was 1.55 (SE = 0.08). The results suggest a significant inverse relationship between the DASH diet and VAI (ß = -0.19, t = -2.73, p = 0.009). CONCLUSIONS: Results of this study suggest that protective properties of the DASH diet pattern may be due in part to its inverse relationship with visceral adiposity. This information supports practitioners' use of the VAI with older adults in addition to providing nutrition counseling with the DASH diet to reduce patients' cardiometabolic risk.


Subject(s)
Dietary Approaches To Stop Hypertension/statistics & numerical data , Health Status Indicators , Intra-Abdominal Fat/physiopathology , Obesity, Abdominal/diagnosis , Obesity, Abdominal/prevention & control , Adiposity , Aged , Anthropometry , Female , Humans , Independent Living/statistics & numerical data , Linear Models , Male , Nutrition Surveys
7.
Gerontologist ; 61(4): 552-562, 2021 06 02.
Article in English | MEDLINE | ID: mdl-33000128

ABSTRACT

BACKGROUND AND OBJECTIVES: In long-term care facilities in the United States, certified nursing assistants (CNAs) provide mealtime assistance to residents with dementia, a task that substantially increases caregiver burden due to the time and attention required. The aim of this qualitative study was to explore the individual and interpersonal barriers and facilitators CNAs experience when providing mealtime assistance to residents with dementia. RESEARCH DESIGN AND METHODS: Focus group questions were developed based on the corresponding levels of the Social Ecological Model. Using purposive sampling, 9 focus groups were conducted with 53 CNAs who had at least 1 year of experience as a CNA working with older adults. Focus groups were audio-recorded and transcribed verbatim. Data were analyzed using the directed content analysis approach. RESULTS: CNAs reported individual skills, training, and personal characteristics that affected their ability to provide mealtime assistance. At the interpersonal level, CNAs identified their relationships with residents, residents' family members, and other health care professionals as factors that affect their ability to provide mealtime assistance. DISCUSSION AND IMPLICATIONS: These findings provide evidence for strategies that administrators can utilize to reduce caregiver burden by improving the mealtime experience. First, CNAs need adequate training, particularly to develop communication skills. Developing verbal communication skills may improve interpersonal relationships between CNAs and residents' family members and other coworkers. Developing nonverbal communication skills may foster an improved relationship between CNAs and their residents with dementia. Future research should evaluate interventions that seek to improve these skills to determine their impact on the mealtime experience.


Subject(s)
Dementia , Nursing Assistants , Aged , Communication , Humans , Meals , Nursing Homes , United States
8.
South Med J ; 112(12): 621-625, 2019 12.
Article in English | MEDLINE | ID: mdl-31796973

ABSTRACT

OBJECTIVES: To assess the present use of dietary supplements among the Parkinson disease (PD) population and to determine which dietary supplements are most commonly taken. METHODS: This cross-sectional study used an online questionnaire that was administered to individuals with PD via support group Web sites. Dietary supplement users also were asked whether they spoke with a healthcare professional about their supplement use. RESULTS: Of the 205 respondents, 83.4% reported taking at least 1 dietary supplement. Although 94 different types of dietary supplements were identified, >50% of participants taking dietary supplements took multivitamins, vitamin D, and vitamin B12 (52.6%, 74.3%, and 56.1%, respectively). Respondents reported taking coenzyme Q10, Mucuna pruriens, folate, vitamin B12, vitamin B6, melatonin, and N-acetylcysteine most commonly for PD. Among supplement users, 29.2% did not discuss their supplement use with a healthcare practitioner. CONCLUSIONS: The results of this study demonstrate a high prevalence of dietary supplement use among individuals with PD, in addition to a wide variety of supplements being taken. This study's findings also indicate the need for better dialog between patients and healthcare practitioners regarding the use of dietary supplements.


Subject(s)
Dietary Supplements/statistics & numerical data , Parkinson Disease/epidemiology , Self Medication/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , United States/epidemiology , Vitamins/administration & dosage
9.
Health Aff (Millwood) ; 28(1): 46-56, 2009.
Article in English | MEDLINE | ID: mdl-19124853

ABSTRACT

This paper presents findings about weight management programs at the workplace, and employers' and employees' views about these programs. Data are from a survey of 505 randomly selected public and private employers with fifty or more employees, and a survey of 1,352 households with employer-based insurance. The majority of employers with 5,000 or more workers offer programs such as on-site exercise facilities, nutritional counseling, and health risk appraisals, whereas sizable minorities of smaller employers offer them. Employers and employees view weight management programs as appropriate and effective. Employers want programs to pay for themselves, whereas employees are willing to pay higher premiums for them.


Subject(s)
Attitude to Health , Obesity , Occupational Health , Adolescent , Adult , Female , Health Promotion , Humans , Interviews as Topic , Male , Middle Aged , Young Adult
10.
Health Aff (Millwood) ; 27(3): 711-7, 2008.
Article in English | MEDLINE | ID: mdl-18474962

ABSTRACT

The United States appears headed toward another national debate about health system reform. Worry about access and health system deficiencies has reached critical mass, and polls indicate that health care leads the domestic agenda for the 2008 elections. This debate, like previous debates, will succeed or fail in Congress. We highlight key elements of recent sagas in health legislation and offer advice to the next president and Congress for improving the likelihood of a successful outcome in 2009-10: (1) make health reform a top legislative priority; (2) be leaders, not partisans; and (3) develop broad policy consensus but leave the policy details to Congress.


Subject(s)
Health Care Reform/legislation & jurisprudence , Consensus , Health Care Reform/history , Health Care Reform/organization & administration , Health Priorities , History, 20th Century , History, 21st Century , Humans , Leadership , United States
11.
Health Aff (Millwood) ; 26(5): 1358-65, 2007.
Article in English | MEDLINE | ID: mdl-17848446

ABSTRACT

In an environment of limited resources, the question of who is deserving and undeserving of assistance becomes critical. Policymakers' biases about whether a health condition is self-inflicted, as well as their perceptions about whether treatments are truly effective, play a major role--often unstated--in the allocation of resources.


Subject(s)
Attitude of Health Personnel , Health Behavior , Health Services Accessibility , Public Health Administration , Resource Allocation , Risk-Taking , Vulnerable Populations/psychology , Attitude to Health , Decision Making, Organizational , Health Priorities , Humans , Social Values , United States
SELECTION OF CITATIONS
SEARCH DETAIL
...