ABSTRACT
BACKGROUND: Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. SUBJECTS/METHODS: The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35â kg/m(2) with comorbidity or ≥40â kg/m(2) without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6â months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. RESULTS: Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135â kg (BMI=49.1â kg/m(2)) with 87.2% of patients having a BMI≥40â kg/m(2) and 12.4% with BMI≥60â kg/m(2). The mean weight change of all patients enrolled was -4.1â kg (95% CI -3.6 to -4.6â kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving -5.5â kg (95% CI -4.2 to -6.2â kg, p=0.0001) and non-completers achieving -2.3â kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss. CONCLUSIONS: The SLiM programme is an effective group intervention for the management of severe and complex obesity.
Subject(s)
Cognitive Behavioral Therapy/methods , Feeding Behavior , Motor Activity , Obesity/therapy , Patient Education as Topic/methods , Self Care/methods , Adult , Behavior Therapy/methods , Cohort Studies , Female , History, Ancient , Humans , Middle Aged , Psychotherapy, Group , Treatment Outcome , Weight Reduction ProgramsABSTRACT
OBJECTIVES: To raise middle school student awareness, attitudes, and proactive behaviors about immunization, and to increase immunization rates among middle school students through implementation of a comprehensive integrated immunization promotion curriculum (Immunization Plus!) METHODS: Evaluation used a quasi-experimental non-equivalent comparison-groups design conducted in a sample of 40 classrooms in 22 schools in California. RESULTS: Sixth-grade students exposed to the curriculum developed more positive knowledge and attitudes, and were more likely to be immunized, to intend to obtain newly required immunizations, and to tell parents about immunizations. CONCLUSION: Infectious disease control and immunizations are under-developed subject areas within school-based health promotion in the United States that can be effectively taught to middle school students.
Subject(s)
Communicable Diseases/immunology , Health Behavior , Health Education , Immunization , Schools , Adolescent , Attitude to Health , Awareness , Cognition , Curriculum , Humans , Preventive Health Services/organization & administration , Surveys and QuestionnairesABSTRACT
Disaggregated data, vital statistics, and a comprehensive literature review were used to assess the relationship between Hawaiian maternal predictors and infant health outcomes. Despite near universal health care coverage, Hawaiians continue to use less prenatal care, have average rates of low birth weight and the highest infant mortality rates compared to other ethnic groups in Hawaii. Specific investigations and interventions are necessary to reduce the disparity of Hawaiian infant health outcomes.
