Background: Implementation of physical activity (PA) initiatives within the scope of Primary Health Care (PHC) is still a challenge for the field of public health. It is necessary to consolidate operational processes to promote PA in the daily lives of patients in PHC. The use of implementation science has significant potential for advancing PA initiatives.
View Article and Find Full Text PDFBackground: The presence of chronic conditions such as type 2 diabetes mellitus (T2DM) requires behavioral lifestyle changes mediated by individuals' motivation for change and adherence to treatment. This study aims to explore activation levels in individuals with T2DM treated in primary care facilities and to identify the association between demographic, clinical, psychosocial factors, and patient activation amongst populations in the Brazilian state of Amazonas.
Methods: SAPPA is a cross-sectional study conducted in Amazonas, approved by the Universidade Federal do Amazona's IRB in Brazil.
Objective: To evaluate the effectiveness of two technology-enhanced interventions for diabetes prevention among adults at risk for developing diabetes in a primary care setting.
Methods: The DiaBEAT-it study employed a hybrid 2-group preference (Choice) and 3-group randomized controlled (RCT) design. This paper presents weight related primary outcomes of the RCT arm.
Objective: To examine changes in cardiovascular disease (CVD) risk outcomes of overweight/obese adults with prediabetes.
Methods: Using data from a randomized control trial of digital diabetes prevention program (d-DPP) with 599 participants. We applied the atherosclerotic CVD (ASCVD) risk calculator to predict 10-year CVD risk for d-DPP and small education (comparison) groups.
Background: A conservative physiotherapy service development addressed to treat urinary incontinence for older women was studied using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework.
Design: We conducted a pragmatic case study design based on RE-AIM.
Settings/participants: Included women ≥ 60 years of age, with self-reported UI symptoms.
Front Public Health
September 2022
Introduction: The effective translation of evidence-based interventions has contributed to implementing actions that impact public policies and the population's health. However, there is a gap in the literature regarding the factors associated with the successful implementation of these interventions. The Active Life Improving Health Behavior Change Program (BCP-VAMOS) uses behavioral strategies to promote an active and healthy lifestyle in the community.
View Article and Find Full Text PDFBackground: Changes in the profiles of patients have significant impacts on the health care system. Diabetes mellitus type 2 (T2DM) prevention and management should be studied in different contexts.
Objective: The Study of Health in Primary Care for the Amazonas Population (SAPPA) primarily aims to describe T2DM prevention and management actions offered by primary health care settings in Brazil and whether the care delivered is consistent with the chronic care model (CCM).
Introduction: In light of the need to expand the reach and access of clinically proven digital Diabetes Prevention Programs (d-DPPs) and the need for rigorous evidence of effectiveness, the purpose of this study was to determine the effectiveness of a digital Diabetes Prevention Program for improving weight, HbA1c, and cardiovascular risk factors among people with prediabetes compared to enhanced standard care plus waitlist control.
Study Design: This was a single-blind RCT among participants at risk of developing type 2 diabetes and included 12 months of follow-up.
Setting/participants: A total of 599 volunteer patients with prediabetes were recruited primarily through electronic medical records and primary care practices.
There is increasing debate about the importance of using information and communication technologies to strengthen health systems. Information systems are one of the most widespread technologies for this end in different healthcare contexts. The primary objective of this study was to highlight and discuss the main characteristics of the regulation and use of health information systems in Brazil and abroad.
View Article and Find Full Text PDFSelf-efficacy is a commonly examined cognitive determinant of behavior change in weight-loss trials, but there has been little uniformity in its measurement. To address this, a recently developed survey captures self-efficacy as it relates to three behavioral domains of interest to weight-loss interventionists: physical activity (PA), healthful eating, and weight loss. The purpose of this study was to test the psychometric properties of the Brief Weight-Loss-Related Behavior Self-Efficacy Scales in a large sample ( = 599) of adults with prediabetes.
View Article and Find Full Text PDFPopulation health management (PHM) strategies to address diabetes prevention have the potential to engage large numbers of at-risk individuals in a short duration. We examined a PHM approach to recruit participants to a diabetes prevention clinical trial in a metropolitan health system. We examined reach and representativeness and assessed differences from active and passive respondents to recruitment outreach, and participants enrolled through two clinical screening protocols.
View Article and Find Full Text PDFExplored the role of public health centers in the delivery of physical activity programs to older Brazilians. Total of 114 older adults (81% women) from public health centers across the city of Florianopolis, Brazil, were randomized into three groups: behavior change group ( = 36), traditional exercise group ( = 52), and control group ( = 26). The behavioral change group included 12 weekly meetings (2 h each).
View Article and Find Full Text PDFBackground: Diabetes prevention remains a top public health priority; digital approaches are potential solutions to existing scalability and accessibility challenges. There remains a gap in our understanding of the relationship between effectiveness, costs, and potential for sustained implementation of digital diabetes prevention strategies within typical healthcare settings.
Purpose: To describe the methods and design of a type 1 hybrid effectiveness-implementation trial of a digital diabetes prevention program (DPP) using the iPARIHS and RE-AIM frameworks.
The implementation of evidence-based physical activity interventions is improved when integrated research-practice partnerships are used. These partnerships consider both research- and practice-based evidence that moves beyond only assessing program efficacy. Our novel hypothesis is that integrated research-practice partnerships may lead to interventions that are practical and effective, reach more participants, and are more likely to be sustained in practice.
View Article and Find Full Text PDFThis study aimed to evaluate the effectiveness of the VAMOS strategy (Health-Improving Active Life) in improving physical activity (PA), dietary habits, and anthropometric variables of primary health care (PHC) users in Brazil. A randomized controlled community trial was conducted at two units of the Health Academy Program (HAP; a service provided by PHC), which were randomly assigned either to control group (CG) or intervention group (IG). Participants in both groups (CG = 156 and IG = 135) took part in physical activity classes provided by HAP facilities with those in IG also participating in the VAMOS strategy for 12 weeks.
View Article and Find Full Text PDFExcessive adiposity (particularly visceral fat mass) increases the risks of developing metabolic syndrome. Women have lower deposit of visceral fat than men, and this pattern becomes diminished postmenopausally, but the underlying mechanism remains largely unknown. Here, we show that the gender difference in visceral fat distribution is controlled by an estradiol-autophagy axis.
View Article and Find Full Text PDFEnvironmental factors (e.g., malnutrition and physical inactivity) contribute largely to metabolic disorders including obesity, type 2 diabetes, cardiometabolic disease and nonalcoholic fatty liver diseases.
View Article and Find Full Text PDFThis study assessed the lifetime health and economic consequences of an efficacious scalable community weight loss program for overweight and obese adults. We applied a state-transition Markov model to project lifetime economic outcome (US dollar) and the degree of disease averted as a result of a weight loss intervention, compared with no intervention, from a payer perspective. Effect sizes of the intervention on weight loss, by sex, race and ethnicity, and body mass index (BMI) of participants, were derived from a 12-month community program.
View Article and Find Full Text PDFObjective: the purpose of this study was to evaluate the efficacy of telephone-based support for the metabolic control of elderly patients with diabetes mellitus.
Method: a pragmatic study was conducted in two groups, called G1 (n=36) and G2 (n=27), at a health unit from the countryside of São Paulo state. Patients in G1 group received telephone support over four months, through 16 telephone contacts with educational material; for the G2 group the educational material was mailed.
J Phys Act Health
December 2017
Background: This study aimed to analyze the effect of a behavior change program, called Vida Ativa Melhorando a Saúde (VAMOS), on physical activity, eating habits, and quality of life in patients with hypertension.
Methods: A randomized controlled trial was carried out in 90 patients with hypertension (57.8 ± 9.
Integrated research-practice partnerships (IRPPs) may improve adoption of evidence-based programs. The aim of this study is to compare adoption of an IRPP-developed physical activity (PA) program (Fit Extension, FitEx) to a typical efficacy-effectiveness-dissemination pipeline model program (Active Living Every Day, ALED). Guided by the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework, a randomized controlled trial assigned health educators (HEs) to FitEx (n = 18) or ALED (n = 18).
View Article and Find Full Text PDFBackground: Primary care addresses obesity through physician oversight of intensive lifestyle interventions or referral to external programs with demonstrated efficacy. However, limited information exists on community program reach, effectiveness, and costs across different groups of participants.
Objective: To evaluate a scalable, community weight loss program using reach, effectiveness, and cost metrics.
Type 2 diabetes (T2D) is characterized by mitochondrial derangement and oxidative stress. With no known cure for T2D, it is critical to identify mitochondrial biomarkers for early diagnosis of prediabetes and disease prevention. Here we examined 87 participants on the diagnosis power of fasting glucose (FG) and hemoglobin A1c levels and investigated their interactions with mitochondrial DNA methylation.
View Article and Find Full Text PDFObesity and related metabolic disorders constitute one of the most pressing heath concerns worldwide. Increased adiposity is linked to autophagy upregulation in adipose tissues. However, it is unknown how autophagy is upregulated and contributes to aberrant adiposity.
View Article and Find Full Text PDFSelf-efficacy is a commonly included cognitive variable in weight-loss trials, but there is little uniformity in its measurement. Weight-loss trials frequently focus on physical activity (PA) and eating behavior, as well as weight loss, but no survey is available that offers reliable measurement of self-efficacy as it relates to each of these targeted outcomes. The purpose of this study was to test the psychometric properties of brief, pragmatic self-efficacy scales specific to PA, healthful eating and weight-loss (4 items each).
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