Outcomes of behavioral lifestyle interventions for promoting weight loss vary widely across participants. The effectiveness of a weight management intervention may depend on a person's environmental context. This study compared short- and longer-term effects of a structured nationwide weight management program for people living in neighborhoods with different levels of walkability and different access to recreational places (parks, fitness facilities). Drawing on the health production model, we tested competing hypotheses for whether treatment effects of the program complement environmental supports or substitute for environmental constraints. We studied the US Department of Veterans Affairs (VA) MOVE! weight management program using VA electronic heath record data (2009-2014) and a difference-in-differences design with an inverse propensity score matched comparison group. A total of 114,256 program participants and 498,494 non-participants comprised the sample. Built environment features were measured within one-mile of each person's home. We estimated program effects on body mass index (BMI) for subgroups with different built environments at 6-, 12-, 18-, and 24-month follow-up using linear regressions with person and year fixed effects. At 6 months, the program reduced BMI by 0.4-0.6 kg/m among men and 0.3-0.5 kg/m among women. The effect diminished at 12, 18, and 24 months. The program effect did not vary significantly across subgroups with different walkability, park access, or fitness facility access. The MOVE! program was not sensitive to environmental context. Results did not lend support to either hypothesis that the MOVE! program complements or substitutes for a person's built environment to affect weight management outcomes.
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http://dx.doi.org/10.1016/j.ypmed.2019.105776 | DOI Listing |
Prim Care Diabetes
December 2024
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Aims: This study aims to describe pain management technique usage and social functioning limitations among adults with chronic pain by diabetes status.
Methods: The 2019 and 2020 National Health Interview Survey data were pooled to complete this analysis. Use of the following techniques in the past 3 months were measured: 1) prescription opioids; 2) physical, rehabilitative, or occupational therapy; 3) talk therapies; 4) chiropractic care; 5) yoga, Tai Chi, or Qi Gong; 6) massage; and 7) relaxation techniques.
Int J Cardiol
December 2024
Department of Cardiothoracic Surgery, Stanford University School of Medicine, 870 Quarry Rd, Palo Alto, CA 94304, USA.
Background: Only 3 % of children in sub-Saharan Africa with congenital heart disease (CHD) have access to life-saving surgery. There is an urgent need to scale up the volume of cardiac procedures. Cost-utility analysis can assess the health economic impacts of performing congenital heart surgery in this region.
View Article and Find Full Text PDFOrthop Traumatol Surg Res
December 2024
Service de chirurgie orthopédique, Hôpital Nord, Pôle Locomoteur, Assistance Publique-Hôpitaux de Marseille, Institut du Mouvement et de l'Appareil Locomoteur, Marseille, France.
Introduction: Septic nonunion is one of the most feared complications in traumatology. Two-stage management using the induced membrane technique is a validated treatment option, but to date there is no consensus on the ideal type of osteosynthesis for the second stage of surgery. The aim of this study was to compare the results of two-stage treatment of tibial septic nonunion, depending on the type of osteosynthesis used.
View Article and Find Full Text PDFActa Psychiatr Scand
December 2024
Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands.
Eur J Pediatr
December 2024
Dept. of Research and Development, SeysCentra, Malden, The Netherlands.
Unlabelled: Children with Noonan syndrome-like RASopathies are at increased risk for developing feeding problems due to comorbid organic impairments at an early age, such as gastrointestinal problems or other organicity. Their feeding problems can ultimately often be classified as avoidant/restrictive food intake disorder, for which behavioral therapy is the first-choice treatment. The research question in this study is whether this treatment leads to similar results as in children without these RASopathies.
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