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Langås JR, Hofvind S, Støer NC, Eskild A, Bjelland EK. Adolescence to Midlife Exercise Trajectories and Age at Natural Menopause: A Population Study of 246 147 Women in Norway. BJOG 2025. [PMID: 40313207 DOI: 10.1111/1471-0528.18204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2024] [Revised: 04/09/2025] [Accepted: 04/21/2025] [Indexed: 05/03/2025]
Abstract
OBJECTIVE Lifestyle factors influence age at natural menopause, but the role of exercise remains uncertain. We aimed to identify adolescence to midlife exercise trajectories and study the associations of exercise trajectories with age at natural menopause. DESIGN Retrospective population-based cohort study. SETTING Self-administered questionnaires in the Norwegian breast cancer screening program (BreastScreen Norway) during the years 2005-2016. POPULATION A total of 246 147 women, aged 50-69 years. METHODS We used latent class mixed model analyses to identify distinct exercise trajectories from adolescence to midlife. The associations were estimated as hazard ratios using Cox proportional hazard models. Adjustments were made for year and country of birth, educational level, number of childbirths, smoking habits and body mass index. We identified four adolescence to midlife exercise trajectories: high (reference), increasing, decreasing and low exercise levels. MAIN OUTCOME MEASURE Age at natural menopause. RESULTS The adjusted hazard ratio of reaching menopause was highest for women with constantly low exercise levels as compared to women with constantly high exercise levels (adjusted hazard ratio 1.06, 95% CI: 1.05-1.07). Also, decreasing and increasing exercise levels were associated with higher hazards of reaching menopause (adjusted hazard ratios 1.02; 95% CI: 1.01-1.04 and 1.02; 95% CI: 1.00-1.03, respectively). CONCLUSIONS Women with low exercise levels from adolescence to midlife had the earliest menopause, and women with high exercise levels had the latest. However, the associations were weak, suggesting little influence of exercise on the large variation in age at menopause.
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Affiliation(s)
- Julie R Langås
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Solveig Hofvind
- Department of Breast Cancer Screening, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
- Department of Health and Care Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Nathalie C Støer
- Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Eskild
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway
| | - Elisabeth K Bjelland
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
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Lee DI, Kim S, Kang DO. Exploring the complex interplay between alcohol consumption and cardiovascular health: Mechanisms, evidence, and future directions. Trends Cardiovasc Med 2025; 35:243-253. [PMID: 39756716 DOI: 10.1016/j.tcm.2024.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 12/30/2024] [Accepted: 12/30/2024] [Indexed: 01/07/2025]
Abstract
This review article explores the intricate relationship between alcohol consumption and cardiovascular health, underscoring on both clinical outcomes and underlying pathophysiological mechanisms. It examines the complex dose-response relationships for various cardiovascular disease (CVD) subtypes, including coronary heart disease, stroke, and atrial fibrillation, while categorizing pathophysiological mechanisms into three conceptual areas: primary initiating factors, secondary transmission pathways, and end-organ effects. Although mild-to-moderate alcohol consumption may confer some benefits for cardiovascular health and certain CVD subtypes, growing evidence highlights the importance of lifestyle modifications to reduce alcohol intake, particularly among heavy drinkers. This review provides a comprehensive overview of current knowledge, emphasizes the need for future research with robust methodologies, and advocates for incorporating updated scientific evidence into personalized approaches within international cardiovascular and national guidelines.
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Affiliation(s)
- Dae-In Lee
- Cardiovascular Center, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sunwon Kim
- Cardiovascular Center, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dong Oh Kang
- Cardiovascular Center, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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Sun K, Zhan M, Andrade FCD. Impact of a diabetes diagnosis on preventive care utilization among middle-life adults in the United States: A mediation analysis of depressive symptoms. Prev Med Rep 2025; 53:103047. [PMID: 40226482 PMCID: PMC11987001 DOI: 10.1016/j.pmedr.2025.103047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Revised: 03/19/2025] [Accepted: 03/20/2025] [Indexed: 04/15/2025] Open
Abstract
Objective To examine the association between diabetes diagnosis and preventive care utilization and whether depressive symptoms mediate this relationship. Methods The study used data from four waves of the National Longitudinal Survey of Youth gathered between 2006 and 2016 (n = 6995) in the United States. Logistic regression models were used to examine the relationship between a diabetes diagnosis and preventive care utilization and whether depressive symptoms mediated this relationship. Results After controlling for demographic, socioeconomic, and health variables, a diabetes diagnosis significantly increased preventive care utilization of blood pressure, cholesterol, blood sugar, electrocardiograph tests, and influenza vaccinations. Also, depressive symptoms mediated the association between a diabetes diagnosis and three preventive care service utilization types: influenza vaccinations, blood pressure, and electrocardiograph tests. Depressive symptoms decreased blood pressure tests and increased influenza vaccinations and electrocardiograph tests. Depressive symptoms did not mediate blood cholesterol or blood sugar tests. Conclusions Results indicated that a diagnosis of diabetes increases the use of preventative services, with the strongest effect on blood sugar tests. However, depressive symptoms slightly reduced the utilization of blood pressure testing. Future studies need to further examine the roles of doctor's recommendations and the roles of family members and familial care.
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Affiliation(s)
- Kang Sun
- Department of Social Work, Southern Illinois University, 1263 Lincoln Dr., Carbondale, IL 62901, USA
| | - Min Zhan
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 W Nevada St, Urbana, IL 61801, USA
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Xu L, Qiu J, Shen P, Wang Y, Wu Y, Hu J, Yang Z, Zhu Z, Lin H, Shui L, Jiang Z, Tang M, Jin M, Tong F, Chen K, Wang J. Associations of waist circumference and BMI with the trajectory of cardiometabolic multimorbidity in hypertensive patients: A multi-state model. Nutr Metab Cardiovasc Dis 2025; 35:103851. [PMID: 39934045 DOI: 10.1016/j.numecd.2025.103851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 12/21/2024] [Accepted: 12/28/2024] [Indexed: 02/13/2025]
Abstract
BACKGROUND AND AIMS The burden of cardiometabolic multimorbidity (CMM) in hypertensive patients is substantial, and obesity may play an important role in progression of CMM. We aim to explore associations of obesity with the transition patterns from hypertension to first cardiometabolic disease (FCMD), CMM, and death. METHODS AND RESULTS 21 286 hypertensive patients over 40 were enrolled in Yinzhou Health Information System from 2010 to 2015, followed until June 30, 2022. CMM was defined as the coexistence of stroke, diabetes, and coronary heart disease. Two indices of obesity including body mass index (BMI) and waist circumference (WC) were assessed at baseline. We used multi-state models to evaluate associations of BMI and WC between risk of CMM trajectories in hypertensive patients. During a median follow-up of 8.06 years, 13 289 hypertensive patients developed CMD, 6401 further developed CMM, and 1648 died. WC in every 1 cm increase was positively associated with risk of transitions from hypertension to FCMD (HR = 1.01, 95 % CI: 1.00-1.01) and from FCMD to CMM (HR = 1.01, 95 % CI: 1.01-1.02). Underweight participants had a 17 % elevated risk of transition from FCMD to CMM, while overweight participants had a 5 % elevated risk of transition from hypertension to FCMD. U-shape curves were observed for the association of WC with transitions from FCMD or CMM to death. CONCLUSIONS Underweight and abnormal WC were associated with an increased risk of CMM and death in hypertensive patients. Our findings emphasize the role of healthy body shape in hypertensive management.
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Affiliation(s)
- Lisha Xu
- Department of Public Health, And Department of National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Jie Qiu
- Department of Public Health, And Department of National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315100, China
| | - Yixing Wang
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yonghao Wu
- Department of Public Health, And Department of National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Jingjing Hu
- Department of Public Health, And Department of National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Zongming Yang
- Department of Public Health, And Department of National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Zhanghang Zhu
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Hongbo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315100, China
| | - Liming Shui
- Yinzhou District Health Bureau of Ningbo, Ningbo, 315040, China
| | - Zhiqin Jiang
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315100, China
| | - Mengling Tang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Mingjuan Jin
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Feng Tong
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, 315010, China.
| | - Kun Chen
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Jianbing Wang
- Department of Public Health, And Department of National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
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Coste J, Delpierre C, Robineau O, Rushyizekera M, Richard JB, Alleaume C, Gallay A, Tebeka S, Steichen O, Lemogne C, Makovski TT. A multidimensional network of factors associated with long COVID in the French population. COMMUNICATIONS MEDICINE 2025; 5:114. [PMID: 40223130 PMCID: PMC11994787 DOI: 10.1038/s43856-025-00846-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/03/2025] [Indexed: 04/15/2025] Open
Abstract
BACKGROUND Various factors associated with long COVID have been evidenced, but the heterogeneity of definitions and epidemiological investigations has often hidden risk pathways relevant for understanding and preventing this condition. METHODS This nationwide random sampling survey conducted in France after the Omicron waves in autumn 2022 assessed eight sets of factors potentially associated with long COVID in a structured epidemiological investigation based on a conceptual model accounting for the relationships between these sets of factors. A representative sample of 1813 adults of whom 55% were infected with SARS-CoV-2 was assessed for infection dates and context, post-COVID symptoms and these factors. Four definitions of long COVID, including the World Health Organisation's, were used. RESULTS Female sex, household size (≥2), low financial security, negative impact of COVID-19 pandemic on occupation and work conditions, number of comorbidities (≥2), presence of respiratory disease, mental and sensory disorders, number of SARS-CoV-2 infections (≥2) and initial symptoms (≥6), perceived high severity of COVID-19 are positively and consistently associated with long COVID. Age ≥ 75 years, retirement, SARS-CoV-2 vaccination (≥2 doses) and good perceived information regarding long Covid are negatively associated with the condition. CONCLUSIONS The broad spectrum of factors confirmed here strongly suggests that long COVID should be regarded not only as a direct complication of SARS-CoV-2 infection but also as driven by a broader network of contextual, medical, psychological and social factors. These factors should be better considered in strategies aimed at limiting the long COVID burden in the general population.
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Affiliation(s)
- Joël Coste
- French Public Health Agency (Santé Publique France), Saint-Maurice, France.
| | | | - Olivier Robineau
- Service Universitaire des Maladies Infectieuses, Centre Hospitalier Gustave Dron, Tourcoing, France
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMR-S, 1136, Paris, France
| | | | | | - Caroline Alleaume
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | - Anne Gallay
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | - Sarah Tebeka
- Université Paris Cité, INSERM UMR1266, Institute of Psychiatry and Neurosciences, Team 1, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Olivier Steichen
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMR-S, 1136, Paris, France
- AP-HP, Hôpital Tenon, Service de Médecine Interne, Paris, France
| | - Cédric Lemogne
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
| | - Tatjana T Makovski
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
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Yap JF, Ahmad WAW, Lim YC, Moy FM. Cardiovascular disease incidence and its predictors among school teachers in Peninsular Malaysia: a prospective cohort study. INDUSTRIAL HEALTH 2025; 63:182-197. [PMID: 39198183 PMCID: PMC11995152 DOI: 10.2486/indhealth.2024-0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 08/19/2024] [Indexed: 09/01/2024]
Abstract
Cardiovascular disease (CVD) caused substantial morbidity among occupationally active populations. However, data regarding the longitudinal burden of CVD were limited, particularly among school teachers. The objectives of our study were to estimate the incidence rate of CVD and determine its predictors among school teachers in Peninsular Malaysia through a prospective cohort study. We followed 14,046 eligible school teachers recruited between 2013 and 2014 until 31st December 2021. We accessed three computerised, country-level registries to determine incident CVD cases during the study period from 2013 to 2021. Baseline sociodemographic, lifestyle, work-related and clinical characteristics were recorded. Cox proportional hazard regression models with adjusted hazard ratio and 95% confidence interval were reported. With a median follow-up of 7.71 yr, we observed 209 incident CVD cases (or 195.7 CVD cases per 100,000 person-years). Male gender, age ≥40 yr old, Indian or others ethnicity (as compared to Chinese), family history of CVD, laboratory-confirmed diabetes mellitus, self-reported hypertension, high low-density lipoprotein cholesterol and high triglyceride were predictors for incident CVD among school teachers. Neither work-related nor lifestyle factors were significantly associated with incident CVD. Screening at-risk teachers for diabetes mellitus, hypertension or dyslipidemia is recommended to delay the onset or progression of CVD.
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Affiliation(s)
- Jun Fai Yap
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Malaysia
- Institute for Public Health, National Institutes of Health, Ministry of Health, Malaysia
| | - Wan Azman Wan Ahmad
- Cardiology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Malaysia
| | - Yin Cheng Lim
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Malaysia
- Centre of Epidemiology & Evidence Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Malaysia
| | - Foong Ming Moy
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Malaysia
- Centre of Epidemiology & Evidence Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Malaysia
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Peng Y, Wang P, Liu F, Wang X, Si C, Gong J, Zhou H, Song F. Role of Cardiovascular Health in the Bidirectional Progression Trajectories Between Cardiovascular Disease, Type 2 Diabetes, and Cancer. J Am Heart Assoc 2025; 14:e038180. [PMID: 40008518 DOI: 10.1161/jaha.124.038180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 01/15/2025] [Indexed: 02/27/2025]
Abstract
BACKGROUND There existed bidirectional associations of cardiovascular disease (CVD) and type 2 diabetes (T2D) with cancer, partly attributed to their shared risk factors. We aimed to explore the role of cardiovascular health (CVH) in bidirectional transitions between CVD, T2D, and cancer. METHODS Based on the UK Biobank, we used 2 subcohorts: a disease-free cohort of 277 997 individuals without cancer, CVD, and T2D; and a disease survivor cohort consisting of 61 971 cases with cancer, CVD, and T2D at baseline. The CVH was assessed on the basis of Life's Essential 8 score. We conducted the multistate model and Cox proportional hazards model to explore the role of CVH in bidirectional transitions between CVD, T2D, and cancer in disease-free and disease survivor cohorts, respectively. RESULTS High CVH was significantly associated with a lower transition risk from CVD to cancer (hazard ratio, 0.822 [95% CI, 0.693-0.975]). On the other hand, increased CVH was related to reduced risks of progression from cancer to CVD and T2D (both P for trend<0.001), particularly in the high CVH group. For disease survivor cohorts, per 10-point increase in CVH was associated with >10% lower cancer risk in CVD and T2D cases, and a 16% and 42% reduction in the risk of incident CVD and T2D among cancer survivors, respectively. CONCLUSIONS High CVH was related to a decreased risk of bidirectional transitions between CVD, T2D, and cancer. This highlighted the significance of maintaining high CVH throughout the life span for the primary prevention of CVD, T2D, and cancer.
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Affiliation(s)
- Yu Peng
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Tianjin China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Tianjin China
| | - Fubin Liu
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Tianjin China
| | - Xixuan Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Tianjin China
| | - Changyu Si
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Tianjin China
| | - Jianxiao Gong
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Tianjin China
| | - Huijun Zhou
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Tianjin China
| | - Fangfang Song
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Tianjin China
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Assari S, Sheikhattari P. Smokers with Multiple Chronic Disease Are More Likely to Quit Cigarette. GLOBAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE 2024; 4:60-68. [PMID: 39544622 PMCID: PMC11563157 DOI: 10.31586/gjeid.2024.1068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2024]
Abstract
Objective This study aims to investigate the relationship between the presence of chronic medical conditions and cessation among U.S. adults who use combustible tobacco. We hypothesized that having chronic medical conditions would be associated with a higher likelihood of successfully quitting combustible tobacco. Methods We utilized longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study, using data from Waves 1 to 6. Only current daily smokers were included in our analysis. The independent variable was the number of chronic medical conditions, defined as zero, one, or two or more. The outcome was becoming a former smoker (quitting smoking). Using multivariate regression analyses, we assessed the association between the number of chronic conditions and tobacco cessation over the six waves. We controlled for potential confounding variables, including demographic factors and socioeconomic status. Results Our analysis revealed a significant association between the number of chronic medical conditions and the likelihood of quitting smoking. Specifically, individuals with two or more chronic conditions exhibited a greater probability of quitting smoking compared to those with no chronic conditions. The results remained significant after adjusting for potential confounders. Conclusions Multiple chronic medical conditions may act as a catalyst for smoking cessation among U.S. adults. This suggests that the presence of multimorbidity, defined as multiple chronic disease diagnoses, may serve as "teachable moments," prompting significant health behavior changes. These findings highlight the potential for leveraging chronic disease management and healthcare interventions to promote tobacco cessation, particularly among individuals with multiple chronic conditions.
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Affiliation(s)
- Shervin Assari
- Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Payam Sheikhattari
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
- The Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
- Department of Public and Allied Health, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
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Wang W, Zhou K, Wang L, Qin Q, Liu H, Qin L, Yang M, Yuan L, Liu C. Aging in chronic lung disease: Will anti-aging therapy be the key to the cure? Eur J Pharmacol 2024; 980:176846. [PMID: 39067566 DOI: 10.1016/j.ejphar.2024.176846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 07/24/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024]
Abstract
Chronic lung disease is the third leading cause of death globally, imposing huge burden of death, disability and healthcare costs. However, traditional pharmacotherapy has relatively limited effects in improving the cure rate and reducing the mortality of chronic lung disease. Thus, new treatments are urgently needed for the prevention and treatment of chronic lung disease. It is particularly noteworthy that, multiple aging-related phenotypes were involved in the occurrence and development of chronic lung disease, such as blocked proliferation, telomere attrition, mitochondrial dysfunction, epigenetic alterations, altered nutrient perception, stem cell exhaustion, chronic inflammation, etc. Consequently, senescent cells induce a series of pathological changes in the lung, such as immune dysfunction, airway remodeling, oxidative stress and regenerative dysfunction, which is a critical issue that needs special attention in chronic lung diseases. Therefore, anti-aging interventions may bring new insights into the treatment of chronic lung diseases. In this review, we elaborate the involvement of aging in chronic lung disease and further discuss the application and prospects of anti-aging therapy.
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Affiliation(s)
- Weijie Wang
- Department of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Physiology, School of Basic Medicine Science, Central South University, Changsha, Hunan, China; National Experimental Teaching Demonstration Center for Medical Function, China
| | - Kai Zhou
- Department of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China; Basic and Clinical Research Laboratory of Major Respiratory Diseases, Central South University, Changsha, Hunan, China; National Experimental Teaching Demonstration Center for Medical Function, China
| | - Leyuan Wang
- Department of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China; Basic and Clinical Research Laboratory of Major Respiratory Diseases, Central South University, Changsha, Hunan, China; National Experimental Teaching Demonstration Center for Medical Function, China
| | - Qiuyan Qin
- Department of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China; Basic and Clinical Research Laboratory of Major Respiratory Diseases, Central South University, Changsha, Hunan, China; National Experimental Teaching Demonstration Center for Medical Function, China
| | - Huijun Liu
- Department of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China; Basic and Clinical Research Laboratory of Major Respiratory Diseases, Central South University, Changsha, Hunan, China; National Experimental Teaching Demonstration Center for Medical Function, China
| | - Ling Qin
- Department of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China; Basic and Clinical Research Laboratory of Major Respiratory Diseases, Central South University, Changsha, Hunan, China
| | - Ming Yang
- Centre for Asthma and Respiratory Disease, School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle and Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Lin Yuan
- Department of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Physiology, School of Basic Medicine Science, Central South University, Changsha, Hunan, China; National Experimental Teaching Demonstration Center for Medical Function, China.
| | - Chi Liu
- Department of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Physiology, School of Basic Medicine Science, Central South University, Changsha, Hunan, China; Basic and Clinical Research Laboratory of Major Respiratory Diseases, Central South University, Changsha, Hunan, China; National Experimental Teaching Demonstration Center for Medical Function, China.
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Sayed A, Labieb F, Stevens ER, Tamura K, Boakye E, Virani SS, Jiang N, Hu L, Blaha MJ, El-Shahawy O. Association between a diagnosis of diabetes mellitus and smoking abstinence: An analysis of the National Health Interview Survey (2006-2018). Prev Med 2024; 187:108085. [PMID: 39053517 DOI: 10.1016/j.ypmed.2024.108085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/28/2024] [Accepted: 07/21/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE Both diabetes and smoking significantly increase the risk of cardiovascular disease (CVD). Understanding whether a diagnosis of diabetes can be leveraged to promote smoking cessation is a gap in the literature. METHODS We used data from the US National Health Interview Survey, 2006 to 2018, to investigate the relationship between self-report of diagnosis of diabetes and subsequent smoking abstinence among 142,884 respondents who reported regular smoking at baseline. Effect sizes were presented as hazard ratios (HRs) derived from multivariable Cox regression models adjusted for potential confounders using diabetes as a time-dependent covariate. Subgroup-specific estimates were obtained using interaction terms between diabetes and variables of interest. RESULTS A self-reported diagnosis of diabetes was associated with smoking abstinence (HR: 1.21; 95% CI: 1.16 to 1.27). The strength of the association varied based on race (P for interaction: 0.004), where it was strongest in African Americans (HR: 1.44; 95% CI: 1.29 to 1.60); income (P for interaction <0.001), where it was strongest in those with a yearly income less than $35,000 (HR: 1.45; 95% CI: 1.36 to 1.53); and educational attainment (P for interaction <0.001), where it was strongest in those who did not attend college (HR: 1.48; 95% CI: 1.40 to 1.57). CONCLUSION Among adults who smoke, a diagnosis of diabetes is significantly associated with subsequent smoking abstinence. The association is strongest in socially disadvantaged demographics, including African Americans, low-income individuals, and those who did not attend college.
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Affiliation(s)
- Ahmed Sayed
- Ain Shams University, Faculty of Medicine, Cairo, Egypt; Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - Fatma Labieb
- Beni Suef University, Faculty of Medicine, Beni Suef, Egypt
| | | | - Kosuke Tamura
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Ellen Boakye
- Division of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Salim S Virani
- Department of Medicine, Aga Khan University, Karachi, Pakistan; Baylor College of Medicine and Texas Heart Institute, Houston, TX, USA
| | - Nan Jiang
- New York University Grossman School of Medicine, New York, NY, USA
| | - Lu Hu
- New York University Grossman School of Medicine, New York, NY, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Omar El-Shahawy
- Ain Shams University, Faculty of Medicine, Cairo, Egypt; New York University Grossman School of Medicine, New York, NY, USA; New York University School of Global Public Health, New York, NY, USA.
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11
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Akinrolie O, Ripat J, Strachan S, Webber SC, Barclay R. Virtual Motivational Interviewing (VIMINT) to support physical activity: Experiences of older adults and counsellors. J Health Psychol 2024; 29:1416-1430. [PMID: 38414103 PMCID: PMC11528923 DOI: 10.1177/13591053241235094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
The aim of this study was to explore the experiences of older adults and counsellors involved in virtual motivational interviewing (MI). This study was part of the Virtual Motivational INTerviewing (VIMINT) feasibility trial of virtual MI for physical activity in older adults. A descriptive qualitative design utilized content analysis. Seven older adults and three counsellors were interviewed. Four categories were developed: (i) Benefits and limitations of using technology (ii) Relationships between older adults and counsellors (iii) MI skills and spirit and (iv) Effects of virtual MI. Older adults and counsellors reported that receiving/delivering MI virtually was convenient and flexible. They described reduced non-verbal communication in virtual MI. Virtual MI facilitates interpersonal relationships, and counsellors reported that MI skills and spirit can be applied virtually. This study showed that virtual MI offers potential benefits with some limitations. The findings could inform future research involving virtual delivery of MI.
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12
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Zhang S, Jiang Z, Zhang H, Liu Y, Qi J, Yan Y, Wang T, Zeng P. Association of cigarette smoking, smoking cessation with the risk of cardiometabolic multimorbidity in the UK Biobank. BMC Public Health 2024; 24:1910. [PMID: 39014423 PMCID: PMC11253396 DOI: 10.1186/s12889-024-19457-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 07/11/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND To investigate the association between cigarette smoking, smoking cessation and the trajectory of cardiometabolic multimorbidity (CMM), and further to examine the association of age at smoking initiation and smoking cessation with CMM. METHODS This study included 298,984 UK Biobank participants without cardiometabolic diseases (CMDs) (including type 2 diabetes, coronary heart diseases, stroke, and hypertension) at baseline. Smoking status was categorized into former, current, and never smokers, with age at smoking initiation and smoking cessation as a proxy for current and former smokers. The multi-state model was performed to evaluate the association between cigarette smoking, smoking cessation and CMM. RESULTS During a median follow-up of 13.2 years, 59,193 participants developed first cardiometabolic disease (FCMD), 14,090 further developed CMM, and 16,487 died. Compared to former smokers, current smokers had higher risk at all transitions, with hazard ratio (95% confidence interval) = 1.59 (1.55 ∼ 1.63) vs. 1.18 (1.16 ∼ 1.21) (P = 1.48 × 10- 118) from health to FCMD, 1.40 (1.33 ∼ 1.47) vs. 1.09 (1.05 ∼ 1.14) (P = 1.50 × 10- 18) from FCMD to CMM, and 2.87 (2.72 ∼ 3.03) vs. 1.38 (1.32 ∼ 1.45) (P < 0.001) from health, 2.16 (1.98 ∼ 2.35) vs. 1.25 (1.16 ∼ 1.34) (P = 1.18 × 10- 46) from FCMD, 2.02 (1.79 ∼ 2.28) vs. 1.22 (1.09 ∼ 1.35) (P = 3.93 × 10- 17) from CMM to death; whereas quitting smoking reduced the risk attributed to cigarette smoking by approximately 76.5% across all transitions. Reduced risks of smoking cessation were also identified when age at quitting smoking was used as a proxy for former smokers. CONCLUSIONS Cigarette smoking was associated with a higher risk of CMM across all transitions; however, smoking cessation, especially before the age of 35, was associated with a significant decrease in CMM risk attributed to cigarette smoking.
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Affiliation(s)
- Shuo Zhang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Zhou Jiang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Hao Zhang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Yuxin Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Jike Qi
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Yu Yan
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
- Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
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13
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Gil‐Salcedo A, Massart R, de Langavant LC, Bachoud‐Levi A. Modifiable factors associated with Huntington's disease progression in presymptomatic participants. Ann Clin Transl Neurol 2024; 11:1930-1941. [PMID: 38855890 PMCID: PMC11251488 DOI: 10.1002/acn3.52120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 05/26/2024] [Indexed: 06/11/2024] Open
Abstract
OBJECTIVE Huntington's disease (HD) is a neurodegenerative disorder characterized by progressive motor, cognitive, and psychiatric symptoms. Our aim here was to identify factors that can be modified to slow disease progression even before the first symptoms appear. METHODS We included 2636 presymptomatic individuals (comparison with family controls) drawn from the prospective observational cohort Enroll-HD, with more than 35 CAG repeats and at least two assessments of disease progression measured with the composite Huntington's disease rating Scale (cUHDRS). The association between sociodemographic factors, health behaviors, health history, and cUHDRS trajectory was assessed with a mixed-effects random forest using partial dependence plots and Shapley additive explanation method. RESULTS Participants were followed by an average of 3.4 (SD = 1.97) years. We confirmed the negative impact of age and a high number of CAG repeats. We found that a high level of education, a body mass index (BMI) <23 kg/m2 before the age of 40 and >23 kg/m2 thereafter, alcohol consumption of <15 units per week, current coffee consumption and no smoking were linked to slow disease progression, as did no previous exposure to antidepressants or anxiolytic, no psychiatric history or comorbidities, and being female. Other comorbidities or marital status showed no major association with HD evolution. INTERPRETATION Reducing modifiable risk factors for HD is one way to support the presymptomatic population. A high level of education, low-to-moderate alcohol consumption, no smoking, and BMI control are likely to slow disease progression in this population.
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Affiliation(s)
- Andres Gil‐Salcedo
- Département d'Études Cognitives, École Normale SupérieurePSL UniversityParis75005France
- Faculté de MédecineUniversité Paris‐Est CréteilCréteil94000France
- Inserm U955, Institut Mondor de Recherche Biomédicale, Équipe NeuroPsychologie InterventionnelleCréteil94000France
- NeurATRIS, Mondor NodeCréteilFrance
| | - Renaud Massart
- Département d'Études Cognitives, École Normale SupérieurePSL UniversityParis75005France
- Faculté de MédecineUniversité Paris‐Est CréteilCréteil94000France
- Inserm U955, Institut Mondor de Recherche Biomédicale, Équipe NeuroPsychologie InterventionnelleCréteil94000France
- NeurATRIS, Mondor NodeCréteilFrance
| | - Laurent Cleret de Langavant
- Département d'Études Cognitives, École Normale SupérieurePSL UniversityParis75005France
- Faculté de MédecineUniversité Paris‐Est CréteilCréteil94000France
- Inserm U955, Institut Mondor de Recherche Biomédicale, Équipe NeuroPsychologie InterventionnelleCréteil94000France
- NeurATRIS, Mondor NodeCréteilFrance
- APHP, Hôpital Henri Mondor, service de neurologie, centre national de référence maladie de HuntingtonCréteil94000France
| | - Anne‐Catherine Bachoud‐Levi
- Département d'Études Cognitives, École Normale SupérieurePSL UniversityParis75005France
- Faculté de MédecineUniversité Paris‐Est CréteilCréteil94000France
- Inserm U955, Institut Mondor de Recherche Biomédicale, Équipe NeuroPsychologie InterventionnelleCréteil94000France
- NeurATRIS, Mondor NodeCréteilFrance
- APHP, Hôpital Henri Mondor, service de neurologie, centre national de référence maladie de HuntingtonCréteil94000France
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14
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Zhang P, Zhang L, Chen W. Patients' perception of lifestyle advice as a mechanism between health shocks and health behaviours: Evidence from a longitudinal study in China. J Glob Health 2024; 14:04059. [PMID: 38515430 PMCID: PMC10958586 DOI: 10.7189/jogh.14.04059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
Background The heavy burden of non-communicable chronic diseases (NCDs) and the deficiency of health behaviours (HB) are threatening the middle- and older-aged population in China. However, little is known about the relational mechanism between health shocks (HS) and HBs, while the importance of patients' perception of lifestyle advice (PPLA) to initiate HB is insufficiently emphasised. In this study, we aimed to examine this perception as a mediator between HS and HB and the variety of mediation effects caused by the different contents of lifestyle advice. Methods We retrieved panel data from the two latest waves of a nationally representative cohort, the China Health and Retirement Longitudinal Study (CHARLS). After constructing well-balanced groups through propensity score matching, we conducted descriptive and multilevel logistic regression analyses to analyse the state of and factors influencing PPLA. We employed the Preacher's Sobel test with 1000 replications bootstrap to examine the mediating effect of PPLA. Results On a sample of 7922 respondents (post-propensity score matching), we found that HSs had a positive direct effect on HB, with observed decreases in smoking and drinking and increases in exercise. A limited and selected perception of lifestyle advice showed a gap between the advice given by providers and perceived by patients, with gender, education level, social support inside the family, self-reported health, comorbidity, treatment regimens, and utilisation of family doctors being significant influencing factors. Nevertheless, any content of lifestyle advice partially mediated the relationship in which HS increases non-addictive HB (exercise), while only the targeted and detailed content of lifestyle advice about corresponding behaviours partially mediated the effect between HS and addictive HB (smoking and drinking). Conclusions This study provides the first evidence that PPLA partially mediates the positive effect of HS on HB. Personalised chronic disease management; targeted advice and interventions; and multiple social resources COULD BE beneficial for patients with HS to initiate HB.
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Affiliation(s)
- Peng Zhang
- School of Public Health, Fudan University, Xuhui District, Shanghai, China
- School of Humanities, Shanghai Institute of Technology, Fengxian District, Shanghai, China
| | - Luying Zhang
- School of Public Health, Fudan University, Xuhui District, Shanghai, China
| | - Wen Chen
- School of Public Health, Fudan University, Xuhui District, Shanghai, China
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15
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Timkova V, Minarikova D, Fabryova L, Buckova J, Minarik P, Katreniakova Z, Nagyova I. Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model. Front Psychol 2024; 15:1280071. [PMID: 38455118 PMCID: PMC10919221 DOI: 10.3389/fpsyg.2024.1280071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Increasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B. Methods The study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m2; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data. Results The associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health. Discussion Behavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change.
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Affiliation(s)
- Vladimira Timkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
| | - Daniela Minarikova
- Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
| | - Lubomira Fabryova
- Biomedical Research Centre of the Slovak Academy of Sciences, Bratislava, Slovakia
- Institute for Prevention and Intervention, St. Elisabeth University of Health and Social Work, Bratislava, Slovakia
- Faculty of Nursing and Medical Professional Studies, Slovak Health University, Bratislava, Slovakia
| | - Jana Buckova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
| | - Peter Minarik
- Biomedical Research Centre of the Slovak Academy of Sciences, Bratislava, Slovakia
- Institute for Prevention and Intervention, St. Elisabeth University of Health and Social Work, Bratislava, Slovakia
| | - Zuzana Katreniakova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
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16
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Cheney MK, Song H, Bhochhibhoya S, Lu Y. Chronic disease as a risk factor for cigarette and e-cigarette use from young adulthood to adulthood. Prev Med Rep 2023; 36:102473. [PMID: 37881176 PMCID: PMC10594544 DOI: 10.1016/j.pmedr.2023.102473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/27/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
Chronic disease prevalence in young adults is increasing with 15-20 % reporting 1 or more chronic diseases. This study examined cross-sectional and prospective relationships between chronic disease and e-cigarette/cigarette use from young adulthood to adulthood utilizing the U.S.- based National Longitudinal Study of Adolescent to Adult Health (Add Health). Add Health Study wave 3 (2001-2002; ages 18-26), wave 4 (2008; ages 24-34), and wave 5 (2016-2018; ages 33-44) were used. Past 30-day cigarette use at waves 3-5 and past 30-day e-cigarette use at wave 5 were assessed. Two measures of chronic disease were used: asthma (yes/no) and non-asthmatic chronic disease (yes/no) composed of 7 additional chronic diseases (diabetes, migraine, heart problem, hepatitis B/C, high blood pressure, epilepsy, and cancer). Weighted multilevel logistic regression (controlling for age, race/ethnicity, gender, and education) was used to assess cross-sectional associations at wave 3, and then prospective associations of wave 3 chronic disease (asthma and non-asthmatic) with waves 4 and 5 cigarette and wave 5 e-cigarette use. Logistic regressions showed no significant cross-sectional or prospective relationships between asthma and cigarette and e-cigarette use. However, wave 3 non-asthmatic chronic disease was significantly associated with wave 4 cigarette use (aOR 1.38, p <.001, 95 % CI: 1.15, 1.65) and with wave 5 cigarette use (aOR 1.49, p <.001, 95 % CI: 1.21, 1.84) but not e-cigarette use. The association between chronic disease in young adulthood and tobacco use in adulthood differed by type of chronic disease and tobacco product, indicating the need for targeted interventions.
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Affiliation(s)
- Marshall K Cheney
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK, 73019, USA
| | - Hairong Song
- Department of Psychology, University of Oklahoma, Norman, OK USA
| | - Shristi Bhochhibhoya
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK USA
| | - Yu Lu
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK USA
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17
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Fontvieille E, Viallon V, Recalde M, Cordova R, Jansana A, Peruchet-Noray L, Lennon H, Heath AK, Aune D, Christakoudi S, Katzke V, Kaaks R, Inan-Eroglu E, Schulze MB, Mellemkjær L, Tjønneland A, Overvad K, Farràs M, Petrova D, Amiano P, Chirlaque MD, Moreno-Iribas C, Tin Tin S, Masala G, Sieri S, Ricceri F, Panico S, May AM, Monninkhof EM, Weiderpass E, Gunter MJ, Ferrari P, Freisling H. Body mass index and cancer risk among adults with and without cardiometabolic diseases: evidence from the EPIC and UK Biobank prospective cohort studies. BMC Med 2023; 21:418. [PMID: 37993940 PMCID: PMC10666332 DOI: 10.1186/s12916-023-03114-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/16/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Whether cancer risk associated with a higher body mass index (BMI), a surrogate measure of adiposity, differs among adults with and without cardiovascular diseases (CVD) and/or type 2 diabetes (T2D) is unclear. The primary aim of this study was to evaluate separate and joint associations of BMI and CVD/T2D with the risk of cancer. METHODS This is an individual participant data meta-analysis of two prospective cohort studies, the UK Biobank (UKB) and the European Prospective Investigation into Cancer and nutrition (EPIC), with a total of 577,343 adults, free of cancer, T2D, and CVD at recruitment. We used Cox proportional hazard regressions to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between BMI and incidence of obesity-related cancer and in turn overall cancer with a multiplicative interaction between BMI and the two cardiometabolic diseases (CMD). HRs and 95% CIs for separate and joint associations for categories of overweight/obesity and CMD status were estimated, and additive interaction was quantified through relative excess risk due to interaction (RERI). RESULTS In the meta-analysis of both cohorts, BMI (per ~ 5 kg/m2) was positively associated with the risk of obesity-related cancer among participants without a CMD (HR: 1.11, 95%CI: 1.07,1.16), among participants with T2D (HR: 1.11, 95% CI: 1.05,1.18), among participants with CVD (HR: 1.17, 95% CI: 1.11,1.24), and suggestively positive among those with both T2D and CVD (HR: 1.09, 95% CI: 0.94,1.25). An additive interaction between obesity (BMI ≥ 30 kg/m2) and CVD with the risk of overall cancer translated into a meta-analytical RERI of 0.28 (95% CI: 0.09-0.47). CONCLUSIONS Irrespective of CMD status, higher BMI increased the risk of obesity-related cancer among European adults. The additive interaction between obesity and CVD suggests that obesity prevention would translate into a greater cancer risk reduction among population groups with CVD than among the general population.
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Affiliation(s)
- Emma Fontvieille
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
| | - Vivian Viallon
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
| | - Martina Recalde
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
| | - Reynalda Cordova
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
| | - Anna Jansana
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
| | - Laia Peruchet-Noray
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Hannah Lennon
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elif Inan-Eroglu
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | | | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Marta Farràs
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia, Bellvitge Biomedical Research Institute (IDIBELL), 08908, L'Hospitalet de Llobregat, Spain
| | - Dafina Petrova
- Escuela Andaluza de Salud Pública (EASP), 18011, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
| | - Pilar Amiano
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 2013, San Sebastian, Spain
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, 20014, San Sebastián, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - María-Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Conchi Moreno-Iribas
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Sandar Tin Tin
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, Oxford, UK
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Milan, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health, University of Turin, Turin, Italy
| | - Salvatore Panico
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Evelyn M Monninkhof
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Elisabete Weiderpass
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Pietro Ferrari
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France.
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Paltzat K, Scott S, Dhaliwal KK, Saunders-Smith T, Manns BJ, Campbell T, Ivers N, Pannu R, Campbell DJ. Patient Perspectives on a Tailored Self-Management Education and Support Intervention for Low-Income Seniors With Chronic Health Conditions. CJC Open 2023; 5:808-815. [PMID: 38020328 PMCID: PMC10679452 DOI: 10.1016/j.cjco.2023.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/07/2023] [Indexed: 12/01/2023] Open
Abstract
Background The Assessing Outcomes of Enhanced Chronic Disease Care Through Patient Education and a Value-based Formulary Study (ACCESS) was a 2 x 2 factorial randomized trial that tested the impact of a tailored self-management education support (SMES) program, which demonstrated a 22% reduction in adverse clinical events. We sought to qualitatively explore participants' perspectives on the SMES intervention, and the ways in which it may have improved self-management skills. Methods We used a qualitative descriptive approach and conducted individual semistructured interviews. We conducted inductive and deductive thematic analysis using NVivo 12 (QSR International, Burlington, MA). Results We interviewed 20 participants who had recently completed the 3-year SMES intervention. The following 3 main themes emerged from the data: (i) empowerment; (ii) intervention acceptability; and (iii) suggestions for improvement. Regarding empowerment, we identified subthemes of health literacy, self-efficacy, self-management, and active role in health. Several participants reported that empowerment promoted health behaviour change or improved confidence in self-management. Regarding acceptability, we identified subthemes of ease of use and presentation style. Most participants expressed positive feelings toward the intervention and felt that it was easy to understand. Finally, we identified subthemes of learning style, content, and engagement strategies, within the theme of suggestions for improvement. Some participants said that the messages were too general and did not fully address the complex health concerns they had. Conclusions Our results highlighted key strategies to promote patient engagement and self-management behaviours and demonstrated how they may have been used to improve clinical endpoints. Additionally, we demonstrated the novel use of marketing principles in SMES interventions.
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Affiliation(s)
- Kaitlyn Paltzat
- Global Studies Institute, Université de Genève, Geneva, Switzerland
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sara Scott
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kirnvir K. Dhaliwal
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Terry Saunders-Smith
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Braden J. Manns
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tavis Campbell
- Department of Psychology, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Noah Ivers
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Raj Pannu
- Emergence Creative, New York, New York, USA
| | - David J.T. Campbell
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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19
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Taniguchi C, Narisada A, Ando H, Hashimoto A, Nakayama A, Ito M, Tanaka H, Suzuki K. Smoking cessation behavior in patients with a diagnosis of a non-communicable disease: The impact of perceived disease severity of and susceptibility to the disease. Tob Induc Dis 2023; 21:125. [PMID: 37808588 PMCID: PMC10557053 DOI: 10.18332/tid/170430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION The Health Belief Model comprises two constructs influencing changed behaviors impacting on health, namely perceived severity and susceptibility. The aim of this study was to identify the impact of the combination of, or interactions between, these two constructs on quitting smoking in smokers with a diagnosis of a non-communicable disease (NCD). METHODS From the large insurance claims database maintained by JMDC database (JMDC, Tokyo), we extracted data on 13284 participants who smoked. All participants were stratified according to their NCD diagnosis based on perceived severity and susceptibility as follows: Category I (high severity and high susceptibility) - acute myocardial infarction, and lung cancer; Category II (high severity and low susceptibility) - colorectal cancer, and stomach cancer; Category III (low severity and high susceptibility) - asthma, and transient ischemic attack; Category IV (low severity and low susceptibility) - appendicitis, and glaucoma. We performed multi-variable logistic regression analysis and calculated the proportion of those who were smoking at the first health check-up after the diagnosis and every three years thereafter. RESULTS Using glaucoma as the reference, the adjusted odds ratios for smoking cessation were 14.2 (95% CI: 11.4-17.8) to 14.8 (95% CI: 12.5-17.4) in Category I; 4.5 (95% CI: 3.8-5.4) to 6.6 (95% CI: 5.4-8.0) in Category II; and 1.9 (95% CI: 1.7-2.1) to 2.8 (95% CI: 2.2-3.7) in Category III. In Categories I and II, the proportion of smokers rapidly decreased after diagnosis and mostly remained low thereafter. Smoking cessation rates for Categories I and II were not associated with readiness to improve lifestyles prior to NCD diagnosis. CONCLUSIONS Our study confirms the significant impact of perceived severity of and susceptibility to the diagnosed disease on smoking cessation. The multiplicative effect of these two constructs at NCD diagnosis represents a 'teachable moment', a window of opportunity, for encouraging successful long-term smoking cessation.
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Affiliation(s)
- Chie Taniguchi
- College of Nursing, Aichi Medical University, Nagakute, Japan
| | - Akihiko Narisada
- Institute for Occupational Health Science, Aichi Medical University, Nagakute, Japan
| | - Hirohiko Ando
- Department of Cardiology, Aichi Medical University, Nagakute, Japan
| | - Akane Hashimoto
- College of Nursing, Aichi Medical University, Nagakute, Japan
| | - Ayako Nakayama
- College of Nursing, Aichi Medical University, Nagakute, Japan
| | - Masaki Ito
- College of Nursing, Aichi Medical University, Nagakute, Japan
| | - Hideo Tanaka
- Neyagawa City Public Health Center, Neyagawa, Japan
| | - Kohta Suzuki
- Institute for Occupational Health Science, Aichi Medical University, Nagakute, Japan
- Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
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20
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Sun K, Chen XS, Muzhylko T, Andrade FCD. Doctors' recommendations and healthy lifestyle behaviors among individuals with hypertension in Brazil. Prev Med Rep 2023; 35:102315. [PMID: 37576845 PMCID: PMC10413139 DOI: 10.1016/j.pmedr.2023.102315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 08/15/2023] Open
Abstract
Little is known about whether doctors' recommendations encourage healthy behaviors among individuals with hypertension in Brazil. This study examined the biological, social, and health factors related to doctor's recommendations and the associations between doctor's recommendations and healthy behaviors. The sample consisted of individuals with hypertension (N = 18,260) from Brazil's 2019 National Health Survey. The outcomes examined included smoking, drinking, diet, salt intake, physical activity, and doctor visits. Study findings indicated that more than 80% of people with hypertension in Brazil received doctors' recommendations to adhere to medical care and engage in healthy behaviors. Those who received recommendations were more likely to practice healthy eating and exercise regularly but also to be obese/overweight, smoke, and drink excessively. Nonetheless, the findings concerning diet and exercise suggest the value of doctors' recommendations for individuals with hypertension in Brazil.
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Affiliation(s)
- Kang Sun
- University of Illinois at Urbana-Champaign, United States
| | | | - Tonya Muzhylko
- University of Illinois at Urbana-Champaign, United States
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21
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Cherpitel CJ, Li L, Kerr WC. The Relationship Between Drinking Patterns and Chronic Health Conditions: New Evidence From Two U.S. National Alcohol Surveys. J Stud Alcohol Drugs 2023; 84:661-669. [PMID: 37306370 PMCID: PMC10600973 DOI: 10.15288/jsad.23-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE The association of many chronic disease conditions with alcohol consumption is well established, and research on drinking patterns following diagnosis suggests that those with a chronic condition drink less than their healthy counterparts. However, these studies have not controlled for confounding influences on this relationship. This article reports current drinking patterns of those with one of four chronic disease conditions (hypertension, diabetes, heart disease, cancer) compared to those without, controlling for covariates. METHOD Data were analyzed from a merged sample of the two National Alcohol Surveys of the U.S. adult population (2014-2015 and 2019-2020; n = 9,597). Those reporting any one of the four disease conditions were matched to healthy control respondents on demographic characteristics and history of drinking using propensity score weighting (PSW). RESULTS Those with hypertension and heart disease appeared to drink less than controls during the last year, but after models were adjusted for covariates or PSW, no significant differences were found. For diabetes, only the PSW models showed no significant difference in drinking from controls, whereas both unadjusted and adjusted models for cancer showed no differences from controls. CONCLUSIONS Controlling for covariates and PSW appeared to make cases and their healthy controls more similar in past-year drinking patterns. Observed similarity in drinking patterns of those with and without a chronic disease may serve as an impetus for a greater focus on screening and identification of those with chronic conditions who would benefit from focused harm-reduction messages and implementation of effective alcohol interventions.
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Affiliation(s)
| | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - William C. Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California
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22
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Gao M, Park S, Lee C. Social Participation and Persistent Smoking Among Older Chinese With Smoking-Related Morbidity. J Gerontol B Psychol Sci Soc Sci 2023; 78:1572-1580. [PMID: 37210675 DOI: 10.1093/geronb/gbad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Indexed: 05/22/2023] Open
Abstract
OBJECTIVES Chronic diseases are common in midlife and old age and smoking can pose more health and longevity challenges for older people with chronic illnesses. In China where smoking is highly prevalent, older adults are likely to continue smoking even after developing severe chronic diseases. We examined the national prevalence of persistent smoking among older adults. We also investigated the sociodemographic characteristics of persistent smoking among ever-smokers with chronic diseases and its association with social participation (of various types). METHODS We used data from a nationally representative sample of older adults aged 45-80 in the China Health and Retirement Longitudinal Study (2011-2018). Multinomial logistic and multilevel logistic models were fitted. RESULTS The national prevalence of persistent smoking was around 24% of older men and 3% of older women. Among those with a history of smoking and chronic illness, younger, nonmarried/partnered, nonretired, or less educated individuals are more likely to continue smoking. Social participation is significantly associated with persistent smoking among those with chronic diseases, but the association differs across different forms of activities. Although the most popular but sedentary activities in China (playing Mahjong, chess, or cards) are associated with an elevated risk of persistent smoking, physical social activities (community-organized dancing, fitness, and qigong) are associated with a reduced risk of persistent smoking. DISCUSSION Given the enormous burden of persistent smoking on individuals and society, public smoking cessation inventions should address sociocultural factors of persistent smoking and target older adults who participate in specific social activities.
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Affiliation(s)
- Manjing Gao
- Department of Sociology, University of California, Riverside, Riverside, California, USA
| | - Soojin Park
- Graduate School of Education, University of California, Riverside, Riverside, California, USA
| | - Chioun Lee
- Department of Sociology, University of California, Riverside, Riverside, California, USA
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23
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Qin W. Health Behavior Changes after a Diabetes Diagnosis: The Moderating Role of Social Support. Behav Med 2023; 49:292-301. [PMID: 35350953 PMCID: PMC9519805 DOI: 10.1080/08964289.2022.2050670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 02/25/2022] [Accepted: 03/02/2022] [Indexed: 11/02/2022]
Abstract
The present study aims to investigate the relationship between a diagnosis of diabetes and health behavior changes among middle-aged and older adults, and whether self-efficacy and social support moderate the relationship. The study sample was selected from the 2006 to 2016 waves of the Health and Retirement Study (N = 13,143). A diagnosis of diabetes was ascertained by self-reported physician-diagnosed condition. Self-efficacy was measured using a 5-item scale. Social support from family and friends was measured separately by a same 3-item scale. Three health behaviors were assessed, including drinking, smoking, and physical activity. Mixed-effects regression models were conducted to test the study aims. Findings showed that participants reduced drinking after a diagnosis of diabetes. A significant interaction between social support from family and a diabetes diagnosis was found in predicting drinking reduction and smoking cessation. These findings suggest that a diagnosis of diabetes may trigger individuals' motivation to initiate health-promoting behaviors. Mobilizing social support from family may help individuals adopt health-promoting behaviors and manage diabetes after a diagnosis.
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Affiliation(s)
- Weidi Qin
- Population Studies Center, University of Michigan
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24
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Sims R, Michaleff ZA, Glasziou P, Jones M, Thomas R. Quantifying the psychological and behavioural consequences of a diagnostic label for non-cancer conditions: systematic review. BJPsych Open 2023; 9:e73. [PMID: 37073644 PMCID: PMC10134215 DOI: 10.1192/bjo.2023.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Screening for asymptomatic health conditions is perceived as mostly beneficial, with possible harms receiving little attention. AIMS To quantify proximal and longer-term consequences for individuals receiving a diagnostic label following screening for an asymptomatic, non-cancer health condition. METHOD Five electronic databases were searched (inception to November 2022) for studies that recruited asymptomatic screened individuals who received or did not receive a diagnostic label. Eligible studies reported psychological, psychosocial and/or behavioural outcomes before and after screening results. Independent reviewers screened titles and abstracts, extracted data from included studies, and assessed risk of bias (Risk of Bias in Non-Randomised Studies of Interventions). Results were meta-analysed or descriptively reported. RESULTS Sixteen studies were included. Twelve studies addressed psychological outcomes, four studies examined behavioural outcomes and none reported psychosocial outcomes. Risk of bias was judged as low (n = 8), moderate (n = 5) or serious (n = 3). Immediately after receiving results, anxiety was significantly higher for individuals receiving versus not receiving a diagnostic label (mean difference -7.28, 95% CI -12.85 to -1.71). On average, anxiety increased from the non-clinical to clinical range, but returned to the non-clinical range in the longer term. No significant immediate or longer-term differences were found for depression or general mental health. Absenteeism did not significantly differ from the year before to the year after screening. CONCLUSIONS The impacts of screening asymptomatic, non-cancer health conditions are not universally positive. Limited research exists regarding longer-term impacts. Well-designed, high-quality studies further investigating these impacts are required to assist development of protocols that minimise psychological distress following diagnosis.
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Affiliation(s)
- Rebecca Sims
- Institute for Evidence-Based Healthcare, Bond University, Australia
| | - Zoe A. Michaleff
- Institute for Evidence-Based Healthcare, Bond University, Australia
- Research Office, Northern New South Wales Local Health District, Australia
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Australia
| | - Mark Jones
- Institute for Evidence-Based Healthcare, Bond University, Australia
| | - Rae Thomas
- Institute for Evidence-Based Healthcare, Bond University, Australia
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25
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Xu C, Cao Z, Huang X, Wang X. Associations of healthy lifestyle with depression and post-depression dementia: A prospective cohort study. J Affect Disord 2023; 327:87-92. [PMID: 36736794 DOI: 10.1016/j.jad.2023.01.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Depressive symptoms may be a risk factor or prodrome of dementia, but the modifiable risk factors for dementia after onset of depression has not been fully elucidated. The current study aimed to investigate the associations of lifestyle factors with depression and post-depression dementia. METHODS Our analysis was based on data from the ongoing UK Biobank study, which included 497,533 participants (age 37-73 years) between 2006 and 2010, and thereafter followed up to 2020. High-risk lifestyle factors included current smoking, heavy alcohol intaking, poor diet pattern, physically inactive. Multistate models were used to estimate the transition-specific hazard ratios (HRs) and 95 % confidence intervals (CIs). RESULTS During a 14.8-year follow-up, 23,164 participants developed depression, and 989 developed post-depression dementia. The incidence rate of dementia in people with depression was far more than those who were free of depression. In multistate model, high-risk lifestyle factors were substantially associated with higher risks of incident depression (HR = 2.14, 95 % CI: 1.95-2.35), dementia (HR = 1.87, 95 % CI: 1.51-2.31), and post-depression dementia (HR = 1.72, 95 % CI: 1.13-2.62). When the analyses were divided by individual lifestyle factors, we found that only physically inactive contributed significantly to the development of dementia after the onset of depression (HR = 1.15, 95 % CI: 1.01-1.30). CONCLUSION Our study found that high-risk lifestyle factors were associated with higher risk of transition from depression to dementia, highlighting the great significance of integrating comprehensive behavioral interventions, particularly for regular physical activity, for prevention of both depression and post-depression dementia.
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Affiliation(s)
- Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China.
| | - Zhi Cao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xianhong Huang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiaohe Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China.
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26
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Lip GYH, Lenarczyk R, Pastori D, Ntaios G, Doehner W, Schnabel R. Post-stroke cardiovascular management: Current concepts, integrated care and future developments. Curr Probl Cardiol 2023; 48:101738. [PMID: 37040854 DOI: 10.1016/j.cpcardiol.2023.101738] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 04/13/2023]
Abstract
After an ischaemic stroke patients often have cardiovascular complications known as stroke-heart syndrome. The cardiovascular management after stroke has a significant impact on life expectancy as well as the quality of life. The development and implementation of management pathways to improve outcomes for patients with stroke-heart syndrome requires a multidisciplinary involvement from health care professionals from primary, secondary and tertiary prevention levels. A holistic, integrated care approach could follow the ABC pathway: A) Appropriate antithrombotic therapy in all stroke/TIA patients in the acute phase as well as recommendations for the longer term treatment regimen are required to avoid recurrent stroke. B) For better functional and psychological status the assessment of post-stroke cognitive and physical impairment, depression, and anxiety as part of routine post-stroke work-up in every patient is necessary. C) Cardiovascular risk factors and comorbidities management further includes cardiovascular work-up, adapted drug therapy, but often also lifestyle changes that are central to the success of integrated care for stroke-heart syndrome. Greater patient and family/caregiver involvement in planning actions and the input and feedback on optimizing stroke care pathways is needed. Achieving integrated care is challenging and highly context dependent on different healthcare levels. A tailored approach will utilize a variety of enabling factors. In this narrative review, we summarize the current evidence and outline potential factors that will contribute to the successful implementation of integrated cardiovascular care for stroke-heart syndrome management.
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Affiliation(s)
- Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Radosław Lenarczyk
- The Medical University of Silesia, Division of Medical Sciences in Zabrze, Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center of Heart Diseases, Curie-Sklodowska Str 9, 41-800 Zabrze, Poland
| | - Daniele Pastori
- Emergency Medicine Unit - Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Italy
| | - George Ntaios
- Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Wolfram Doehner
- BIH Center for Regenerative Therapies (BCRT) and Department of Internal Medicine and Cardiology (Virchow Klinikum), German Centre for Cardiovascular Research (DZHK) partner site Berlin and Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Renate Schnabel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
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27
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Yun JY, Yun YH. Health-promoting behavior to enhance perceived meaning and control of life in chronic disease patients with role limitations and depressive symptoms: a network approach. Sci Rep 2023; 13:4848. [PMID: 36964273 PMCID: PMC10039031 DOI: 10.1038/s41598-023-31867-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/20/2023] [Indexed: 03/26/2023] Open
Abstract
The association between health-related role limitations in the mental and physical subdomains and clinical status (i.e., chronic disease and comorbid depressive symptoms) is mediated by health-promoting behaviors. To enhance health-promoting behaviors in adults with chronic disease, it is necessary to identify item-level associations among targets of health-related monitoring and management. Therefore, the current study used a network approach to examine associations among health-related role limitations, depressive symptoms, existential well-being, socioeconomic position, and health-promoting behavior in adults with chronic disease. A total of 535 adults (mean ± SD age = 62.9 ± 11.9 years; males, n = 231, females, n = 304) who were regularly visiting an outpatient clinic for chronic disease treatment participated in this cross-sectional study. Data on participant demographics, chronic disease diagnoses, socioeconomic status, health-related role limitations (12-item short form survey scores), depressive symptoms (patient health questionnaire-9 scores), existential well-being (scores for four items of the McGill quality of life questionnaire-Revised), and health-promoting behavior (Healthy Habits Questionnaire scores) were acquired. "Undirected regularized partial correlations" and "directional joint probability distributions" among these variables were calculated using a mixed graphical model (MGM) and directed acyclic graph (DAG). In the MGM, the most influential nodes were emotional well-being, feelings of failure, and health-related limitations affecting usual role and physical activities. According to both the MGM and DAG, the relationship between emotional well-being and feelings of failure mediated the relationships of health-related role limitations with concentration difficulty and suicidal ideation. A positive mindset was dependent on the probability distributions of suicidal ideation, controllability of life, and positive self-image. Both the meaning of life and a positive mindset had direct associations with proactive living. Specifically, proactive living was associated with a balanced diet, regular exercise, volunteering in the community, and nurturing intimacy in social interactions. The meaning and controllability of life in individuals with chronic diseases could mediate the relationships of health-promoting behavior with health-related limitations related to usual role activities, physical activities, and depressive symptoms. Thus, interventions targeting health-promoting behaviors should aim to enhance the meaning and controllability of life (as it pertains to limitations in usual role and physical activities), as well as promote proactive screening and timely psychiatric treatment of depressive symptoms including feelings of failure, concentration difficulties, and suicidal ideation.
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Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Ho Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Family Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
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28
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Gomez KU, McBride O, Roberts E, Angus C, Keyes K, Drummond C, Buchan I, Fleming K, Gilmore I, Donoghue K, Bonnet L, Goodwin L. The clustering of physical health conditions and associations with co-occurring mental health problems and problematic alcohol use: a cross-sectional study. BMC Psychiatry 2023; 23:89. [PMID: 36747152 PMCID: PMC9901006 DOI: 10.1186/s12888-023-04577-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/27/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND There is strong evidence for the co-occurrence of mental health conditions and alcohol problems, yet physical health outcomes among this group are not well characterised. This study aimed to identify clusters of physical health conditions and their associations with mental health and problematic alcohol use in England's general population. METHODS Cross-sectional analysis of the 2014 Adult Psychiatric Morbidity Survey (N = 7546) was conducted. The survey used standardised measures of problematic alcohol use and mental health conditions, including the Alcohol Use Disorders Identification Test (AUDIT) and the Clinical Interview Schedule-Revised. Participants self-reported any lifetime physical health conditions. Latent class analysis considered 12 common physical illnesses to identify clusters of multimorbidity. Multinomial logistic regression (adjusting for age, gender, ethnicity, education, and occupational grade) was used to explore associations between mental health, hazardous drinking (AUDIT 8 +), and co-occurring physical illnesses. RESULTS Five clusters were identified with statistically distinct and clinically meaningful disease patterns: 'Physically Healthy' (76.62%), 'Emerging Multimorbidity' (3.12%), 'Hypertension & Arthritis' (14.28%), 'Digestive & Bowel Problems'' (3.17%), and 'Complex Multimorbidity' (2.8%). Having a mental health problem was associated with increased odds of 'Digestive & Bowel Problems' (adjusted multinomial odds ratio (AMOR) = 1.58; 95% CI [1.15-2.17]) and 'Complex Multimorbidity' (AMOR = 2.02; 95% CI [1.49-2.74]). Individuals with co-occurring mental health conditions and problematic alcohol use also had higher odds of 'Digestive & Bowel Problems' (AMOR = 2.64; 95% CI [1.68-4.15]) and 'Complex Multimorbidity' (AMOR = 2.62; 95% CI [1.61-4.23]). CONCLUSIONS Individuals with a mental health condition concurrent with problematic alcohol use experience a greater burden of physical illnesses, highlighting the need for timely treatment which is likely to include better integration of alcohol and mental health services.
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Affiliation(s)
- Katalin Ujhelyi Gomez
- Department of Primary Care and Mental Health, University of Liverpool, Waterhouse Block B 1St Floor, 1-5 Brownlow St, Liverpool, L69 3G, UK.
| | - Orla McBride
- School of Psychology, Ulster University, Belfast, UK
| | - Emmert Roberts
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and the Maudsley NHS Foundation Trust, London, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Katherine Keyes
- Department of Epidemiology, Columbia University, New York, USA
| | - Colin Drummond
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and the Maudsley NHS Foundation Trust, London, UK
| | - Iain Buchan
- Department of Public Health, Policy, and Systems, University of Liverpool, Liverpool, UK
| | - Kate Fleming
- National Disease Registration Service, NHS Digital, Leeds, UK
| | - Ian Gilmore
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, UK
| | - Kim Donoghue
- Clinical, Education & Health Psychology, University College London, London, UK
| | - Laura Bonnet
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Laura Goodwin
- Division of Health Research, Lancaster University, Lancaster, UK
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Cherpitel CJ, Ye Y, Kerr WC. Association of short-term changes in drinking after onset of a serious health condition and long-term heavy drinking. Drug Alcohol Depend 2022; 241:109691. [PMID: 36371996 PMCID: PMC9772249 DOI: 10.1016/j.drugalcdep.2022.109691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Literature on changes in drinking following diagnosis of chronic health conditions is limited, especially differential response to specific conditions or across demographic subgroups. Methods Data were analyzed from the 2020 National Alcohol Survey of the U.S. adult population (n = 9968). Predictors of change in drinking following first diagnosis of hypertension, heart disease, diabetes, and cancer, and how the short-term post-disease change in drinking was associated with a change in long-term heavy (5 +) drinking from the decade before diagnosis to the decade following diagnosis were analyzed. Results The majority of respondents reported no change in drinking after diagnosis. Men were more likely than women to reduce drinking after hypertension (OR=1.47) but less likely to quit after heart disease (OR=0.46). Black and Hispanic/Latinx drinkers were more likely than white or other drinkers to reduce (OR=2.68, 2.35, respectively) or quit (OR=2.69, 2.34) after hypertension, and more likely to quit after diabetes (OR=3.44, 2.74) and cancer (OR=5.00, 5.27). Black drinkers were more likely to quit after heart disease (OR=3.26). Heavier drinkers were more likely to reduce or quit drinking than lighter drinkers. For all disease types, those who quit drinking after disease onset were less likely to report heavy drinking in the following decade. Conclusions Just cutting down had little effect on subsequent long-term heavy drinking compared to quitting. These data are important for informing efforts aimed at harm reduction in patients diagnosed with a chronic health condition and suggest specific demographic subgroups.
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Affiliation(s)
- Cheryl J Cherpitel
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA.
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
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Choi EY, Park YK, Ock M. Comparison of low-salt preference trends and regional variations between patients with major non-communicable diseases and the general population. PLoS One 2022; 17:e0276655. [PMID: 36282856 PMCID: PMC9595509 DOI: 10.1371/journal.pone.0276655] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Abstract
Background We compared low-salt preference between patients with major chronic diseases, also known as non-communicable diseases (hereinafter referred to as ‘“major NCD patients’”), and the general population. Methods We used data extracted from the Korea Community Health Survey Community during the period of 2008–2019. We evaluated the low-salt preference of 13 major NCD patients by year and region to analyse recent changes in low-salt preference trends, using joinpoint regression. Results A greater majority of major NCD patients had a higher low-salt preference than general population; however, the overall trend was not significantly significant. The low-salt preference rate (Type III) was highest among patients with diabetes (15.6%), followed by hypertension (14.1%) and dyslipidaemia (13.4%), with the general population displaying the lowest rate (11.3%). The rates of adherence to a low-salt diet and fried food without soy sauce gradually increased until 2013 and then declined. The rate of adherence to not adding salt and soy sauce at the table gradually increased and maintained a high rate of adherence until 2019, except for patients with some diseases. Regional variations in low-salt preference tended to be greater in patients with major NCDs than general population. Conclusion There is a need to improve the low-salt diet behaviour of not only major NCD patients, but also the general population. Various low-salt diet programs need to be promoted, such as education on a low-salt diet, certification for low-salt restaurants, and sodium tax. Moreover, it is necessary to continuously monitor the low-salt preferences of major NCD patients.
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Affiliation(s)
- Eun Young Choi
- College of Nursing, Sungshin Women’s University, Seoul, Republic of Korea
| | - Young-Kwon Park
- Prevention and Management Center, Ulsan Regional Cardiocerebrovascular Disease Center, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Minsu Ock
- Prevention and Management Center, Ulsan Regional Cardiocerebrovascular Disease Center, Ulsan University Hospital, Ulsan, Republic of Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
- * E-mail:
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Xie H, Li J, Zhu X, Li J, Yin J, Ma T, Luo Y, He L, Bai Y, Zhang G, Cheng X, Li C. Association between healthy lifestyle and the occurrence of cardiometabolic multimorbidity in hypertensive patients: a prospective cohort study of UK Biobank. Cardiovasc Diabetol 2022; 21:199. [PMID: 36183084 PMCID: PMC9526960 DOI: 10.1186/s12933-022-01632-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiometabolic multimorbidity (CMM) is becoming increasingly common in patients with hypertension, and it is well established that healthy lifestyle plays a key role in the prevention of hypertension. However, the association between combined lifestyle factors and CMM in patients with hypertension is uncertain. METHODS This prospective analysis included the data (obtained from the UK biobank) of participants with hypertension who did not have coronary heart disease (CHD), stroke, or diabetes. The outcome was the occurrence of CMM, defined as ≥ 1 disease of CHD, stroke, and diabetes that occurred in participants with hypertension. Four lifestyle factors (smoking, alcohol consumption, diet, and physical activity) were assessed using a weighted healthy lifestyle score, and participants were divided into four groups: the very unhealthy, unhealthy, healthy, and very healthy groups. The flexible parameter Royston-Parmar proportional hazard model was used to estimate hazard ratios (HRs) between lifestyles and CMM, as well as the difference in CMM-free life expectancy. RESULTS During a median follow-up of 12.2 years, 9812 (18.4%) of the 53,397 hypertensive patients occurred CMM. Compared with the very unhealthy group, the very healthy group had a 41% reduction in the risk for CMM in hypertensive patients and a 32-50% reduction in the risk for specific cardiometabolic diseases such as CHD, stroke, and diabetes. For each lifestyle factor, non-smoking had the greatest protective effect against CMM (HR: 0.64, 95% confidence interval (CI) 0.60-0.68). A lifestyle combining multiple healthy factors extended CMM-free life expectancy (e.g., six years longer at age 45 years for participants in the very healthy group). CONCLUSIONS Combined healthy lifestyle factors were associated with a lower risk for CMM in hypertensive patients. This suggests that combined healthy lifestyle should be supported to decrease disease burden.
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Affiliation(s)
- Hejian Xie
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jinchen Li
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xuanmeng Zhu
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jing Li
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jinghua Yin
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Tianqi Ma
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Luo
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lingfang He
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Guogang Zhang
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, China.,Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Chuanchang Li
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87#, Changsha, 410008, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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Gomez del Pulgar M, Cuevas-Budhart MA, Hernández-Iglesias S, Kappes M, Riquelme Contreras VA, Rodriguez-Lopez E, De Almeida Souza AM, Gonzalez Jurado MA, Crespo Cañizares A. Best Nursing Intervention Practices to Prevent Non-Communicable Disease: A Systematic Review. Public Health Rev 2022; 43:1604429. [PMID: 36189187 PMCID: PMC9516617 DOI: 10.3389/phrs.2022.1604429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/19/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives: To explore nursing health education interventions for non-communicable disease patients. Methods: The design was a systematic review of research work published between 2008 and 2018. The data sources included the Web of Science, PubMed, Scopus, COCHRANE, and LILACS. The studies that met the inclusion were assessed, and the analysis for methodological quality through the recommended tools CASPe, and JADAD. Results: Fifteen original studies from eight counties were included in the review; Findings revealed 13 studies with randomized samples and six used power analysis. Nurses’ interventions included house calls, home care, and individual and group health education. Conclusion: Nursing interventions showed 76.4% the effectiveness of results in patient outcomes to promote and improve healthier lifestyles and quality of life of non-communicable disease patients. This review discloses the significant impact of nursing health education interventions. Nursing leadership and political decision-makers should consider providing programs to enhance health education knowledge and abilities. All of this can favor the sustainability of the global economy by changing the life style of thousands of people worldwide. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42020208809.
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Affiliation(s)
- Mercedes Gomez del Pulgar
- Centro de Educación Superior Hygiea, Madrid, Spain
- Coordination of the Center for Advanced Clinical Simulation of the Nursing Degree, Universidad Francisco de Vitoria, Posuelo de Alarcon, Madrid, España
| | - Miguel Angel Cuevas-Budhart
- Unidad de Investigación Médica en Enfermedades Nefrológicas, Instituto Mexicano del Seguro Social (IMSS), Mexico City, México
- *Correspondence: Miguel Angel Cuevas-Budhart, , ,
| | - Sonsoles Hernández-Iglesias
- Institutional Relations and Health Practices of Health Sciences, Faculty of the Nursing Degree, Universidad Francisco de Vitoria, Pozuelo de Alarcon, Madrid, España
| | - Maria Kappes
- College of Health Care Sciences, Nursing School, Universidad San Sebastián, Puerto Montt, Chile
| | | | | | | | | | - Almudena Crespo Cañizares
- Clinical Practices of the Degree in Nursing, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
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Wang D, Dai X, Mishra SR, Lim CCW, Carrillo-Larco RM, Gakidou E, Xu X. Association between socioeconomic status and health behaviour change before and after non-communicable disease diagnoses: a multicohort study. Lancet Public Health 2022; 7:e670-e682. [PMID: 35907418 DOI: 10.1016/s2468-2667(22)00157-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/23/2022] [Accepted: 06/10/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Behavioural risk factors of non-communicable diseases (NCDs) are socially patterned. However, the direction and the extent to which socioeconomic status (SES) influences behaviour changes before and after the diagnosis of NCDs is not clearly understood. We aimed to investigate the influence of SES on behaviour changes (physical inactivity and smoking) before and after the diagnosis of major NCDs. METHODS In this multicohort study, we pooled individual-level data from six prospective cohort studies across 17 countries. We included participants who were diagnosed with either diabetes, cardiovascular disease, chronic lung disease, or cancer after recruitment. Participants were surveyed every 2 years. Education and total household wealth were used to construct SES. We measured behaviour changes as whether or not participants continued or initiated physical inactivity or smoking after NCD diagnosis. We used multivariable logistic regression models to estimate odds ratios (ORs), prevalence ratios (PRs), and 95% CIs for the associations between SES and continuation or initiation of unfavourable behaviours. FINDINGS We included 8107 individuals recruited between March, 2002, and January, 2016. Over the 4-year period before and after NCD diagnosis, 886 (60·4%) of 1466 individuals continued physical inactivity and 1018 (68·8%) of 1480 participants continued smoking; 1047 (15·8%) of 6641 participants with physical activity before diagnosis initiated physical inactivity after diagnosis and 132 (2·0%) of 6627 non-smokers before diagnosis initiated smoking after diagnosis. Compared with participants with high SES, those with low SES were more likely to continue physical inactivity (244 [70·3%] of 347 vs 23 [50.0%] of 46; PR 1·41 [95% CI 1·05-1·99]; OR 2·28 [1·18-4·41]), continue smoking (214 [75·4%] of 284 vs 39 [60·9%] of 64; PR 1·27 [1·03-1·59]; OR 2·08 [1·14-3·80]), but also to initiate physical inactivity (188 [26·1%] of 720 vs 47 [7·4%] of 639; PR 3·59 [2·58-4·85]; OR 4·31 [3·02 - 6·14]). INTERPRETATION Low SES was associated with continuing or initiating physical inactivity and continuing smoking after NCD diagnosis. Reducing socioeconomic inequality in health behaviour changes should be prioritised and integrated into NCD-prevention programmes. FUNDING Zhejiang University and Fundamental Research Funds for the Central Universities.
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Affiliation(s)
- Danyang Wang
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaochen Dai
- Department of Health Metrics Sciences, School of Medicine, School of Public Health, University of Washington, Seattle, USA; Institute for Health Metrics and Evaluation, School of Public Health, University of Washington, Seattle, USA
| | - Shiva Raj Mishra
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Academy for Data Sciences and Global Health, Kathmandu, Nepal
| | - Carmen C W Lim
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia; School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Rodrigo M Carrillo-Larco
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Emmanuela Gakidou
- Department of Health Metrics Sciences, School of Medicine, School of Public Health, University of Washington, Seattle, USA; Institute for Health Metrics and Evaluation, School of Public Health, University of Washington, Seattle, USA; Department of Global Health, School of Public Health, University of Washington, Seattle, USA; Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, USA
| | - Xiaolin Xu
- Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
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Zhang P, Jiang H, Chen W. Health shocks and changes in preventive behaviors: Results from the China Health and Retirement Longitudinal Study. Front Public Health 2022; 10:954700. [PMID: 35968418 PMCID: PMC9363769 DOI: 10.3389/fpubh.2022.954700] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChina is facing the challenge of rising prevalence and ballooning burden of chronic non-communicable diseases (NCDs); however, the Chinese middle- and older-aged population considerably lack preventive behaviors. Health shocks (HS), widely defined as sudden health deterioration brought on by diseases or accidents, bring a “teachable moment” to motivate changes in preventive behaviors.ObjectiveThis study aims to examine the effect of HS on changes in preventive behaviors, including personal health practices and preventive care utilization.MethodsHS was defined as any five chronic disease diagnoses (cancer, heart disease, stroke, diabetes, and hypertension). The impacts of HS on smoking, drinking, and exercise, physical examination were estimated. The panel data of 13,705 respondents were obtained from the latest two waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. A multilevel propensity score match difference-in-difference (multilevel PSM-DID) model was constructed.ResultsHS significantly decreased smoking (OR = 0.59, p < 0.05) and drinking (OR = 0.62, p < 0.01) and increased the utilization of auxiliary inspection in physical examination (OR = 1.19, p < 0.1). Major HS had significantly considerable and specific effects on reducing smoking and drinking (OR = 0.37 and 0.56, p < 0.01), while minor HS had relatively small effects on reducing smoking (OR = 0.74, p < 0.05) and drinking (OR = 0.69, p < 0.01), but extensive effects on initiating exercise (OR = 1.32, p < 0.05), physical examination (OR = 1.18, p < 0.1), and auxiliary inspection (OR = 1.30, p < 0.05).ConclusionAfter HS, there is a teachable moment to promote positive changes in preventive behaviors. Guided by the 5A's brief intervention model (Ask, Advise, Assess, Assist, Arrange), tailored interventions should be targeted at these populations to reduce the risk of the progression and complications of existing diseases, prevent the related comorbidity, and prolong the expected life-span.
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Signore AK, Jung ME, Semenchuk B, Kullman SM, Tefft O, Webber S, Ferguson LJ, Kowalski K, Fortier M, McGavock J, Ahmed R, Orr M, Strachan S. A pilot and feasibility study of a randomized clinical trial testing a self-compassion intervention aimed to increase physical activity behaviour among people with prediabetes. Pilot Feasibility Stud 2022; 8:111. [PMID: 35624519 PMCID: PMC9135984 DOI: 10.1186/s40814-022-01072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes. METHODS This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical activity, and low self-compassion) were randomized to a self-compassion (Mage = 60.22 years) or control condition (Mage = 56.13 years). All participants received behaviour change education (e.g. SMART goals, action-coping planning) and either other health knowledge (control condition: e.g. sleep, benefits of water) or self-compassion training (intervention condition: practising mindfulness, writing a letter to themselves offering the same support that they would offer to a friend). The primary outcome was to determine the feasibility and acceptability of the trial. To be considered feasible, our outcomes needed to meet or surpass our pre-determined criteria (e.g. time for group formation: 14-20 participants per month). Feasibility was assessed by examining the recruitment rates, retention, adherence, fidelity, and capacity. Semi-structured interviews were conducted with participants to determine trial acceptability. As a secondary purpose, we examined the means on key study variables (secondary and exploratory variables; see Table 1) at all planned time points (baseline, intervention-end, 6- and 12-week follow-up) to identify if they are suitable to include in the efficacy trial (see Additional Table 3). RESULTS Eighteen participants were screened and randomized to one of two conditions. Retention, instructor fidelity, safety, capacity, adherence to most of the study aspects, and acceptability by participants and facilitators all met the criteria for feasibility. Recruitment rate, process time, and adherence to home practice were below our criteria, and we offer ways to address these shortcomings for the efficacy trial. CONCLUSION The results from this study suggest that it should be feasible to deliver our intervention while highlighting the alterations to components that may be altered when delivering the efficacy trial. We outline our changes which should improve and enhance the feasibility and acceptability of our planned intervention. Funding for this study was from the Canadian Institutes of Health Research (CIHR). TRIAL REGISTRATION ClinicalTrials.gov, NCT04402710 . Registered on 09 April 2020.
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Affiliation(s)
- Alana K Signore
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Brittany Semenchuk
- Applied Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Sasha M Kullman
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Olivia Tefft
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Sandra Webber
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Leah J Ferguson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Kent Kowalski
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Michelle Fortier
- School of Human Kinetics, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Jon McGavock
- Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 3P5, Canada
| | - Rashid Ahmed
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, 58202, USA
| | - Marion Orr
- Inner Compass Counselling, Winnipeg, MB, R3G 2X6, Canada
| | - Shaelyn Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
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Using Patient Health Profile Evaluation for Predicting the Likelihood of Retinopathy in Patients with Type 2 Diabetes: A Cross-Sectional Study Using Latent Profile Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106084. [PMID: 35627621 PMCID: PMC9141098 DOI: 10.3390/ijerph19106084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 02/04/2023]
Abstract
Background: To determine whether long-term self-management among patients with type 2 diabetes mellitus has the risk of developing complications. Methods: We conducted a survey of self-management behavior using diabetes self-management scales (DMSES-C and TSRQ-d) from November 2019 to May 2020 linked with biomarkers (glucose, lipid profile, blood pressure, and kidney function), and the varying measure values were transformed into normal rate proportions. We performed latent profile analysis (LPA) to categorize the patient into different patient health profiles using five classes (C1-C5), and we predicted the risk of retinopathy after adjusting for covariates. Results: The patients in C1, C2, and C4 had a higher likelihood of retinopathy events than those in C5, with odds ratios (ORs) of 1.655, 2.168, and 1.788, respectively (p = 0.032). In addition, a longer duration of diabetes was correlated with an increased risk of retinopathy events as well as being elderly. Conclusions: Optimal biomarker health profiles and patients with strong motivation pertaining to their T2DM care yielded better outcomes. Health profiles portraying patient control of diabetes over the long term can categorize patients with T2DM into different behavior groups. Customizing diabetes care information into different health profiles raises awareness of control strategies for caregivers and patients.
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Fung TKF, Lai PY, Chang L, Leung HM. Applying the comprehensive model of information seeking to understand chronic illness information scanning: Hong Kong evidence. WORLD MEDICAL & HEALTH POLICY 2022. [DOI: 10.1002/wmh3.515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Timothy K. F. Fung
- Department of Communication Studies Hong Kong Baptist University Kowloon Tong Hong Kong
| | - Po Yan Lai
- Department of Communication Studies Hong Kong Baptist University Kowloon Tong Hong Kong
| | - Leanne Chang
- Department of Communication Studies Hong Kong Baptist University Kowloon Tong Hong Kong
| | - Ho Man Leung
- Department of Communication Studies Hong Kong Baptist University Kowloon Tong Hong Kong
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Guo F, Bostean G, Berardi V, Velasquez AJ, Robinette JW. Obesogenic environments and cardiovascular disease: a path analysis using US nationally representative data. BMC Public Health 2022; 22:703. [PMID: 35399056 PMCID: PMC8994874 DOI: 10.1186/s12889-022-13100-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION People living in obesogenic environments, with limited access to healthful food outlets and exercise facilities, generally have poor health. Previous research suggests that behavioral risk factors and indicators of physiological functioning may mediate this link; however, no studies to date have had the requisite data to investigate multi-level behavioral and physiological risk factors simultaneously. The present study conducted serial and parallel mediation analyses to examine behavioral and physiological pathways explaining the association between environmental obesogenicity and cardiovascular disease (CVD). METHODS This cross-sectional observational study used data from the 2012-2016 Health and Retirement Study, a representative survey of US older adults (n = 12,482, mean age 65.9). Environmental obesogenicity was operationalized as a combined score consisting of nine environmental measures of food and physical activity. CVD and health-compromising behaviors (diet, alcohol consumption, smoking, and exercise) were self-reported. Physiological dysregulation was assessed with measured blood pressure, heart rate, HbA1c, cholesterol levels, BMI, and C-reactive protein. The Hayes Process Macro was used to examine serial and parallel paths through health-compromising behaviors and physiological dysregulation in the environmental obesogenicity-CVD link. RESULTS People living in more obesogenic environments had greater odds of self-reported CVD (odds ratio = 1.074, 95% confidence interval (CI): 1.028, 1.122), engaged in more health-compromising behaviors (β = 0.026, 95% CI: 0.008, 0.044), and had greater physiological dysregulation (β = 0.035, 95% CI: 0.017, 0.054). Combined, health-compromising behaviors and physiological dysregulation accounted for 7% of the total effects of environmental obesogenicity on CVD. CONCLUSION Behavioral and physiological pathways partially explain the environmental obesogenicity-CVD association. Obesogenic environments may stymie the success of cardiovascular health-promotion programs by reducing access to resources supporting healthy lifestyles.
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Affiliation(s)
- Fangqi Guo
- Psychology Department, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA.
| | - Georgiana Bostean
- Department of Sociology, Humanities, and Social Sciences, Wilkinson College of Arts, Chapman University, Orange, CA, USA
- Environmental Science & Policy Program, Schmid College of Science and Technology, Chapman University, Orange, CA, USA
| | - Vincent Berardi
- Psychology Department, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA
| | - Alfredo J Velasquez
- Psychology Department, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA
| | - Jennifer W Robinette
- Psychology Department, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA
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Bergaoui J, Latiri I, Ben Saad H. Deficiency, incapacity and social disadvantage of patients with chronic hepatitis B: a case-control study. LA TUNISIE MEDICALE 2022; 99:682-692. [PMID: 35260999 PMCID: PMC8796680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Studies examining impairment, disability and social disadvantage of patients with chronic viral hepatitis B (CHB) are scarce and present conflicting conclusions. AIM To assess the deficiency, incapacity, and social disadvantage of patients with CHB. METHODS This is a project of a case-control study with two age-matched groups. Cases (n=27) will be untreated patients with a CHB. Controls (n=27) will be healthy participants. The following data will be collected: deficiency [anthropometric, biochemical (renal and hepatic functions, lipid balance, and inflammatory markers), haematological, virological, handgrip-strength, and spirometric data], incapacity [6-min walk distance, number of stops, oxy-haemoglobin saturation, dyspnoea (visual analogue scale), heart-rate, and blood-pressure] and social disadvantage ["chronic liver disease" and physical-activity questionnaires]. Each spirometric data < lower-limit-of-normal will be considered abnormal. A handgrip-strength <26 kg (male) or <16 kg (female) will be considered low. The signs of walking intolerance will be: stop during the walk, 6-min walk distance ≤ lower-limit-of-normal, dyspnoea at the end of the walk> 5/10, drop in oxy-haemoglobin saturation >5 points, heart-rate at the end of the walk ≤60%. A total physical-activity score <9.42 will classify the participant as sedentary. EXPECTED RESULTS Compared with controls, cases will have a marked alteration of submaximal aerobic data. These alterations will worsen quality-of-life and may be related to muscle and/or spirometric abnormalities, and supported by systemic inflammation and high viral load.
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Affiliation(s)
- Jihene Bergaoui
- 1. Reasearch laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHEDSousseTunisie
| | - Imed Latiri
- 1. Reasearch laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHEDSousseTunisie
- 2. Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de PhysiologieTunisie
| | - Helmi Ben Saad
- 1. Reasearch laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHEDSousseTunisie
- 2. Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de PhysiologieTunisie
- 3. Université de Sousse, Hôpital Farhat HACHED, Service de Physiologie et Explorations FonctionnellesSousse, Tunisie
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Qin W. A diagnosis of diabetes and health behavior maintenance in middle-aged and older adults in the United States: The role of self-efficacy and social support. Prev Med 2022; 155:106958. [PMID: 35065973 PMCID: PMC9015723 DOI: 10.1016/j.ypmed.2022.106958] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/08/2022] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
Abstract
The present study aims to investigate the relationship between a diagnosis of diabetes and the maintenance of health behaviors, and whether self-efficacy and social support moderate the relationship. The study sample came from the 2006 to 2016 waves of the Health and Retirement Study in the United States (N = 13,143). A diagnosis of diabetes was ascertained by self-reported physician-diagnosed condition. Self-efficacy was measured using a 5-item scale. Social support from family and friends were measured separately by a 3-item scale. Three health behaviors were examined, namely alcohol consumption, smoking, and physical activity. Cox proportional hazards regression models were performed to test the study aims. Respondents who reported a diagnosis of diabetes were 1.50 times more likely to fail to maintain physical activity (95% CI = 1.26, 1.77). This relationship was moderated by social support from family, which was related to lower hazards of failure to maintain physical activity among individuals who had a diagnosis of diabetes compared to those without a diagnosis. The study suggests that a diagnosis of diabetes may be a stressful health event that negatively affects physical activity maintenance. In addition, the findings highlight the importance of incorporating strategies to mobilize social support from family, which may help individuals sustain their efforts to maintaining health-promoting behaviors after a diabetes diagnosis.
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Affiliation(s)
- Weidi Qin
- Population Studies Center, University of Michigan, Ann Arbor, MI, USA.
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Hoek AG, van Oort S, Mukamal KJ, Beulens JWJ. Alcohol Consumption and Cardiovascular Disease Risk: Placing New Data in Context. Curr Atheroscler Rep 2022; 24:51-59. [PMID: 35129737 PMCID: PMC8924109 DOI: 10.1007/s11883-022-00992-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW A clear link between excessive alcohol consumption and cardiovascular disease (CVD) has been established, but no consensus exists on the effects of moderate alcohol consumption on CVD. RECENT FINDINGS A lower risk of coronary heart disease and myocardial infarction among moderate drinkers compared to abstainers has been consistently observed in epidemiological studies and meta-analyses of these studies. However, ambiguity remains on the effect of alcohol on other CVDs and all-cause mortality. Short-term randomized controlled trials (RCT) have identified potentially beneficial effects of alcohol consumption on cardiovascular risk factors, but studies investigating genetic polymorphisms that influence alcohol consumption (i.e., Mendelian randomization) have yielded inconclusive results. To date, a long-term RCT providing causal evidence is lacking but urgently needed. Triangulation of evidence from different study designs, including long-term RCTs, pragmatic trials and the evaluation of policy measures, combined will lead to the best available evidence.
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Affiliation(s)
- Anna G. Hoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology & Data Science, Amsterdam Cardiovascular Sciences Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Sabine van Oort
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology & Data Science, Amsterdam Cardiovascular Sciences Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Kenneth J. Mukamal
- Beth Israel Deaconess Medical Center, Harvard Medical School and Harvard TH Chan School of Public Health, Boston, MA USA
| | - Joline W. J. Beulens
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology & Data Science, Amsterdam Cardiovascular Sciences Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
- University Medical Centre Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
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Tran SHN, Weaver RG, Manns BJ, Saunders-Smith T, Campbell T, Ivers N, Hemmelgarn BR, Tonelli M, Pannu R, Campbell DJT. Factors Affecting the Reception of Self-Management Health Education: A Cross-Sectional Survey Assessing Perspectives of Lower-Income Seniors with Cardiovascular Conditions. Patient Prefer Adherence 2022; 16:971-981. [PMID: 35422615 PMCID: PMC9005130 DOI: 10.2147/ppa.s351459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/11/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Self-management education and support (SMES) programs can prevent adverse chronic disease outcomes, but factors modifying their reception remain relatively unexplored. We examined how perceptions of an SMES program were influenced by the mode of delivery, and co-receipt of a paired financial benefit. METHODS AND PATIENTS Using a cross-sectional survey, we evaluated the perceived helpfulness of a SMES program among 446 low-income seniors at high risk for cardiovascular events in Alberta, Canada. Secondary outcomes included frequency of use, changes in perspectives on health, satisfaction with the program, and comprehensibility of the material. Participants received surveys after engaging with the program for at least 6 months. We used modified Poisson regression to calculate relative risks. Open-ended questions were analyzed inductively. RESULTS The majority of participants reported that the SMES program was helpful (>80%). Those who also received the financial benefit (elimination of medication copayments) were more likely to report that the SMES program was helpful (RR 1.24, 95% CI 1.11-1.39). Those who received the program electronically were more likely to use the program weekly (RR 1.51, 1.25-1.84). Both those who received the intervention electronically (RR 1.18, 1.06-1.33), and those who also received copayment elimination (RR 1.17, 1.05-1.31) were more likely to state that the program helped change their perspectives on health. CONCLUSION When designing SMES programs, providing the option for electronic delivery appears to promote greater use for seniors. The inclusion of online-delivery and co-receipt of tangible benefits when designing an SMES program for seniors results in favorable reception and could facilitate sustained adherence to health behavior recommendations. Participants also specifically expressed that what they enjoyed most was that the SMES program was informative, helpful, engaging, and supportive.
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Affiliation(s)
- Sophia H N Tran
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Robert G Weaver
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Braden J Manns
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | | | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Noah Ivers
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Women’s College Hospital, Toronto, ON, Canada
| | | | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Raj Pannu
- Emergence Creative, New York, NY, USA
| | - David J T Campbell
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada
- Correspondence: David JT Campbell, Tel +1 403-210-9511, Email
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Holahan CJ, Holahan CK, Lim S, Powers DA, North RJ. Living with a Smoker and Physical Inactivity across Eight Years in High-Risk Medical Patients. Behav Med 2022; 48:284-293. [PMID: 33780324 PMCID: PMC8478957 DOI: 10.1080/08964289.2021.1889458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Recent research has demonstrated a link between living with a smoker and physical inactivity. However, no research has examined this issue in the context of recovery in medical patients. The present study broadens research on living with a smoker by applying it to physical inactivity in a group of high-risk medical patients with histories of cancer or cardiovascular disease compared to a control group without histories of these conditions. In addition, this study extends the time frame of research on living with a smoker in predicting physical inactivity to eight years. Participants were 76,758 women between 49 and 81 years of age from the Women's Health Initiative Observational Study. Data on living with a smoker were collected at baseline; data on physical activity were collected at baseline and annually from 3 to 8 years. Analyses utilized latent growth modeling. Patient status, compared to control status, was associated with more physical inactivity at baseline. Independent of patient status, living with a smoker predicted a significant increase in the odds of no moderate or strenuous exercise and a significant increase in the odds of no walking at baseline. The effect of living with a smoker on physical inactivity was stronger than that of patient status. Moreover, the living with a smoker effect on physical inactivity remained stable across eight years. These findings highlight an overlooked impediment to compliance with recommendations for lifestyle change among high-risk medical patients.
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Affiliation(s)
| | - Carole K. Holahan
- Department of Kinesiology and Health Education, University of Texas at Austin
| | - Sangdon Lim
- Department of Educational Psychology, University of Texas at Austin
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Choi J, Park J, Kim JE, Lee JK, Kang D, Lee M, Chung IJ, Choi JY. Relative Effects of Demographic, Psychological, Behavioral, and Social Factors on the Initiation and Maintenance of Leisure-time Physical Activity: Results From a Confirmatory Path Analysis in a Longitudinal Study. J Epidemiol 2021; 31:557-565. [PMID: 32779627 PMCID: PMC8502832 DOI: 10.2188/jea.je20200073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background There is a lack of evidence of the complicated pathways of underlying determinants in the phases of physical activity. The purpose of this study was to evaluate simultaneously a set of potential determinants on the initiation and maintenance phases of leisure-time physical activity (LTPA). Methods The longitudinal data of 54,359 Korean adults aged 40–69 years from the Health Examinees study were used. The median follow-up duration was 4.2 years. The self-reported durations per week of LTPA was repeatedly assessed. Based on previous longitudinal studies, the potential determinants were selected, and hypothetical models were constructed that consider the complex associations between the determinants. The standardized coefficients for direct and indirect effects were estimated using path analysis to differentiate contributions of mediation from the total effects. Results In the total population, age, education, chronic diseases, smoking, depression symptoms, and self-rated health were significantly associated with both initiation and maintenance phases. Income (B = 0.025) and social supports (B = 0.019) were associated only with the initiation phase. Waist-to-hip ratio (B = −0.042) and stress (B = −0.035) were associated only with the maintenance phase. After stratifying by sex, the significant effects of education, chronic diseases, and smoking were found only in men. The initiation phase-specific effects of income and social supports and the maintenance phase-specific effects of stress were found only in women. It was estimated that indirect effects contributed approximately 15% of the total effect. Conclusion The findings suggested that there were initiation- or maintenance-specific determinants of leisure-time physical activity according to sex.
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Affiliation(s)
- Jaesung Choi
- Institute of Health Policy and Management, Seoul National University Medical Research Center.,BK21plus Biomedical Science Project, Seoul National University College of Medicine
| | - JooYong Park
- BK21plus Biomedical Science Project, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School
| | - Ji-Eun Kim
- BK21plus Biomedical Science Project, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School
| | - Jong-Koo Lee
- JW Lee Center for Global Medicine, Seoul National University College of Medicine.,Department of Family Medicine, Seoul National University College of Medicine
| | - Daehee Kang
- Department of Biomedical Sciences, Seoul National University Graduate School.,Department of Preventive Medicine, Seoul National University College of Medicine.,Cancer Research Institute, Seoul National University.,Institute of Environmental Medicine, Seoul National University Medical Research Center
| | - Miyoung Lee
- College of Physical Education and Sport Science, Kookmin University
| | | | - Ji-Yeob Choi
- Institute of Health Policy and Management, Seoul National University Medical Research Center.,BK21plus Biomedical Science Project, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School.,Department of Preventive Medicine, Seoul National University College of Medicine.,Cancer Research Institute, Seoul National University
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Palladino J, Frum-Vassallo D, Taylor JD, Webb VL. Improving medical residents' utilisation of integrated mental health in primary care. BMJ Open Qual 2021; 10:bmjoq-2021-001388. [PMID: 34429300 PMCID: PMC8386211 DOI: 10.1136/bmjoq-2021-001388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background Integration of mental health services allows for improved prevention and management of chronic conditions within the primary care setting. This quality improvement project aimed to increase adherence to and functioning of an integrated care model within a patient-centred medical home. Specifically, the project focused on improving collaboration between Primary Care Mental Health Integration (PC-MHI) and the medical resident Patient Aligned Care Teams (PACT) at a Veterans Affairs Medical Center in Northport, New York (VAMC Northport). Method The project used increased education, training and relationship building among the medical resident PACTs, and the establishment of regularly occurring integrated team meetings for medical and mental health providers. Education of residents was measured with a self-assessment pre-training and post-training, while utilisation was measured by the percentage of patients currently on a PACT’s panel with at least one PC-MHI encounter in the last 12 months (known in VAMC Northport as PACT-15 metric). Results Two resident PACTs that received both training and weekly integrated meetings increased their utilisation of integrated mental health services by 3.8% and 4.5%, respectively. PACTs that participated in training only, with no regular meetings, showed an initial improvement in utilisation that declined over time. Conclusions Training alone appeared beneficial but insufficient for increased integration over time. The addition of a regularly occurring integrated weekly meeting may be a critical component of facilitating sustained mental health integration in a primary care medical home model.
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Affiliation(s)
- Jenna Palladino
- Psychiatry and Behavioral Health, Stony Brook University, Commack, New York, USA
| | | | - Joanne D Taylor
- Psychology Service, Northport VA Medical Center, Northport, New York, USA
| | - Victoria L Webb
- Main Line Therapy and Psychological Services, LLC, Wayne, Pennsylvania, USA
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Arora K, Bhagianadh D. Smoking and Alcohol Consumption Following a New Dementia Diagnosis. J Gerontol B Psychol Sci Soc Sci 2021; 76:745-755. [PMID: 31587074 DOI: 10.1093/geronb/gbz127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Despite extensive research on lifestyle factors that influence the risk of developing dementia, limited evidence exists on whether older adults adopt healthier habits post-diagnosis in the hope of preserving their quality of life. METHOD Using panel data (1998-2014) from the Health and Retirement Study, this study investigated whether individuals who received a new dementia diagnosis were more likely to modify smoking and drinking behaviors than those without such a diagnosis. Propensity score weighting was used to adjust for observable differences between groups. RESULTS Older adults with a new dementia diagnosis were 2.8 times more likely to reduce alcohol consumption than those without such a diagnosis. This result was mainly attributable to "light" drinkers at baseline and appeared to fade over time. We found no statistically significant effect of a dementia diagnosis on smoking cessation or on reduction in the number of cigarettes smoked. These results were robust to multiple sensitivity tests, including the use of cognition scores to indicate dementia onset instead of self-reported physician diagnosis. DISCUSSION A new dementia diagnosis can serve as a window of opportunity that prompts some older adults to change habits related to alcohol consumption. This has important implications for clinical practice surrounding dementia diagnosis disclosure, the rates of which are currently much lower than other medical conditions.
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Affiliation(s)
- Kanika Arora
- Department of Health Management and Policy, University of Iowa
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Sudeck G, Geidl W, Abu-Omar K, Finger JD, Krauß I, Pfeifer K. Do adults with non-communicable diseases meet the German physical activity recommendations? GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [DOI: 10.1007/s12662-021-00711-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Abstract
Introduction
The numerous health benefits of physical activity (PA) for people with non-communicable diseases (NCDs) are well-documented. In Germany, there are limited data on whether adults with NCDs fulfill health-oriented PA recommendations. This study describes the prevalence of meeting PA recommendations among adults with select NCDs.
Method
Based on the national representative GEDA-2014/2015-EHIS (N = 24,016), the self-reported PA data of the European Health Interview Survey–Physical Activity Questionnaire (EHIS-PAQ) were classified with respect to fulfilling recommendations for health-enhancing aerobic activities (≥ 150 min per week with at least moderate intensity) and muscle strengthening (≥ 2 times per week). These binary indicators were used to analyze the association between the prevalence of sufficient PA and the self-reported presence of certain NCDs and multiple NCDs to reflect multimorbidity.
Results
Compared to the general adult population, sufficient aerobic PA was lower for most NCDs, with the lowest level among people with diabetes mellitus, obesity, stroke, chronic obstructive pulmonary disease (COPD), and depression. Compared to the general adult population, sufficient muscle strengthening was lower for some NCDs (diabetes mellitus, obesity, depression), but it was higher in people with musculoskeletal diseases (osteoarthritis, lower back pain). Multimorbidity was negatively associated with sufficient PA levels.
Conclusion
The study specifies the need to promote PA among adults with select NCDs to counteract insufficient levels of health-enhancing PA and to reduce the individual and societal burden of NCDs.
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A Population-Level Assessment of Smoking Cessation following a Diagnosis of Tobacco- or Nontobacco-Related Cancer among United States Adults. J Smok Cessat 2021; 2021:6683014. [PMID: 34306234 PMCID: PMC8279190 DOI: 10.1155/2021/6683014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/30/2020] [Accepted: 12/17/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction Smoking cessation after a cancer diagnosis can significantly improve treatment outcomes and reduce the risk of cancer recurrence and all-cause mortality. Aim We sought to measure the association between cancer diagnosis and subsequent smoking cessation. Methods Data was sourced from the Population Assessment of Health and Tobacco (PATH) study, a representative population-based sample of United States adults. Our analytic sample included all adult smokers at Wave I, our baseline. The exposure of interest was either a tobacco-related cancer diagnosis, nontobacco-related cancer diagnosis, or no cancer diagnosis (the referent) reported at Wave II or III. The primary outcome was smoking cessation after diagnosis, at Wave IV. Results/Findings. Our sample was composed of 7,286 adult smokers at the baseline representing an estimated 40.9 million persons. Smoking cessation rates after a diagnosis differed after a tobacco-related cancer (25.9%), a nontobacco-related cancer (8.9%), and no cancer diagnosis (17.9%). After adjustment, diagnosis with a tobacco-related cancer was associated with a higher odds of smoking cessation (OR 1.83, 95% CI 1.00-3.33) compared to no cancer diagnosis. Diagnosis with a nontobacco-related cancer was not significantly linked to smoking cessation (OR 0.52, 95% CI 0.48-1.45). Conclusion Diagnosis with a tobacco-related cancer is associated with greater odds of subsequent smoking cessation compared to no cancer diagnosis, suggesting that significant behavioral change may occur in this setting.
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van den Broek T. Early-Life Circumstances, Health Behavior Profiles, and Later-Life Health in Great Britain. J Aging Health 2020; 33:317-330. [PMID: 33345690 PMCID: PMC8120632 DOI: 10.1177/0898264320981233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objectives: Drawing on UK Household Longitudinal Study data, this study assessed a pathway from early-life disadvantage to suboptimal later-life health via health behavior. Methods: Latent class analysis was used to identify distinct smoking, nutrition, alcohol, and physical activity health behavior profiles. Mediation analyses were performed to assess indirect effects of early-life disadvantage via health behavior on allostatic load, an objective measure of physiological wear and tear. Results: Four health behavior profiles were identified: (1) broadly healthy and high alcohol consumption, (2) low smoking and alcohol consumption, healthy nutrition, and physically inactive, (3) broadly unhealthy and low alcohol consumption, and (4) broadly moderately unhealthy and high alcohol consumption. Having grown up in a higher socioeconomic position family was associated with lower later-life allostatic load. This was partly attributable to health behavioral differences. Discussion: Growing up under disadvantageous socioeconomic circumstances may initiate a chain of risk by predisposing people to health behavior profiles associated with poorer later-life health.
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Jeon YJ, Pyo J, Park YK, Ock M. Health behaviors in major chronic diseases patients: trends and regional variations analysis, 2008-2017, Korea. BMC Public Health 2020; 20:1813. [PMID: 33246439 PMCID: PMC7694307 DOI: 10.1186/s12889-020-09940-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 11/19/2020] [Indexed: 12/20/2022] Open
Abstract
Background Improving the health behaviors of those with chronic diseases such as hypertension and diabetes is important for disease management. Few in-depth studies have been conducted in Korea on the health behaviors of chronic disease patients. This study examined the health behaviors of chronic disease patients over time and compared them with those of the general population. Methods Cross-sectional time-series data obtained from the Korea Community Health Survey from 2008 to 2017 were analyzed. Thirteen diseases were included in this analysis, namely, hypertension, diabetes, dyslipidemia, stroke, myocardial infarction, angina, osteoarthritis, osteoporosis, asthma, allergic rhinitis, atopic dermatitis, cataract, and depression. The current smoking rate, drinking rate, and the walking rate, which are leading health behaviors necessary for preventing chronic diseases, were analyzed by disease type. We compared patients’ health behaviors with those of the general population and identified regional variations. Results Although the current overall smoking rate was seemingly declining, the overall monthly drinking and high-risk drinking rates were increasing. In 2017, patients experiencing depression symptoms had a higher smoking rate than did the general population; hypertension and diabetes patients had a higher risk-drinking rate than did the latter. The general population’s walking rate was highest. There were considerable variations by region among chronic disease patients. Conclusions Chronic disease patients displayed worse health behaviors than those of the general population, in some instances. Rather than focusing only on chronic disease patients’ medication adherence, strategies must be devised to increase their smoking cessation rate, decrease their drinking rate, and increase their walking rate. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09940-7.
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Affiliation(s)
- Young-Jee Jeon
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea
| | - Young-Kwon Park
- Preventive Medicine Center, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea. .,Preventive Medicine Center, Ulsan University Hospital, Ulsan, Republic of Korea.
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