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Diabetes Prevention Program Translation in the Veterans Health Administration.
Moin, T, Damschroder, LJ, AuYoung, M, Maciejewski, ML, Datta, SK, Weinreb, JE, Steinle, NI, Billington, C, Hughes, M, Makki, F, et al
American journal of preventive medicine. 2017;(1):70-77
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Abstract
INTRODUCTION This clinical demonstration trial compared the effectiveness of the Veterans Affairs Diabetes Prevention Program (VA-DPP) with an evidence-based usual care weight management program (MOVE!®) in the Veterans Health Administration health system. DESIGN Prospective, pragmatic, non-randomized comparative effectiveness study of two behavioral weight management interventions. SETTING/PARTICIPANTS Obese/overweight Veterans with prediabetes were recruited from three geographically diverse VA sites between 2012 and 2014. INTERVENTION VA-DPP included 22 group-based intensive lifestyle change sessions. MAIN OUTCOME MEASURES Weight change at 6 and 12 months, hemoglobin A1c (HbA1c) at 12 months, and VA health expenditure changes at 15 months were assessed using VA electronic health record and claims data. Between- and within-group comparisons for weight and HbA1c were done using linear mixed-effects models controlling for age, gender, race/ethnicity, baseline outcome values, and site. Analyses were conducted in 2015-2016. RESULTS A total of 387 participants enrolled (273 VA-DPP, 114 MOVE!). More VA-DPP participants completed at least one (73.3% VA-DPP vs 57.5% MOVE! p=0.002); four (57.5% VA-DPP vs 42.5% MOVE!, p=0.007); and eight or more sessions (42.5% VA-DPP vs 31% MOVE!, p=0.035). Weight loss from baseline was significant at both 6 (p<0.001) and 12 months (p<0.001) for VA-DPP participants, but only significant at 6 months for MOVE! participants (p=0.004). Between groups, there were significant differences in 6-month weight loss (-4.1 kg VA-DPP vs -1.9 kg MOVE!, p<0.001), but not 12-month weight loss (-3.4 kg VA-DPP vs -2.0 kg MOVE!, p=0.16). There were no significant differences in HbA1c change or outpatient, inpatient, and total VA expenditures. CONCLUSIONS VA-DPP participants had higher participation rates and weight loss at 6 months, but similar weight, HbA1c, and health expenditures at 12 months compared to MOVE! PARTICIPANTS Features of VA-DPP may help enhance the capability of MOVE! to reach a larger proportion of the served population and promote individual-level weight maintenance.
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The HAT TRICK programme for improving physical activity, healthy eating and connectedness among overweight, inactive men: study protocol of a pragmatic feasibility trial.
Caperchione, CM, Bottorff, JL, Oliffe, JL, Johnson, ST, Hunt, K, Sharp, P, Fitzpatrick, KM, Price, R, Goldenberg, SL
BMJ open. 2017;(9):e016940
Abstract
INTRODUCTION Physical activity, healthy eating and maintaining a healthy weight are associated with reduced risk of cardiovascular disease, type 2 diabetes and cancer and with improved mental health. Despite these benefits, many men do not meet recommended physical activity guidelines and have poor eating behaviours. Many health promotion programmes hold little appeal to men and consequently fail to influence men's health practices. HAT TRICK was designed as a 12-week face-to-face, gender-sensitised intervention for overweight and inactive men focusing on physical activity, healthy eating and social connectedness and was delivered in collaboration with a major junior Canadian ice hockey team (age range 16-20 years). The programme was implemented and evaluated to assess its feasibility. This article describes the intervention design and study protocol of HAT TRICK. METHODS AND ANALYSIS HAT TRICK participants (n=60) were men age 35 years, residing in the Okanagan Region of British Columbia, who accumulate 150 min of moderate to vigorous physical activity a week, with a body mass index of >25 kg/m2 and a pant waist size of >38'. Each 90 min weekly session included targeted health education and theory-guided behavioural change techniques, as well as a progressive (ie, an increase in duration and intensity) group physical activity component. Outcome measures were collected at baseline, 12 weeks and 9 months and included the following: objectively measured anthropometrics, blood pressure, heart rate, physical activity and sedentary behaviour, as well as self-reported physical activity, sedentary behaviour, diet, smoking, alcohol consumption, sleep habits, risk of depression, health-related quality of life and social connectedness. Programme feasibility data (eg, recruitment, satisfaction, adherence, content delivery) were assessed at 12 weeks via interviews and self-report. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of British Columbia Okanagan Behavioural Research Ethics Board (reference no H1600736). Study findings will be disseminated through academic meetings, peer-reviewed publication, web-based podcasts, social media, plain language summaries and co-delivered community presentations. TRIAL REGISTRATION NUMBER ISRCTN43361357,Pre results.
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Hypnobehavioral and hypnoenergetic therapy in the treatment of obese women: a pragmatic randomized clinical trial.
Gelo, OC, Zips, A, Ponocny-Seliger, E, Neumann, K, Balugani, R, Gold, C
The International journal of clinical and experimental hypnosis. 2014;(3):260-91
Abstract
This study compared the effectiveness of hypnobehavioral therapy (HypBe) and HypBe enhanced by elements of energetic psychotherapy (hypnoenergetic therapy, HypEn) for obese women. Sixty clients were randomized to either HypBe or HypEn. Body weight, BMI, eating behavior, and body concept were assessed at baseline, posttreatment, and at a follow-up. Mixed ANOVA models and effect sizes were used for statistics. Both treatments improved weight, BMI, eating behavior, and some aspects of body concept. Improvements in eating behavior and body concept were higher for those who also lost weight (responders). Weight and BMI reductions were not significantly different for the HypEn versus HypBe groups at follow-up.