The combination of self-tracking and persuasive eCoaching in healthy lifestyle interventions is a promising approach. The objective of this study is to map the key components of existing healthy lifestyle interventions combining self-tracking and persuasive eCoaching using the scoping review methodology in accordance with the York methodological framework by Arksey and O’Malley. Seven studies were included in this preliminary scoping review. Components related to persuasive eCoaching applied only in effective interventions were reduction of complex behavior into small steps, providing positive motivational feedback by praise and providing reliable information to show expertise. Concerning self-tracking, it did not seem to matter if more action was required by the participant to obtain personal data. The first results of this study indicate the necessity to identify the needs and problems of the specific target group of the interventions, due to differences found between various groups of users. In addition to objective data on lifestyle and health behavior, other factors need to be taken into account, such as the context of use, daily experiences, and feelings of the users.
DOCUMENT
Unhealthy lifestyle behaviours are common among vocational students and increase their risk of non-communicable diseases later in life. Unfortunately, only a limited number of school-based healthy lifestyle interventions have been developed for vocational students. Moreover, there is no evidence that these interventions are effective. They have often been developed by professionals without involving students and therefore may not align with the target group’s perceptions and needs. We used a participatory design approach to develop an intervention to promote healthy physical activity and dietary behaviours, in co-creation with vocational students. ‘Contextmapping’ was used to assess student conscious and subconscious motivation for a healthy lifestyle (n = 27, ages 17-26 years). All sessions and interviews were recorded and transcribed. The transcripts were analysed using framework analysis. Contextual characteristics that influenced student lives were their peers, family and short-term motives like earning money, being cool and looking good. In addition, they often had a passive attitude towards daily life, were unaware of their health illiteracy and being healthy was a goal for the distant future. These findings led to four design concepts that converged in a peer-led healthy lifestyle intervention that includes a social media campaign and activities to demonstrate and practice specific health behaviours among vocational students.
DOCUMENT
Abstract Background: Cardiovascular disease is the leading cause of the estimated 11–25 years reduced life expectancy for persons with serious mental illness (SMI). This excess cardiovascular mortality is primarily attributable to obesity, diabetes, hypertension, and dyslipidaemia. Obesity is associated with a sedentary lifestyle, limited physical activity and an unhealthy diet. Lifestyle interventions for persons with SMI seem promising in reducing weight and cardiovascular risk. The aim of this study is to evaluate the effectiveness and cost-effectiveness of a lifestyle intervention among persons with SMI in an outpatient treatment setting. Methods: The Serious Mental Illness Lifestyle Evaluation (SMILE) study is a cluster-randomized controlled trial including an economic evaluation in approximately 18 Flexible Assertive Community Treatment (FACT) teams in the Netherlands. The intervention aims at a healthy diet and increased physical activity. Randomisation takes place at the level of participating FACT-teams. We aim to include 260 outpatients with SMI and a body mass index of 27 or higher who will either receive the lifestyle intervention or usual care. The intervention will last 12 months and consists of weekly 2-h group meetings delivered over the first 6 months. The next 6 months will include monthly group meetings, supplemented with regular individual contacts. Primary outcome is weight loss. Secondary outcomes are metabolic parameters (waist circumference, lipids, blood pressure, glucose), quality of life and health related self-efficacy. Costs will be measured from a societal perspective and include costs of the lifestyle program, health care utilization, medication and lost productivity. Measurements will be performed at baseline and 3, 6 and 12 months. Discussion: The SMILE intervention for persons with SMI will provide important information on the effectiveness, cost-effectiveness, feasibility and delivery of a group-based lifestyle intervention in a Dutch outpatient treatment setting. Trial registration: Dutch Trial Registration NL6660, registration date: 16 November 2017.
DOCUMENT
Abstract Background: Several interventions have been developed to improve physical health and lifestyle behaviour of people with a severe mental illness (SMI). Recently, we conducted a pragmatic cluster-randomised controlled trial which evaluated the efects of the one-year Severe Mental Illness Lifestyle Evaluation (SMILE) lifestyle intervention compared with usual care in clients with SMI. The SMILE intervention is a 12-month group-based lifestyle intervention with a focus on increased physical activity and healthy food intake. The aim of the current study was to explore the experiences of people with SMI and healthcare professionals (HCPs) regarding implementation feasibility of the SMILE intervention and the fdelity to the SMILE intervention. Methods: A process evaluation was conducted alongside the pragmatic randomized controlled trial. The experiences of clients and HCPs in the lifestyle intervention group were studied. First, descriptive data on the implementation of the intervention were collected. Next, semi-structured interviews with clients (n=15) and HCPs (n=13) were performed. Interviews were audiotaped and transcribed verbatim. A thematic analysis of the interview data was performed using MAXQDA software. In addition, observations of group sessions were performed to determine the fdelity to the SMILE intervention using a standardised form. Results: Ten out of 26 HCPs who conducted the group sessions discontinued their involvement with the intervention, primarily due to changing jobs. 98% of all planned group sessions were performed. Four main themes emerged from the interviews: 1) Positive appraisal of the SMILE intervention, 2) Suggestions for improvement of the SMILE intervention 3) Facilitators of implementation and 4) Barriers of implementation. Both clients and HCPs had positive experiences regarding the SMILE intervention. Clients found the intervention useful and informative. The intervention was found suitable and interesting for all people with SMI, though HCPs sometimes had to tailor the intervention to individual characteristics of patients (e.g., with respect to cognitive functioning). The handbook of the SMILE intervention was perceived as user-friendly and helpful by HCPs. Combining SMILE with daily tasks, no support from other team members, and lack of staf and time were experienced as barriers for the delivery of the intervention Conclusion: The SMILE intervention was feasible and well-perceived by clients and HCPs. However, we also identifed some aspects that may have hindered efective implementation and needs to be considered when implementing the SMILE intervention in daily practice
DOCUMENT
For the needs analysis, an assessment of the national (and local) status quo in the area of Healthy Ageing, specifically towards Active and Healthy Lifestyles. This status quo will serve as important starting point for the exploration of a potential shared goal of the local community of practice. This needs analysis report includes generic sections towards definitions and methodologies, and an introduction towards the topics assessed. Secondly, national/ local chapters will outline the situation in the communities of Groningen (the Netherlands), Odense (Denmark), Malaga (Spain), Kaunas (Lithuania) and Cascais (Portugal). Within each local COP chapter the partners taking part of the COP are described and the shared goals illustrated. These shared goals are: COP Groningen: “stimulating a Healthy environment (physical & social) with focus on physical activity”. COP Odense: “further develop and educate professionals who work on stimulating physical activity in community dwelling older adult”’. COP Malaga: “developing, implementing and evaluating outdoor fitness” COP Kaunas: “to provide opportunities for primary school children and Kaunas district community members older than 50 more opportunities for exercising and physical activity” COP Cascais: “develop, organize for and together with the stakeholders and end users (youngsters from 12-24 years old) activities focused on healthy lifestyle (e.g., healthy cooking workshops, parent-child physical activities etc.) embedded in approach GERAÇÃO S+ “.
DOCUMENT
Objective: Gaining too much or too little weight in pregnancy (according to Institute of Medicine (IOM) guidelines) negatively affects both mother and child, but many women find it difficult to manage their gestational weight gain (GWG). Here we describe the use of the intervention mapping protocol to design ‘Come On!’, an intervention to promote adequate GWG among healthy pregnant women. Design: We used the six steps of intervention mapping: (i) needs assessment; (ii) formulation of change objectives; (iii) selection of theory-based methods and practical strategies; (iv) development of the intervention programme; (v) development of an adoption and implementation plan; and (vi) development of an evaluation plan. A consortium of users and related professionals guided the process of development. Results: As a result of the needs assessment, two goals for the intervention were formulated: (i) helping healthy pregnant women to stay within the IOM guidelines for GWG; and (ii) getting midwives to adequately support the efforts of healthy pregnant women to gain weight within the IOM guidelines. To reach these goals, change objectives and determinants influencing the change objectives were formulated. Theories used were the Transtheoretical Model, Social Cognitive Theory and the Elaboration Likelihood Model. Practical strategies to use the theories were the foundation for the development of ‘Come On!’, a comprehensive programme that included a tailored Internet programme for pregnant women, training for midwives, an information card for midwives, and a scheduled discussion between the midwife and the pregnant woman during pregnancy. The programme was pre-tested and evaluated in an effect study.
MULTIFILE
Het strategisch project Citizen Science for a Healthy Lifestyle is gestart op 1 november 2019. Het project had als doel: kennis, ervaring, scholing en internationalisering op het thema Citizen Science for Healthy Lifestyle bevorderen. Deze strategische fonds heeft op concrete wijze vorm en inhoud gegeven aan de visie en doelen van het CoE HA. Deze aanvraag heeft mede geleid tot het benoemen van Citizen Science als belangrijke enabler/versneller binnen de visie van het CoE HA. In jaar 1 lag het accent op scholing (expert conference/workshop etc.) en de opzet van een 3-tal pilots. In jaar 2 werd de opgedane kennis en ervaring verwerkt in ontwikkelde onderwijs modules Citizen Science. De Hanzehogeschool stelt zich tot doel waarde en impact te cre ren in Noord-Nederland, met de inzet van onderwijs, onderzoek en innovatie. De strategie van het Centre of Expertise Healthy Ageing (CoE HA) belicht drie thema’s: 1) gelijkheid en participatie in gezondheidszorg, 2) gezonde leefstijl en omgeving, en 3) kwetsbaarheid en passende zorg. Zowel als onderzoek/innovatiestrategie en als middel om burgers en gemeenschappen te betrekken, speelt Citizen Science for health een belangrijke rol in het mogelijk maken en versnellen van processen binnen de drie thema’s. Citizen Science kan gedefinieerd worden als een vorm van onderzoekssamenwerking en co-creatie die burgers betrekt bij onderzoek en innovatie om concrete vraagstukken aan te pakken, en die dus vereist dat niet-professionele bijdragers onderdeel van de samenwerking zijn.Belangrijkste resultaten:• Citizen Science is mede door deze strategische fonds aanvraag en van de drie enablers geworden in de nieuwe CoE HA strategische koers 2021-2026;• Opstart pilots van Living Lab Beweegvriendelijk Vinkhuizen, Living Lab Oldambt Tijd voor Toekomst en Meer Gezonde Jaren Appingedam. Mede door blijvende investering en honorering van Living Labs Sport en Bewegen van ZonMw; Het gaat hier om een netwerksubsidie (8 maanden), lokale verankering (12 maanden) en experiment subsidie (5 maanden);• Integratie Citizen Science in Erasmus+ capacity building project Sustainable Wellbeing (SUSWELL);• Ontwikkeling SPRONG-aanvraag op het thema Citizen Science (deadline 31 mei 2022);• Diverse scholingsactiviteiten en workshops (master HAP, bachelor, docent-onderzoekers van de Healthy Ageing schools, studiedagen) hebben in 2020, 2021 en 2022 plaatsgevonden;• Studie tweedaagse over Citizen Science gehouden voor studenten en docent-onderzoekers CoE HA en KC Noorderruimte;• Samenwerking met Stanford University en Our Voice: Citizen Science for Health Equity network gerealiseerd;• Positioning statement Citizen Science geschreven in NL en EN;• Lid geworden van European Citizen Science Association (ECSA);• Scholingsmateriaal ontwikkeld voor studenten en docent-onderzoekers van de vijf schools vallend onder Healthy Ageing;• Ontwikkeling NWO-subsidie aanvraag maatschappelijk verdien vermogen over citizen-student Science voor studenten welzijn tijdens en na de Corona pandemie (deadline voorjaar 2022);• Postdoc aanstelling Citizen Science vanuit het CoE HA.• Met de Citizen Science scholingsactiviteiten zijn in totaal 270 bachelor studenten, 145 master studenten, 279 docent-onderzoekers, 109 professionals en 180 burgers bereikt verspreid over de verschillende pilots.Aanbevelingen:• Mede op basis van de impact van praktijkgericht onderzoek op praktijk, onderwijs en onderzoek (PRIME-model pagina 29), doorgaan met onderwijs en praktijk ontwikkelingen. De bijdrage aan het wetenschappelijke/onderzoeksdomein op Citizen Science verdient dekomende jaren extra aandacht;• Mede op basis van bevindingen visitatie terugkoppeling CoE HA (6-7 april 2022), verder doorontwikkelen tot herkend en erkend expertisecentrum op Citizen Science in de context van (publieke) gezondheidsdomein;• De komende jaren verder investeren in mensen en middelen in Citizen Science zodat het een van de leidende aanpakken wordt binnen onderwijs-onderzoek binnen het CoE HA zodat de Hanze zich ontwikkelt tot een expertisecentrum (o.a. m.b.v. SPRONG);• Komende jaren verder kennis en expertise ontwikkelen op Citizen Science door eigenonderzoek (promovendi/postdocs) en scholing;• Citizen Science integreren in relevante onderzoeksprojectaanvragen;• Citizen Science verder integreren in de drie inhoudelijke thema’s van het CoE HA;• Citizen Science onderwijsmodules en scholingen implementeren in het onderwijs van studenten (bachelors, masters) en bij- en nascholing van docent-onderzoekers.
DOCUMENT
Abstract: Combined lifestyle interventions (CLI) are focused on guiding clients with weight-related health risks into a healthy lifestyle. CLIs are most often delivered through face-to-face sessions with limited use of eHealth technologies. To integrate eHealth into existing CLIs, it is important to identify how behavior change techniques are being used by health professionals in the online and offline treatment of overweight clients. Therefore, we conducted online semi-structured interviews with providers of online and offline lifestyle interventions. Data were analyzed using an inductive thematic approach. Thirty-eight professionals with (n = 23) and without (n = 15) eHealth experience were interviewed. Professionals indicate that goal setting and action planning, providing feedback and monitoring, facilitating social support, and shaping knowledge are of high value to improve physical activity and eating behaviors. These findings suggest that it may be beneficial to use monitoring devices combined with video consultations to provide just-in-time feedback based on the client’s actual performance. In addition, it can be useful to incorporate specific social support functions allowing CLI clients to interact with each other. Lastly, our results indicate that online modules can be used to enhance knowledge about health consequences of unhealthy behavior in clients with weight-related health risks.
DOCUMENT
Abstract Background Clients with severe mental illness (SMI) have overall poor physical health. SMI reduces life expectancy by 5–17 years, primarily due to physical comorbidity linked to cardiometabolic risks that are mainly driven by unhealthy lifestyle behaviours. To improve physical health in clients with SMI, key elements are systematic somatic screening and lifestyle promotion. The nurse-led GILL eHealth was developed for somatic screening and the imple‑ mentation of lifestyle activities in clients with SMI. Aims of this study are to evaluate the efectiveness of the GILL eHealth intervention in clients with SMI compared to usual care, and to evaluate the implementation process, and the experiences of clients and healthcare providers with GILL eHealth. Methods The GILL study encompasses a cluster-randomised controlled trial in approximately 20 mental health care facilities in the Netherlands. The randomisation takes place at the team level, assigning clients to the eHealth inter‑ vention or the usual care group. The GILL eHealth intervention consists of two complementary modules for somatic screening and lifestyle promotion, resulting in personalised somatic treatment and lifestyle plans. Trained mental health nurses and nurse practitioners will implement the intervention within the multidisciplinary treatment context, and will guide and support the participants in promoting their physical health, including cardiometabolic risk management. Usual care includes treatment as currently delivered, with national guidelines as frame of reference. We aim to include 258 clients with SMI and a BMI of 27 or higher. Primary outcome is the metabolic syndrome severity score. Secondary outcomes are physical health measurements and participants’ reports on physical activity, perceived lifestyle behaviours, quality of life, recovery, psychosocial functioning, and health-related self-efcacy. Measurements will be completed at baseline and at 6 and 12 months. A qualitative process evaluation will be conducted alongside, to evaluate the process of implementation and the experiences of clients and healthcare professionals with GILL eHealth. Discussion The GILL eHealth intervention is expected to be more efective than usual care in improving physical health and lifestyle behaviours among clients with SMI. It will also provide important information on implementation of GILL eHealth in mental health care. If proven efective, GILL eHealth ofers a clinically useful tool to improve physical health and lifestyle behaviours.
DOCUMENT
IMPORTANCE People with a severe mental illness (SMI) have a life expectancy reduced by 10 to 20 years compared with the general population, primarily attributable to cardiometabolic disorders. Lifestyle interventions for people with SMI can improve health and reduce cardiometabolic risk. OBJECTIVE To evaluate the effectiveness of a group-based lifestyle intervention among people with SMI in outpatient treatment settings compared with treatment as usual (TAU). DESIGN, SETTING, AND PARTICIPANTS The Severe Mental Illness Lifestyle Evaluation (SMILE) study is a pragmatic cluster randomized clinical trial performed in 8 mental health care centers with 21 flexible assertive community treatment teams in the Netherlands. Inclusion criteria were SMI, age of 18 years or older, and body mass index (calculated as weight in kilograms divided by height in meters squared) of 27 or greater. Data were collected from January 2018 to February 2020, and data were analyzed from September 2020 to February 2023. INTERVENTIONS Weekly 2-hour group sessions for 6 months followed by monthly 2-hour group sessions for another 6 months, delivered by trained mental health care workers. The intervention targeted overall lifestyle changes, emphasizing establishing a healthy diet and promoting physical activity. TAU (control) did not include structured interventions or advice on lifestyle. MAIN OUTCOMES AND MEASURES Crude and adjusted linear mixed models and multivariable logistic regression analyses were performed. The main outcome was body weight change. Secondary outcomes included changes in body mass index, blood pressure, lipid profiles, fasting glucose level, quality of life, self-management ability, and lifestyle behaviors (physical activity and health, mental health, nutrition, and sleep). RESULTS The study population included 11 lifestyle intervention teams (126 participants) and 10 TAU teams (98 participants). Of 224 included patients, 137 (61.2%) were female, and the mean (SD) age was 47.6 (11.1) years. From baseline to 12 months, participants in the lifestyle intervention group lost 3.3 kg (95%CI, −6.2 to −0.4) more than those in the control group. In the lifestyle intervention group, people with high attendance rates lost more weight than participants with medium and low rates (mean [SD] weight loss: high, −4.9 [8.1] kg; medium, −0.2 [7.8] kg; low, 0.8 [8.3] kg). Only small or no changes were found for secondary outcomes. CONCLUSIONS AND RELEVANCE In this trial, the lifestyle intervention significantly reduced weight from baseline to 12 months in overweight and obese adults with SMI. Tailoring lifestyle interventions and increasing attendance rates might be beneficial for people with SMI. TRIAL REGISTRATION Netherlands Trial Register Identifier: NTR6837
DOCUMENT
