Self-management for obesity and cardio-metabolic fitness: Description and evaluation of the lifestyle modification program of a randomised controlled trial (original) (raw)
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Background: Metabolic syndrome is an asymptomatic disorder and an important risk factor for cardiovascular disease and type 2 diabetes. Lifestyle modification and self-management of health-promoting behaviors are the most important actions to control metabolic syndrome. This study was done to investigate the effectiveness of self-management interventions based on group Cognitive-Behavioral Therapy (CBT) on lifestyle among adults with metabolic syndrome. Methods: This research was a randomized clinical trial study. First, 80 adults with metabolic syndrome were selected using the convenience sampling method, and then, using the randomized blockchain method, they were divided into two groups of 40 people (intervention and control groups). Data collection using the Health Promotion Lifestyle Profile II Questionnaire (HPLP II) was performed in two stages before and three months after the intervention. Teaching selfmanagement interventions based on cognitive-behavioral therapy was done twice a week for eight 90-minute sessions. Data were analyzed using the Chi-square test, independent t-tests, and Analysis of Covariance (ANCOVA). A P-value less than 0.05 was considered significant. Results: the results of ANCOVA showed that self-management intervention based on group CBT had a significant effect on the dimensions of lifestyle, including exercise and physical activity with an effect size of 0.51, nutrition with 0.49, health responsibility with 0.39, and stress management with 0.32 (P<0.05), but it did not significantly affect the two dimensions of selfactualization and spiritual growth (effect size= 0.003, P=0.669) and interpersonal relationships (effect size= 0.029, P=0.151). Conclusion: Self-management interventions based on group CBT can improve lifestyle and some dimensions in adults with metabolic syndrome. Identifying people with metabolic syndrome and performing effective interventions with the active participation of the individual through self-management based on cognitive-behavioral therapy seem necessary.
Journal of Research and Health
Background: Metabolic syndrome is an asymptomatic disorder and an important risk factor for cardiovascular disease and type 2 diabetes. Lifestyle modification and self-management of health-promoting behaviors are the most important actions to control metabolic syndrome. This study was done to investigate the effectiveness of self-management interventions based on group Cognitive-Behavioral Therapy (CBT) on lifestyle among adults with metabolic syndrome. Methods: This research was a randomized clinical trial study. First, 80 adults with metabolic syndrome were selected using the convenience sampling method, and then, using the randomized blockchain method, they were divided into two groups of 40 people (intervention and control groups). Data collection using the Health Promotion Lifestyle Profile II Questionnaire (HPLP II) was performed in two stages before and three months after the intervention. Teaching self-management interventions based on cognitive-behavioral therapy was done t...
The patient’s voice: an exploratory study of the impact of a group self-management support program
BMC Family Practice, 2012
Background: Given the potential value of self-management support programs for people with chronic diseases, it is vital to understand how they influence participants' health attitudes and behaviours. The Stanford Chronic Disease Self-Management Program (CDSMP), the most well-known and widely studied such program, is funded in many provinces and jurisdictions throughout Canada. However, there is little published evidence on its impact in the Canadian health-care system. We studied participants' reactions and perceived impacts of attending the Stanford program in one Ontario health region so we could assess its value to the health region. The study asked: What are participants' reactions and perceived impacts of attending the Stanford CDSMP? Methods: This mixed methods exploratory study held four focus groups approximately one year after participants attended a Stanford program workshop. At the beginning of each session, participants filled out a survey on the type and frequency of community and health resources used for their self-management. During the sessions, a moderator guided the discussion, asking about such things as long-term impact of the program on their lives and barriers to self-management of their chronic conditions. Results: Participants perceived diverse effects of the workshop: from having a profound impact on one area to affecting all aspects of their lives. A change in physical activity patterns was the most prominent behaviour change, noted by over half the participants. Other recurrent effects included an improved sense of social connection and better coping skills. Barriers to self-management were experienced by almost all participants with several dominant themes emerging including problems with the health system and patient-physician interaction. Participants reported a wide variety of resources used in their self-management, and in some cases, an increase in use was noted for some resources. Conclusions: Self-management support is, at its core, a complex and patient-centred concept, so a diversity of outcomes to match the diversity of participants should be expected. As these interventions move into different target populations and communities, it is essential that we continue to explore through multiple research methods, the effects, and their meaning to participants, ensuring the optimal investment of resources for the very individuals these interventions aim to serve.
Forschende Komplementärmedizin (2006), 2016
Epidemiological data shows globally increasing numbers of obesity and stress-related diseases. In this article, a comprehensive medical lifestyle modification programme - called Individual Health Management (IHM) - is described in detail and discussed as a promising tool to individually manage and reverse such negative health trends in patients. The IHM programme is based on a blended learning concept. It comprises a 12-week basic training phase, followed by a 9-month maintenance phase, and includes the following key features: 1) web-based and physician-led health screenings; 2) a structured 12-week basic training with a core curriculum providing tuition in behavioural self-management strategies for weight loss and stress reduction; 3) weekly supervised group sessions during the core curriculum; 4) tailoring of materials, strategies and lifestyle goals; 5) continuous self-monitoring and feedback of the achieved progress; 6) regular contact with physicians or health professionals bas...
A national dissemination of an evidence-based self-management program: a process evaluation study
Patient Education and Counseling, 2005
While evidence exists regarding the effectiveness of many health education interventions, few of these evidence-based programs have been systematically or widely disseminated. This paper reports on the dissemination of one such intervention, the 6-week peer-led Chronic Disease Self-Management Program, throughout a large health-care system, Kaiser Permanente. We describe the dissemination process and, using qualitative analysis of interviews and surveys, discuss the factors that aided and hindered this process and make recommendations for similar dissemination projects. Six years after the beginning of the dissemination process, the program is integrated in most of the Kaiser Permanente regions and is being offered to several thousand people a year.
Japan Journal of Nursing Science, 2009
Aim: Patient education that enhances one's self-management ability is of utmost importance for improving patient outcomes in chronic diseases. We developed a 12 month self-management education program for type 2 diabetes, based on a previous 6 month program, and examined its efficacy. Methods: A randomized controlled trial was carried out on outpatients with type 2 diabetes from two hospitals who met the criteria and gave consent to participate. They were randomly divided into an intervention group that followed the program and a control group that followed usual clinical practise. The intervention group received <30 min of monthly interviews based on the program's textbook and biweekly telephone calls from a nurse educator throughout the 12 months. Results: Of the 50 participants in the intervention group and the 25 participants in the control group, 42 and 23, respectively, completed the program (a completion rate of 84.0%). The body weight, HbA1c, self-efficacy, dietary and exercise stages, quality of life, diastolic blood pressure, and total cholesterol level were significant by two-way repeated-measures anova. As for changes over time within the groups, only the intervention group showed significant differences by Friedman's test. The complication prevention behaviors showed a high implementation rate in the intervention group. The overall evaluation of this program by the participants was very high and, therefore, they highly recognized the need for this type of program. Conclusions: Self-management education works successfully in relation to patients' behavior modification skills, degree of goal attainment, and self-efficacy, consequently improving their health outcomes.
INTERNATIONAL JOURNAL OF OBESITY, 2006
Objective: To investigate the effect of an 8-week group-based cognitive behaviour therapy lifestyle intervention with monthly follow-up to 6 months and further follow up at 12 months on change in weight and other weight-related variables, change in physical activity and change in health and well being compared to individualised dietetic treatment or giving an information booklet only (BO). Design: A randomised controlled trial of two intervention groups, a group-based cognitive behaviour therapy lifestyle intervention, Fat Booters Incorporated -(FBI) and individualised dietetic treatment (IDT) and control group receiving an information booklet only (BO). The intervention groups involved weekly contact for 8 weeks with monthly follow-up to 6 months and further follow-up at 12 months, conducted in real practice setting. Subjects: A total of 176 adults with body mass index (BMI)427 kg/m 2 , mean (7s.d.) age 48713 years, mean BMI 3475.5 kg/m 2 . Main outcome measures: Weight, percent body fat, waist circumference, physical activity, health status, self-efficacy and satisfaction with life were measured at baseline, 3, 6 and 12 months. Results: A statistically significant difference between groups was observed for weight change over time (P ¼ 0.05). The change in weight (mean7s.e.) for the FBI group was significantly greater than the BO group at 3 and 12 months (À2.870.7 compared to À1.070.6 kg, Po0.05 and À2.970.9 compared to þ 0.570.9 kg, Po0.005, respectively). Change in weight in the IDT group did not differ from the FBI group at any time point. For all groups, waist circumference was significantly less than baseline at all time points (Po0.001). Significant differences in self-efficacy were observed over time (P ¼ 0.02), with both intervention groups having greater self-efficacy than the BO group. Significant drop-outs occurred over time for all three groups. Conclusions: A cognitive behaviour-based lifestyle intervention was more effective than providing an information booklet alone and as effective as intensive individualised dietetic intervention in weight loss and improvements in self-efficacy.