AIM: To assess the effectiveness of the Chronic Disease Self-Management Program(CDSMP) on glycated hemoglobin A1c(HbA1c) and selected self-reported measures.METHODS: We compared patients who received a diabetes self-c...AIM: To assess the effectiveness of the Chronic Disease Self-Management Program(CDSMP) on glycated hemoglobin A1c(HbA1c) and selected self-reported measures.METHODS: We compared patients who received a diabetes self-care behavioral intervention, the CDSMP developed at the Stanford University, with controls whoreceived usual care on their HbA1c and selected self-reported measures, including diabetes self-care activities, health-related quality of life(HRQOL), pain and fatigue. The subjects were a subset of participants enrolled in a randomized controlled trial that took place at seven regional clinics of a university-affiliated integrated healthcare system of a multi-specialty group practice between January 2009 and June 2011. The primary outcome was change in HbA1c from randomization to 12 mo. Data were analyzed using multilevel statistical models and linear mixed models to provide unbiased estimates of intervention effects.RESULTS: Demographic and baseline clinical characteristics were generally comparable between the two groups. The average baseline HbA1c values in the CDSMP and control groups were 9.4% and 9.2%, respectively. Significant reductions in HbA1c were seen at 12 mo for the two groups, with adjusted changes around 0.6%(P < 0.0001), but the reductions did not differ significantly between the two groups(P = 0.885). Few significant differences were observed in participants' diabetes self-care activities. No significant differences were observed in the participants' HRQOL, pain, or fatigue measures.CONCLUSION: The CDSMP intervention may not lower HbA1c any better than good routine care in an integrated healthcare system. More research is needed to understand the benefits of self-management programs in primary care in different settings and populations.展开更多
Little is known about the role of active school travel(AST)on mental health among adolescents.Thus,this study aimed to explore the AST-depression association among adolescents aged 12–15 years from 26 low-and middle-...Little is known about the role of active school travel(AST)on mental health among adolescents.Thus,this study aimed to explore the AST-depression association among adolescents aged 12–15 years from 26 low-and middle-income countries(LMICs).Data from the Global School-based Student Health Survey were analyzed in 51,702 adolescents[mean(SD)age 13.8(1.0)years;49.3%boys).Both depressive symptoms and AST were assessed by a single question self-reported measure,respectively.Participants who reported having 5 days or above were considered as AST.Multivariable logistic regression analysis(accounting for sampling weights)was performed while controlling for gender,age,physical activity,sedentary behavior,and food insecurity,and a countrywide meta-analysis was undertaken.The prevalence of depressive symptoms and AST were 30.1%and 37.0%,respectively.Compared with those not having AST,adolescents with AST were less likely to have self-reported depressive symptoms(OR=0.88,95%CI:0.85-0.93)regardless of gender.Countrywide meta-analysis demonstrated that having AST versus not having AST was associated with 12%lower odds for depressive symptoms(OR=0.88;95%CI:0.82-0.94)but with a moderate between-country heterogeneity(I^(2)=59.0%).Based on large samples of adolescents from LMICs,it would be expected that AST may play a critical role in preventing adolescent depression worldwide.However,it is necessary to consider more country-specific factors when implementing AST-related mental health interventions.Future studies should adopt the solid study design to confirm or negate our researchfindings.展开更多
This research is designed to investigate the relationship between the 24-h movement guidelines(24-HMG)and self-reported academic achievement(AA)using nationally representative data derived from the 2019 U.S.National Y...This research is designed to investigate the relationship between the 24-h movement guidelines(24-HMG)and self-reported academic achievement(AA)using nationally representative data derived from the 2019 U.S.National Youth Risk Behaviour Survey.A multiple-stage cluster sampling procedure has been adopted to ensure a representative sample(N=9127 adolescents;mean age=15.7 years old;male%=49.8%).Logistic regression has been adopted to obtain the odds ratio(OR)regarding the associations between adherence to 24-HMG and AA while controlling for ethnicity,body mass index,sex and age.The prevalence of meeting the 24-h movement guidelines in isolation and combination varied greatly(physical activity=23.3%,screen time=32.5%,sleep=22.3%,and 24-HMG=2.8%),while the percentage of highest-class AA was 42.5%.Compared with the situation when none of 24-HMG is met,the achievement of any of the combined guidelines(except for meeting the physical activity guidelines)was significantly associated with higher odds of achieving first-class AA.Meeting the sleep guideline had 1.42 times increased likelihood to achieve highest-class AA as compared with not meeting the sleep guideline.Meeting screen time guidelines and physical activity guidelines,respectively,were 1.32 and 1.13 times more likely to report first-class AA;but meeting the guidelines of physical activity was not significantly related to AA.Meeting the 24-HMG had the highest odds of achieving first-class AA(OR=2.01,95%CI:1.47-2.73).In both sexes,adolescents who met 24-HMG self-reported better AA(boys OR=2.05,95%CI:1.34-3.15;girls OR=2.26,95%CI:1.36-3.76).Significant relationships were observed in adolescents from 9-10th grade,but not higher grades.Our research findings suggest that optimal movement behaviours can be seen as an important element to better academic achievement among U.S.adolescents.Future studies can adopt our discoveries to promote adolescents’academic achievement through implementing optimal 24-h movement behaviour patterns.展开更多
基金Supported by The National Institutes of Health’s National Institute on Minority Health and Health Disparities,No.#1P20MD002295
文摘AIM: To assess the effectiveness of the Chronic Disease Self-Management Program(CDSMP) on glycated hemoglobin A1c(HbA1c) and selected self-reported measures.METHODS: We compared patients who received a diabetes self-care behavioral intervention, the CDSMP developed at the Stanford University, with controls whoreceived usual care on their HbA1c and selected self-reported measures, including diabetes self-care activities, health-related quality of life(HRQOL), pain and fatigue. The subjects were a subset of participants enrolled in a randomized controlled trial that took place at seven regional clinics of a university-affiliated integrated healthcare system of a multi-specialty group practice between January 2009 and June 2011. The primary outcome was change in HbA1c from randomization to 12 mo. Data were analyzed using multilevel statistical models and linear mixed models to provide unbiased estimates of intervention effects.RESULTS: Demographic and baseline clinical characteristics were generally comparable between the two groups. The average baseline HbA1c values in the CDSMP and control groups were 9.4% and 9.2%, respectively. Significant reductions in HbA1c were seen at 12 mo for the two groups, with adjusted changes around 0.6%(P < 0.0001), but the reductions did not differ significantly between the two groups(P = 0.885). Few significant differences were observed in participants' diabetes self-care activities. No significant differences were observed in the participants' HRQOL, pain, or fatigue measures.CONCLUSION: The CDSMP intervention may not lower HbA1c any better than good routine care in an integrated healthcare system. More research is needed to understand the benefits of self-management programs in primary care in different settings and populations.
基金supported by the National Social Science Foundation(18BTY011)Brendon Stubbs is supported by a Clinical Lectureship(ICA-CL-2017-03-001)jointly funded by Health Education England(HEE)and the National Institute for Health Research(NIHR)+1 种基金Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust.Brendon Stubbs also holds active grants with the Medical Research Council(GCRF and multimorbidity calls)and Guys and St Thomas Charity(GSTT).Brendon Stubbs has received consultancy fees from ASICS Europe BV.The views expressed are those of the author(s)and not necessarily those of the(partner organization),the NHS,the NIHR,the Department of Health and Social Care,the MRC or GSTTZD’s contribution was supported by the Hungarian National Research,Development and Innovation Office(KKP126835,ELTE Thematic Excellence Programme 2020,KP2020-IKA-05).
文摘Little is known about the role of active school travel(AST)on mental health among adolescents.Thus,this study aimed to explore the AST-depression association among adolescents aged 12–15 years from 26 low-and middle-income countries(LMICs).Data from the Global School-based Student Health Survey were analyzed in 51,702 adolescents[mean(SD)age 13.8(1.0)years;49.3%boys).Both depressive symptoms and AST were assessed by a single question self-reported measure,respectively.Participants who reported having 5 days or above were considered as AST.Multivariable logistic regression analysis(accounting for sampling weights)was performed while controlling for gender,age,physical activity,sedentary behavior,and food insecurity,and a countrywide meta-analysis was undertaken.The prevalence of depressive symptoms and AST were 30.1%and 37.0%,respectively.Compared with those not having AST,adolescents with AST were less likely to have self-reported depressive symptoms(OR=0.88,95%CI:0.85-0.93)regardless of gender.Countrywide meta-analysis demonstrated that having AST versus not having AST was associated with 12%lower odds for depressive symptoms(OR=0.88;95%CI:0.82-0.94)but with a moderate between-country heterogeneity(I^(2)=59.0%).Based on large samples of adolescents from LMICs,it would be expected that AST may play a critical role in preventing adolescent depression worldwide.However,it is necessary to consider more country-specific factors when implementing AST-related mental health interventions.Future studies should adopt the solid study design to confirm or negate our researchfindings.
基金supported by the National Social Science Foundation(217BTY032)Key Project from the Social Science Foundation of Hunan Province(16ZDB015).
文摘This research is designed to investigate the relationship between the 24-h movement guidelines(24-HMG)and self-reported academic achievement(AA)using nationally representative data derived from the 2019 U.S.National Youth Risk Behaviour Survey.A multiple-stage cluster sampling procedure has been adopted to ensure a representative sample(N=9127 adolescents;mean age=15.7 years old;male%=49.8%).Logistic regression has been adopted to obtain the odds ratio(OR)regarding the associations between adherence to 24-HMG and AA while controlling for ethnicity,body mass index,sex and age.The prevalence of meeting the 24-h movement guidelines in isolation and combination varied greatly(physical activity=23.3%,screen time=32.5%,sleep=22.3%,and 24-HMG=2.8%),while the percentage of highest-class AA was 42.5%.Compared with the situation when none of 24-HMG is met,the achievement of any of the combined guidelines(except for meeting the physical activity guidelines)was significantly associated with higher odds of achieving first-class AA.Meeting the sleep guideline had 1.42 times increased likelihood to achieve highest-class AA as compared with not meeting the sleep guideline.Meeting screen time guidelines and physical activity guidelines,respectively,were 1.32 and 1.13 times more likely to report first-class AA;but meeting the guidelines of physical activity was not significantly related to AA.Meeting the 24-HMG had the highest odds of achieving first-class AA(OR=2.01,95%CI:1.47-2.73).In both sexes,adolescents who met 24-HMG self-reported better AA(boys OR=2.05,95%CI:1.34-3.15;girls OR=2.26,95%CI:1.36-3.76).Significant relationships were observed in adolescents from 9-10th grade,but not higher grades.Our research findings suggest that optimal movement behaviours can be seen as an important element to better academic achievement among U.S.adolescents.Future studies can adopt our discoveries to promote adolescents’academic achievement through implementing optimal 24-h movement behaviour patterns.
