| 1. |
- Bonn, Stephanie Erika, et al.
(författare)
-
App Technology to Support Physical Activity and Intake of Vitamins and Minerals After Bariatric Surgery (the PromMera Study): Protocol of a Randomized Controlled Clinical Trial
- 2020
-
Ingår i: JMIR Research Protocols. - : JMIR PUBLICATIONS, INC. - 1929-0748. ; 9:8
-
Tidskriftsartikel (refereegranskat)abstract
- Background: To optimize postoperative outcomes after bariatric surgery, lifestyle changes including increased physical activity are needed. Micronutrient deficiency after surgery is also common and daily supplementation is recommended. Objective: The aim of the PromMera study is to evaluate the effects of a 12-week smartphone app intervention on promotion of physical activity (primary outcome) and adherence to postsurgery vitamin and mineral supplementation, as well as on other lifestyle factors and overall health in patients undergoing bariatric surgery. Methods: The PromMera study is a two-arm, randomized controlled trial comprising patients undergoing bariatric surgery. Participants are randomized postsurgery 1:1 to either the intervention group (ie, use of the PromMera app for 12 weeks) or the control group receiving only standard care. Clinical and lifestyle variables are assessed pre- and postsurgery after 18 weeks (postintervention assessment), 6 months, 1 year, and 2 years. Assessments include body composition using Tanita or BOD POD analyzers, muscle function using handgrip, biomarkers in blood, and an extensive questionnaire on lifestyle factors. Physical activity is objectively measured using the ActiGraph wGT3X-BT triaxial accelerometer. Results: A total of 154 participants have been enrolled in the study. The last study participant was recruited in May 2019. Data collection will be complete in May 2021. Conclusions: Implementing lifestyle changes are crucial after bariatric surgery and new ways to reach patients and support such changes are needed. An app-based intervention is easily delivered at any time and can be a key factor in the adoption of healthier behavioral patterns in this rapidly growing group of patients.
|
|
| 2. |
- Bonn, Stephanieb E. E., et al.
(författare)
-
Effect of a Smartphone Application on Physical Activity and Weight Loss After Bariatric Surgery-Results from a Randomized Controlled Trial
- 2023
-
Ingår i: Obesity Surgery. - : SPRINGER. - 0960-8923 .- 1708-0428. ; 33:9, s. 2841-2850
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose Ways to motivate and support patients in being physically active after bariatric surgery are needed. This trial was aimed at evaluating the effect of using a smartphone application targeting physical activity during 12 weeks on moderate-to-vigorous physical activity (MVPA, primary outcome) and secondary outcomes of inactivity, light physical activity (LPA), body mass index (BMI), and percent total weight loss (%TWL) after bariatric surgery.Materials and Methods Data from a randomized controlled trial comprising 146 patients (79.5% women) undergoing bariatric surgery was analyzed. Mean age and BMI pre-surgery were 40.9 years and 40.5 kg/m(2), respectively. Participants were randomized 1:1 to an intervention or a control group. Physical activity and body weight were objectively measured at baseline pre-surgery and post-surgery follow-ups after 6 weeks (weight only), 18 weeks, 6 months, and 1 year. Linear mixed models were fitted to assess longitudinal differences in outcomes between the groups.Results A significant effect of the intervention (group-by-time interaction 16.2, 95% CI 3.5 to 28.9) was seen for MVPA at 18 weeks; the intervention group had increased their MVPA since baseline, while the control group had decreased their MVPA. The control group had lowered their BMI approximately 1 kg/m(2) more than the intervention group at follow-up after 18 weeks and 12 months, yet, mean BMI did not differ between the groups. No intervention effect was seen on inactivity, LPA, or %TWL.ConclusionOur results indicate that use of a smartphone application targeting physical activity may have the potential to promote short-term MVPA post bariatric surgery.
|
|
| 3. |
- Hult, Marja, et al.
(författare)
-
Cost-effectiveness calculators for health, well-being and safety promotion : a systematic review
- 2021
-
Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 31:5, s. 997-1003
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The health, well-being and safety of the general population are important goals for society, but forecasting outcomes and weighing up the costs and benefits of effective promotional programmes is challenging. This study aimed to identify and describe the cost-effectiveness calculators that analyze interventions that promote health, well-being and safety. METHODS: Our systematic review used the CINAHL, PsycINFO, SocINDEX, EconLit, PubMed and Scopus databases to identify peer-reviewed studies published in English between January 2010 and April 2020. The data were analyzed with narrative synthesis. RESULTS: The searches identified 6880 papers and nine met our eligibility and quality criteria. All nine calculators focussed on interventions that promoted health and well-being, but no safety promotion tools were identified. Five calculators were targeted at group-level initiatives, two at regional levels and two at national levels. The calculators combined different data sources, in addition to data inputted by users. This included empirical research and previous literature. The calculators created baseline estimates and assessed the cost-effectiveness of the interventions before or after they were implemented. The calculators were heterogeneous in terms of outcomes, the interventions they evaluated and the data and methods used. CONCLUSION: This review identified nine calculators that assessed the cost-effectiveness of health and well-being interventions and supported decision-making and resource allocations at local, regional and national levels, but none focussed on safety. Producing calculators that work accurately in different contexts might be challenging. Further research should identify how to assess sustainable evaluation of health, well-being and safety strategies.
|
|
| 4. |
- Hult, Marja, et al.
(författare)
-
Cost-effectiveness calculators on health and social services planning and evaluation : an explorative interview study of key informants
- 2023
-
Ingår i: International Journal of Health Promotion and Education. - : Routledge. - 1463-5240 .- 2164-9545. ; 61:5, s. 243-254
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine the views of key experts on developing and using cost-effectiveness calculators to plan and evaluate health and wellbeing promotion interventions in health and social services. Data for this qualitative interview study were collected from 14 Finnish experts in health and wellbeing coordination, health and social service management and research and health economics in spring 2021. A semi-structured interview method with thematic analysis was used. The experts said that there is a need for cost-effectiveness evaluation tools that support local evidence-based decision-making. This would enable organizations to plan and allocate scarce resources for interventions that promote equitable and effective health and wellbeing. However, practical tools and calculators that enable users to make decisions based on the best available evidence are not widely used. Local decision-makers, researchers and service providers all need to be involved in agreeing goals and selecting the right target groups and measures. They also need to make decisions about the best available data sources and how to use calculators to define and evaluate outcomes. Cost-effectiveness calculators are needed for local evidence-based decision-making, so that municipalities can allocate scarce resources to effective services that increase the wellbeing and equality of residents. This requires key stakeholders to work together to plan, develop and evaluate comprehensive, easy-to-use cost-effectiveness calculators.
|
|
| 5. |
- Hult, Mari
(författare)
-
Next in bariatric surgery : the role of lifestyle and adequate information to improve patients’ quality of life and health
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this doctoral thesis is to increase the knowledge about how behavioral modification and information can improve the individual results following bariatric surgery or conventional weight loss treatment. Background: Obesity is a growing health issue often affecting quality of life and morbidity. Bariatric surgery is since many years acknowledged to lead to successful long-term weight loss. Its effect on weight loss is more pronounced in the beginning post-surgery and thereafter some weight regain is to be expected. To counteract this, it is of importance to explore possible ways to support lifestyle changes among patients who choose to undergo bariatric surgery. Digital solutions may be useful in supporting lifestyle changes pre- or post-surgery, but they have to be scientifically evaluated. Methods and materials: In Paper I, 250 women with obesity from Finland, Norway, Germany, Sweden and the Netherlands were asked about their main reasons to seek surgery and their expectation on post-surgery weight loss result. In Paper II, at 1-year post-surgery the Swedish participants from paper I (n=50) were asked which issue they felt most satisfied with post-surgery, and if they were satisfied with their post-surgery weight loss. In Paper III, a cohort of 23,233 persons were recruited within a Web-based weight loss program (viktklubb.se) and the participants eating behavior were measured with TFEQ-R18 at baseline, 3- and 6-months. In Paper IV, 146 out of 201 patients accepted for bariatric surgery were randomized either to standard care or to standard care plus a 3-month-smartphone app intervention to increase their level of moderate-to-vigorous physical activity post-surgery. Results: The main reason to seek bariatric surgery was weight loss. The odds ratio for certain reasons like less co-morbidity, less medication, and longevity was dependent on if the participants had co-morbidities. The participants expected to lose almost 80% of their excessive weight post-surgery. The issue of most satisfaction 1-year post-surgery was improved selfesteem. Only those with a weight loss of more than 80% of their excessive weight were satisfied with their post-surgery weight loss. A change in eating behavior was associated with a greater weight loss in the Web-based weight loss program. The uncontrolled eating score decreased and the cognitive restrained eating score increased in both men and women, whereas a reduction in the emotional eating score only was seen among men. A smartphone app intervention led to a significant increase in minutes/day of moderate-to-vigorous physical activity in the intervention group, compared to the control group receiving standard care postsurgery. Conclusions: To address patient expectations before bariatric surgery may improve postsurgery satisfaction. Individualized pre-surgery information and post-surgery care could be of importance for the lifestyle changes required after bariatric surgery. Technology like Webbased or app-based programs may serve as interactive solutions to support lifestyle changes and the need for individualized information.
|
|
| 6. |
- Spetz, Kristina, et al.
(författare)
-
A smartphone application to improve adherence to vitamin and mineral supplementation after bariatric surgery
- 2022
-
Ingår i: Obesity. - : Wiley. - 1930-7381 .- 1930-739X. ; 30:10, s. 1973-1982
-
Tidskriftsartikel (refereegranskat)abstract
- Objective This trial evaluated a smartphone applications effectiveness in improving adherence to vitamin and mineral supplementation postoperatively. Methods This study was a randomized controlled trial comprising 140 patients undergoing bariatric surgery (gastric bypass or sleeve gastrectomy). Participants were randomized 1:1 to the 12-week intervention, using the smartphone application PromMera, or to standard care. The primary end point was adherence to vitamin and mineral supplementation. Results Initiation rate and overall adherence to supplementation were high in both groups. Change in objectively measured adherence rate from before the intervention to 1 year post surgery, measured with pharmacy refill data, did not differ between groups for vitamin B-12 (-9.6% [SD = 27%] vs. -9.3% [SD = 30%]; p = 0.48) or calcium/vitamin D (-12.3% [SD = 29%] vs. -11.5% [SD = 32%]; p = 0.44). A modest effect on the secondary end point (subjectively measured adherence, using the Medication Adherence Report Scale-5) was seen immediately after the intervention (intervention group 0.00 [SD = 1.3] vs. control group -1.2 [SD = 3.5]; p = 0.021), but this effect did not persist 1 year post surgery. No differences were detected in the prevalence of biochemical deficiencies. Conclusions The use of the smartphone application PromMera did not obtain a lasting improvement in adherence to vitamin and mineral supplementation 1 year post bariatric surgery.
|
|
| 7. |
- Spetz, Kristina, 1981-, et al.
(författare)
-
A Smartphone Application to Improve Adherence to Vitamin and Mineral Supplementation after Bariatric Surgery : a Randomized Controlled Trial
- 2022
-
Ingår i: The 25th world congress of IFSO (International Federation for the Surgery of Obesity and Metabolic Disorders) held in Miami, USA, 23-27 August 2022.
-
Konferensbidrag (refereegranskat)abstract
- Introduction: Previous studies suggest insufficient adherence to vitamin and mineral supplementation after bariatric surgery. Objective: This trial evaluated a smartphone application’s effectiveness in improving adherence to vitamin and mineral supplementation postoperatively. Methods: A two-arm, randomized controlled trial comprising 140 patients undergoing bariatric surgery (gastric bypass or sleeve gastrectomy). Participants were randomized 1:1 post-surgery to 12-week intervention, using the smartphone application PromMera, or standard care. The PromMera application was designed to promote vitamin and mineral use and physical activity after bariatric surgery. The primary end point was adherence to vitamin and mineral supplementation, objectively assessed with pharmacy claim data the first-year post-surgery. Additional endpoints were adherence subjectively assessed with change in MARS-5 score, measured pre-intervention, and at 18 weeks and one year post surgery and development of nutritional deficiencies one-year post-surgery.Results: Initiation rate and overall adherence to supplementation were high in both groups. Change in objectively measured adherence rate from before intervention to 1 year post surgery, measured with pharmacy refill data, did not differ between groups for vitamin B12 (-9.6% [SD 27%] vs. -9.3% [SD 30%]; p=0.48) or calcium/vitamin D (-12.3% [SD 29%] vs. -11.5% [SD 32%]; p=0.44). A modest effect on the secondary end point (subjectively measured adherence, using the Medication Adherence Report Scale-5 [MARS-5]) was seen immediately after the intervention (intervention group 0.00 [SD 1.3] vs. control group -1.2 [SD 3.5]; p=0.021), but this effect did not persist 1 year post surgery. No differences were detected in the prevalence of biochemical deficiencies.Conclusions The use of the smartphone application PromMera did not obtain a lasting improvement in adherence to vitamin and mineral supplementation one year post bariatric surgery.
|
|
| 8. |
- Svensson, Madeleine, 1983-, et al.
(författare)
-
The Change in Eating Behaviors in a Web-Based Weight Loss Program : A Longitudinal Analysis of Study Completers
- 2014
-
Ingår i: Journal of Medical Internet Research. - Toronto, ON : Journal of Medical Internet Research. - 1438-8871. ; 16:11
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Eating behaviors are essential components in weight loss programs, but limited research has explored eating behaviors in Web-based weight loss programs.Objectives: The aim was to evaluate an interactive Web-based weight loss program on eating behaviors using the 18-item Three-Factor Eating Questionnaire Revised (TFEQ-R18) which measures uncontrolled eating, emotional eating, and cognitive restrained eating. Our Web-based weight loss program is comprised of information about healthy lifestyle choices, weekly chats with experts, social networking features, databases for recipe searches, and features allowing members to self-report and track their weight, physical activity, and dietary intake on the website.Methods: On registering for the weight loss program, 23,333 members agreed to take part in the research study. The participants were then asked to complete the TFEQ-R18 questionnaire at baseline and after 3 and 6 months of participation. All data collection was conducted online, with no face-to-face contact. To study changes in TFEQ-R18 eating behaviors we restricted our study to those members who completed all 3 TFEQ-R18 questionnaires. These participants were defined as "completers" and the remaining as "noncompleters." The relationships between sex, change in eating behaviors, and total weight loss were studied using repeated measures ANOVA and Pearson correlation coefficient.Results: In total, 22,800 individuals participated (females: 19,065/22,800, 83.62%; mean age 39.6, SD 11.4 years; BMI 29.0 kg/m2; males: 3735/22,800, 16.38%; mean age 43.2, SD 11.7 years; BMI 30.8 kg/m2). Noncompleters (n=22,180) were younger and reported a lower score of uncontrolled eating and a higher score of cognitive restrained eating. Over time, completers (n=620) decreased their uncontrolled eating score (from 56.3 to 32.0; P<.001) and increased their cognitive restrained eating (from 50.6 to 62.9; P<.001). Males decreased their emotional eating (from 57.2 to 35.9; P<.001), but no significant change was found among females. The baseline cognitive restrained eating score was significantly and positively associated with weight loss for completers in both men (P=.02) and women (P=.002).Conclusions: To our knowledge, this is the largest TFEQ sample that has been documented. This Web-based weight loss intervention suggests that eating behaviors (cognitive restrained eating, uncontrolled eating, and emotional eating) measured by TFEQ-R18 were significantly changed during 6 months of participation. Our findings indicate differences in eating behaviors with respect to sex, but should be interpreted with caution because attrition was high.
|
|
