Dissertations / Theses: 'Lifestyle modification'

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Elege, Vivian. "Staff Education: Prediabetes Lifestyle Modification Toolkit." ScholarWorks, 2020. https://scholarworks.waldenu.edu/dissertations/7922.

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Prediabetes patients are at a high risk of developing Type 2 diabetes. The purpose of this project was to educate the medical staff of the project site clinic on lifestyle modifications that can help patients prevent prediabetes from progressing to Type 2 diabetes. The project took place at an outpatient clinic in the Southwestern United States. The clinic patient population is mostly African American, a population at risk for diabetes. The theoretical framework to support the project was the Iowa model of evidence-based practice. Staff education on patient diabetes prevention was the goal of the project. The project question focused on staff education for lifestyle modifications to increase nurses' knowledge and skills in prediabetes patient management. The educational content of the module was formed using evidenced-based guidelines from the Centers for Disease Control and Prevention's Road to Health toolkit and from the American Diabetes Association. The educational program was evaluated by 3 content experts in primary care and diabetes management. Expert responses were measured with a 5-point Likert-scale survey. The expert panel indicated the content would be applicable and beneficial for clinic staff. The program was then provided to 3 clinic nurses. Each nurse answered pretest and posttest questionnaires to assess their knowledge of program content related to lifestyle modifications to prevent Type 2 diabetes. All participants answered the posttest questions as agree or strongly agree. Results from the questionnaires indicated the nurses improved their knowledge on the subject matter after program completion. The toolkit supports social change by providing nurses with the necessary education to help prediabetes patients experience improved outcomes.

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Makondo, Rulani. "Adherence to lifestyle modification recommendations in hypertensive patients at Parirenyatwa Hospital." University of the Western Cape, 2018. http://hdl.handle.net/11394/6899.

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Magister Public Health - MPH
Background: Hypertension (HTN) complications are one of the leading causes of disability and mortality worldwide, with increasing trends noted in Africa. The most neglected causes of uncontrolled HTN and its complications are unhealthy diets, excess alcohol consumption and physical inactivity. Adherence to recommended lifestyle modifications remains low in Zimbabwe. This study seeks to explore the factors influencing adherence to World Health Organisation (WHO) lifestyle modification recommendations in patients with hypertension at Parirenyatwa Hospital, Harare. Methodology: An analytic cross-sectional study design was utilized. 328 hypertensive patients aged at least 18, receiving care at Parirenyatwa Hospital were recruited into the study. A self-administered questionnaire was used to collect information on demographics, knowledge and adherence to WHO recommended lifestyle modifications from participants. Statistical Package for Social Scientists (SPSS) version 20 was used for data analysis. The Spearman test was used to test for linear correlation among variables and the 5-point Likert Scale was utilized to categorize the extent of practice of dietary and physical activity recommendations by WHO.

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Nwanna, Anthonia Ninikanwa. "A Lifestyle Modification Toolkit to Increase Physical Activity Among Young Adults." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7709.

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Substantial decreases in physical activity have been observed between early to late adolescence in males and females, with decreases in levels of activity into adulthood. Physical inactivity among young adults leads to medical conditions such as Type 2 diabetes, stroke, ischemic heart disease, falls resulting in hip fractures, and depression later in life. Advanced Nurse Practitioners have a significant impact on the problem of physical inactivity among young adults through education to improve knowledge regarding physical activity participation. The focus of this project was to develop a toolkit on lifestyle modification as a resource for physical education teachers and nurses to increase physical activity participation and to decrease sedentary behaviors among young adults. The project practice question asked whether an evidence-based toolkit would address the identified needs of improving lifestyle diet and physical activity in young adults. Pender’s health promotion model guided the planning and development of the project. The Computer Attitude Questionnaire together with the 3-Day Physical Activity Recall was used during a needs assessment. Feedback from the survey was included in the development of the toolkit. A 5-item survey was given to 5 content experts who evaluated the toolkit. Data were analyzed using descriptive statistics to obtain a content validity index score of 1.00. Findings show universal agreement about the content of the toolkit as a resource for physical education teachers and school nurses to encourage physical activity participation in young adults. The implications of project findings for positive social change include the potential to increase the involvement of young adults in activities that improve the lives of the individual.

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Ugorji, Julia Ugochi. "Developing a Lifestyle Modification Toolkit to Prevent and Manage Hypertension Among African American Women." ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/170.

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Hypertension is a global public health issue affecting many people in the United States. African American women remain the highest in percentage by race and ethnicity for developing hypertension with poor risk awareness. Hypertension has costly implications for the health care system. Through lifestyle modifications in the form of a nutrition plan called Dietary Approach to Stop Hypertension and increased physical activity, hypertension could be prevented. Among African Americans, the incidence of hypertension increases in their late thirties. The purpose of the project was to develop a toolkit of resources for African American women between the ages of 20 to 45 years as a reference guide to reduce the risk of developing hypertension through lifestyle modifications. The clinical question for the project examined the effectiveness of a lifestyle modification toolkit as an evidence-based strategy to prevent and manage hypertension among African America women. Pender's health promotion model guided the planning and development of the project. The readability of the toolkit was at a 5th grade level for easy comprehension. A 5-item survey was given to 2 content experts and 3 members from the target population to evaluate the toolkit. Data were analyzed using descriptive statistics to obtain a content validity index score of 1.00. Findings suggested universal agreement on the content of the toolkit which was developed as a resource tool to provide culturally-based educational materials from scholarly literature. This toolkit will promote positive social change by improving the outcomes of African American women with hypertension.

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Hattori, Takuya, and Kohzo Nagata. "CARDIOPROTECTIVE MECHANISMS OF LIFESTYLE MODIFICATIONS AND PHARMACOTHERAPIES ON CARDIAC REMODELING AND DYSFUNCTION IN HYPERTENSIVE HEART DISEASE: AN OVERVIEW." Nagoya University School of Medicine, 2011. http://hdl.handle.net/2237/15352.

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Htoo, Zaw Wai. "Is lifestyle modification effective for glycemic control among type II diabetic adults in Southeast Asia?" Thesis, Kansas State University, 2015. http://hdl.handle.net/2097/19191.

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Master of Public Health
Human Nutrition
Richard R. Rosenkranz
Background: Type 2 diabetes mellitus (T2DM) is a costly and burdensome lifelong disease, and without proper glycemic control, severe life-threatening complications result. In Southeast Asia, the prevalence of T2DM is forecast to increase markedly from 2000 to 2030. Although literature reviews on lifestyle modification for glycemic control are available, these are mainly for the Western context, and there is a dearth of evidence for Southeast Asians who are at greater risk of T2DM and have differing patterns of diet, physical activity and body composition than Western populations. Objective: To systematically review literature on the effectiveness of lifestyle modification interventions for glycemic control in T2DM patients from Southeast Asia. Methods: Randomized controlled trials (RCT) with interventions ≥ 8 weeks that compared HbA1c or blood glucose for intervention (lifestyle modification) versus control groups were identified from searches in Cochrane Library, CINAHL, PubMed, ProQuest, Science Direct, SPORTDiscus, Scopus and Web of Science. Results: Seven RCTs (679 participants) meeting inclusion and exclusion criteria were identified. There was a significant reduction in HbA1c% (MD = -0.56%; 95% CI = -0.95,-0.16%; p = 0.006; n = 5 studies) and in blood glucose mg/dl (MD = -16.76 mg/dl; 95% CI = -31.36, -2.17 mg/dl; p = 0.02; n = 4 studies) over 3 months for lifestyle modification intervention groups. Lifestyle interventions included diet (n = 2), exercise (n = 2), and general lifestyle interventions (n = 3). Duration of interventions ranged from 12 weeks to 6 months. Studies included populations from Thailand (n = 5) and Malaysia (n = 2). Conclusion: Overall, lifestyle modification interventions are effective for the glycemic control of T2DM patients in countries of Southeast Asia.

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Patterson, Andrea M. "Evaluating The Effects of an Educational Lifestyle Modification Intervention on Blood Pressure in Adults With Prehypertension." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/496.

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The purpose of this project was to evaluate the effectiveness of an educational lifestyle modification (LM) intervention on blood pressure (BP) among adults with prehypertension. Prehypertension is a precursor to hypertension (HTN) and is a public epidemic in the United States. Approximately 68 million (31%) U.S. adult’s aged ≥18 years have hypertension. Hypertension can cause significant target organ damage, lead to coronary heart disease, heart failure, stroke, and kidney failure. Early identification and the primary treatment of persons with prehypertension with LM have the potential to minimize the progression and delay the onset of comorbidities associated with hypertension. This quality improvement project retrospectively reviewed changes in blood pressure for a small sample (n=5) of patients diagnosed with prehypertension who received education about modifying lifestyle behaviors according to nationally accepted clinical practice guidelines. Blood pressure measurements were extracted from the medical record beginning at the time of the education through a three month period. Descriptive data indicates that all five patients had a decrease in systolic and diastolic blood pressure. The median systolic blood pressure at baseline was 129 mmHg decreasing to 121 mmHg at end of study period. The median diastolic blood pressure was 86 mmHg decreasing to 76 mmHg. Integration of lifestyle modification education and subsequent blood pressure monitoring during a routine primary care visit is feasible and may help motivate patients to implement changes and subsequently reduce blood pressure. Future studies should include identifying strategies for improving patient participation.

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Parker, Whadi-ah. "Lifestyle modification education in chronic diseases of lifestyle : insight into counselling provided by health professionals at primary health care facilities in the Western Cape, South Africa." Doctoral thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/2742.

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Includes abstract.
Includes bibliographical references.
The aim of this study is to conduct a formative assessment to explore health professionals’ capacity as well as the conditions within primary health care facilities in the Western Cape Metropole that facilitate or impede the provision of lifestyle modification education and counselling to patients with chronic diseases of lifestyle in order to make recommendations for an intervention programme that utilises available resources.

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Werner, Timothy Jason. "Effect of Nebivolol and Lifestyle Modification on Large Artery Stiffness in Middle-Aged and Older Hypertensive Adults." Diss., Virginia Tech, 2013. http://hdl.handle.net/10919/23316.

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For more than half a century cardiovascular disease has been the leading cause of death in the United States. Aging, hypertension, and obesity are major risk factors for cardiovascular disease and clearly associated with arterial stiffness. Arterial stiffness generates higher afterloads and diminishes coronary perfusion thereby causing ventricular hypertrophy and ischemia. Importantly, arterial stiffness is an independent predictor of cardiovascular disease risk and all-cause mortality. Current strategies such as inhibition of angiotensin II or angiotensin converting enzyme, reduction of smooth muscle tone, blood volume, or inflammatory mediators, and improving glucose homeostasis are effective destiffening options. Nebivolol, a third generation beta-blocker, has unique vasodilatory characteristics and may be particularly efficacious as a destiffening agent. Only a few studies have addressed this issue while relying on indirect, blood pressure-dependent stiffness indices precluding clear understanding of study outcomes. There remains a need to determine the potential utility of nebivolol therapy as an arterial destiffening strategy. Thus, we hypothesized that the combination of nebivolol and lifestyle modification would reduce central arterial stiffness in middle-aged and older hypertensive adults more than either intervention alone. To test this hypothesis, we randomized 45 hypertensive adults to receive lifestyle modification, nebivolol, or combination for 12 weeks. Î"-stiffness index, pulse wave analysis, and arterial compliance were measured at baseline and following the intervention. No baseline differences in variables of interest were observed between groups. In contrast to our hypothesis, lifestyle modification, nebivolol, and combination groups had similar (P>0.05) reductions in beta-stiffness index (-1.87±0.83; -2.03±0.60; and -2.51±0.90 U), respectively, while carotid-femoral pulse wave velocity declined only in the nebivolol and combination groups. Our findings suggest combination of nebivolol and lifestyle modification reduces arterial stiffness to a similar degree as either intervention alone in middle-aged and older hypertensive adults. Further studies are needed to determine if the changes in arterial stiffness continue to occur or remain clinically significant over longer durations.
Ph. D.

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Dorough, Ashley E. "Dash 2 Wellness: Effects of a Multi-Component Lifestyle Modification Program on Nutrition, Physical Activity, and Blood Pressure in Prehypertensive Middle-Aged Adults, a Randomized Controlled Trial." Diss., Virginia Tech, 2009. http://hdl.handle.net/10919/37736.

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The primary goal of this project was to develop, implement, and evaluate a lifestyle modification intervention that did not require extensive, ongoing personal contact to improve lifestyle behaviors shown to lower blood pressure (BP) in adults with prehypertension (N=23, mean age=54, mean BP=126.7/75.1). Incorporating clinical practices and psychological approaches to behavior change, this intervention used primarily the DASH Eating Plan, coupled with a low-sodium diet and a walking program; it applied social cognitive theory to health behavior change, specifically self-regulation for self-monitoring and management of BP, diet, exericse, and weight. The study compared two conditions, the DASH 2 Wellness Only standard of care condition to the DASH 2 Wellness Plus treatment condition on the primary outcome measures of fruit and vegetable (servings/day), sodium consumption (milligrams/day), physical activity (steps/day), weight (kgs), and blood pressure (primarily systolic BP). Consistent with hypotheses, MANOVAs detected significant differences between the conditions with D2W Plus evidencing a larger increase in change of total daily steps (M= 2900.14, SD= 1903.83) than D2W Only, (M= 636.39, SD= 1653.26), a larger decrease in systolic BP change (MMHG) (M= 15.14, SD= 4.33) than D2W Only, (M= 4.61, SD= 8.28), and a larger decrease in weight change (kg) (M= 4.78, SD= 3.81) than D2W Only, (M= 1.47, SD= 2.57). While conditions did not significantly differ on daily sodium reduction or fruit and vegetable increase, D2W Plus evidenced a larger decrease in sodium (mg) (M= 932.22, SD= 1019.22) than D2W Only, (M= 423.64, SD= 749.15) and larger increase in fruit and vegetable increase, (M= 2.10, SD= 1.73) than D2W Only, (M= 1.02, SD= 2.24). It was also hypothesized that the D2W Plus condition would show greater improvements in nutrition-specific and PA-specific health beliefs of self-regulation, social support, self-efficacy, social support, and outcome-expectancy compared to those in the D2W Only condition. A MANOVA revealed significant group differences in PA-specific health beliefs primarily attributable to increased PA self-regulation in D2W Plus compared to D2W Only, (M= 1.78, SD= 0.75) and (M= 0.55, SD= 0.57), respectively. While no overall significant group differences were found for nutrition-specific health beliefs, analyses showed meaningful differences in nutrition-specific health beliefs attributable to increased nutrition self-regulation strategies in D2W Plus compared to D2W Only. Results provide preliminary support for the efficacy of an electronic delivery of an intervention aimed at improving lifestyle behaviors and lowering BP in middle-aged individuals with prehypertension.
Ph. D.

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Hamadi, Caroline. "Public health nutrition intervention to enhance healthy eating and lifestyle modification among Lebanese women with Polycystic Ovarian Syndrome." Thesis, University of Westminster, 2018. https://westminsterresearch.westminster.ac.uk/item/q947q/public-health-nutrition-intervention-to-enhance-healthy-eating-and-lifestyle-modification-among-lebanese-women-with-polycystic-ovarian-syndrome.

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Polycystic ovary syndrome (PCOS) is the most common endocrinopathy disorder in reproductive age women. The symptoms of this disorder are the androgen excess seen with anovulation/oligoovulation or morphologically ovarian cysts. The aim of the study was to assess the efficacy of public health nutrition intervention designed to enhance healthy eating and lifestyle modification among PCOS patients attended the obstetrics and gynecology clinic at the American University of Beirut Medical Centre (AUB-MC) in Beirut, Lebanon. A prospective hospital based public health nutrition intervention was proposed in which 76 women with PCOS were recruited in the pilot study and 588 women were recruited in the scale-up intervention divided between PCOS and non-PCOS. During the scale up phase non-PCOS women were recruited to study the effect of the nutritional counseling on them as a way to compare the outcome with PCOS women. Recruited population were divided into 8 groups; group A: overweight/obese PCOS patient’s intervention (received weight management program with nutritional guidelines). Group B: overweight/ obese PCOS controls (received the usual heath care by the gynecologist), Group C: lean PCOS controls (received the usual heath care by the gynecologist), Group D: lean PCOS intervention (received weight maintenance program with nutritional guidelines ), Group E: overweight/obese non-PCOS patient’s intervention (received weight management program with nutritional guidelines) ,Group F: overweight/ obese non-PCOS controls, Group G: lean non- PCOS intervention (received weight maintenance program with nutritional guidelines), Group H: lean non-PCOS controls. Data were collected using a pre-validated questionnaire to capture sociodemographic variables, nutritional status, and physical activity, psychological and medical status. Blood analysis was carried out to determine biochemical indices. Assessment of study indicators were carried out at baseline, after 3 and 6 months from inception of intervention (pilot as well scale up). Patients in intervention groups attended a 6 month tailored nutrition counseling/education program (2 sessions per month), to enhance their understanding of their dietary intake and assist them with weight management, physical activity, healthy cooking, lifestyle, and food shopping. Following a six months pilot study intervention results have shown that 7% weight loss was achieved in overweight/ obese intervention groups and weight maintenance in lean intervention groups( Group A,B,C and D). There was a significant reduction in waist (-4.2 cm (±5.6)) and hip circumference (-3.1cm (±3.5)) with P < 0.001. There was no significant biochemical markers change (fasting blood sugar, CRP, LDL-C,HDL-C,TG,total cholesterol, fasting insulin, total testosterone,Vit D), however there was an increase in physical activity (3.1 hours/week (±1.5)) , and decrease in anxiety and depression score ( BDI-II and BAD-7); -0.8 (±0.8) and -0.7 (±0.7) with P < 0,001 compared to interventions. Following six months scale up intervention, the results have shown a weight reduction among overweight/obese PCOS women (group A) who lost, on average, 8.2 kg (P=0.001). Whilst non-PCOS women lost, on average 11.6 kg (P < 0.001)(Group E). Controls gained weight (Group B, D F and H). The biochemical, psychological and reproductive profile showed significant improvements among PCOS women (P < 0.001). Pregnancy rate increased to 70% among women trying to conceive. The results of this study have shown this intervention to be effective in Lebanese women with PCOS, decreasing their initial body weight by 5%- 10% and improving their reproductive, metabolic and endocrine profiles. This suggests the need for a nutritional intervention (nutritional guidelines) for women diagnosed with PCOS patients as a first line treatment. The study results support the effectiveness of lifestyle modification diet for PCOS women.

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Thomasouli, Maria-Anna. "A lifestyle modification programme for people with Obstructive Sleep Apnoea (OSA) at high risk of Cardiovascular Disease (CVD) and Dysglycaemia." Thesis, University of Leicester, 2014. http://hdl.handle.net/2381/28832.

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The aim of the work reported in this thesis was centred on the development of a fit for purpose structured education lifestyle modification programme for the self-management of Obstructive Sleep Apnoea (OSA). The programme aimed to promote compliance to Continuous Positive Airway Pressure (CPAP) therapy and increase physical activity levels. A mixed method study, the Predicting the Use of Continuous Positive Airway Pressure Therapy in Obstructive Sleep Apnoea in a UK population: The PUCOSA-UK study was carried out to explore the interplay of potential psycho-social predictors of CPAP adherence using a strong framework of psychology models in newly diagnosed and established OSA patients. The study showed that adherence to CPAP therapy was heavily dependent on the early formation of strong beliefs and preconceptions of the condition and CPAP therapy prior to trialling the therapy. The qualitative element of the study identified a number of common barriers associated with CPAP compliance including inability to recognise symptoms and link to with being diagnosed with OSA, initial negative reactions to the idea of using CPAP therapy, discomfort and inconvenience caused when wearing a CPAP mask and operating a CPAP device, lack of spousal or peer support and self-image issues. A systematic review and meta-analysis was conducted to evaluate the impact of diet, exercise and lifestyle modification interventions with or without CPAP therapy on obesity indices, OSA parameters and quality of life in adults with OSA. Intensive lifestyle intervention programmes were found to be more effective in reducing indices of obesity and in improving OSA parameters than less intensive lifestyle interventions or routine care. A structured education curriculum was written and piloted in small groups. The results of the pilot work combined with the results of the aforementioned studies informed the content of the curriculum. Overall, the patients benefited from attending the education programme and learnt useful self-management skills. Concluding, the findings from the work reported here warrant formal testing of the educational programme in a definitive randomised controlled trial.

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Becker, Craig M. "A pilot test of the usability of a lifestyle instrument based on the Deming approach to management." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/845958.

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This study was designed to determine if the Deming approach to monitoring manufacturing processes could be successfully adapted to monitoring lifestyle processes. This study tested a new self-monitoring instrument that provides quick, accurate, personal feedback. The usability of this new instrument was tested. Validity of the instrument was established through review by experts in appropriate lifestyle management disciplines.The pilot test of this new instrument was done in a program with a convenience sample of 29 people who used the instrument for 28 days. A high percentage of the participants used the instrument and found the instrument to be helpful in developing a healthy lifestyle, although they desired a less cumbersome format. It is recommended that the instrument be adapted for use in lifestyle change programs.
Institute for Wellness

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Kaur, Ramandeep. "Impact of a Lifestyle Modification Intervention on Health Behaviors and Health Outcomes in a Mexican American population: A Mixed-methods Study." FIU Digital Commons, 2018. https://digitalcommons.fiu.edu/etd/3782.

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Metabolic syndrome (MetS), a global public health problem, is the primary cause of type 2 diabetes and cardiovascular disorders. Lifestyle modification interventions (dietary and physical activity modifications) are effective in preventing and ameliorating MetS and associated comorbidities. However, the impact of lifestyle changes on MetS among Mexican Americans has yet to be investigated, particularly due to high attrition rates in this population. The overall goal of the explanatory mixed-methods study presented in this dissertation was to identify efficacious lifestyle modification efforts directed towards Mexican Americans to promote their retention in lifestyle modification programs, ameliorate the severity of MetS, and understand underlying behavior modification process. In particular, we examined secondary data from an extensive study Beyond Sabor to 1) examine predictors of program completion, 2) compare variation in MetS severity scores (z-scores) between intervention (Beyond Sabor) and attention control (Healthy Living) groups, over time and, 3) investigate processual development of self-efficacy in a sample of 1153 disadvantaged Mexican Americans participants. Findings suggest that program completers were more likely to be older, had more years of education, lower fasting blood glucose levels, and participated in sites with high group cohesiveness. Results also revealed that when compared with the standard nutrition program, Healthy Living, the lifestyle modification intervention, Beyond Sabor, was more effective in ameliorating MetS severity, systolic blood pressure, triglyceride, and fasting plasma glucose levels among study participants. Qualitative results demonstrate the high acceptability of Beyond Sabor intervention. Four sub-themes emerged illustrating important underlying conditions contributing to participants’ improved self-efficacy: desire to gain knowledge about ways to improve health, development of social support, adoption of program teachings in family lifestyle, and improvement in health outcomes. Findings of the current study may allow researchers to identify Mexican Americans at risk of non-completion and to develop strategies to improve lifestyle modification program attendance, and thus health outcomes. Qualitative findings underscore the importance of sociocultural context on individuals’ attempts to make lifestyle changes to manage their chronic illnesses. Successful adaptation of lifestyle interventions such as Beyond Sabor for at-risk populations in community-based settings will be critical in stemming the tide of MetS.

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Reese, Sandra J. "Increasing diabetes awareness in adolescents through educational programs." [Johnson City, Tenn. : East Tennessee State University], 2003. http://etd-submit.etsu.edu/etd/theses/available/etd-0328103-161433/unrestricted/ResseS042103b.pdf.

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Thesis (M.S.)--East Tennessee State University, 2003.
Title from electronic submission form. ETSU ETD database URN: etd-0328103-161433. Includes bibliographical references. Also available via Internet at the UMI web site.

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Katiya, Lulama Pearl. "An investigation on the effectiveness of lifestyle modification interventions for hypertensive patients in a public health clinic, in the Eastern Cape Province." Thesis, University of Fort Hare, 2014. http://hdl.handle.net/10353/d1021131.

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The continued increase in morbidity and mortality of hypertensive patients in Alice in the Eastern Cape Province, prompted the researcher to investigate the effectiveness of lifestyle modification intervention on hypertensive patients. High morbidity and mortality rates of hypertensive patients are occuring in spite of hypertensive patients being taught about lifestyle modification (De Haan, 2006:55). According to the fifth South African Guidelines (2011:60), hypertension is a global health burden affecting developed and developing countries including South Africa. In 2003, the South African District Health Statistics showed that in the Eastern Cape, 221 females over 15 years of age and 101 males over 15 years of age had moderate hypertension and 92 males over 15 years had severe hypertension. Hypertension is a `silent killer` because it seldom gives rise to any symptoms (De Haan, 2006:66). The objectives of the study were to: investigate the effectiveness of lifestyle modification intervention on hypertensive patients, and to determine the strategies used in order to ensure the effectiveness of lifestyle modification by hypertensive patients. The research question was: what is the level of effectiveness of lifestyle modification on hypertensive patients in Alice? A descriptive quantitative research design was used in this study. This design allowed the researcher to investigate the effectiveness of lifestyle modification of hypertensive patients in Alice area. A convenience sample was used to sample the target population for the study on the criteria and a total of 169 respondents served as a size of the sample. A pre-test of the tool was carried out on 16 participants to validate the tool before the actual data collection commenced. Ethical approval was obtained from University of Fort Hare, the Department of Health, as well as Victoria Hospital and clinics. Data were collected by means of self-administered questionnaires. The Statistical Package for Social Science (SPSS) version 21.0 software for windows reference was used to analyse the data. The results were presented in tables, graphs and pie charts. The results revealed that 77% (n=125) reported to know nothing about hypertension. Twenty three percent of the participants (n=37) knew about hypertension, they mentioned that it is when the heart has too much blood that is overloading the heart due to problems of the heart, then the blood flow through the heart is disturbed. Furthermore participants stated that it is important that every hypertensive patient engage in lifestyle modification. The study recommended that the Department of Health should emphasise the use of Hypertension Guidelines where all nurses in public clinics should be trained in educating and doing counselling to all hypertensive patients, including those who are pre-hypertensive that are visiting the clinics. Health education about risk factors and complications of hypertension must be done. All patients visiting public clinics must be educated regardless of their problems.

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Murphy, Elizabeth Ann. "Lay health concepts and response to medical advice about lifestyle modification : the case of people with a diagnosis of non-insulin dependent diabetes." Thesis, University of Southampton, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316042.

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Andreou, Eleni P. "The use and effectiveness of behavioural modification techniques in achieving and maintaining normal weight and fitness : the lifestyle changes for adults in Cyprus." Thesis, Middlesex University, 2011. http://eprints.mdx.ac.uk/9059/.

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Background and aim: Research showed that behavioural modification techniques were the most effective way to achieve and maintain a healthy weight compared to diet and exercise alone. If behavioural modification was the most effective technique, then at least the two thirds of the candidates (Weight Loss Candidate with Behaviour Modification-WLCB) who used the specific behavioural modification techniques regarding eating and physical activity would achieve a weight loss of average ½ -1kg per week for the 18 weeks of the treatment and then maintain it or continue to lose after treatment termination with a total treatment period of 36 weeks. The treatment was efficient and long-lasting compared to the control candidates who followed a diet plan only. Furthermore, if the use of behavioural modification was the most effective way for diet and exercise, then the weight loss and maintenance would be more efficient and long-lasting. The principal aim of this project was to develop behaviour modification techniques (protocol and guidelines) in order to promote effective weight management for sedentary and active Cypriot adults, concentrating on nutrition and exercise. Study design: The study was quantitative and qualitative in nature using an action research approach. Furthermore, it was observational and longitudinal using structured methods and a representative sample of adults 19-50 years of age is investigated for 36 weeks. Methods: Anthropometric data and health and diet history were taken using standard methods from 315 (the control and intervention group (1:1) Cypriot adults from rural and urban areas. Individualised diet plans, personalised physical activities as well as behavioural modification parameters were assessed with the aid of a questionnaire, interview, food and exercise diary and behavioural checklist. Obesity and overweight were defined using the current International Obesity Task Force definition. The validated questionnaires for Physical Activity (IPAQ) and the nutritional assessment (National Integrated Health Associates) were used for initial assessment and the behavioural checklists were used for the follow up. Behavioural checklists were completed by the candidates on a bi-weekly basis along with the food and exercise diary. The questionnaire reliability (test-retest), internal consistency and ability to differentiate obese vs. normal-weight adult behaviours were tested using a pilot population of 50 adults not enrolled in a formal weight loss programme. Its reliability (checklists, food and exercise diary) and predictive validity were tested using a selective population: 265 adults of the observational group enrolled in behavioural modification treatment vs. diet. OBJECTIVES OF THE STUDY: Τhe objectives of the research were a) The study of every aspect of weight management and thus be capable of making suggestions for the development of guidelines and protocols for behavioural modification to health professionals working with the public. b) The identification and adjustment of eating and exercise behaviour related to body weight in order to achieve an efficient weight management in Cypriot overweight/obese adults. c) The evaluation of the effectiveness of the modest lifestyle changes in weight management induced by short-term energy/calorie restriction and behaviour modification in overweight and obese Greek Cypriots with Body Mass Index (BMI) above 25 or 30 respectively, or body weight 20% or above of Ideal Body weight (IBW), or body fat above normal levels. d) The development of education and counselling protocols and guidelines for professionals for weight management protocols based on the Mediterranean Diet and the eating and exercise habits of Cypriot Adults. e) The implementation of the protocols to intervention groups in order to identify the efficiency. Outcomes: The outcomes of the project was the development of an education and counselling protocol/manual which included teaching tools and guidelines for professionals for weight management with the title “Protocol and Guidelines for professional users for weight management for Adults: assessment, categorization, therapy/ follow up of overweight and obesity”. The development of an eating behaviour and physical activity protocol/manual based on the Mediterranean Diet and the demonstrated eating and exercise habits of Cypriot Adults can be used by the stakeholders and the public for efficient and effective weight management. RESULTS: The average length of weight loss treatment was 18 weeks for the intervention and the control groups, and the average weight loss for the intervention group was 11.96kg (t-test, p-value ≤ 0.001) and for the control group was 5.56kg (t-test, p-value≤ 0.002). During the 18 weeks of the maintenance period the 50% of the intervention group continued to lose while, an additional 48% of them maintained the weight and only 2% of them gained weight. Conclusions: To conclude, the prevalence of obesity worldwide has reached epidemic proportions. Physical inactivity and poor diet have been identified as primary contributors to the leading causes of death in developed countries including Cyprus. It is unfortunate that more emphasis is given to calorie restriction dieting rather than behavioural modification for diet and physical activity in achieving and maintaining weight loss. The fact is that incorporating appropriate behavioural modification techniques for diet and sufficient physical activity into one’s life is an essential component of achieving a healthy body weight. The research project aimed at developing a behavioural approach and behavioural modification techniques for the treatment of obesity and weight management adjusted to the needs of the Cypriot adult population. The difference of this approach underlines the emphasis that has to be given to the follow-up programme for the maintenance of the weight loss through behavioural modification. This approach evolved from the environmental control of eating behaviour to a broader approach characterized by systematic manipulation of all factors associated with eating and exercise patterns. The need for the project derives from the fact that obesity is a chronic condition with a substantial potential for relapse; therefore long–term treatments are needed. The expected outcomes of this project are the development of guidelines and protocols to be used by health professionals. The ultimate goal is the reduction of the obesity epidemic in Cyprus.

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Feigelman, Leonid. "PATTERNS OF USING ANTIHYPERTENSIVE DRUGS IN OUTPATIENT SETTINGS." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140618_233839-08839.

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We did not know the patterns of using antihypertensive drugs in outpatient settings in Israel that is why we raised a research aim to analyze the pattern of use of HBP in outpoint setting. In order to meet this aim we raised several research objectives:. 1) Does lifestyle modification is important for the patient for blood pressure control? 2) Do the patients need to change their medication at set of time until BP goals reached? 3) Does the use of more than one drug would help achieving better HBP results? Does the use of single doses combination would have better affect then using fixed dose combination? 4) How often noncompliance take in HBP control? 5) How many patients suffer from side effects? Methods: a questionnaire composed of 36 questions and qualitative statistical analysis.
Mes nežinojome, kad naudojant antihipertenzinių vaistinių preparatų ir ambulatorinėmis Izraelyje, kuris yra, kodėl mes iškėlė Tyrimo tikslas išanalizuoti naudojimo HBP Išėjo taško nustatymo modelį modelius. Siekiant įgyvendinti šį tikslą, mes iškėlė kelis mokslinių tyrimų tikslams:. 1) Ar gyvenimo būdo pakeitimas yra svarbus kraujospūdžio kontrolės pacientui? 2) Ar pacientai turi pakeisti savo vaistą esant rinkinį, kol pasiekė BP tikslai? 3) Ar iš daugiau nei vieno narkotiko naudojimas padėtų pasiekti geresnių HBP rezultatus? Ar vienos dozės deriniu būtų geriau veikia tada naudojant fiksuotų dozių derinys? 4) Kaip dažnai nesilaikymo imtis HBP kontrolės? 5) Kiek pacientų kenčia nuo šalutinio poveikio? Metodai: Klausimynas sudarytas iš 36 klausimų ir kokybinio statistinę analizę.

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Alcántara, Aragón Valeria. "Telematic monitorization and intensification for life style modification as a treatment for obesity and cardiometabolic risk prevention." Doctoral thesis, Universitat Autònoma de Barcelona, 2018. http://hdl.handle.net/10803/664097.

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La obesidad, la diabetes mellitus tipo 2 (DMT2) y sus complicaciones son problemas de salud pública con progresivo incremento en las últimas décadas, prácticamente a nivel global. Los sistemas sanitarios del mundo no están siendo capaces de atender a toda la población que necesitaría tratamiento. La telemedicina es un campo que ofrece muchas posibilidades debido a la amplia red de internet y el popular uso de dispositivos con conexión. El proyecto de telemedicina PREDIRCAM2, consistió en el diseño y validación clínica de una plataforma web para el tratamiento de obesidad, prevención de DMT2 y promoción de estilos de vida saludables. Fue diseñada por un equipo multidisciplinar y probada por un grupo de voluntarios sanos. Posteriormente, se realizó un ensayo clínico para validar su uso en el tratamiento de la obesidad y la prevención de DMT2, con los criterios de inclusión: adultos de hasta 65 años de edad, obesidad con índice de masa corporal(IMC) 30 a 39 kg/m2, no estar recibiendo tratamientos farmacológicos para DMT2, control de peso, hipertensión o dislipemia al momento de inclusión. Se incluyeron 183 personas, en 2 centros sanitarios y fueron aleatorizadas a 2 grupos: grupo control de intervención no telemática(GNT) y grupo de intervención telemática(GT). Ambos recibieron tratamiento durante un año: GNT de forma tradicional en 9 visitas presenciales y GT en 5 visitas presenciales además de utilizar la plataforma web donde realizaron 4 visitas telemáticas y recibieron soporte telemático continuado. Las tasas generales de abandono fueron 31.1% a los 6 meses y 42.1% a 12 meses. A 6 meses las tasas de abandono fueron significativamente más altas en GT (38%GT vs. 24%GNT, X2 p=0.034); esta diferencia entre grupos tendió a disminuir hacia el final del estudio. A corto plazo ambos grupos perdieron peso de forma significativa. GT perdió más peso que GNT, esta diferencia no fue estadísticamente significativa en la comparación entre grupos en análisis por intención de tratar. Resultados metabólicos fueron similares entre los grupos, con una disminución significativa y progresiva de HbA1c a lo largo del seguimiento. A largo plazo, ambos grupos presentan tendencia a re-ganancia de peso a partir de los 9 meses, estos cambios no fueron estadísticamente significativos. En el análisis por protocolo, la proporción de participantes que logró reducciones de ≥5% del peso corporal fue significativamente mayor en el GT (65% GT vs 43% GNT, MWU p=0.031). IMC, diámetro de cintura y el porcentaje de peso corporal perdido mostraron resultados similares a los 9 meses. Sin embargo estas diferencias no fueron significativas en el análisis por intención de tratar. Evaluaciones de satisfacción mostraron adecuada aceptación de la intervención telemática y de la funcionalidad de la plataforma PREDIRCAM2. La incorporación de psicólogos al equipo multidisciplinar está implícita en los motivos de abandono reportados por los participantes así como las valoraciones de satisfacción con el programa. La incorporación de sistemas automatizados serán de utilidad para el agilizar el registro dietético y así mejorar la usabilidad y con esto probablemente también mejorar la adherencia. La intervención telemática fue -113 €/paciente/año más económica que la tradicional no telemática, principalmente ahorrando en gasto asistencial. La intervención telemática no resultó costo-efectiva con el uso de dispositivos con pulsómetro para la actividad física (+24€ p=0.001, CI95% 7.5–24.35). En futuros estudios de intervenciones en este ámbito es recomendable la incorporación de tecnologías de uso diario como los dispositivos móviles, los contadores de pasos y las redes sociales. El tratamiento mediante telemedicina con el uso de la plataforma web PREDIRCAM2 es efectivo dentro de un programa de tratamiento intensificado para la obesidad y la prevención de DMT2, con un coste reducido en comparación con las intervenciones intensificadas tradicionales.
Obesity, Type 2 diabetes mellitus (T2DM) and their complications are public health issues that have progressively increased in the past decades at an almost worldwide scale. Given this alarming trend and the growing population affected, most health-care systems are unable to assume the intensified treatments that would be needed for obesity and T2DM prevention. Telemedicine is a promising field given the broad and ubiquitous use of the Internet and the popularization of connection devices. The term telemedicine literally means “healing at a distance”. The telemedicine project PREDIRCAM2, consisted of the design and clinical validation of a web platform for the treatment of obesity, T2DM prevention and healthy lifestyle promotion. A multidisciplinary team composed of engineers and health professionals designed the platform. Healthy volunteers tested its functionality and then it was validated in a clinical trial. Inclusion criteria were: adults younger than 65 years old, body mass index (BMI) of 30 to 39kg/m2, not receiving any medications for blood glucose, blood pressure, lipid or weight control at the time of recruitment. 183 participants were recruited in two participant centers and were randomized in two groups: a non-telematic (NTI) intervention control group, and an experimental group that received a telematic intervention (TI). Both groups received one-year follow-up. Participants in the NTI group received full in-person care in 9 visits and participants of the TI group received 5 in-person visits plus access to the web platform were they performed 4 telematic visits and received continued telematic support for 1-year. General dropout rates were 31.1% at 6 months and 42.1% at 12 months. At 6-months follow-up the dropout rates were significantly higher for the TI group (38% TI vs. 24% NTI, X2 p = 0.034); this difference tended to diminish towards the end of the study. Both groups lost weight significantly at short term. The TI group lost more weight however this difference was not statistically significant in the intention-to-treat analysis. Metabolic results were similar between groups, finding a progressive reduction of HbA1c values during follow-up. At long term, both groups tended to regain weight beginning at 9-months follow-up, these 9 to 12-month changes were not statistically significant. In the completers analysis, the percentage of participants who achieved a ≥5 weight loss was significantly greater for the TI group (65% TI vs. 43% NTI, MWU p = 0.031). BMI, waist circumference and percentage of weight-loss showed similar results at 9 months follow-up. However these differences were not significant in the intention-to-treat analysis. Satisfaction evaluations showed an adequate acceptance of the telematic intervention and functionality of the PREDIRCAM2 platform. The need to incorporate behavior change psychologists into the multidisciplinary team for future interventions is suggested by the most frequently reported reasons for dropout, as well as by expressed participant opinions. The incorporation of automatized systems may be useful to improve dietary logging, potentially improving usability and adherence. The cost-effectiveness evaluation showed the TI intervention was -113 €/patient/year less expensive than traditional non-telematic care, mainly by reducing cost in health-care appointments. The use of physical activity tracking devices with pulsometers made the TI more expensive than the NTI (+24 € (p=0.001, CI 95% 7.5 – 24.35). Every day technologies, such as mobile devices, pedometers, and social media should be incorporated into future studies of telemedicine interventions on obesity and T2DM prevention and may improve their cost-effectiveness. Telemedicine treatment delivered by the PREDIRCAM2 web platform is effective for the treatment of obesity, T2DM prevention at a reduced cost when compared to traditional full in-person intensified care.

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Nishimura, Akiko. "Color record in self-monitoring of blood glucose improves glycemic control by better self-management." 京都大学 (Kyoto University), 2014. http://hdl.handle.net/2433/189360.

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Saleh, Zyad T. "ADHERENCE TO PHYSICAL ACTIVITY AMONG INDIVIDUALS WITH OR WITHOUT CARDIOVASCULAR DISEASE." UKnowledge, 2013. http://uknowledge.uky.edu/nursing_etds/8.

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Cardiovascular disease (CVD) is a major public health problem and a primary cause of morbidity and mortality in the United States. Regular physical activity is recommended for prevention and management of CVD. Despite the cardiovascular health benefits of physical activity most adults are physically inactive. Therefore, the aim of this dissertation was to examine the factors associated with adherence to physical activity among individuals with or without CVD. The first paper is a report of a study conducted to examine which baseline demographic (age, gender, marital status, socioeconomic status, and place of residency), psychosocial (social support, depression, anxiety, and fatalism), and clinical (past history of exercising, comorbidity, and health literacy) variables predicted successful adoption of the active lifestyle recommendation of increasing moderate-to-vigorous physical activity by an accumulated 15 minutes or more each day following a CVD risk reduction intervention and 2) to identify which of those same factors predicted dropout from the CVD risk reduction intervention among at-risk individuals in rural America. The study sample consisted of 399 rural Americans. The results revealed that a higher anxiety level was a predictor of active lifestyle modification following a CVD risk reduction intervention. In contrast, younger age and low health literacy were predictors of dropout from a CVD risk reduction intervention. The second paper is a literature review of studies investigating the factors that affected enrollment in cardiac rehabilitation in patients with heart failure (HF). The aims of this review were to: (a) describe enrollment rates of patients with HF in cardiac rehabilitation programs, (b) review the literature on factors affecting enrollment of patients with HF, and (c) identify areas for future research. It is difficult to draw conclusion about enrollment rates because the period of time after hospital discharge that enrollment was measured varied across studies. A wide array of demographic, psychosocial, and clinical variables have been identified as potential barriers of enrollment in cardiac rehabilitation programs. Additional research including patients with HF is needed. The third paper is a report of a cross-sectional study of 279 patients with HF. The aims were to determine 1) the amount of variance in the functional status predicted by depressive symptoms, perceived control, self-rated health, HF self-care maintenance behaviors, and serum N-terminal pro-B-type natriuretic peptide ( NT-pro-BNP) biomarker of cardiac dysfunction in patients with HF and 2) whether NT-pro-BNP mediated the relationship between self-care maintenance behaviors and functional status. Depressive symptoms, poor self-rated health, non-adherence to physical activity, and greater serum NT-pro-BNP levels were independently associated with worse perceptions of functional status. Serum NT-pro-BNP levels partially mediated the association between adherence to physical activity and perception of functional status. The findings from this dissertation provided further evidence of the importance of adherence to physical activity and identify key variables that promote participation in interventions to promote heart healthy lifestyles and adherence to physical activity.

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Ukomadu, Chinyere. "An Educational Module on High Blood Pressure Management and Control." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7765.

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An educational module, based on evidence-based practice (EBP) guidelines by the 8th Joint National Committee (JNC 8) and the American College of Cardiology (ACC), was created and implemented to determine if its implementation would impact the knowledge of clinic staff regarding current EBP guidelines about self-management of hypertension (HTN). The module has the potential to contribute to the resolution of patient noncompliance on HTN treatment and management by increasing nursing staff proficiency in knowledge transfer to patients on effective self-management of their health condition. The creation of the module was guided by the concept of need or asset assessment and the theory of planned behavior. The module was composed of 2 short lecture presentations on HTN, current EBP guidelines on lifestyle modifications, and proper blood pressure measurement. The module also included pre- and postlecture surveys to evaluate knowledge and practices of staff, and reiterated the current guidelines and approaches presented in the lectures. Survey data were analyzed using McNemar’s test for paired and binary data. Results showed the agreement of all the staff in recognizing the utility of the module in standardizing their knowledge of current EBP guidelines on lifestyle modifications and blood pressure measurement procedures. The results also showed the enhancement of staff proficiency which might lead to efficient education of patients on effective HTN treatment and management protocol. This pathway has the potential to bring about social change by decreasing the incidence of patient noncompliance and improving patient health.

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Neumann, Anne. "Prevention of type 2 diabetes : modeling the cost-effectiveness of diabetes prevention." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-123553.

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Background: Diabetes is a common and costly disease that is expected to continue even to grow in prevalence and health expenditures over the coming decades. Type 2 diabetes is the most common diabetes type and is characterized by insulin resistance and relative insulin deficiency. Type 2 diabetes develops over a long period and is often undetected over years. During this time, people almost always first develop any of the pre-diabetic states, i.e. impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or a combination of both (IFG&IGT). This thesis focuses on type 2 diabetes only. In the following, the term diabetes is used to refer to type 2 diabetes only. Diabetes is associated with a sedentary lifestyle and obesity. While those are not the only factors contributing to the development and maintenance of diabetes, several studies have shown that prevention of diabetes among individuals at high risk through lifestyle change is possible, effective and cost-effective, especially targeting diet and exercise to reduce weight. No previous study had, however, estimated the cost-effectiveness of diabetes prevention strategies from a population-based perspective including healthy individuals and also considered IFG and IGT as two distinct pre-diabetic states. Objective: The overall objective of this thesis was to establish, describe and evaluate a model that can assess the cost-effectiveness of lifestyle intervention programs to prevent diabetes. Methods: First, a Markov Model was established using data from the literature. The cost of a German diabetes prevention program was estimated. Second, risk equations for change to worsened glucose states were estimated using factor analysis and logistic regression based on consecutive data from the Västerbotten Intervention Program (VIP). The risk equations described transition probabilities in the final model and were based on several risk factors such as age, sex, physical activity and smoking status. Third, information on the Short-Form 36 questionnaire from the VIP population was transformed into Short-Form 6D. Health utility weights (HUW) by glucose group and four risk factors were estimated using beta regression. Fourth, an updated Markov model was established using an updated model structure compared to the one in Paper I, program costs of Paper I, risk equations of Paper II, health utility weights of Paper III and updated cost and mortality estimates. Results: The first model in Paper I showed that lifestyle intervention programs have the potential to be cost-effective with a high degree of uncertainty. The risk equations in Paper II indicated that the impact of each risk factor depended on the starting and ending pre-diabetes state, where high levels of triglyceride, hypertension, and high body mass index were the strongest risk factors to transit to a worsened glucose state. The overall mean HUW in Paper III was 0.764 with healthy individuals having the highest HUW, those with diabetes the lowest and those in pre-diabetic states ranging in between. The intervention described in Paper IV was cost-effective for all sex and age scenarios ranging from 3,833 EUR/QALY gained (women, 30 years) to 9,215 EUR/QALY gained (men, 70 years). The probability that the intervention is cost-effective was high (85.0-91.1%). Conclusion: We established a model that can estimate the cost-effectiveness of different scenarios of initiatives to prevent diabetes. The prevention or the delay of the onset of diabetes is feasible and cost-effective. A small investment in a healthy lifestyle with the change in physical activity and diet together with weight loss can have a decent, cost-effective result. The full range of possibilities this model offers has not been evaluated so far. We have, however, shown that implementing a lifestyle intervention program like the Västerbotten Intervention Programme would be cost-effective.

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Chin, Vida. "Lifestyle modifications of HIV-infected adults after knowledge of diagnosis." FIU Digital Commons, 1995. http://digitalcommons.fiu.edu/etd/2334.

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Using a descriptive design, this study sought to identify lifestyle modifications of Human Immunodeficiency Virus (HIV)-infected adults after knowledge of diagnosis. A sample of 101 HIV-infected adults from a multi-purpose, multi-ethnic primary health care center completed the Self-Rated Abilities and Health Practices Scale (SAHPS) and the Risk Behavior Assessment (RBA). Study findings indicated that over 91% of the sample changed their behavior after diagnosis. Correlational analysis utilizing Pearson's r revealed that changes in behavior showed significant correlations (p<.01) with frequent use of condoms, and sexual communication skills (p<.01). Other behavior changes included sexual abstinence, reduced number of sexual partners, and reduced number of times of sexual intercourse. Analysis of these findings suggest an increased awareness of safe sex practice and that condom use is the preferred method for preventing the spread or contraction of HIV.

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McLaughlin, Ruth. "Lifestyle modifications associated with regulation of the energy balance response to exercise." Thesis, University of Strathclyde, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.415301.

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Chang, Lissette Raquel. "Patients' Perspectives in Following Hypertensive Guidelines on Sodium Intake and Lifestyle Modifications in Panama." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4652.

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The purpose of this study was to explore patients' perception and knowledge regarding hypertension and hypertensive guidelines on sodium intake and lifestyle modifications in a work environment in the Republic of Panama. Hypertension is important not only because of its high prevalence but also because it is a major modifiable risk factor for cardiovascular diseases. In Panama the prevalence of hypertension is about 38.7% and uncontrolled hypertension is almost 50%.This number may translate into complications for the general population. For instance 52.8% of the population has had an ischemic disease and death by ischemic disease climbed from third place to second place from 2009 to 2010. This qualitative study used an exploratory approach and semi-structured in-depth interviews to answer the research questions. A purposive sample included woman with a hypertension diagnosis, between 30 to 59 years of age, and working in a single organization. A constant comparative analysis was used to search for themes grounded in the data. Emerging themes illustrated that participants perspectives of hypertension had become their drives towards the management of their disease and throughout their daily lives constant different factors played the role of motivating or discouraging their non-pharmacological treatment. Participants had also provided a list of barriers and coping strategies which were redundant on the need of practical knowledge, obtainable goals and policy changes of their environment in order for them to keep their disease management. Further research at a population level may aid to generalize this finding and to provide a better understanding of patients' compliance to non-pharmacological treatment.

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Ikombele, Botomwito. "Knowledge, attitudes and practices regarding lifestyle modifications among type 2 diabetic patients attending Mamelodi Hospital, Pretoria, South Africa." Thesis, University of Limpopo (Medunsa Campus), 2011. http://hdl.handle.net/10386/699.

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Thesis (M Med (Family Medicine) -- University of Limpopo, 2011.
Introduction The burden of type 2 diabetes mellitus continues to rise and constitutes a real threat especially in the developing world. As for most non-communicable diseases, change of behavior and adoption of healthy lifestyle habits help to prevent and slow down the increase of type 2 diabetes mellitus. Aim of the Study To establish the knowledge, attitudes and practices regarding lifestyle modifications among type 2 diabetic patients attending the diabetic clinic at Mamelodi hospital. Methods: This cross sectional study describes the knowledge, attitudes and practices regarding lifestyle modifications (KAP) among 217 type 2 diabetes mellitus patients attending Mamelodi Hospital, Pretoria, Republic of South Africa. A face-to-face interview using a structured questionnaire was carried out for data collection. Socio-demographic characteristics of the participants and anthropometric measurements were obtained and the body mass index (8MI) of participants were determined. The Knowledge, attitude and practice of participants were assessed. 2 Results: Majority of participants were female 176(81.1 %), while male were 41 (18.9%). This amounted to a female to male ratio of 4:1. Most participants were in the age group 51-60 years 93(42.9%). Majority of them had low level of education 108(49.5%) and low income 206(94.9%). Majority of participants were obese 153(71 %) with more female diabetic patients being obese 120 (78.4%) than male 33 (21.6%). 15 participants (14 females and 1 male) were morbidly obese (BMI~40kg/m2). 108 participants (49.5%) did not have a formal education. No respondent had good knowledge and 92.6% of respondents had poor knowledge of the benefits of exercise, weight loss and healthy diet. Majority of respondents (97.7%) had bad practices in relation to lifestyle modifications. Nevertheless, majority of them (84.3%) had positive attitudes toward lifestyle modifications. Significant positive correlation (r= 0.170, p=0.012) was found between the global knowledge level and attitude level alone, whereas there was no significant correlation found between the global knowledge level and practice level as well as the attitude level and practice level. Conclusion: In conclusion, despite positive attitudes of participants toward healthy lifestyle habits, the knowledge and practices regarding lifestyle modifications among type 2 diabetes mellitus patients attending Mamelodi Hospital were generally low. Nevertheless the positive attitudes of participants should be encouraged and the implementation of a lifestyle intervention program will help improve the knowledge and practices of type 2 diabetes mellitus patients attending Mamelodi Hospital for the better management and control of this current pandemic of type 2 diabetes mellitus.

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Smith, Kimberly M., and Amy Smorra. "Retrospective Analysis of the Effect Metformin Use and Lifestyle Modifications Have on Conception and Live Birth in Polycystic Ovary Syndrome." The University of Arizona, 2008. http://hdl.handle.net/10150/624301.

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Class of 2008 Abstract
Objectives: To assess the effect of metformin usage and lifestyle modifications in women with polycystic ovary syndrome (PCOS) in achieving conception and live birth. Methods: A retrospective chart review of patients at a southwest reproductive health center was performed. Patients given a diagnosis of PCOS, treated with metformin alone, with at least 12 weeks of outcome data were enrolled. Diagnostic, reproductive history, and baseline endocrine and metabolic data were collected. All available metformin use, menstrual cyclycity, ovulation, pregnancy, pregnancy outcome, and alternative treatment data were captured. Results: A total of 1250 charts were reviewed and 103 patients were enrolled. Pre-treatment, a significant relationship between BMI and HDL, triglycerides/HDL, and fasting glucose (P <0.001, 0.018, 0.016) was noted with leaner patients having better metabolic profiles. The pregnancy, miscarriage, and live birth rates with metformin treatment were 55.3 %, 18.2 %, and 35.0 % respectively. Patients (40/103) that did not conceive with metformin attempted alternative fertility treatment; 55% became pregnant and 30% had a live birth. One third of all patients experienced minor adverse events, primarily gastrointestinal in nature. Logistic regression analyses comparing responders to nonresponders did not identify any baseline patient characteristics useful as significant predictors of success with metformin treatment. Conclusions: For the population under study, metformin use and lifestyle modifications resulted in conception and live birth for as many as 35 % of patients. Contrary to recent publications, it appears that this method of fertility treatment remains a viable option to treat infertility in patients with polycystic ovary syndrome.

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Bisiriyu, Ganiyu Adewale. "Non-adherence to lifestyle modifications (Diet and exercise) amongst type 2 diabetes mellitus patients attending extension II clinics in Gaborone, Botswana." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/259.

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Thesis (M Med (Family Medicine))--University of Limpopo (Medunsa Campus), 2010.
Abundant literature supports the beneficial effects of diet and exercise recommendations for improving and maintaining glycaemic levels of people with type 2 diabetes mellitus. Patient adherence to therapeutic lifestyle measures is notoriously difficult to initiate and sustain; however, reason for non-adherence amongst diabetes population is very complex and multi-faceted in nature. Objectives To determine rates of non-adherence and reasons/barriers for not adhering to diet and exercise recommendations amongst type 2 diabetes mellitus patients attending Extension II clinic in Gaborone, Botswana. Summary of methods Design: descriptive cross-sectional study using self administered questionnaire Setting: Extension II clinic, a public family practice in Gaborone, Botswana. Study population: Consenting adults diagnosed with type 2 diabetes mellitus, aged 30 years or older, diagnosed 2 or more years and on clinic care. Sample selection: Convenience sampling method was used to select 35 subjects per month, over a period of three successive months and a total of 105 participants were recruited into the study, made up of 44 men and 61 women. Results 104 correctly filled questionnaires were included in the data analysis, of which, 59% were female. Estimated rates of non-adherence to diet and exercise were 37.4%; 95% CI, 27.7 – 46.3% and 52%; 95% CI, 42.4 – 61.6% respectively. The main perceived reasons for non-adherence to diet were granting self-permission (36.5%), lack of information (33.3%), eating out (31.7%), financial constraints (28.8%) and poor self control (26.9%); while the main perceived reasons for non-adherence to exercise were lack of information (65.7%), exercise as potentially exacerbating illness (57.6%), lack of exercise partner (24.0%), specific locations away from home (18.0%), and winter weather (15.4%). The overall reasons for not adhering to diet and exercise include lack of moral and emotional supports from the spouse (54.1%), family members (44.8%), and friends (58.7%). 95% and 67.3% of the participants had reported that diet and exercise respectively could improved and maintained their diabetic control. Conclusion Non-adherence to diet and exercise recommendations amongst type 2 diabetes patients is far more prevalent and no particular single reason could be attributed to poor adherence to either diet or exercise recommendations, rather a combination of many factors.

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Weidemann, Annchen. "The role of fructose restriction in addition to dietary modifications for weight loss and lifestyle improvement, on fertility outcome and other markers of metabolic syndrome (MS), in obese women with polycystic ovarian syndrome (PCOS)." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71878.

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Thesis (MNutr)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: The role of fructose restriction in addition to dietary modifications for weight loss and lifestyle improvement, on fertility outcome and other markers of metabolic syndrome, in obese women with polycystic ovarian syndrome (PCOS) Introduction: At the time at which the current study was undertaken no data, as yet, existed on whether restriction of fructose, while treating obese patients with PCOS for weight loss, improves the clinical symptoms and metabolic/anthropometric profile so as to promote fertility. Objectives: To evaluate the baseline intake of fructose, as well as the effect of restricting fructose intake from fruit and soft beverages to less than 20 g daily, as well as to provide guidelines for weight loss on anthropometric measurements, for improving subjective clinical symptoms, and for promoting fertility outcome in obese patients with PCOS, who seek to become fertile. Methods: The study was conducted in the Tygerberg Hospital Infertility Clinic, as an experimental cohort. Patients with a body mass index (BMI) higher than 27, seeking fertility after diagnosis with PCOS, were referred for dietary consultation, and followed up 3 monthly over 1 year. At each visit anthropometric measurements and a detailed dietary history were taken and a questionnaire for clinical symptoms was completed. Results: Baselinely, 86 patients were included in the study. Averages for weight and BMI were 99.8 ± 24.3 kg and 39.2 ± 8.7kg/m2, respectively. Average baseline daily fructose intake was 167 ± 116.8g. At baseline, significant relationships were shown between fructose intake and burning feet (ρ=0.02) and frequent waking (ρ=0.02), with a trend towards nightly eating (ρ=0.07). The dropout rate after visit 1 was 50%, with a further dropout of 41% after visit 2. After 3 visits (n=18), fructose intake significantly reduced (ρ=0.018), with the significant relationships with clinical symptoms having disappeared by visit 2. After 3 visits (n=18), both weight and BMI decreased significantly (ρ=0.017) and (ρ=0.019), respectively. Fructose was tested as a covariate to BMI, with high significance (ρ=0.006) in said population group. Conclusion: Dietary intervention to reduce fructose intake proved significant for weight loss and BMI after 3 visits. Reduced fructose intake was associated with reduced clinical symptoms. With fructose being a significant covariate to BMI, it can be concluded that fructose overconsumption could possibly contribute to both clinical symptoms and elevated BMI in said study population.
AFRIKAANSE OPSOMMING: Die rol wat die beperking van fruktose speel bykomend tot dieetaanpassings en lewenstylverbetering vir gewigsverlies by oorgewig vroue met polisistiese ovariële sindroom (PCOS) in die uitkoms van fertiliteit en ander merkers van metaboliese sindroom. Inleiding: Met die aanvang van hierdie studie was daar is geen data beskikbaar oor die invloed van die beperking van fruktose in die dieet van oorgewig pasiënte met PCOS wat vir gewigsverlies behandel word nie. Dit was ook nie bekend of laasgenoemde pasiënte se kliniese simptome en metaboliese/antropometriese profiel sou verbeter met die beperking van fruktose sodat fertiliteit by hierdie pasiënte terselfdertyd ook bevorder word nie. Doelwitte: Die evaluering van die aanvanklike inname van fruktose, sowel as die beperking van fruktose afkomstig van eetbare vrugte en versoete drankies en sap tot ’n inname van minder as 20 g daagliks, tesame met riglyne vir gewigsverlies. Die uitkoms hiervan is bepaal deur antropometriese metings, die verbetering in subjektiewe kliniese simptome en die fertiliteituitkoms by oorgewig pasiënte wat hulp met fertiliteit verlang. Metodes: Die studie het as ’n eksperimentele kohort by die Infertiliteitskliniek by Tygerberg Hospitaal plaasgevind. Pasiënte wat na diagnose met PCOS fertiliteitsbehandeling verlang het en ’n BMI hoër as 27 gehad het , is vir dieetbehandeling verwys en driemaandeliks oor ’n tydperk van een jaar opgevolg. Tydens elke besoek is antropometriese metings en ’n omvattende dieetgeskiedenis geneem en ’n vraelys oor kliniese simptome ingevul. Resultate: Aanvanklik is 86 pasiënte by die studie ingesluit. Gemiddeldes vir gewig en BMI was 99.8 ± 24.3 kg en 39.2 ± 8.7 kg/m2 respektiewelik. Gemiddelde aanvanklike daaglikse inname van fruktose was 167 ± 116.8 g. Oorspronklik het betekenisvolle verhoudings tussen fruktose en die volgende bestaan: brandvoete (ρ=0.02) en veelvuldige episodes van nagtelike wakkerheid (ρ=0.02), met ’n neiging na nagtelike etery (ρ=0.07). Die uitvalsyfer na een besoek was 50% met ’n verdere uitvalsyfer van 41% na die tweede besoek. Na drie besoeke (n=18) het sowel die gewig as die BMI betekenisvolle afname getoon (ρ= 0.017) en (ρ=0.019), respektiewelik. Fruktose is as ’n belangrike kovariant vir BMI (ρ= 0.006) vir hierdie populasiegroep geïdentifiseer. Gevolgtrekking: Dieetintervensie vir die vermindering van die inname van fruktose was beduidend vir gewigsverlies en afname in BMI na drie besoeke. Verminderde fruktose-inname het gelei tot die vermindering van kliniese simptome. Met fruktose as beduidende kovariant vir BMI kan die gevolgtrekking gemaak word dat die oor-inname van fruktose by hierdie studiepopulasie waarskynlik tot sowel kliniese simptome as BMI bygedra het.

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Rehel, Stephane. "Modifications du sommeil au cours du vieillissement : impact sur la mémoire prospective et lien avec le style de vie Effects of sleep and age on prospective memory consolidation Impact of lifestyle and cognitive reserve on the association between sleep and cognition in ageing." Thesis, Normandie, 2019. http://www.theses.fr/2019NORMC048.

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De nombreux travaux indiquent que le sommeil joue un rôle crucial dans la préservation des fonctions cognitives. Toutefois, l’avancée en âge s’accompagne de modifications de la qualité de sommeil, pouvant avoir un impact sur le processus de consolidation mnésique mais aussi sur le fonctionnement cognitif global. Parallèlement à cela, plusieurs études suggèrent qu’un style de vie sain, enrichi et cognitivement stimulant tout au long de la vie favoriserait le maintien d’un fonctionnement cognitif optimal à un âge avancé. Cependant, il n’y a à notre connaissance que peu de travaux ayant investigué l’impact du style de vie sur la relation entre le sommeil et la cognition au cours du vieillissement. Dans une première étude, nous avons montré un effet bénéfique du sommeil sur la consolidation et le rappel d’intentions de mémoire prospectives chez des sujets âgés. En revanche, nous n’avons pas mis en évidence un effet délétère de l’âge sur le sommeil et la mémoire prospective. Dans un second travail, nous avons évalué l’impact de différents facteurs du style de vie sur la relation entre sommeil et cognition chez une population de sujets âgés. Les résultats ont révélé que l’engagement cognitif au cours de la vie modulait le lien entre le sommeil lent profond et la cognition. Ainsi, tandis que les individus fortement stimulés cognitivement pourront être en mesure de maintenir un fonctionnement cognitif efficace, même en cas de troubles du sommeil affectant la quantité de sommeil à ondes lentes, les individus moins stimulés sur le plan cognitif apparaîtraient plus vulnérables aux effets négatifs d’une réduction de sommeil lent profond. L’ensemble de ces résultats indique que la cognition à un âge avancé dépendrait de la qualité de sommeil mais aussi de l’engagement cognitif au cours de la vie. Une réflexion sur l’existence d’une fenêtre temporelle critique a également été soulevée en vue d’approfondir ces résultats
Many studies report that sleep plays a crucial role for maintaining an efficient cognitive functioning. However, ageing is accompanied by changes in sleep quality, which may lead to an impairment in overall cognitive functioning. Otherwise, several studies support the idea that a healthy and cognitevly stimulating lifestyle would help to maintain an optimal cognitive functioning in old age. However, to our knowledge, the impact of lifestyle on the relationship between sleep and cognition during ageing has been little investigated. In a first study, we showed a beneficial effect of sleep on prospective memory performance in older adults. However, we did not show any deleterious effect of age on sleep and prospective memory. In a second work, we assessed the impact of different lifestyle factors on the association between sleep and cognition in a population of older adults. These results revealed that cognitive engagement throughout life modulates the link between slow-wave sleep and cognition. Thus, while highly cognitively stimulated individuals may be able to maintain effective cognitive functioning, even with sleep disorders affecting the amount of slow-wave sleep, less cognitively-stimulated individuals would appear more vulnerable to the effects of sleep disruption. All of these results indicate that cognition in old age would depend on sleep quality but also cognitive engagement during life. We discuss the existence of a critical period in order to deepen these results

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Chen, Shin-Hong, and 陳欣宏. "Lifestyle modification for chronic prostatitis." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/41780352914905988351.

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碩士
國立臺灣大學
公共衛生碩士學位學程
100
Background: The prostate is a gland unique to men, the part surrounding the urethra at the opening of the urinary bladder. The prostate functions physiologically as a sphincter, an exocrine, and an endocrine. According to clinical statistics, males over 50 years old have a chance around 50% to have enlarged prostates, but in urology outpatients departments, prostatitis is an illness more usually seen in males between 30 and 50. Suffering from prostatitis could yield no symptoms at all, but it could also cause persistent or recurrent discomfort of the urinary system. Among these is the chronic non-bacterial prostatitis. The etiologies of chronic pelvic pain syndrome (CPPS) are not fully understood, and the symptoms tend to relapse, resulting in serious impact on quality of life of the patients. In addition, the treatment for chronic prostatitis (CP) is controversial in the medical field, making it one of the most troublesome problems an urologist can find in clinical practice. Taiwan Adventist Hospital is one of over 700 healthcare institutions operated by the Seventh-day Adventist Church in a worldwide mission system. We have been promoting the NEWSTART project ever since 1997. The project includes emphasis on nutrition, exercise, water, sunshine, temperance, air, rest, and trust. We hope to improve increasingly serious health problems through everyday life, decreasing the chances for cancer, cerebrovascular disease, heart disease, diabetes and many other modern chronic diseases, while also decreasing waste of medical resources. In this study we hope to find positive results in the involvement of the NEWSTART project in CPPS treatment, thus proving effective and complete treatment can be yielded through changes in eating and living habits. Method: We divide patients into an experimental group and a control group. Patients can choose between receiving medical treatment, rehabilitation and take no part in the NEWSTART program (control group), or NEWSTART intervention only without medical treatment (experimental group). All the patients in the control group are given antibiotics, anti-inflammatory drugs/muscle relaxants, and other rehabilitative treatment, including infrared, magnetic therapy etc., but for patients in the experimental group, we only suggest that they accept NEWSTART treatment. We use questionnaires including NIH-CPSI (National Institute of Health –Chronic Prostatitis Symptoms Index)、IPSS (International Prostate Symptom Score)、IIEF-5 (International Index of Erectile Function-5) etc. After 3-month intervention treatment, we compare the subjective symptoms change of both groups. Using SPSS v.19, the data analysis was carried out with paired sample t test as statistic method. Result: All of our statistics are assessed with Cronbach ''s Alpha before analysis with an aim to measure the consistency and stability of our study questionnaire. We found overall reliability to be 0.823, which shows that the credibility of our studies is within acceptable range. From the data we have seen from the first three months, patients of study group (n=25) and control group (n=20) show obvious improvements not only in the total scores of CPSI and IPSS, but also in the domains of CPSI including pain, urination and quality of life. Furthermore, statistical differences before and after treatment also show significant differences (P value < 0.05). Although patients in the experimental group have no improvements in IIEF-5 after three months follow-up, this might result from the factors which are extensive and complicated in etiologies of sexual erectile dysfunction (ED). It could be hard to achieve significant improvement of ED just through the treatment of chronic prostatitis; and this is also a focal point for us when observing if sexual erectile dysfunction can be treated through lifestyle changes in future long-term follow-up studies. Conclusion: The preliminary significance of this study lies in that through NEWSTART intervention, patients with CPPS can receive the same amount of improvement achievable through medical treatment without the use of drugs. However, it need more long-term follow-up to reach further conclusions.

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Chih-YuanLin and 林志遠. "Effectiveness of lifestyle modification on health promotion in workplace." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/17385595580381358006.

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碩士
國立成功大學
環境醫學研究所
103
Can health promotion strategies in the workplace promote the workers` health status changing and also prevent the metabolic syndrome and depression? We conduct a case-control study and arrange the health intervention program of exercise and diet. There are five cases of metabolic syndrome into non-metabolic syndrome (P〉0.05), waistline and blood pressure showed significant improvement. There are areas of improvement of statistical significance in the CES-D depression inventory and SF-36. In the long-term health effects, there are shown no change in health state after the health intervention 1 year later. Of this study was conducted in the future to enhance the health of workers of high-tech industries.

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Lin, Yu-Hui, and 林鈺惠. "The effects of super-circuit training combined with lifestyle modification for subjects." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/98456105574220278768.

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碩士
國立陽明大學
物理治療暨輔助科技學系
96
Background: Metabolic syndrome (MS) is the clustering of metabolic abnormalities (abdominal obesity, hypertension, hyperglycemia and hyperlipidemia), which is more strongly associated with cardiovascular morbidity and mortality than its individual component. Thus, attention to the full syndrome is important in primary care and health promotion. Lifestyle modifications, especially exercise, are important for preventing and improving MS. Purpose: The purpose of this study is to examine the effect of a 12-week comprehesive intervention (super-circuit exercise training combined lifestyle modification) on resting metabolic rate, body composition, cardiovascular fitness, muscular fitness and metabolic abnormalies in subjects with metabolic syndrome. Methods: This was a control trial study design. Twenty-seven subjects (52.5±7.0 years old, 10 men) were included under a diagnosis of MS, and were divided into either intervention group (I, n=13) or control group (C, n=14). A 12-week intervention program for subjects in the intervention group included a supervised super-circuit exercise training of aerobic and resistance exercise (1-3 times/week, 1.5 hours/time), home exercises, and instructions of healthy diet and lifestyle. Subjects in the control group received the healthy instructions only. Main outcome measures were assessed at baseline and 12 weeks after intervention, which included (1)The markers of metabolic abnormalies: waist circumference, resting blood pressure (BP), fasting plasma glucose (FPG), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC); (2) resting metabolic rate and body composition, (3) cardiorespiratory fitness, (4) muscular fitness, (5) diet and physical activity questionnaire. Results: The basic characteristics and baseline values were similar in both groups. After intervention, significant interaction effects were found, which included TC( I：201.0±33 to 186.4±33.5 mg/dl vs C：198.0±27.1 to 201.9±31.2 mg/dl, p=0.002), resting metabolic rate ( I：1381.1±354.0 to 1607.1±286.9 kcal/day vs 1688.2±425.4 to 1446.8±374.1 Kcal/day, p<0.001), waist circumference ( I：95.3±6.6 to 90.4±5.8 cm vs 99.0±10.6 to 98.4±10.3 cm, p=0.001), SBP ( I：121.1±13.7 to 117.4±14.3 mmHg vs C：123.3±14.6 to 128.7±15.2 mmHg, p=0.020), elbow extension muscle strength ( I：5.9±2.8 to 7.7±1.8 kg vs C：6.3±2.1 to 5.6±1.6 kg, p<0.001)，AT ( I：14.0±2.6 to 15.3±1.9 ml/min vs C：15.4±3.1 to 12.5±3.0 ml/min, p=0.007)，heavy physical activity ( I：0.8±1.5 to 4.7±3.0 hr/week vs C：0.5±0.9 to 0.4±0.8 hr/week, p<0.001). Conclusions: A 12-week super-circuit exercise training composed of aerobic and resistance exercises could increase the resting metabolic rate muscular fitness, aerobic threshold, and improve waist circumference, rest blood pressure, total cholesterol, low-density lipoprotein and some of metabolic abnormalies in subjects with metabolic syndrome. This study enhances the importance of exercise for improving metabolic activities and provides an effective model of intervention for health promotion.

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Pettman, Tahna Lee. "Practical lifestyle modification for improving obesity and metabolic syndrome : a randomised controlled trial." 2008. http://arrow.unisa.edu.au:8081/1959.8/50746.

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Can we reduce obesity and chronic disease risk factors without "going on a diet?" Appropriate management of obesity and metabolic syndrome (MetS) remains a challenging issue for public health. Interventions demonstrating reductions in weight generally rely on labour-intensive, individualised counselling and usually feature highlyprescriptive diet/exercise plans which are time and cost-intensive to deliver, and potentially unsustainable at the community level. Moreover, there is limited evidence from randomised trials on the importance of active follow-up following initial intervention. This thesis describes the effectiveness of a 1-year randomised controlled trial incorporating an initial 16-week active lifestyle modification program on body composition and cardio-metabolic health.

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Abedi, Masomeh Seyeda. "A study of the impact of lifestyle clinic attendance on individual behaviour modification /." 2002.

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Rakumakoe, Mmamontsheng Dulcy. "To determine the knowledge, attitudes and perceptions of hypertensive patients towards lifestyle modification in controlling hypertension." Thesis, 2012. http://hdl.handle.net/10539/11047.

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BACKGROUND Worldwide, hypertension is the third leading risk factor contributing to death, surpassed only by malnutrition and smoking. 1 Hypertension is common and treatable and because uncontrolled hypertension has serious consequences, preventive measures and control of blood pressure should be a high priority. A healthy lifestyle remains the cornerstone of the management of blood pressure (BP) for all severities of hypertension. It is possible to prevent the development of hypertension and to lower blood pressure levels by simply adopting a healthy lifestyle. 2 Health care workers can assess and contribute to the management of hypertension with exercise adequately if the patient is educated and convinced that lifestyle changes are essential and indeed the most cost effective method of obviating cardiovascular disease. METHODS Patients with hypertension (N=110) were identified from a cohort of patients attending the outpatients department of Carletonville Hospital, a district hospital situated in the mining town of Carletonville, South Africa, and were then invited to participate in the study. A crosssectional descriptive study design was used to determine the knowledge and attitudes of these patients with respect to the importance of lifestyle modification in the management of hypertension. This was achieved by administering a questionnaire. Descriptive and inferential statistical methods were employed to analyze the data. RESULTS The largest number of respondents fell in the 50-59 year old age groups (28%). Females (62%) made up a significant majority of the study population. The population breakdown included the following: Black respondents were 75%, while 24 % were white and 1% coloured. Body Mass Index was more than 25 in 81% of the respondents and 84% of the population had schooling levels below high school. Fifty seven percent (57%) of the respondents ate fried foods regularly, 70 % cooked with salt, 18% add salt to their food, while 14% ate red meat regularly and 26 % consumed alcohol, with 6 % having more than 3 beers/day. The majority of participants led sedentary lifestyles according to the physical activity score, with 74% having little or no activity. At the time of the study 69% had blood pressure (BP) levels above 140/90 mmHg with only 42% knowing what their normal BP should be. Seventy seven percent (77%) believed that exercise lowers BP, and only 30% reported having received such advice from a medical professional. Ninety five percent (95%) believed that a balanced diet is important in controlling hypertension and fifty one percent (51%) reported having being advised by a medical professional about a balanced diet. Ninety four percent (94%) knew that adding salt to food affects BP and sixty nine percent (69%) reported having being told by a medical professional about the effects of excessive salt intake in their diets. Eighty percent (80%) believed that alcohol affects blood pressure and forty four percent (44%) reported having received such information from a medical professional. Seventy five percent (75%) believed that smoking affects BP and thirty six percent (36%) got this information from a medical professional. DISCUSSION The results indicate that respondents reported having received advice about lifestyle modification from medical professionals. The advice varied between areas of lifestyle change, which included education on diet, alcohol, smoking and exercise. The most frequently given advice was on diet and salt intake, with exercise being the least often information provided to the patients by medical professionals. Reduced salt intake advice was the most frequently reported (69%), followed by a balanced diet (51%), reduced alcohol intake (44%), not smoking (35%) and benefits of exercise (30%).Despite this most of the respondents were leading sedentary lifestyles, were overweight (BMI>25) and had BP`s greater than 140/90 mmHg . The reasons provided for not exercising varied from “not being used to it”, “no- time” to “body pain”. Twenty one percent (21%) were not on a proper diet due to financial reasons, 16% stated lack of information as the reason and 9% just found unhealthy food to be very tempting. CONCLUSION The results of this study suggest that although patients do receive advice on lifestyle modification, it is not effective in changing patient behavior, and may therefore be inadequate and not emphasized enough and also not all patients are advised by medical professionals about lifestyle change. The reason for this is not known. Greeff (2006) in his study emphasized that building a trusting relationship between the healthcare worker and the patient is one of the most important aspects when motivating patients. 2

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Muthwa, Nelisiwe Eugenia. "Exploring compliance to lifestyle modification amongst hypertensive clients in a selected community in Durban." Thesis, 2012. http://hdl.handle.net/10413/11105.

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Background Hypertension is a global health burden affecting developed and developing countries, and South Africa is no exception (Seedat, Croasdale, Milne, Opie, Atkinson, Rayner and Veriava, 2006). In 2003, hypertension was estimated to have caused 7.1 million premature deaths and accounted for 4.5% of the disease burden worldwide (Lippincott and Wilkins, 2003). In 2001, non-communicable diseases accounted for almost 60% of the 56 million deaths annually and 47% of the global burden of disease. In countries such as Nigeria, Ghana and South Africa, the prevalence of chronic diseases is increasing, while the threat of communicable and poverty-related diseases (infant mortality, cholera and malnutrition) still exists (Belue, Okotor, Iwelunmor, Taylor, Degboe, Agyemang and Ogedegbe, 2009). Purpose The purpose of this study was to explore the compliance of hypertensive clients to lifestyle modification practices within a selected community in Durban, and to make recommendations for a structured programme of health promotion, through lifestyle modification. Method A quantitative approach was adopted to explore the compliance to lifestyle modification amongst hypertensive clients, and purposive sampling was used. Data collection was through a structured, self-administered questionnaire. A total of 205 participants completed the questionnaires. The questionnaire was divided into nine sections: Section A was on biographic data, Section B referred to compliance with lifestyle modification, and Sections C- I dealt with health belief model constructs. A four-point Likert scale was used to assess the health belief model constructs. Results Results revealed that 90% of the respondents in the study had a good understanding of the benefits of complying with their doctor’s treatment and the recommended lifestyle modification practices. They also possessed good knowledge and understanding about their condition, a factor which made them more compliant with lifestyle modification practices. The majority of respondents viewed health information shared through TV and radio programmes as motivators that helped them to comply with lifestyle modifications, and cited long waiting periods in the clinic and insufficient time to engage in physical activities as barriers to their lifestyle modification. Recommendations Health education campaigns and structured programmes of health promotion concerning lifestyle modification practices should be emphasized, especially with regard to diet and exercise. Foods containing high amounts of animal fats and fast foods should be avoided, and the importance of doing physical activities for 30 minutes at least three times a week should be emphasized.
Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2012.

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Huang, Jen-Chun, and 黃任淳. "Effects of Lifestyle Modification Program on Metabolic Syndrome Features in Women with Abdominal Obesity Entering Group-Base Weight Control Project." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/69437179940769211497.

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碩士
中國醫藥大學
營養學系碩士班
98
Abdominal obesity may induce hyperinsulinemia、insulin resistance and dyslipidemia while the prevalence of abdominal obesity was increasing year by year. Therefore, to improve health of abdominal obese subjects is an urgent work. Lifestyle modification program may improve over weight, lifestyle and nutrition knowledge, and help to reduce accumulation of abdominal adipose tissue. The aim of our study was to evaluate the effectiveness of lifestyle modification program on weight control, metabolic syndrome features, behavior and health-related knowledge. We recruited 18 women aged older than 18 years whose waistline more than 80 cm, and without chronic diseases such as hypertension, diabetes and cardiovascular disease via advertisement on newspaper. We formulated a group-based weight control project upon lifestyle modification program for women with abdominal obesity. The study period was 10 weeks. Results showed that the body weight, BMI and body fat were significantly reduced. The lifestyle modification program helped to improve the waist, fasting serum sugar and high density lipoprotein concentration（p < 0.05） among metabolic syndrome features, but blood pressure and triglyceride level were no significant changes. Besides, abnormal population percentages of waist, blood pressure, fasting serum sugar and high density lipoprotein were reduced, particularly abnormal population percentages of waist. The diet behavior, physical activity behavior and health knowledge were significantly improved through the intervention. In conclution, lifestyle modification based on group-base weight control project could ameliorate the metabolic syndrome markers in abdominal obese women, and can be further applied to prevent and cure metabolic syndrome in community.

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Webber, Janine. "The effect of a lifestyle modification adherence tool on risk factors in patients with chronic hypertension compared to usual management." Thesis, 2012. http://hdl.handle.net/10539/11678.

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M.Sc. (Physiotherapy), Faculty of Health Sciences, University of the Witwatersrand, 2011
Background Poor adherence to lifestyle interventions and medication-taking poses a problem universally. However, there are interventions to help patients adhere to treatment regimens and in turn, lower the risk of cardiovascular disease by decreasing blood pressure. These interventions need to be investigated further. Change in risk factors as a result of a lifestyle modification adherence tool in patients with chronic hypertension is not clear and will be further investigated in this study. Aim To determine the effect of a lifestyle modification adherence tool in patients with chronic hypertension and compare this with usual management. Objectives 1. To compare the changes in: · Blood pressure · Waist-hip ratio · Weight and body mass index · Blood glucose, cholesterol, triglycerides, HDL and LDL levels · Exercise Capacity between two experimental and one control group at baseline and after a six month intervention using a lifestyle modification tool 2. To determine the sustainability of the intervention three months after the intervention is concluded. Design The study design was a quantitative, longitudinal randomized control trial consisting of two experimental and one control group. Method Ninety subjects at the hypertension clinic at Helen Joseph Hospital were sampled consecutively and then randomized using computer generated randomization and concealed allocation. The study consisted of three groups, two experimental and one control group. All three groups underwent the usual treatment in the Hypertension Clinic. Experimental group one (EG1) received the Lifestyle Modification Adherence Tool (LMAT) as well as a once-a-month telephone call from the research assistant. Experimental group two (EG2) received only a once-a-month telephone call from the research assistant. The control group (CG) received the standard treatment at the clinic. The significance of the study was set at p=0.05. A Students t-test (independent) was used to compare variables between groups at baseline. The Pearsons Chi Square test was used to compare and analyze non parametric data at baseline. Change in blood pressure, waist-hip ratio, weight and body mass index, glucose levels and exercise capacity between control and intervention groups was established using an ANCOVA. Pairwise t-tests were used to compare p-values between groups one and two; one and three and; two and three. Results No reductions in weight and body mass index (BMI) were observed. Significant differences in EG1 for waist/hip ratios were noted compared with the EG2 (p=0.04) and CG (p=0.04) between month 0 and month 6. Blood pressure reductions were greater in EG1 compared with EG2 and the CG at six months but greater drops in blood pressure were noted in EG2 compared with EG1 and the CG between six and nine months. However, these differences were not significant. Significant reductions were observed in blood glucose levels in the EG1 compared with EG2 group between month 6 and month 9 (p=0.05). There were also significant reductions in the EG2 in triglycerides and low density lipoprotein (LDL) between month 0 and month 6 compared with the CG (p= 0.04 and p= 0.03 consecutively) and significant LDL reductions in both EG1 and EG2 between month 6 and month 9 compared with the CG (p= 0.02 for both comparisons). Walking distances improved minimally in both EG1 and EG2 but these changes were not significant. Conclusion Although not all results were significant, diary and telephone interventions and telephone only intervention to improve adherence did show a positive trend towards improvements in risk factors of patients with chronic hypertension.

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Edo, Thomas Akpan. "Factors affecting compliance with anti-hypertensive drug treatment and required lifestyle modifications among hypertensive patients on Praslin island." Thesis, 2009. http://hdl.handle.net/10500/3249.

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Various studies on compliance with anti-hypertensive medications and appropriate lifestyle modifications have been conducted worldwide but studies specific to the Island of Praslin are lacking. The purpose of this quantitative, descriptive-correlational study was to describe factors that affected compliance with hypertension medications and lifestyle modification strategies in a sample of 102 hypertensive persons. The comprehensive version of the Health Belief Model served as the conceptual framework directing the study. The researcher investigated whether there were any significant relationships between compliance and the Health Belief Model variables. Data was collected by means of structured interviews and document analysis, involving an interview schedule and a checklist. All respondents were diagnosed hypertension patients registered at either of the two public health centres on the Island of Praslin. Individual perception of the benefits and risks of hypertension treatment as well as cues to action were found to be significant determinants of compliance behaviour. The study highlighted the need for improved health education and follow-up measures to strengthen patients’ perceptions about the benefits of treatment and compliance.
Public Health
M.A. (Public Health)

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Lin, Chia-Huei, and 林佳慧. "A Lifestyle Modification Program with Stage-Matched Physical Activity Counseling to Reduce Metabolic Risks in Middle-Aged and Older Women with Metabolic Syndrome: A Randomized Controlled Trial." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/582c9f.

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博士
國防醫學院
醫學科學研究所
103
Background:Metabolic syndrome (MetS) has been reported very high prevalence in various countries around the world, particularly some specific groups or minority such as middle-aged and elderly women. It may contribute to type 2 diabetes, diabetic retinopathy, diabetic nephropathy and stroke which are related to most of chronic disease, presenting almost 60% of all the death. Besides, all the chronic diseases related MetS was ranked in the top ten causes of mortality in Taiwan. MetS, which results mainly from unhealthy lifestyles especially physical inactivity, impacts seriously on the physiological and psychological health of modern people. Such non-significant or non-immediate risks of fatal symptoms are invisible killers around people. With progressive aging, diabetes or cardiovascular diseases seems become the inevitable results. The primary prevention of MetS progression is based on lifestyle modification especially physical activity (PA). Therefore, a theory-oriented and structured education program of PA for this population needs to be developed and tested. Objective: To test the effectiveness of a 12-week lifestyle modification program that includes PA counseling based on Trans-Theoretical Model (TTM). Outcome measures include PA stage of change, weekly amount of PA, MetS risks (elevated fasting plasma glucose, elevated blood pressure, elevated triglyceride, reduced high-density lipoprotein, and central obesity), mean number of MetS risks, and patient-reported outcomes (quality of life and depression status) in women (age > 40). Methods: A randomized clinical trial was conducted. Three hundred twenty-eight middle-aged and older women were invited from a community health center and an outpatient clinic of a medical center in Taiwan. One hundred-fifteen women met the inclusion criteria and were randomly assigned to one of three groups. The intervention group, received lifestyle modification and TTM-guided/stage-matched PA counseling with telephone-delivered motivational interviewing (TTM-MI), the brief intervention group (BI) received a single brief lifestyle modification counseling, and the usual care group (UG) maintained usual lifestyle activities. PA was assessed with the Taiwan-version International Physical Activity Questionnaire and MetS risks measured by serum markers and anthropometric measures at baseline and end of the 12-week intervention. Patients’ quality of life and depression status were evaluated by Short-form 36 and Beck Depression Inventory. Results:One hundred women completed the study and 115 were included in intention-to-treat analysis. More women in the TTM-MI (p = .01) upgraded their PA stage of change from pre-contemplation of physical activity (50% [55.3 % to 5.3%]) as compared with the UG (15.4% [71.8% to 56.4%]). PA increased from 1609 to 1892 MET-min/week (p = .01), and the mean number of MetS risks decreased (4.0 to 3.6, p< .001) in the TTM-MI compared with the UG (4.4 to 4.6) at 12 weeks. The overall prevalence of MetS decreased (100% to 81.6%, p = .003) in the TTM-MI compared with the UG (no change). The mean number of MetS risks in the BI without an increase in PA decreased (p = .02) compared to the UG. As compared to the BI, women in TTM-MI, showed trends in increased PA (p=.09) and moderate-intensity PA (p=.08), had a lower mean number of MetS risks (p = .003). The quality of life (+ 16.8) and depression status (-2.7) in the TTM-MI were significantly improved as compared to both BI (quality of life: + 0.8, p< .001; depression status: + 0.1, p< .001) and UG (quality of life: - 5.1, p< .001; depression status: + 1.4, p< .001). Conclusion:The individualized lifestyle modification program with the TTM-guided stage-matched PA counseling can be applied as an effective method for middle-aged and older Taiwanese women with MetS risk.

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Makofane, Pheladi Doreen. "The self-management strategies for diabetic patients under treatment in the primary health care facilities of the Sekhukhune District of the Elias Motsoaledi Municipality in the Limpopo Province, South Africa." Thesis, 2019. http://hdl.handle.net/10386/3123.

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Thesis (M. A. (Nursing Science)) -- University of Limpopo, 2019
Background: Non-attendance of diabetic patients at primary health care facilities for scheduled appointments has been identified as one of the most pressing issues in chronic illness, including diabetes mellitus, management and results into uncontrolled illnesses. Diabetes mellitus has an increased mortality and morbidity rate, thus has been identified as the second most frequent killer disease in South Africa. Aim of the study: The purpose of the study is to determine self-management strategies to maintain a healthy life for diabetic patients under treatment in primary health care facilities in the Sekhukhune District. Methods: A qualitative, phenomenological, explorative and descriptive study design was conducted in 5 clinics of the Sekhukhune District in the Elias Motswaledi Municipality in Limpopo Province. Data were collected through one-to-one interviews using semi-structured guide. An non-probability purposive sampling method was used to select participants until data saturation was reached. Data were analysed using Tech’s coding qualitative data analysis approach. Results: The findings of this research reveal that diabetic patients know the importance of adherence to diet. However, they also elaborated on the challenges they face, like inability to afford proper diet and their stress levels. They are aware of predisposing factors and recommend support structures like food parcels as well as adhering to the prescribed treatment. Conclusion and recommendations: Diabetic patients lack self-management strategies to maintain their quality of life when diagnosed with diabetes. Furthermore, the study concludes that diabetics lack encouragement and empowerment from health care workers and their families. The study recommends that diabetic patients adhere to a prescribed diet and treatment and that they could be offered food parcels and taught how to avoid factors that could trigger stress. Additionally, it is recommended that support structures be developed to assist diabetic patients about self-management strategies that they could use in order to maintain a good quality of v life. It is also recommended that the Department of Health employ Home-Based Carers in the facilities to assist diabetic patients with their day-to-day care.

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"The effects of a lifestyle intervention program on patient outcomes and lifestyle modifications in Chinese adults with metabolic syndrome." 2015. http://repository.lib.cuhk.edu.hk/en/item/cuhk-1292055.

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Wang, Qun.
Thesis Ph.D. Chinese University of Hong Kong 2015.
Includes bibliographical references (leaves 332-412).
Abstracts also in Chinese; some appendixes in Chinese.
Title from PDF title page (viewed on 30, December, 2016).

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Torres, Alexandra. "Dietary and lifestyle modifications in the prevention of epithelial ovarian cancer recurrence." Thesis, 2017. https://hdl.handle.net/2144/26949.

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BACKGROUND: Advanced stage epithelial ovarian cancer (EOC) presents with an extremely poor prognosis. While some patients respond well to standard treatments of chemotherapy and cytoreductive surgery, the recurrence rate is high and five-year survival is low. The importance of nutritional eating and a healthy lifestyle has been recognized as a protective factor against the development of many cancers. There may be a role for dietary and lifestyle interventions on reducing the recurrence of EOC, thereby prolonging survival. LITERATURE REVIEW FINDINGS: A review of the literature was performed, focusing on dietary and lifestyle patterns and their effects on the development and recurrence of epithelial ovarian cancers. In general, carotenoids, flavonoids, cruciferous vegetables, and flaxseed rich diets have all been proposed to reduce the risk of developing ovarian cancer. Conversely, red and processed meats, and foods with high glycemic index have been associated with an increased risk of ovarian cancer development. Additionally, obesity and high Body Mass Index (BMI) have been linked to increased cancer risk as well as increased mortality rates from cancer. PROPOSE METHODS: Given the broad spectrum of dietary and lifestyle recommendations for prevention of EOC, many providers are not aware of what information they can give to their patients regarding this topic. A Continuing Medical Education (CME) lecture summarizing the most up-to-date literature on the topic of lifestyle interventions to increase EOC survival would be beneficial. A one hour long course will be offered for CME credit to expand the knowledge base of providers and equip them with the resources necessary to educate patients on healthy lifestyle modifications in order to minimize ovarian cancer recurrence. CONCLUSIONS: With a lack of definitive cure and poor overall prognosis for women diagnosed with advanced stage epithelial ovarian cancer, there is a need for alternative treatment options when traditional methods fail. There is promising evidence that a diet high in carotenoids, cruciferous vegetables, flaxseed, and several other nutritional components is beneficial in preventing development of ovarian cancer. A diet containing processed foods, red meats, dairy, and high sugar content has been associated with increased ovarian cancer risk. It is possible that these dietary recommendations may apply to prevention of recurrence of EOC as well. The CME lecture will present the most up-to-date knowledge in the area of lifestyle interventions for the prevention of EOC. A curriculum for primary care and oncology health care providers will provide them with the tools necessary to provide their patients with nutrition and lifestyle recommendations that may prevent cancer recurrence.

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"Celiac disease and osteoporosis: An online informational brochure on lifestyle modifications to improve bone health." CALIFORNIA STATE UNIVERSITY, LONG BEACH, 2010. http://pqdtopen.proquest.com/#viewpdf?dispub=1472338.

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Hannan, JOHANNA. "Evidence Linking the Structure and Function of the Internal Pudendal Artery to Erectile Function: Impact of Aging, Hypertension, Antihypertensive Treatments and Lifestyle Modifications." Thesis, 2009. http://hdl.handle.net/1974/1881.

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Erectile dysfunction and cardiovascular disease share etiologies, and commonly coexist. One unifying concept is that the arterial insufficiency in hypertension is also the primary basis for blunted sexual responses. The objective of these studies was to characterize the age-related changes in the structure and function of the pudendal artery (the main resistance vessel) in young and old normotensive and hypertensive animals in relation to erectile function. In addition, we assessed the impact of antihypertensive treatments and lifestyle modifications, such as exercise and/or caloric restriction, on erectile responses and the structure and function of the pudendal artery. In 30 week old hypertensive rats or following re-challenges at 50 and 70 weeks, antihypertensive treatment (enalapril or hydralazine) did not prevent the age-related decline in erectile function. Experiments involving cross-over kidney transplantations between treated and untreated young hypertensive rats revealed that changes in penile vasculature and not the level of arterial pressure were important for normalizing erectile responses. In addition, intervention with exercise and caloric restriction showed that these treatments substantially improved erectile responses in normotensive and hypertensive rats. The pudendal artery in young normotensive rats was found to have a thick medial layer but a relatively small lumen. With age, the pudendal lumen didn’t change, but all components of the medial layer were markedly increased. Of interest, the smooth muscle cells within the pudendal medial layer became more disorganized with aging, although iii contractions were similar. In contrast, endothelium-dependent relaxation decreased with age. Young hypertensive rats also had an increased wall thickness, but not lumen diameter or extracellular matrix. Antihypertensive therapy significantly decreased the pudendal wall thickness. In aging hypertensive rats, the pudendal artery walls were even thicker, lumen decreased and extracellular matrix greatly enhanced compared to younger rats. In addition, there were numerous regions of intimal thickening associated with marked disruptions of the internal elastic lamina. Moreover, pudendal smooth muscle cells bordering the intima and in the neointima were round in shape, and electron microscopy confirmed their synthetic state. Taken together, these findings provide key evidence of the importance of the structure and function of the pudendal artery in facilitating erectile responses.
Thesis (Ph.D, Pharmacology & Toxicology) -- Queen's University, 2009-05-19 12:55:30.469

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Kark, Maureen. "The long-term weight maintenance narratives of women following their participation in an integrative, transactional analysis, non-diet programme." Thesis, 2016. http://hdl.handle.net/10500/22282.

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In order to address the paucity of knowledge in regard to the psychological and physiological processes associated with lifelong weight loss (>20 years), this study adopts a qualitative approach informed by phenomenology to explore the experience of lifelong weight loss and maintenance of women who participated in the ITAND Programme. The research questions guiding the exploration of the current research are: (i) Which strategies from the ITAND Programme do women perceive as assisting with initial weight loss? (ii) What are the processes mediating lifelong weight loss? (iii) What strategies and skills mediate the maintenance of lifelong weight loss? (iv) What feelings or beliefs motivate women to continue attempts to lose weight after experiencing multiple failures on diets? and (v) Which psychological, cognitive and behavioural processes are identified as mediating lifelong weight loss? Eight overweight and obese women were invited to write their narratives and engage in interviews in regard to exploring their relationships with food, their bodies and their weight, after a period of more than 20 years following their participation in an integrative, transactional analysis, anti-diet programme (the ITAND Programme). Narratives were used to explore their beliefs about constructs, processes and strategies mediating long-term weight loss maintenance. The participants’ narratives and interviews were analysed through applying narrative analysis and interpretive phenomenological analysis. In addition to a non-diet paradigm, four processes definingweight loss maintenance were identified, including the adult learning process of transformative learning, the psychological process of transactional analysis, the physiological process of intuitive eating and the cognitive-behavioural processes relating to weight loss maintenance. This study contributes an integrative, transactional analysis, non-diet treatment model (ITAND model) which is enabled by the processes of transformative learning, intuitive eating and cognitive-behaviour modification to the successful long- term treatment of overweight and obesity. This model may be applied in whole or in part in a primary health care or community context. The findings of this study may be used to inform future research into the development and implementation of non-diet weight loss maintenance interventions in the treatment of overweight andobesity.
Psychology
D.Litt. et Phil. (Psychology)

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