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  • 1
    Online Resource
    Online Resource
    JMIR Publications Inc. ; 2022
    In:  JMIR Research Protocols Vol. 11, No. 7 ( 2022-7-13), p. e39192-
    In: JMIR Research Protocols, JMIR Publications Inc., Vol. 11, No. 7 ( 2022-7-13), p. e39192-
    Abstract: The majority of older veterans do not meet the minimum healthy diet or physical activity recommendations despite known benefits. Identifying ways to increase adherence to programs that improve dietary quality and physical activity may reduce the risk of disability in older veterans. Peer-based interventions may be one method for facilitating lasting behavior change because peers often share a common culture and knowledge regarding problems their community experiences. Objective This study aims to develop, pilot, and evaluate a theory-driven, 12-week, peer-led nutrition and exercise intervention that targets older veterans with dysmobility and assess its feasibility in 2 diverse urban areas with underrepresented populations. Methods Community-dwelling veterans aged 〉 65 years with self-reported dysmobility (defined as difficulty in at least 1 of the following: walking quickly across a street, walking a mile, ascending a flight of stairs, rising from a chair without the use of arms, or a fear of falling) from 2 Department of Veterans Affairs Geriatric Research, Education, and Clinic Centers (Baltimore, Maryland, and San Antonio, Texas) will be eligible to participate. First, this study will use validated mixed methods via web-based surveys (n=50 per site) to assess potential physical, social or environmental, and behavioral or lifestyle barriers that affect physical activity and dietary quality (phase 1). Next, we will use knowledge gained from these assessments and feedback from a focus group (n=10 per site) to adapt established Department of Veterans Affairs diet and exercise program materials to develop peer-led intervention materials and train peer leaders (n=3 per site). Finally, we will determine the feasibility and acceptability of the intervention to assess reach (recruitment and retention), adoption (satisfaction, perceived utility, attendance, and engagement), and implementation (fidelity of intervention), as well as the estimated magnitude and potential impact on selected outcomes (ie, diet quality and mobility) in 20 older veterans with dysmobility (n=10 per site). Results The study was funded on January 1, 2022, with a projected data collection period of June 1, 2022, to December 31, 2023. Conclusions This study offers an innovative approach to identifying strategies that increase long-term adherence to lifestyle modification programs that improve dietary quality and physical activity in older veterans with dysmobility. Trial Registration ClinicalTrials.gov NCT04994938; https://clinicaltrials.gov/ct2/show/NCT04994938 International Registered Report Identifier (IRRID) PRR1-10.2196/39192
    Type of Medium: Online Resource
    ISSN: 1929-0748
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2022
    detail.hit.zdb_id: 2719222-2
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  • 2
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 401-402
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 401-402
    Abstract: Type 2 diabetes (T2D) and overweight are significant predictors of frailty in older adults. There are no widely accepted intervention strategies for frailty. The Look AHEAD (Action for Health in Diabetes) trial demonstrated the efficacy of behavioral lifestyle intervention on weight loss and glycemic control in overweight older adults with T2D. It is unknown whether this intervention can prevent/delay frailty in older adults. We designed a feasibility study examining the effect of a behavioral lifestyle intervention enhanced with mobile technology (Fitbit) for self-monitoring of diet and physical activity on frailty and T2D outcomes over 6 months in overweight older adults diagnosed with T2D. Forty older adults were randomized to receive either 10 group sessions vs. one condensed session plus monthly phone calls for 6 months. In this analysis, we are reporting on Fitbit wear adherence and weight changes on the 20 participants in the group session for the first 6 group sessions. The study sample was aged 72.3±6.4 years; 62% female; 52% Hispanic; BMI 33.7±5.9 kg/m2; hemoglobin A1c 7.2%; frailty score 1.1±1.0 kg/m2. Thirteen (65%) are pre-frail, 6 (30%) are non-frail, and 1 (5%) is frail (using Fried criteria). Their weight (lbs.) changed from session 1 (210.2±42.5) to session 6 (196.8±44.2). Ten participants wore Fitbit every day between sessions, averaged at 92±12%. The preliminary evaluation showed the feasibility of using Fitbit to promote self-monitoring adherence in a behavioral lifestyle intervention and a positive trend for weight loss. Evaluating intervention effect on frailty at 6 months will provide us further insights.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2905697-4
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  • 3
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Cardiovascular Nursing Vol. 32, No. 3 ( 2017-5), p. 281-287
    In: Journal of Cardiovascular Nursing, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 3 ( 2017-5), p. 281-287
    Abstract: South Asians (SAs) have a well-documented risk for mortality related to coronary artery disease (CAD). However, there is a lack of evidence to guide the implementation and dissemination of primary and secondary interventions to control and deter progression of CAD in SAs. Objective: The aim of this study is to explore and describe self-regulation behaviors in SAs with CAD using Leventhal’s Common Sense Model. Methods: In this mixed-methods study, quantitative data were collected using 3 survey questionnaires (demographics, Illness Perception Questionnaire–Revised, and Coping/Self-Regulation Behaviors). Before completing the surveys, a subset of the sample (n = 20) participated in individual face-to-face or telephone interviews. Results: A total of 102 SAs were enrolled (age, 53.5 ± 9.98 years). On average, participants rated themselves high (63 ± 3.06) on negative perceptions. In addition, they discussed desi diet, stress, a lack of physical activity, ignoring symptoms, and kismet (fate) as the most important perceived causes of their CAD. Most of the participants modified their lifestyle after their CAD event. Participants expressed regret for not having changed their lifestyle earlier when they were experiencing early symptoms of their CAD. Conclusion: Findings from this study enhance the understanding of self-regulation behaviors of SAs with CAD. Ultimately, these findings will inform the development and implementation of targeted interventions that address culture-specific lifestyle modification for SAs with CAD.
    Type of Medium: Online Resource
    ISSN: 1550-5049 , 0889-4655
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2053461-9
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  • 4
    In: Clinical Therapeutics, Elsevier BV, Vol. 41, No. 3 ( 2019-03), p. 376-386
    Type of Medium: Online Resource
    ISSN: 0149-2918
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2025417-9
    SSG: 15,3
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  • 5
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Nursing Research Vol. 70, No. 4 ( 2021-7), p. 317-322
    In: Nursing Research, Ovid Technologies (Wolters Kluwer Health), Vol. 70, No. 4 ( 2021-7), p. 317-322
    Abstract: Metabolomics profiling is an objective assessment of metabolic responses to intricate dietary patterns. However, few studies have investigated the potential benefits associated with personalized behavioral nutrition (PBN) interventions incorporating the metabolomics approach for improving diabetes outcomes for older Asian Americans with Type 2 diabetes. Objective This article describes the protocol for a pilot study testing self-management of a nutrition intervention-provided personalized dietary advice incorporating metabolites phenotypic feedback and digital self-monitoring of diet and blood glucose. Methods A total of 60 older Asian Americans will be randomized into two groups: a PBN group and a control group. Participants in the PBN group will receive personalized dietary advice based on dietary and phenotypic feedback-used metabolic profiles. This study aims to examine the feasibility and preliminary effects of the PBN on diabetes outcomes. Results The study began in September 2020, with estimated complete data collection by late 2021. Discussion Findings from this pilot study will inform future research for developing personalized nutrition interventions for people with Type 2 diabetes.
    Type of Medium: Online Resource
    ISSN: 1538-9847 , 0029-6562
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1480527-3
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  • 6
    In: JMIR Diabetes, JMIR Publications Inc., Vol. 5, No. 3 ( 2020-7-24), p. e19268-
    Abstract: In the United States, more than one-third of the adult population is obese, and approximately 25.2% of those aged ≥65 years have type 2 diabetes (T2D), which is the seventh leading cause of death. It is important to measure patient-reported outcomes and monitor progress or challenges over time when managing T2D to understand patients’ perception of health and quantify the impact of disease processes or intervention effects. The evaluation of patient-reported outcome measures (PROMs) is especially important among patients with multiple chronic conditions in which clinical measures do not provide a complete picture of health. Objective This study examined the feasibility of collecting Patient-Reported Outcome Measurement Information System (PROMIS) measures, and preliminarily evaluated changes in PROMIS scores and compared the scores with standard scores of the general US population. The parent study is a pilot randomized controlled clinical trial testing three different modes (mobile health [mHealth], paper diary, and control) of self-monitoring in a behavioral lifestyle intervention among overweight or obese patients with T2D. Methods Patients with comorbid overweight or obesity and a diagnosis of T2D for at least 6 months were recruited from a diabetes education program. Participants were randomized to the following three groups: mHealth, paper diary, and control (standard of care) groups. Paper diary and mHealth experimental groups received additional behavioral lifestyle intervention education sessions, as well as tools to self-monitor weight, physical activity, diet, and blood glucose. All participants completed PROMIS-57 and PROMIS-Global Health (GH) version 1.0 questionnaires during visits at baseline, 3 months, and 6 months. The PROMIS-57 includes the following seven domains: anxiety, depression, fatigue, pain interference, physical function, satisfaction with participation in social roles, and sleep disturbance. The PROMIS-GH is composed of the following two domains: global mental health and global physical health. Results A total of 26 patients (mHealth, 11; paper diary, 9; control, 6) were included in our analysis. The study sample was predominantly African American (68%) and female (57%), with a mean age of 54.7 years and a mean BMI of 37.5 kg/m2. All patients completed the PROMIS-57 and PROMIS-GH questionnaires, and we compared the mean scores of the three groups to investigate potential differences. No relevant differences were noted across the groups. However, positive trends were noted in both intervention (mHealth and paper diary) groups in the middle (month 3) and end (month 6) of the study. Conclusions Our pilot study provides evidence for the feasibility of using PROMIS questionnaires to record important components of T2D-related symptoms among overweight or obese individuals. The results from our study support the use of PROMIS questionnaires to provide clinicians and researchers with a benchmark for assessing the overall need for symptom management and determining the success or challenges of an intervention. Trial Registration ClinicalTrials.gov NCT02858648; https://clinicaltrials.gov/ct2/show/NCT02858648
    Type of Medium: Online Resource
    ISSN: 2371-4379
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 2955900-5
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  • 7
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 75, No. 1 ( 2020-01-01), p. 102-109
    Abstract: Frailty is a geriatric syndrome that leads to poor health outcomes with aging. Previous studies have demonstrated that insulin resistance and inflammation predict frailty onset. Metformin is a widely used, well-tolerated drug that improves insulin sensitivity and displays anti-inflammatory properties. It is also known to prevent diabetes onset in adults with prediabetes. We hypothesize that metformin in older adults with prediabetes will promote healthy aging and prevent frailty. Here we describe an ongoing placebo-controlled, double-blinded clinical trial of metformin for the prevention of frailty in older adults with prediabetes. Methods Older adults aged more than 65 years are randomized to metformin or placebo and are followed for 2 years. Prediabetes, required for inclusion, is assessed by 2-hour oral glucose tolerance test. Exclusion criteria are baseline frailty (Fried criteria), diabetes, dementia, untreated depression, active malignancy, or severe cardiovascular, pulmonary, and neurologic diseases. Primary outcome is frailty; secondary outcomes are physical function (Short Physical Performance Battery), systemic and skeletal muscle tissue inflammation, muscle insulin signaling, insulin sensitivity (insulin clamp), glucose tolerance (oral glucose tolerance test), and body composition (dual-energy x-ray absorptiometry). Subjects are followed every 3 months for safety assessments and every 6 months for frailty assessment (Fried criteria) and oral glucose tolerance test, and every 12 or 24 months for secondary outcomes. Enrollment of 120 subjects (completers) will take place over a 2-year period. Conclusion Metformin is being examined in this study as a potential therapeutic agent to prevent frailty in older adults with prediabetes. Findings from this trial may have future implications for the screening and potential treatment of prediabetes in older patients with metformin for the prevention of frailty.
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2043927-1
    SSG: 12
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  • 8
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  Current Nutrition Reports Vol. 11, No. 2 ( 2022-06), p. 146-160
    In: Current Nutrition Reports, Springer Science and Business Media LLC, Vol. 11, No. 2 ( 2022-06), p. 146-160
    Type of Medium: Online Resource
    ISSN: 2161-3311
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2660494-2
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  • 9
    In: Aging and Health Research, Elsevier BV, Vol. 3, No. 4 ( 2023-12), p. 100158-
    Type of Medium: Online Resource
    ISSN: 2667-0321
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 3074510-X
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  • 10
    In: Clinical Nursing Research, SAGE Publications, Vol. 31, No. 7 ( 2022-09), p. 1225-1233
    Abstract: Examine the association between glycemic control and cognition. Included subjects ≥60 years who participated in the 2013 to 2014 National Health and Nutrition Examination Survey and completed one of the followings: Consortium to Establish a Registry for Alzheimer’s Disease Word List (CERAD-WL), Animal Fluency (AF), Digit Symbol Substitution Test (DSST), and CERAD-Delayed Recall (CERAD-DR). Stratified participants into: No type 2 diabetes (T2D; N = 557), Controlled T2D ( N = 41), Uncontrolled T2D ( N = 120), and Untreated T2D ( N = 86). Multiple regression was used to examine the association between variables. After adjusting for demographics and cardiovascular risk factors, Uncontrolled T2D was associated with lower DSST (β = −3.164, p = .04), and Untreated T2D was associated with a trend for having lower CERAD-DR (β = −.496, p = .06) scores. T2D, independent of glycemic control, is associated with cognitive impairment and this relationship is influenced by modifiable and non-modifiable risk factors.
    Type of Medium: Online Resource
    ISSN: 1054-7738 , 1552-3799
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2034682-7
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