National Healthcare Quality and Disparities Report
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Topics
- Behavioral Health (5)
- Blood Pressure (3)
- Cardiovascular Conditions (6)
- Care Management (1)
- Case Study (1)
- Children/Adolescents (2)
- Chronic Conditions (2)
- Clinician-Patient Communication (1)
- Communication (1)
- Community-Based Practice (1)
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- Education: Patient and Caregiver (3)
- Elderly (2)
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- Guidelines (1)
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- Heart Disease and Health (3)
- Human Immunodeficiency Virus (HIV) (1)
- (-) Lifestyle Changes (27)
- Low-Income (1)
- (-) Nutrition (27)
- Obesity (8)
- Obesity: Weight Management (4)
- Orthopedics (1)
- Outcomes (1)
- Patient Adherence/Compliance (1)
- Patient Self-Management (7)
- Prevention (6)
- Primary Care (1)
- Quality Improvement (1)
- Racial and Ethnic Minorities (2)
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- Social Determinants of Health (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedHashemi-Arend A, Vasquez KS, Guishard D
Implementing DASH-aligned meals and Self-Measured Blood Pressure to reduce hypertension at senior centers: a RE-AIM analysis.
Investigators implemented two evidence-based interventions not previously tested in senior centers, DASH-aligned congregate meals and Self-Measured Blood Pressure (SMBP), to lower blood pressure (BP) at two senior centers serving low-income, racially diverse communities. Using the RE-AIM framework to analyze implementation, they found that change in systolic BP at Month 1 trended towards significance and change in SMBP reached significance at Month 6; food costs increased by 10%. They concluded that this RE-AIM analysis highlighted the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers.
AHRQ-funded; HS021667.
Citation: Hashemi-Arend A, Vasquez KS, Guishard D .
Implementing DASH-aligned meals and Self-Measured Blood Pressure to reduce hypertension at senior centers: a RE-AIM analysis.
Nutrients 2022 Nov 18;14(22):4890. doi: 10.3390/nu14224890..
Keywords: Blood Pressure, Patient Self-Management, Elderly, Nutrition, Lifestyle Changes
Harris S, Inoue S
AHRQ Author: Harris S
Behavioral counseling interventions to promote a healthy diet and physical activity for CVD prevention in adults without CVD risk factors.
In this Putting Prevention into Practice case study to increase understanding of the USPSTF final recommendation on behavioral counseling interventions to promote a healthy diet and physical activity for CVD prevention in adults without CVD risk factors, a 49-year old patient presents for a wellness visit. The patient’s vital signs are described as well as their daily habits, diet, and other medical history. Three multiple-choice questions are presented regarding risk factors, interventions to be recommended, and the benefits of behavioral counseling to promote a healthy diet and physical activity, followed by their answers.
AHRQ-authored.
Citation: Harris S, Inoue S .
Behavioral counseling interventions to promote a healthy diet and physical activity for CVD prevention in adults without CVD risk factors.
Am Fam Physician 2022 Oct;106(4):439-40..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Prevention, Nutrition, Lifestyle Changes
Hashemi A, Vasquez K, Guishard D
Implementing dash-aligned congregate meals and self-measured blood pressure in two senior centers: An open label study.
This study tested whether implementing two evidence-based interventions--DASH-aligned meals provided through an existing congregate meal program, and support for home Self-Measured Blood Pressure (SMBP) monitoring--lowers blood pressure among participants at two senior centers serving low-income, racially diverse communities. Participants were clients aged ≥60, eating ≥4 meals/week at two NYC senior centers. They received DASH-aligned congregate meals, and training in nutrition, BP management education, and personal SMBP device. Primary outcomes was a) change in systolic BP measured by independent health professionals, and b) change in percent with "controlled BP" (Eighth Joint National Committee (JNC-8) Guidelines), at Month 1 compared to Baseline. The authors enrolled 94 participants, with COVID closures interrupting implementation mid-study. Mean systolic BP at Month-1 changed by -4.41 mmHg compared to Baseline. Participants with controlled BP increased at Month 1 and changes in mean BP at Month 1 was significantly correlated with BMI, age, and baseline BP. Mean systolic mean SMBP changed by -6.9 mmHg at Months 5/6.
AHRQ-funded; HS021667.
Citation: Hashemi A, Vasquez K, Guishard D .
Implementing dash-aligned congregate meals and self-measured blood pressure in two senior centers: An open label study.
Nutr Metab Cardiovasc Dis 2022 Aug;32(8):1998-2009. doi: 10.1016/j.numecd.2022.05.018..
Keywords: Elderly, Blood Pressure, Community-Based Practice, Patient Self-Management, Nutrition, Lifestyle Changes, Vulnerable Populations
Wallace DD, Barrington C, Albrecht S
The role of stress responses on engagement in dietary and physical activity behaviors among Latino adults living with prediabetes.
This study used qualitative methods to understand how Latinos with prediabetes attempted to modify their diet and physical activity behaviors to slow type-2 diabetes progression and how stress affected their engagement in these behaviors. Findings showed that stress affected behavioral and cognitive progresses that adversely altered primarily dietary behaviors.
AHRQ-funded; HS000032.
Citation: Wallace DD, Barrington C, Albrecht S .
The role of stress responses on engagement in dietary and physical activity behaviors among Latino adults living with prediabetes.
Ethn Health 2022 Aug;27(6):1395-409. doi: 10.1080/13557858.2021.1880549..
Keywords: Stress, Nutrition, Lifestyle Changes, Racial and Ethnic Minorities, Diabetes, Chronic Conditions
Patnode CD, Redmond N, Iacocca MO
Behavioral counseling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the US Preventive Serv
This paper’s objective was to synthesize the evidence on benefits and harms of behavioral counseling interventions to promote a healthy diet and physical activity in adults without known cardiovascular disease (CVD) risk factors to inform a USPSTF recommendation. Findings showed that healthy diet and physical activity behavioral counseling interventions for persons without a known risk of CVD were associated with small but statistically significant benefits across a variety of important intermediate health outcomes and small to moderate effects on dietary and physical activity behaviors.
AHRQ-funded; 290201500007I.
Citation: Patnode CD, Redmond N, Iacocca MO .
Behavioral counseling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the US Preventive Serv
JAMA 2022 Jul 26;328(4):375-88. doi: 10.1001/jama.2022.7408..
Keywords: U.S. Preventive Services Task Force (USPSTF), Lifestyle Changes, Cardiovascular Conditions, Risk, Prevention, Nutrition
O'Connor EA, Evans CV, Rushkin MC
Behavioral counseling to pomote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: updated evidence report and systematic review for the US Preventive Services Task Force.
Researchers reviewed the benefits and harms of behavioral counseling interventions to improve diet and physical activity in adults with cardiovascular risk factors. They found that medium- and high-contact multisession behavioral counseling interventions to improve diet and increase physical activity for people with elevated blood pressure and lipid levels were effective in reducing cardiovascular events, blood pressure, low-density lipoproteins, and adiposity-related outcomes, with little to no risk of serious harm.
AHRQ-funded; 290201200015I.
Citation: O'Connor EA, Evans CV, Rushkin MC .
Behavioral counseling to pomote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Nov 24;324(20):2076-94. doi: 10.1001/jama.2020.17108..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Nutrition, Lifestyle Changes, Risk, Prevention, Evidence-Based Practice, Guidelines
Gibbs BB, Tudorascu D, Bryce CL
Lifestyle habits associated with weight regain after intentional loss in primary care patients participating in a randomized trial.
This study examined lifestyle habits associated with weight regain at 6 and 24 months after intentional loss in primary care patients. This randomized trial used adult primary care patients who had a recent weight loss of at least 5%. Lifestyle habits measured using the Connor Diet Habit Survey included consumption of low-fat foods, fish, desserts, sugary beverages, fruits and vegetables and eating at restaurants; moderate-vigorous physical activity by self-report; steps recorded on a pedometer; and sedentary behavior by self-report. Participants had a mean age of 53.4 years, were 26% male and 88% white. Overall, they maintained weight loss at 6 months, but began to regain weight at 24 months. The habits most attributed to weight regain included more eating at restaurants, less fish consumption, and less physical activity. More sedentary behavior was associated with weight regain at 6 months, and reduced consumption of low-fat foods and more desserts and sugary beverages were associated with weight regain at 24 months.
AHRQ-funded; HS021162.
Citation: Gibbs BB, Tudorascu D, Bryce CL .
Lifestyle habits associated with weight regain after intentional loss in primary care patients participating in a randomized trial.
J Gen Intern Med 2020 Nov;35(11):3227-33. doi: 10.1007/s11606-020-06056-x..
Keywords: Obesity: Weight Management, Obesity, Lifestyle Changes, Primary Care, Nutrition
Derose KP, Williams MV, Florez KR
Eat, pray, move: a pilot cluster randomized controlled trial of a multilevel church-based intervention to address obesity among African Americans and Latinos.
The purpose of this study was to implement a multilevel, church-based intervention with diverse disparity populations using community-based participatory research and evaluate feasibility, acceptability, and preliminary effectiveness in improving obesity-related outcomes. The investigators concluded that the intervention resulted in small improvements in obesity outcomes. They assert that a longer time line is needed to fully implement and assess effects of community and congregation environmental strategies and to allow for potential larger impacts of the intervention.
AHRQ-funded; HS000046.
Citation: Derose KP, Williams MV, Florez KR .
Eat, pray, move: a pilot cluster randomized controlled trial of a multilevel church-based intervention to address obesity among African Americans and Latinos.
Am J Health Promot 2019 May;33(4):586-96. doi: 10.1177/0890117118813333..
Keywords: Lifestyle Changes, Nutrition, Obesity, Outcomes, Racial and Ethnic Minorities
Hoffman SA, Ledford G, Cameron KA
A qualitative exploration of social and environmental factors affecting diet and activity in knee replacement patients.
This study examined perceived social and environmental barriers and encouragers for patients undergoing knee replacement surgery who are overweight or obese. Twenty patients were surveyed about factors that helped or hindered healthy behaviors. Many mentioned availability of healthy food, attending social gatherings, social support, and the weather.
AHRQ-funded; HS023011.
Citation: Hoffman SA, Ledford G, Cameron KA .
A qualitative exploration of social and environmental factors affecting diet and activity in knee replacement patients.
J Clin Nurs 2019 Apr;28(7-8):1156-63. doi: 10.1111/jocn.14719..
Keywords: Lifestyle Changes, Nutrition, Orthopedics, Surgery
Chung CF, Wang Q, Schroeder J
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
This study examined if the use of a photo-based food diary app will help patients with irritable bowel syndrome (IBS) help gather food and symptom data to help their doctors with disease management. The investigators designed and developed Foodprint which includes a mobile and web app and pre-visit note to go to experts which communicate an individual’s expectations and questions. A control group and a group with IBS were used to determine the effectiveness of Foodprint.
AHRQ-funded; HS023654.
Citation: Chung CF, Wang Q, Schroeder J .
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
Proc ACM Interact Mob Wearable Ubiquitous Technol 2019 Mar;3(1). doi: 10.1145/3314394..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Digestive Disease and Health, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Patient Self-Management
Sterling MR, Silva AF, Robbins L
Let's talk numbers: a qualitative study of community-dwelling US adults to understand the role of numeracy in the management of heart failure.
This qualitative study examined the role of numeracy (basic number skills) in the management of patients with heart failure (HF). Thirty men and women aged 47-89 years with a history of HF were recruited from an urban academic primary care practice. Participants all had a history of HF within the past year, were seen at the practice within the last year, and had been hospitalized for HF within the last 6 months. They were interviewed about their numeracy to help manage monitoring weight, maintaining a low-salt diet, and monitoring blood pressure. A wide range of knowledge and understanding was found and fear served as a barrier and facilitator to carrying out HF self-care tasks involving numbers. If the patient has a caregiver who also lacks those skills or does not have HF care training, patients may not be managing their HF as well as they should.
AHRQ-funded; HS000066.
Citation: Sterling MR, Silva AF, Robbins L .
Let's talk numbers: a qualitative study of community-dwelling US adults to understand the role of numeracy in the management of heart failure.
BMJ Open 2018 Sep 19;8(9):e023073. doi: 10.1136/bmjopen-2018-023073..
Keywords: Patient Self-Management, Education: Patient and Caregiver, Care Management, Heart Disease and Health, Nutrition, Lifestyle Changes, Obesity: Weight Management, Obesity, Blood Pressure, Cardiovascular Conditions
Lieberman JA, Greenhawt M, Nowak-Wegrzyn A
The environment and food allergy.
The authors argue that, with the recent global increase in non-communicable inflammatory conditions, including atopic disorders and food allergy specifically, identification of the environmental modifiers of the genetic susceptibility and deciphering their mechanism of action are of utmost importance. This knowledge will enable mitigation of the impact of lifestyle and dietary changes, pollution, and global warming on the expression of genetic susceptibility to atopic disorders.
AHRQ-funded; HS024599.
Citation: Lieberman JA, Greenhawt M, Nowak-Wegrzyn A .
The environment and food allergy.
Ann Allergy Asthma Immunol 2018 May;120(5):455-57. doi: 10.1016/j.anai.2018.01.010.
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Keywords: Evidence-Based Practice, Lifestyle Changes, Nutrition
Payan DD, Sloane DC, Illum J
Perceived barriers and facilitators to healthy eating and school lunch meals among adolescents: a qualitative study.
The researchers explored how perceived barriers and facilitators influence healthy eating and investigated the acceptability of changes to school lunch meals among adolescents after implementation of the Healthy, Hunger-Free Kids Act of 2010. Their findings suggest the need to measure perceived and actual barriers to healthy eating among adolescents and to examine the effect of these barriers on dietary behavior.
AHRQ-funded; HS000046.
Citation: Payan DD, Sloane DC, Illum J .
Perceived barriers and facilitators to healthy eating and school lunch meals among adolescents: a qualitative study.
Am J Health Behav 2017 Sep 1;41(5):661-69. doi: 10.5993/ajhb.41.5.15.
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Keywords: Children/Adolescents, Education, Lifestyle Changes, Nutrition
Patnode CD, Evans CV, Senger CA
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the USPSTF
The researchers systematically reviewed the evidence on the benefits and harms of behavioral counseling for the primary prevention of cardiovascular disease in adults without known cardiovascular risk factors to inform the US Preventive Services Task Force (USPSTF). Diet and physical activity behavioral interventions were found to result in consistent modest benefits across a variety of important intermediate health outcomes across 6 to 12 months, including blood pressure, low-density lipoprotein and total cholesterol levels, and adiposity.
AHRQ-funded; 290201200015I.
Citation: Patnode CD, Evans CV, Senger CA .
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the USPSTF
JAMA 2017 Jul 11;318(2):175-93. doi: 10.1001/jama.2017.3303.
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Keywords: Behavioral Health, Cardiovascular Conditions, Evidence-Based Practice, Health Promotion, Lifestyle Changes, Nutrition, Prevention, Risk, U.S. Preventive Services Task Force (USPSTF)
Chung CF, Agapie E, Schroeder J
When personal tracking becomes social: examining the use of Instagram for healthy eating.
The researchers aimed to inform the design of tools to support healthy behaviors by understanding how people appropriate Instagram to track and share food data, the benefits they obtain from doing so, and the challenges they encounter. They concluded that participants tracked to support themselves and others in their pursuit of healthy eating goals.
AHRQ-funded; HS023654.
Citation: Chung CF, Agapie E, Schroeder J .
When personal tracking becomes social: examining the use of Instagram for healthy eating.
Proc SIGCHI Conf Hum Factor Comput Syst 2017 May 2;2017:1674-87. doi: 10.1145/3025453.3025747.
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Keywords: Health Information Technology (HIT), Lifestyle Changes, Nutrition, Patient Self-Management, Social Media
Biener A, Cawley J, Meyerhoefer C
AHRQ Author: Biener A
The high and rising costs of obesity to the US health care system.
The purpose of this editorial is to provide new information on the medical care costs of obesity that help motivate various weight loss interventions. The editorial is a part of a special issue with articles examining behavioral, pharmacotherapy, and surgical interventions for weight loss, based on a 2016 conference on state-of-the-art weight management hosted by the Veterans Health Administration.
AHRQ-authored.
Citation: Biener A, Cawley J, Meyerhoefer C .
The high and rising costs of obesity to the US health care system.
J Gen Intern Med 2017 Apr;32(Suppl 1):6-8. doi: 10.1007/s11606-016-3968-8.
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Keywords: Obesity, Healthcare Costs, Obesity: Weight Management, Lifestyle Changes, Nutrition
Saffran K, Fitzsimmons-Craft EE, Kass AE
Facebook usage among those who have received treatment for an eating disorder in a group setting.
The researchers explored Facebook use among individuals with a history of receiving treatment for an eating disorder (ED) in a group setting. They found that interactions on Facebook could affect patients' recovery and potential for relapse, suggesting that it may be helpful for treatment providers to discuss Facebook use and its potential benefits and drawbacks with patients preparing for discharge from group treatment.
AHRQ-funded; HS000078.
Citation: Saffran K, Fitzsimmons-Craft EE, Kass AE .
Facebook usage among those who have received treatment for an eating disorder in a group setting.
Int J Eat Disord 2016 Aug;49(8):764-77. doi: 10.1002/eat.22567.
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Keywords: Behavioral Health, Lifestyle Changes, Nutrition, Social Media
Aschbrenner KA, Mueser KT, Naslund JA
Feasibility study of increasing social support to enhance a healthy lifestyle intervention for individuals with serious mental illness.
The authors assessed the feasibility of increasing support from family and friends to enhance a healthy lifestyle intervention (In SHAPE) adapted for individuals with serious mental illness. They found that participants reported high satisfaction and perceived benefits from the program, showing that the study design is feasible and that the intervention can facilitate social support for health behavior change in people with serios mental illness.
AHRQ-funded; HS021695.
Citation: Aschbrenner KA, Mueser KT, Naslund JA .
Feasibility study of increasing social support to enhance a healthy lifestyle intervention for individuals with serious mental illness.
J Soc Social Work Res 2016 Summer;7(2):289-313. doi: 10.1086/686486.
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Keywords: Health Promotion, Lifestyle Changes, Behavioral Health, Nutrition, Obesity: Weight Management
Epstein DA, Cordeiro F, Fogarty J
Crumbs: lightweight daily food challenges to promote engagement and mindfulness.
The authors introduced and examined crumbs: daily food challenges completed by consuming one food that meets the challenge. They found that crumbs supported engagement and mindfulness while offering opportunities to learn about food.
AHRQ-funded; HS023654.
Citation: Epstein DA, Cordeiro F, Fogarty J .
Crumbs: lightweight daily food challenges to promote engagement and mindfulness.
Proc SIGCHI Conf Hum Factor Comput Syst 2016 May;2016:5632-44. doi: 10.1145/2858036.2858044.
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Keywords: Nutrition, Health Information Technology (HIT), Health Information Technology (HIT), Lifestyle Changes, Patient Self-Management
Fiechtner L, Kleinman K, Melly SJ
Effects of proximity to supermarkets on a randomized trial studying interventions for obesity.
To determine whether proximity to a supermarket modified the effects of an obesity intervention, the researchers examined distance to the closest supermarket as an effect modifier.They concluded that living closer to a supermarket is associated with greater improvements in fruit and vegetable intake and weight status in an obesity intervention.
AHRQ-funded; HS022986.
Citation: Fiechtner L, Kleinman K, Melly SJ .
Effects of proximity to supermarkets on a randomized trial studying interventions for obesity.
Am J Public Health 2016 Mar;106(3):557-62. doi: 10.2105/ajph.2015.302986.
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Keywords: Obesity, Nutrition, Lifestyle Changes, Social Determinants of Health, Behavioral Health
Whittle HJ, Palar K, Napoles T
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
The researchers investigated the perceived effects of food insecurity on risky sexual behaviors among a population of low-income people living with HIV/AIDS (PLHIV) in San Francisco and Alameda County, California. Their study demonstrated that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among men who have sex with men.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Napoles T .
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
J Int AIDS Soc 2015 Nov 4;18:20293. doi: 10.7448/ias.18.1.20293..
Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Lifestyle Changes, Low-Income, Social Determinants of Health
McNellis R, Lewis P
AHRQ Author: McNellis R
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
This case study quiz is based on the recommendations of the USPSTF. The case concerns a 34-year-old man who smokes. When he presents for his annual checkup for hypertension, his blood pressure is elevated (142/95 mm Hg), and he has gained 10 lb (4.5 kg) since his last visit.
AHRQ-authored.
Citation: McNellis R, Lewis P .
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
Am Fam Physician 2015 Sep 15;92(6):509-10.
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Keywords: Behavioral Health, Cardiovascular Conditions, Case Study, Lifestyle Changes, Nutrition, Prevention, Risk, U.S. Preventive Services Task Force (USPSTF)
Chen R, Smyser M, Chan N
Changes in awareness and use of calorie information after mandatory menu labeling in restaurants in King County, Washington.
This study reports on countywide and subpopulation changes in menu-labeling awareness (i.e., seeing calorie information) and use (i.e., using calorie information) before and after policy implementation. It found that awareness and use of calorie information among residents who ate at regulated chains increased significantly and across all demographic subgroups.
AHRQ-funded; HS013853.
Citation: Chen R, Smyser M, Chan N .
Changes in awareness and use of calorie information after mandatory menu labeling in restaurants in King County, Washington.
Am J Public Health 2015 Mar;105(3):546-53. doi: 10.2105/ajph.2014.302262..
Keywords: Education: Patient and Caregiver, Nutrition, Obesity, Lifestyle Changes
Chen R, Smyser M, Chan N
Changes in awareness and use of calorie information after mandatory menu labeling in restaurants in King County, Washington.
This study reports on countywide and subpopulation changes in menu-labeling awareness (i.e., seeing calorie information) and use (i.e., using calorie information) before and after policy implementation. It found that awareness and use of calorie information among residents who ate at regulated chains increased significantly and across all demographic subgroups.
AHRQ-funded; HS013853.
Citation: Chen R, Smyser M, Chan N .
Changes in awareness and use of calorie information after mandatory menu labeling in restaurants in King County, Washington.
Am J Public Health 2015 Mar;105(3):546-53. doi: 10.2105/ajph.2014.302262..
Keywords: Education: Patient and Caregiver, Nutrition, Obesity, Lifestyle Changes
McVay MA, King HA, Jeffreys AS
Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention.
The authors evaluated mediators of dietary and physical activity outcomes during a spouse-assisted intervention to improve low-density lipoprotein cholesterol. They found that intervention-induced changes in spousal support and dietary self-efficacy did not translate into behavior change.
AHRQ-funded; HS000079.
Citation: McVay MA, King HA, Jeffreys AS .
Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention.
Psychol Health Med 2015;20(7):753-66. doi: 10.1080/13548506.2015.1020817.
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Keywords: Heart Disease and Health, Family Health and History, Lifestyle Changes, Nutrition