Importance: Primary health care is rapidly developing as an occupational therapy practice area. Yet, to date, little evidence supports occupational therapy’s feasibility and efficacy in primary care settings. Objective: To report on the implementation and preliminary clinical outcomes of a Lifestyle Redesign® (LR)–occupational therapy (LR–OT) diabetes management intervention in a primary care clinic. Design: Patients were randomized to be offered LR–OT or to a no-contact comparison group (data not reported). We assessed implementation outcomes using mixed methods. Setting: Safety-net primary care clinic. Participants: Clinic providers and staff; English- or Spanish-speaking clinic patients ages 18–75 yr with diabetes and a current hemoglobin A1c (HbA1c) ≥ 9.0%. Intervention: Eight 1-hr individual sessions of LR–OT focused on diabetes management. Outcomes and Measures: Clinical and health behavior outcomes were assessed via electronic medical record (EMR) review and self-report surveys of patients receiving LR–OT at initial evaluation and discharge. We assessed implementation outcomes (acceptability, appropriateness, feasibility, fidelity, efficiency, and timeliness) using patient and staff surveys, interviews, focus groups, and observations. Results: Seventy-three patients were offered LR–OT: 51 completed one or more sessions, and 38 completed the program. Clinical outcomes among program completers indicate beneficial changes in HbA1c, diabetes self-care, and health status. Implementation challenges included a need for patient and staff education, securing adequate workspace, and establishing a referral process. Factors contributing to implementation success included strong buy-in from clinic leadership, colocation, and shared EMR documentation. Conclusions and Relevance: LR–OT is a feasible approach to enhancing service delivery and clinical outcomes in primary care. What This Article Adds: This study provides insight into factors that may create challenges or contribute to the success of implementing occupational therapy services within primary health care settings. In addition, this study provides preliminary evidence of occupational therapy’s effectiveness in improving clinical outcomes among ethnically diverse, low-income patients with diabetes in a safety-net primary care setting.

Employees and supervisors at various worksites believed that it is feasible and desirable to offer 10-minute physical activity breaks using videos during the workday.

Osteoporosis is a condition when bones decrease in strength, become fragile, and break easily. Osteoporosis can impact an individual's quality of life and their ability to carry out everyday activities. It is recommended that men and women aged 70+ and 65+ undergo (expensive) clinical testing for osteoporosis. Once osteoporosis is diagnosed, it cannot be reversed/cured. Screening for those at-risk for osteoporosis (i.e., those with below-average bone strength) earlier in adulthood would be beneficial, as it would provide the opportunity for individuals to actively take steps to optimize peak bone strength and prevent the decline of bone strength to osteoporotic levels, rather than simply identifying osteoporosis after it is too late. It has been demonstrated that strong muscles and strong bones go hand-in-hand. Having strong, powerful muscles means that bones must be strong in order to withstand the pull that muscles exert. Testing muscle power could be a method for assessing bone strength. Three hundred and three individuals (18-22yrs; 136 males; 167 females) underwent clinical tests for bone strength and structure, and did a peak vertical jump test to assess muscle power. Relationships between muscle power and bone strength were examined, and probabilities were calculated to see if low muscle power predicted belowaverage bone strength. Results indicated the odds of having below-average bone strength decreased 5.4% for females and 3.6% for males per 50 Watts of power. These results suggest muscle power (from vertical jump height) to be a reasonably accurate method of identifying young adults with below-average bone strength.

No abstract

No abstract