Nurses, Cholesterol, and Small Work Sites: Innovative Community Intervention Comparisons

Williams, Armenia; Wold, Judith Lupo

doi:10.1097/00003727-200010000-00007

Cited by 8 publications

(18 citation statements)

References 44 publications

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“…The majority of the studies came from the USA (n = 62 127,[129][130][131][132][133][134]136,138,145,150,154,155,[164][165][166][167][168][169][170][171][172][174][175][176]178,179,[181][182][183][184][185][186]190,191,193,195,196,[198][199][200]202,203,205,206,210,213,214,[219][220][221][222][223][224]230,231 ) and Europe (n = 30 128,135,140,141,...…”

Section: Studies Included In the Reviewmentioning

confidence: 99%

“…There was evidence of substantial heterogeneity (I 2 = 65.87%, p=0.0583) between the studies. Sixty community studies (from 62 papers) 65,66,103,153,[159][160][161][162][163][164][165][166][167][168][169][170][171][172][173][174][175][176][202][203][204][205][206][207][208][209][210][211][212][213][214]225,230,231 were identified that met the review inclusion criteria. Because of heterogeneity in terms of study design and main outcomes, it was possible to conduct meta-analysis only for a small subset of interventions in this category (n = 13 65,103,168,179,182,183,198,211,212,230 for weight, n = 9 65,66,179,182,198,209,…”

Section: Individual-level Interventions: Body Mass Index Changementioning

confidence: 99%

“…The 60 studies are therefore synthesised narratively in terms of whether they followed a universal approach (n = 16 [161][162][163]172,173,175,[186][187][188][189][190][191][192][193][194][195][196] ) or a targeted approach (n = 44 65,66,103,153,159,160,[164][165][166][167][168][169][170][171]174,176,[178][179][180][181][182][183][184][185][197][198][199][200][202][203][204][205][206][207][208][209][210][211][212][213]...…”

Section: Individual-level Interventions: Body Mass Index Changementioning

confidence: 99%

“…Twenty-five 164,[166][167][168][169]176,178,[181][182][183][184]190,196,198,203,204,207,209,210,[212][213][214]225,231 studies were conducted in community settings (e.g. community centres, churches and schools), 17 65,66,159,162,163,[170][171][172][173][174]187,191,193,194,199,200,205,206 were workplace interventions, seven 153,180,185,192,195,211,230 were conducted in health-care settings, two 165,188,202,208 were conducted in both 103,175,186,197 remaining studies investigated grou...…”

Section: Individual-level Interventions: Body Mass Index Changementioning

confidence: 99%

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How effective are interventions at reducing socioeconomic inequalities in obesity among children and adults? Two systematic reviews

Bambra

Hillier

Cairns

et al. 2015

Public Health Research

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BackgroundTackling obesity is one of the major contemporary public health policy challenges and is vital in terms of addressing health inequalities.ObjectivesTo systematically review the effectiveness of interventions (individual, community and societal) in reducing socioeconomic inequalities in obesity among (1) children aged 0–18 years (including prenatal) and (2) adults aged ≥18 years, in any setting, in any country, and (3) to establish how such interventions are organised, implemented and delivered.Data sourcesNine electronic databases including MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and NHS Economic Evaluation Database were searched from database start date to 10 October 2011 (child review) and to 11 October 2012 (adult review). We did not exclude papers on the basis of language, country or publication date. We supplemented these searches with website and grey literature searches.Review methodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Experimental studies and observational studies with a duration of at least 12 weeks were included. The reviews considered strategies that might reduce existing inequalities in the prevalence of obesity [i.e. effective targeted interventions or universal interventions that work more effectively in low socioeconomic status (SES) groups] as well as those interventions that might prevent the development of inequalities in obesity (i.e. universal interventions that work equally along the SES gradient). Interventions that involved drugs or surgery and laboratory-based studies were excluded from the reviews. The initial screening of titles and abstracts was conducted by one reviewer with a random 10% of the sample checked by a second reviewer. Data extraction was conducted by one reviewer and independently checked by a second reviewer. The methodological quality of the included studies was appraised independently by two reviewers. Meta-analysis and narrative synthesis were conducted focusing on the ‘best-available’ evidence for each intervention type (defined in terms of study design and quality).ResultsOf 56,967 papers of inequalities in obesity in children, 76 studies (85 papers) were included, and of 70,730 papers of inequalities in obesity in adults, 103 studies (103 papers) were included. These studies suggested that interventions that aim to prevent, reduce or manage obesity do not increase inequalities. For children, there was most evidence of effectiveness for targeted school-delivered, environmental and empowerment interventions. For adults, there was most evidence of effectiveness for primary care-delivered tailored weight loss and community-based weight loss interventions, at least in the short term among low-income women. There were few studies of appropriate design that could be included on societal-level interventions, a clear limitation of the evidence base found.LimitationsThe reviews located few evaluations of societal-level interventions and this was probably because they included only experimental study designs. The quality assessment tool, although described as a tool for public health interventions, seemed to favour those that followed a more clinical model. The implementation tool was practical but enabled only a brief summary of implementation factors to be made. Most of the studies synthesised in the reviews were from outside the UK and related to women.ConclusionsThe reviews have found some evidence of interventions with the potential to reduce SES inequalities in obesity and that obesity management interventions do not increase health inequalities. More experimental studies of the effectiveness and cost-effectiveness of interventions (particularly at the societal level) to reduce inequalities in obesity, particularly among adolescents and adult men in the UK, are needed.Study registrationThe studies are registered as PROSPERO CRD42011001740 and CRD42013003612.FundingThe National Institute for Health Research Public Health Research programme.

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Section: Studies Included In the Reviewmentioning

confidence: 99%

Section: Individual-level Interventions: Body Mass Index Changementioning

confidence: 99%

Section: Individual-level Interventions: Body Mass Index Changementioning

confidence: 99%

Section: Individual-level Interventions: Body Mass Index Changementioning

confidence: 99%

See 2 more Smart Citations

How effective are interventions at reducing socioeconomic inequalities in obesity among children and adults? Two systematic reviews

Bambra

Hillier

Cairns

et al. 2015

Public Health Research

View full text Add to dashboard Cite

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“…Thus, the result is considered to be an effect of education through CM. According to Williams and Wold [28], low social status leads to a lack of self-management knowledge and, in turn, leading to poor health status and an increased expense for treating preventable diseases. Therefore, CM will have a positive effect on reducing medical expense providing CM service to people who had not been receiving HT treatment due to their lack of knowledge with information about HT treatment and self-management in community.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Community-based Case Management for Patients with Hypertension

Yun

Lee

Kim

et al. 2014

J Korean Acad Community Health Nurs

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Purpose: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization. Methods: This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA. Results: All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group. Conclusion: This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.

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