Sick Individuals and Sick Populations

Rose, Geoffrey

doi:10.1093/ije/14.1.32

Cited by 2,672 publications

(1,698 citation statements)

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“…An alternative but related interpretation is that the apparent ‘failure’ of people to adhere to public health guidance may be explained in terms of the prevention paradox 14, 27: although adhering to guidelines might result in the improvement of the population's health as a whole, most individuals are unlikely to see a noticeable improvement in their own health, and therefore lack a sufficient incentive to comply with health guidelines. Public health guidance, which acknowledges people's concerns about the impacts which their behaviour has on valued responsibilities and relationships, may be more effective than guidance which relies upon individuals changing their behaviour purely because of health considerations 14.…”

Section: Discussionmentioning

confidence: 99%

Lay epidemiology and the interpretation of low‐risk drinking guidelines by adults in the United Kingdom

et al. 2015

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AimsTo explore how the concept of lay epidemiology can enhance understandings of how drinkers make sense of current UK drinking guidelines.MethodsQualitative study using 12 focus groups in four sites in northern England and four sites in central Scotland. Participants were 66 male and female drinkers, aged between 19 and 65 years, of different socio‐economic backgrounds. Data were analysed thematically using a conceptual framework of lay epidemiology.ResultsCurrent drinking guidelines were perceived as having little relevance to participants' drinking behaviours and were generally disregarded. Daily guidelines were seen as irrelevant by drinkers whose drinking patterns comprised heavy weekend drinking. The amounts given in the guidelines were seen as unrealistic for those motivated to drink for intoxication, and participants measured alcohol intake in numbers of drinks or containers rather than units. Participants reported moderating their drinking, but this was out of a desire to fulfil work and family responsibilities, rather than concerns for their own health. The current Australian and Canadian guidelines were preferred to UK guidelines, as they were seen to address many of the above problems.ConclusionsDrinking guidelines derived from, and framed within, solely epidemiological paradigms lack relevance for adult drinkers who monitor and moderate their alcohol intake according to their own knowledge and risk perceptions derived primarily from experience. Insights from lay epidemiology into how drinkers regulate and monitor their drinking should be used in the construction of drinking guidelines to enhance their credibility and efficacy.

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Section: Discussionmentioning

confidence: 99%

Lay epidemiology and the interpretation of low‐risk drinking guidelines by adults in the United Kingdom

et al. 2015

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“…After the intervention the prevalence of obesity decreased 3.8% in boys and 3.0% in girls. Small shifts in BMI may be more effective at a population level than simply reducing the prevalence of obesity [36].…”

Section: Discussionmentioning

confidence: 99%

Improvements of Nutrition Behavior Fitness and Body Fatness with a Short-Term after School Intervention Program

McLellan¹,

Bianchessi²,

Rinaldi³

et al. 2013

FNS

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The prevalence of childhood obesity has been increasing worldwide and lifestyle changes are the most important strategies in managing this prevalence. This study aimed to describe the intervention effects of nutrition and physical activities offered as an after school short-term on outcomes of healthy nutrition practices, fitness and lowering fatness. This quasi-experimental study was conducted with a convenience sample of 59 caucasian children, aged 7.7 ± 1.4 years old (52.5% girls) registered on a private school of a middle-size town located in Sao Paulo State, Brazil. The school-based 12-week intervention consisted of 2 weekly 60 minutes section, during 3 months, including a nutritional education and a physical activity curriculum. Anthropometric data was measured for all children at baseline and after 12 weeks. All parents were contacted and requested to complete questionnaire about child's eating behavior at baseline and after the 12-week program. After the intervention, children showed an increasing in the intake of fruits (64.3%), vegetables (61.9%), and water (52.0%). Overall, 83.3% of the children changed eating behavior according to the questionnaire responded by the parents. Waist circumference was significantly lower and abdominal strength improved after participating in the intervention program. Mean height and weight were significantly higher in boys and girls after a 12-week intervention. Although mean values of BMI remained the same after the intervention it was observed a decreasing in the prevalence of obesity among the children. Thus our study showed that a school-based intervention program focused on nutritional education and physical activity program promoted waist circumference reduction and decreased obesity without affecting the height growth along with improved fitness and healthy eating behavior. This intervention program would be feasible and replicable in others schools around the country.

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“…Comparable programs among high-risk populations indeed found better results, such as modest reductions in blood pressure, cholesterol, and weight, possibly because high risk participants are more likely to achieve measurable changes in behavior (18,44,45). The high risk approach however, does not solve the origin of the problem (46). It may be worthwhile to evaluate an adapted form of the guideline among high risk groups, such as populations at risk for CVD, hypertension, or diabetes.…”

Section: Verweij Et Almentioning

confidence: 99%

“…It may be worthwhile to evaluate an adapted form of the guideline among high risk groups, such as populations at risk for CVD, hypertension, or diabetes. To achieve a meaningful degree of prevention and protection at the workplace, ultimately a combination of primary, secondary, and tertiary interventions may be needed (46). Also, there is ongoing debate what approach may be most suitable for obesity prevention.…”

Section: Verweij Et Almentioning

confidence: 99%

Long-term effects of an occupational health guideline on employees’ body weight-related outcomes, cardiovascular disease risk factors, and quality of life: results from a randomized controlled trial

Verweij¹,

Proper²,

Weel³

et al. 2013

Scand J Work Environ Health

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Long-term effects of an occupational health guideline on employees' body weight-related outcomes, cardiovascular disease risk factors, and quality of life: results from a randomized controlled trial by Verweij LM, Proper KI, Weel ANH, Hulshof CTJ, van Mechelen W Overweight and obesity prevention efforts are warranted. We evaluated the effectiveness of a occupational health guideline aimed at preventing weight gain. Guideline-based care was not more effective than usual care after 18 months follow-up on body weight-related outcomes, CVD risk factors, or quality of life. Therefore, we cannot recommend implementation of the guideline in its current form. Original article Scand J Work Environ Health. 2013;39(3):284-294. doi:10.5271/sjweh.3341 Long-term effects of an occupational health guideline on employees' body weight-related outcomes, cardiovascular disease risk factors, and quality of life: results from a randomized controlled trial Objective This study aims to evaluate the effectiveness of a draft occupational health guideline, aimed at preventing weight gain, on employees' body weight-related outcomes, cardiovascular disease (CVD) risk factors, and quality of life. AffiliationMethods In a cluster randomized controlled trial including 16 occupational physicians (OP) and 523 employees, guideline-based care was compared to usual care by OP between 2009-2011 in the Netherlands. Guideline-based care consisted of (i) providing advice to employers on how to assess and intervene on the obesogenic work environment, (ii) conducting five face-to-face behavioral change counseling sessions with employees to improve their lifestyles, and (iii) evaluating the outcome and maintaining sections i and ii. Data were collected at baseline and 6, 12, and 18-months follow-up. To evaluate the effects of the intervention, multilevel analyses were performed.Results No significant differences were found between the intervention and control group on waist circumference [β 1.2 cm, 95% confidence interval (95% CI) -0.6-2.9], body weight (β 0.3 kg, 95% CI -1.0-1.6), body mass index (β 0.1 kg/m2, 95% CI -0.3-0.5), systolic blood pressure (β 1.7 mmHG, 95% CI -2.4-5.8), diastolic blood pressure (β 0.3 mmHG, 95% CI -1.0-0.6), cholesterol (β 0 mmol/l, 95% CI -0.2-0.2), or quality of life indicators after 18-months follow-up. Stratified analyses showed an increase in waist circumference among men (β 2.5 cm, 95% CI 0.5-4.5) and obese intervention participants (β 2.7 cm, 95% CI 0.6-4.7) compared to control participants. ConclusionThe draft occupational health guideline was not more effective than usual care. Therefore, the guideline in its current form cannot be recommended for implementation.

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Sick Individuals and Sick Populations

Cited by 2,672 publications

References 1 publication

Lay epidemiology and the interpretation of low‐risk drinking guidelines by adults in the United Kingdom

Lay epidemiology and the interpretation of low‐risk drinking guidelines by adults in the United Kingdom

Improvements of Nutrition Behavior Fitness and Body Fatness with a Short-Term after School Intervention Program

Long-term effects of an occupational health guideline on employees’ body weight-related outcomes, cardiovascular disease risk factors, and quality of life: results from a randomized controlled trial

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