Tailoring Health-promoting Programs for Patients with Chronic Kidney Disease: Randomized Controlled Trial

Abstract

Research on dietary and lifestyle modifications to decrease cardiovascular risk and slow disease progression has been limited to patients in the later stages of chronic kidney disease (CKD). Studies on the effectiveness of stage-of-change-tailored interventions on lifestyle modifications for individuals with early stage CKD are limited. Using random assignment, 60 patients with early stage CKD who received up to six tailored intervention visits over 30 months were compared to 60 usual care patients on physical indicators, lifestyle behaviors, and quality of life. Tailored interventions were consistent with the trans-theoretical Model of Change. Waist circumference, nutrition, and stress management improved over time in the intervention group. There was no difference or change in quality of life. To promote a healthier lifestyle, findings suggest that clinicians working with patients with CKD should consider patients’ readiness to change their behaviors as well as implementation strategies tailored for different processes of change.

Barriers to Behavior Change in Parents With Overweight or Obese Children: A Qualitative Interview Study

“…Evidence supports the efficacy of interventions tailored to the stage of change of individuals for a variety of behavioral problems including eating behavior and physical activity (Marcus et al, 1998;Klöckner and Ofstad, 2017;Krebs et al, 2018;Teng et al, 2020). In the childhood overweight/obesity literature, the TTM has been applied as a helpful conceptual framework in a variety of quantitative studies (Rhee et al, 2005(Rhee et al, , 2014Sealy and Farmer, 2011;Giannisi et al, 2014).…”

Lifestyle Interventions, Kidney Disease Progression, and Quality of Life: A Systematic Review and Meta-analysis

“…Nonsignificant improvements were reported in 90 domains across 14 studies. 28 , 29 , 30 , 35 , 36 , 39 , 42 , 44 , 45 , 47 , 54 , 58 , 78 , 79 , 88 , 90 No difference in QoL between intervention and control arms were reported for 3 domains across 3 studies, 47 , 49 , 58 whereas nonsignificant reductions in QoL after lifestyle interventions, compared with those of control, were reported in 17 domains across 10 studies. 36 , 43 , 44 , 45 , 47 , 49 , 54 , 58 , 78 , 79 , 88 No studies reported statistically significant reductions in QoL after lifestyle interventions, compared with those of the control.…”

“…The characteristics of the included studies are outlined in Table 2 , Table 3 , Table 4 , Table 5 . 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 ,…”

“…The glomerular filtration rate was measured or estimated in the included studies using a range of methods, including using the Modification of Diet in Renal Disease Study equation, 35 , 40 , 55 , 67 , 78 , 80 , 82 , 85 Chronic Kidney Disease Epidemiology Collaboration equation, 15 , 16 , 18 , 19 , 20 , 21 , 22 , 23 , 27 , 46 , 54 , 64 , 66 Cockroft and Gault formula, 62 creatinine clearance, 25 , 31 , 34 , 52 , 53 , 56 , 63 , 64 , 68 , 71 and clearance of 125 I-iothalamate 24 , 60 or cystatin. 78 …”

“…The effect of lifestyle interventions on QoL were investigated in 20 studies. Quality of life was assessed using a range of tools, including the 36-item short form survey, 16 , 17 , 28 , 29 , 30 , 35 , 36 , 43 , 44 , 47 , 75 , 88 Kidney Disease Quality of Life Short Form questionnaire, 38 , 43 , 44 , 45 , 47 , 49 , 90 12-item short form survey, 41 , 54 , 79 World Health Organization Quality of Life-BREF, 74 , 78 Assessment of Quality of Life questionnaire, 58 EuroQoL 5-dimensional, 36 Kidney Disease Quality of Life 36-item survey, 41 RAND 36-Item Short Form Health Survey, 39 and Veterans RAND-12 42 ( Item S14 ).…”