Impact of a Community-Based Healthy Lifestyle Program on Individuals With Traumatic Brain Injury

Driver, Simon; Reynolds, Megan; Woolsey, Anne; Callender, Librada; Prajapati, Purvi; Kramer, Kaye

doi:10.1097/htr.0000000000000372

Cited by 18 publications

(19 citation statements)

References 53 publications

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“…Registered dietitians (6%) 19,35,89,107,112 and physical therapists (1%) 23 were also among those health care providers who delivered interventions. Exercise/health coaches and counselors (22%), 21,22,27,30,31,37,63,67,72,83-85,87,95-97,105 research staff (18%), 18,24,33,64,69,75,78,82,88,89,91,92,98,114 trained health practitioners (15%) 20,38,71,73,74,79,87,99,109-112 (eg, medical assistants), and trained/certified health educators (13%) 17,25,28,29,74,98,105,107,108,112 (eg, diabetes educators) made up almost the same proportion of interventionists as physicians and nurses.…”

Section: Resultsmentioning

confidence: 99%

“…26,108 Seven studies (9%) used other, more unique measures to assess physical function, including timed and distance walking tests 27,30,33,74,86,109 and balance scales. 23 In terms of reported findings, 57 studies (73%) [17][18][19]21,22,24,26,27,[32][33][34][35][36][37][38][39][40]62,63,[65][66][67][68][69][70][71]73,74,76,80,82,83,[85][86][87][88][89][90][91][92][94][95]…”

Section: Study Characteristics and Resultsmentioning

confidence: 99%

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Physical Activity Assessment and Promotion in Clinical Settings in the United States: A Scoping Review

et al. 2022

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Objective The purpose of this scoping review was to systematically examine interventions that focused on physical activity assessment and promotion in clinical settings in the United States. Data Sources A literature search was performed in 6 major databases to extract published peer-reviewed studies from 2008 to 2019. Inclusion and Exclusion Criteria Interventions with practicing health professionals in the United States who performed physical activity assessment and promotion with adult patients 18 years of age and older. Studies were excluded if they were published in non-English, observational or case study designs, or gray literature. Data Extraction Studies were screened and coded based on the population, intervention, comparison, outcomes and study setting for scoping reviews (PRISMA-ScR) framework. Of 654 studies that were identified and screened for eligibility, 78 met eligibility criteria and were independently coded by two coders. Data Synthesis Data were synthesized using qualitative and descriptive methods. Results Forty-three of the included studies were randomized controlled trials with a majority being delivered by physicians and nurses in primary care settings. Fifty-six studies reported statistically significant findings in outcome measures such as anthropometrics and chronic disease risk factors, with 17 demonstrating improvements in physical activity levels as a result of the interventions. Conclusion The assessment and promotion of physical activity in clinical settings appears to be effective but warrants continued research.

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristics and Resultsmentioning

confidence: 99%

Physical Activity Assessment and Promotion in Clinical Settings in the United States: A Scoping Review

et al. 2022

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“…Analysis of pilot data determined a required sample size of 66 participants (33 per group) to detect a 5% reduction in weight (GLB-TBI program goal), with a power of 0.8 and assuming a 15% attrition rate (observed during our pilot study). These estimates are based upon the GLB-TBI weight-loss data which included weight at baseline (212 ± 35lbs) and weight-loss after 12 months (10.2 ± 13lbs) [ 3 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

“…The Group Lifestyle Balance (GLB) intervention is a 12-month, evidence-based physical activity and healthy eating program that has been used extensively with the general population [ [15] , [16] , [17] ], but not with people with TBI. Researchers modified the program [ 18 ] to meet the needs of people with a TBI (GLB-TBI) and pilot results with 18 individuals with TBI demonstrated that participation resulted in 5% weight-loss (10.2 ± 13lbs) over 12-months [ 19 ]. To generate strong evidence of the GLB-TBI efficacy for promoting weight loss, this protocol paper describes a randomized controlled trial of the GLB-TBI Intervention compared to an attention-matched Support Group-based Educational Intervention.…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial protocol for people with traumatic brain injury enrolled in a healthy lifestyle program (GLB-TBI)

Driver

Juengst

McShan

et al. 2019

Contemporary Clinical Trials Communications

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Weight gain is prevalent among people with traumatic brain injury (TBI) and may be attributable to environmental or injury-specific factors such as mobility impairment, endocrine dysfunction, behavioral and emotional disorders, and sensory loss. Few weight management programs exist to meet the unique needs of this population. Researchers modified a nationally recognized, evidence-based weight-loss program, Group Lifestyle Balance™ (GLB), to address the needs of over-weight and obese people post TBI (GLB-TBI). This current randomized controlled trial (RCT) examines the efficacy of the GLB-TBI on weight and secondary outcomes compared to an attention control educational support group. Furthermore, researchers have developed a mobile technology app to further engage participants in the program. This RCT will enroll and randomize 66 participants over a two-year period. It is anticipated that findings from this current RCT will contribute to the knowledge and evidence for an effective weight-loss intervention among this underserved population, with a goal of achieving full recognition by the Centers for Disease Control and Prevention-National Diabetes Prevention Program and subsequent Center for Medicare and Medicaid Services reimbursement for participation.

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“…; p = .0048), and total cholesterol (−24 mg/dl; p = .0247). No significant changes were observed in self-reported health (Driver et al, 2018). Findings suggest that participants with TBI engaged in the program and that engagement may support improved health, although a more rigorous study design is required (e.g., randomized controlled trial, larger sample).…”

Section: Introductionmentioning

confidence: 90%

Evaluation of a 12-month lifestyle intervention by individuals with traumatic brain injury.

Douglas¹,

Driver²,

Callender³

et al. 2019

Rehabilitation Psychology

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Weight gain and inactivity are common problems for individuals living with a traumatic brain injury (TBI). Yet, interventions to support a healthy lifestyle specific to individuals with TBI are lacking. The purpose of this study was to complete a program evaluation of a 12-month evidence-based healthy lifestyle intervention adapted for people with a TBI. Eighteen participants completed a brief interview after the yearlong intervention to determine their perceptions of the program effectiveness as well as barriers and facilitators in making lifestyle changes. Participants reported staff, tracking of dietary and activity behavior, and in-person meetings as most helpful aspects. Lack of motivation and difficulty preparing healthy meals were the primary barriers to a healthy lifestyle. Qualitative data revealed five themes that influenced healthy behaviors, including (1) self-regulation, (2) environmental resources, (3) knowledge of health behaviors, (4) TBI-related impairment and comorbidities, and (5) social support. Results suggest that future iterations of the healthy lifestyle intervention should emphasize self-regulation activities; require tracking of dietary and activity behaviors across 12 months; provide concurrent support for individual motivation issues; provide prepared meals; utilize web-based, telephonic, or hybrid approaches to delivery; further simplify the curriculum and learning tools; and include caregivers and peer accountability partners. Impact and ImplicationsThis program evaluation of an evidence-based weight loss intervention modified to meet the unique needs of people with traumatic brain injury (TBI) provides valuable quantitative and qualitative data on participants' perceived helpfulness, barriers, and supports to participation. Program evaluation results following the 12-month intervention suggest that self-regulation, environmental resources, knowledge of health behaviors, TBI-related impairment and comorbidities, and social support are important factors to consider for implementing lifestyle change with this population. Future adaptations of this evidence-based lifestyle intervention should consider emphasizing self-regulation and dietary tracking activities throughout the program, providing additional support for those with mood disorders, and addressing transportation and environmental barriers by providing prepared meals or web-based access for sessions to meet the needs of people with TBI.

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Impact of a Community-Based Healthy Lifestyle Program on Individuals With Traumatic Brain Injury

Abstract: Participants demonstrated high adherence with the program, suggesting that individuals with TBI are able to successfully engage in the program and achieve significant weight loss and changes in key physiologic outcomes.

Cited by 18 publications

References 53 publications

Physical Activity Assessment and Promotion in Clinical Settings in the United States: A Scoping Review

Physical Activity Assessment and Promotion in Clinical Settings in the United States: A Scoping Review

A randomized controlled trial protocol for people with traumatic brain injury enrolled in a healthy lifestyle program (GLB-TBI)

Evaluation of a 12-month lifestyle intervention by individuals with traumatic brain injury.

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