Early education, a well built environment, access to quality and affordable preventive care, social support, and policy changes and implementation are some of the upstream health factors that impact human behavior [1]. Behavioral changes can become manifest in the home environment, in the school setting, inside organizations, and at the community level. The expectations are such that, at the macro level, they will be reflected in the population health. In a recently updated systematic review for the U.S. Preventive Services Task Force, the authors compiled the data on several studies that investigated the benefits and potential negative consequences of early health and behavioral education as a preventive clinical strategy for reducing the incidence of precursors of cardiovascular conditions among healthy people [2]. Out of the 88 studies included in this meta-analysis (of the compiled data), 86 research studies revealed the impacts of behavioral interventions on dietary regimen, sedentary lifestyle, and physical activity.
A) Dietary Regimen: Interventions lasted 6 months or more and resulted in an average loss of 500 kcal per day. Consumption of fruits and vegetables increased by 2.2 servings per day. B) Sedentary Lifestyle: Self-reported sitting time periods decreased significantly. C) Physical Activity: Interventions were of 6 to 12 months duration and on average led to a weekly accumulation of 35 minutes of physical activity. The study participants who received behavioral interventions were 1.32 times (95% CI, 1,12 to 11.56) more likely to have met the recommended 150 minutes of physical activity per week. A total of 34 of the research studies (n = 88) reported on the clinical impacts of behavioral education through the increase in levels of physical activity and or adoption of a healthy eating regimen. A) Blood Pressure: Non-negligible decrease at 6 months or later in systolic and diastolic blood pressures as calculated respectively for all 22 and 23 selected studies. The average decrease in systolic and diastolic blood pressure was respectively 1.26 mmHg (95% CI, -1.77 to -0.75) and 0.49 mmHg (95% CI, -1.77 to -0.75). B) Cholesterol: Noteworthy reduction occurred in low-density lipoprotein cholesterol (LDL-C or bad cholesterol) and total cholesterol levels among participants at 6 months or more. The average reduction of LDL was 2.58 mg/dl (95% CI, -4.30 to -0.85) and of cholesterol was 2.85 mg/dl (95% CI, -4.95 to -0.75) in groups of participants who received behavioral education or counseling compared to the groups of participants who did not. C) Adiposity: The level of adiposity (fat) appreciably went down at 6 months and up for the groups of participants in the behavioral intervention. Accordingly, the average body mass index (BMI) reduction was 0.41 (95% CI, 0.62 to -0.19). Overall, early behavioral health education or counseling is a crucial determinant of behavior change necessary for the maintenance of good clinical outcomes in healthy individuals, excluding the potentially rare "adverse events" [e.g., fractures] related to the interventions" [2]. References 1. Havranek, E. P., Mujahid, M. S., Barr, D. A., Blair, I. V., Cohen, M. S., Cruz-Flores, S., ... & Rosal, M. (2015). Social determinants of risk and outcomes for cardiovascular disease: A scientific statement from the American Heart Association. Circulation, 132(9), 873-898. doi: 10.1161/CIR.0000000000000228 2. Patnode, C., Evans, C., Senger, A. C., Redmond, N., Lin, J. S. (20017). Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors. Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA, 318(2), 175-193. doi: 10.1001/jama.2017.3303
2 Comments
1/3/2018 05:13:50 am
I think it's absolutely a great way to promote behavior change in healthcare. Yes, changing behavior is a huge provocation for anybody. But you just tell me one thing- what do you think- why behavior change is so important? Well, from my perspective, behavior change is significant for attaining the environmental feasibility. Apart from that this behavior change can not only lead to a healthy lifestyle but also help the establishment in improving the productivity and reducing the cost. Better, you should try a different approach and implement various tools for promoting the behavior change in healthy individuals. You can also use commitment as a game plan for encouraging the promotion.
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Mickelder Kercy
1/3/2018 11:05:59 am
Thanks for the comment. As you suggested, different approaches and tools are necessary for effective behavioral change promotion.
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Mickelder Kercy, M.D. M.S.I learned about the art and science of medicine and was introduced to the community and population-based aspects of public health at the Université Notre Dame d'Haiti. My early practical interventions in the field of public health during medical residency in Haiti fostered my interest in pursuing additional academic training in public health. At Columbia University in the City of New York, I specialized in Public Health with a minor focus on Community Health Education. My special interest is in non-communicable chronic diseases, and the social-ecological approach to health education and promotion in secular and faith-based communities. Archives
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