- G. Duijzer (1)
- E.J.M. Feskens (1)
- C.P.G.M. Groot de (1)
- A. Haveman-Nies (1)
- J. Hees van (1)
- G.J. Hiddink (1)
- J. Hoek (1)
- E.L. Hollander de (1)
- S.C. Jansen (1)
- I.E.J. Milder (1)
- H.S.J. Picavet (1)
- L.D. Roorda (1)
- I. Rupp (1)
- G.J. Tijhuis (1)
- W.M.M. Verschuren (1)
SLIMMER: a randomised controlled trial of diabetes prevention in Dutch primary health care: design and methods for process, effect, and economic evaluation
Duijzer, G. ; Haveman-Nies, A. ; Jansen, S.C. ; Beek, J. ter; Hiddink, G.J. ; Feskens, E.J.M. - \ 2014
BMC Public Health 14 (2014). - ISSN 1471-2458 - 9 p.
life-style intervention - impaired glucose-tolerance - real-world settings - 6-minute walk test - physical-activity - behavior-change - public-health - follow-up - sf-36 - risk
Background - Implementation of interventions in real-life settings requires a comprehensive evaluation approach. The aim of this article is to describe the evaluation design of the SLIMMER diabetes prevention intervention in a Dutch real-life setting. Methods/Design - The SLIMMER study is a randomised, controlled intervention study including subjects aged 40 through 70 years with impaired fasting glucose or high risk of diabetes. The 10-month SLIMMER intervention involves a dietary and physical activity intervention, including case management and a maintenance programme. The control group receives usual health care and written information about a healthy lifestyle. A logic model of change is composed to link intervention activities with intervention outcomes in a logical order. Primary outcome is fasting insulin. Measurements are performed at baseline and after 12 and 18 months and cover quality of life, cardio-metabolic risk factors (e.g. glucose tolerance, serum lipids, body fatness, and blood pressure), eating and physical activity behaviour, and behavioural determinants. A process evaluation gives insight in how the intervention was delivered and received by participants and health care professionals. The economic evaluation consists of a cost-effectiveness analysis and a cost-utility analysis. Costs are assessed from both a societal and health care perspective. Discussion - This study is expected to provide insight in the effectiveness, including its cost-effectiveness, and delivery of the SLIMMER diabetes prevention intervention conducted in Dutch primary health care. Results of this study provide valuable information for primary health care professionals, researchers, and policy makers.
Changes in weight and health-related quality of life. The Doetinchem Cohort Study
Milder, I.E.J. ; Hollander, E.L. de; Picavet, H.S.J. ; Verschuren, W.M.M. ; Groot, C.P.G.M. de; Bemelmans, W.J.E. - \ 2014
Journal of Epidemiology and Community Health 68 (2014). - ISSN 0143-005X - p. 471 - 477.
body-mass index - of-life - population - obesity - surgery - gender - women - sf-36
Background The cross-sectional association between obesity and a lower health-related quality of life (HRQL) is clear. However, less is known about the association between changes in weight and HRQL. We examined the association between weight changes and changes in HRQL in a population-based sample of 2005 men and 2130 women aged 26–70 years. Methods Weight was measured two or three times with 5-year intervals between 1995 and 2009, and was categorised as stable (change =2 kg, 40%), weight loss (19%), or weight gain 2.1–4.0 kg, 4.1–6.0 kg, or >6 kg (41%). Changes in HRQL (SF36 questionnaire, including physical and mental scales) per weight change category were compared with a stable weight using generalised estimating equations. Results Weight gain was associated with declines of up to 5 points on five mainly physical scales and holds for different age categories. Especially for women, a dose-response relationship was observed, that is, larger weight gain was associated with larger declines in HRQL. Changes in HRQL for those with weight loss were small, but particularly on the mental scales, changes were in the negative direction compared to a stable weight. Conclusions Weight gain and weight loss were associated with unfavourable changes in HRQL compared with a stable weight. For weight gain, this was most pronounced on the physical scales and for weight loss, although less consistent, on the mental scales.
Long-Term Physical Functioning and Its Association With Somatic Comorbidity and Comorbid Depression in Patients With Established Rheumatoid Arthritis: A Longitudinal Study
Hoek, J. ; Roorda, L.D. ; Boshuizen, H.C. ; Hees, J. van; Rupp, I. ; Tijhuis, G.J. ; Dekker, J. ; Bos, G.A.M. van den - \ 2013
Arthritis Care & Research 65 (2013)7. - ISSN 2151-464X - p. 1157 - 1165.
quality-of-life - chronic disease - health survey - co-morbidity - metaanalysis - prevalence - classification - outcomes - impact - sf-36
ObjectiveTo describe long-term physical functioning and its association with somatic comorbidity and comorbid depression in patients with established rheumatoid arthritis (RA). MethodsLongitudinal data over a period of 11 years were collected from 882 patients with RA at study inclusion. Patient-reported outcomes were collected in 1997, 1998, 1999, 2002, and 2008. Physical functioning was measured with the Health Assessment Questionnaire and the physical component summary score of the Short Form 36 health survey. Somatic comorbidity was measured by a questionnaire including 12 chronic diseases. Comorbid depression was measured with the Center for Epidemiologic Studies Depression Scale. We distinguished 4 groups of patients based on comorbidity at baseline. ResultsSeventy-two percent of the patients at baseline were women. The mean +/- SD age was 59.3 +/- 14.8 years and the median disease duration was 5.0 years (interquartile range 2.0-14.0 years). For the total group of patients with RA, physical functioning improved over time. Patients with somatic comorbidity, comorbid depression, or both demonstrated worse physical functioning than patients without comorbidity at all data collection points. Both groups with comorbid depression had the lowest scores. Only patients with both somatic comorbidity and comorbid depression showed significantly less improvement in physical functioning over time. ConclusionBoth somatic comorbidity and comorbid depression were negatively associated with physical functioning during an 11-year followup period. Furthermore, their combination seems to be especially detrimental to physical functioning over time. These results emphasize the need to take somatic comorbidity and comorbid depression into account in the screening and treatment of patients with RA.