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7. Diet and Weight Management

Author

Chapman, Leah Elizabeth, Alexander, Ramine, Keyserling, Thomas C., Ammerman, Alice S., Daaleman, Timothy P., editor, and Helton, Margaret R., editor

Published
2018
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9. A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices

Author

Cykert, Samuel, Keyserling, Thomas C., Pignone, Michael, DeWalt, Darren, Weiner, Bryan J., Trogdon, Justin G., Wroth, Thomas, Halladay, Jacqueline, Mackey, Monique, Fine, Jason, Kim, Jung In, and Cene, Crystal

Subjects
Primary health care -- Quality management, Cardiovascular diseases -- Prevention -- Risk factors -- Demographic aspects, Business, Health care industry
Abstract

Objective: To assess the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. Study Setting: A total of 219 small primary care practices ([less than or equal to]10 clinicians per site) across North Carolina with primary data collection from electronic health records (EHRs) from the fourth quarter of 2015 through the second quarter of 2018. Study Design: We performed a stepped-wedge, stratified, cluster randomized trial of a one-year intervention consisting of practice facilitation utilizing quality improvement techniques coupled with a cardiovascular dashboard that included lists of risk-stratified adults, aged 40-79 years and their unmet treatment opportunities. The primary outcome was change in 10-Year ASCVD Risk score among all patients with a baseline score [greater than or equal to]10 percent from baseline to 3 months postintervention. Data Collection/ Extraction Methods: Data extracts were securely transferred from practices on a nightly basis from their EHR to the research team registry. Principle Findings: ASCVD risk scores were assessed on 437 556 patients and 146 826 had a calculated 10-year risk [greater than or equal to]10 percent. The mean baseline risk was 23.4 percent (SD [+ or -] 12.6 percent). Postintervention, the absolute risk reduction was 6.3 percent (95% CI 6.3, 6.4). Models considering calendar time and stepped-wedge controls revealed most of the improvement (4.0 of 6.3 percent) was attributable to the intervention and not secular trends. In multivariate analysis, male gender, age >65 years, low-income ( Conclusion: A risk-stratified, population management dashboard combined with practice facilitation led to substantial reductions of 10-year ASCVD risk for patients at high risk. Similar approaches could lead to effective dissemination and implementation of other new evidence, especially in rural and other under-resourced practices. Registration: ClinicalTrials.Gov 15-0479. KEYWORDS CVD risk reduction, practice facilitation, primary care, primary prevention, quality improvement, risk stratification, statins, 1 | INTRODUCTION Cardiovascular disease (CVD) remains the leading cause of death across the United States and is particularly devastating in rural North Carolina counties, (1,2) several of which are [...]

Published
2020
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11. Eating Well While Dining Out: Collaborating with Local Restaurants to Promote Heart Healthy Menu Items

Author

Thayer, Linden M., Pimentel, Daniela C., Smith, Janice C., Garcia, Beverly A., Sylvester, Laura Lee, Kelly, Tammy, Johnston, Larry F., Ammerman, Alice S., and Keyserling, Thomas C.

Abstract

Background: Because Americans commonly consume restaurant foods with poor dietary quality, effective interventions are needed to improve food choices at restaurants. Purpose: The purpose of this study was to design and evaluate a restaurant-based intervention to help customers select and restaurants promote heart healthy menu items with healthful fats and high-quality carbohydrates. Methods: The intervention included table tents outlining 10 heart healthy eating tips, coupons promoting healthy menu items, an information brochure, and link to study website. Pre- and postintervention surveys were completed by restaurant managers and customers completed a brief "intercept" survey. Results: Managers (n = 10) reported that the table tents and coupons were well received, and several noted improved personal nutrition knowledge. Overall, 4214 coupons were distributed with 1244 (30%) redeemed. Of 300 customers surveyed, 126 (42%) noticed the table tents and, of these, 115 (91%) considered the nutrition information helpful, 42 (33%) indicated that the information influenced menu items purchased, and 91 (72%) reported that the information will influence what they order in the future. Discussion: The intervention was well received by restaurant managers and positively influenced menu item selection by many customers. Translation to Health Education Practice: Further research is needed to assess effective strategies for scaling up and sustaining this intervention approach.

Published
2017
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30. Testing The Efficacy of a Couple-Focused, Tailored eHealth Intervention for Symptom Self-Management Among Men with Prostate Cancer and Their Partners: The Study Protocol

Author

Song, Lixin, primary, Nielsen, Matthew E., additional, Chen, Ronald C., additional, Rini, Christine, additional, Keyserling, Thomas C., additional, Idiagbonya, Eno, additional, Fuller, Gail P., additional, Northouse, Laurel, additional, Palmer, Mary H., additional, and Tan, Xianming, additional

Published
2021
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32. A Comparison of Live Counseling With a Web-Based Lifestyle and Medication Intervention to Reduce Coronary Heart Disease Risk: A Randomized Clinical Trial

Author

Keyserling, Thomas C., Sheridan, Stacey L., Draeger, Lindy B., Finkelstein, Eric A., Gizlice, Ziya, Kruger, Eliza, Johnston, Larry F., Sloane, Philip D., Samuel-Hodge, Carmen, Evenson, Kelly R., Gross, Myron D., Donahue, Katrina E., Pignone, Michael P., Vu, Maihan B., Steinbacher, Erika A., Weiner, Bryan J., Bangdiwala, Shrikant I., and Ammerman, Alice S.

Published
2014
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33. Dietary Sodium and Blood Pressure.

Author

Keyserling, Thomas C., Saraiya, Veeral M., and Ammerman, Alice S.

Subjects
*DIETARY sodium, *BLOOD pressure, *MEDITERRANEAN diet, *DIETARY patterns, *HEALTH of minorities
Published
2024
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34. Validation of a brief dietary assessment to guide counseling for cardiovascular disease risk reduction in an underserved population

Author

Jilcott, Stephanie B., Keyserling, Thomas C., Samuel-Hodge, Carmen D., Johnston, Larry F., Gross, Myron D., and Ammerman, Alice S.

Subjects
Cardiovascular diseases -- Prevention, Cardiovascular diseases -- Research, Diet therapy -- Research, Women -- Health aspects, Women -- Research
Abstract

Background Brief dietary assessment tools are needed to guide counseling in underserved populations to reduce cardiovascular disease (CVD) risk. The Dietary Risk Assessment is one such tool modified over time to reflect emerging evidence concerning diet and CVD risk. Objective To examine the capacity of the modified Dietary Risk Assessment tool to measure aspects of diet quality in a sample of underserved, midlife (aged 40 to 64 years) women, by comparing Dietary Risk Assessment results to those of a longer food frequency questionnaire (FFQ) and with serum carotenoids. Design This study used baseline data from women enrolled in a CVD risk reduction intervention trial. The Dietary Risk Assessment was administered to 236 women and results were compared to those from a longer FFQ administered to 104 women, and to serum carotenoids results from all participants. Results Correlations between Dietary Risk Assessment indexes and corresponding measures from the FFQ were statistically significant: fruit and vegetable, r=-0.53 (P<0.0001, correlation is negative as a lower Dietary Risk Assessment score indicates greater fruit and vegetable intake); saturated fat, r=0.60 (P<0.0001). In linear regression models stratified by smoking and adjusted for body mass index, low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, very-lowdensity lipoprotein cholesterol level, and age, the Dietary Risk Assessment fruit and vegetable index was significantly associated with serum carotenoids (parameter estimate for nonsmokers -0.22, P=0.01; smokers -0.45, P=0.003). Correlation coefficients between Dietary Risk Assessment total score and three diet quality index scores derived from FFQ variables were statistically significant, ranging in magnitude from 0.57 to 0.60. Conclusions The modified Dietary Risk Assessment provides a reasonable assessment of dietary factors associated with CVD risk; thus, it is appropriate for use to guide dietary counseling in CVD prevention programs for underserved, midlife, women.

Published
2007

40. Projections of incident atherosclerotic cardiovascular disease and incident type 2 diabetes across evolving statin treatment guidelines and recommendations: A modelling study

Author

Engeda, Joseph C., primary, Lhachimi, Stefan K., additional, Rosamond, Wayne D., additional, Lund, Jennifer L., additional, Keyserling, Thomas C., additional, Safford, Monika M., additional, Colantonio, Lisandro D., additional, Muntner, Paul, additional, and Avery, Christy L., additional

Published
2020
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