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A randomized controlled trial of a 12-week intensive lifestyle intervention program at a primary care obesity clinic for adults in western Saudi Arabia.

ABSTRACT: OBJECTIVES:To assess the ability of a 12-week primary care-based intensive lifestyle intervention (ILI), to facilitate a 5% reduction in baseline weight compared with an education-only active comparator (AC). Methods: A randomized clinical trial was conducted in a primary health care setting in Jeddah, Saudi Arabia between December 2014 and June 2015. Arab participants with obesity, but who were otherwise healthy (n=140), were randomized to the ILI (n=70) or AC (n=70) group. The ILI group received 8 clinical visits throughout the study. The AC group received only an initial health education session. The primary outcome was the proportion of participants who achieved clinically significant weight loss (?5% of their baseline weight). Results: Participants in the ILI group were significantly more likely than those in the AC group to achieve the primary outcome (p=0.008, relative risk: 1.8 [95% confidence interval [CI]: 1.15 to 2.93). At week 12, the ILI group exhibited a mean weight decrease of 5.58 ± 5.60 kg (-5.37 ± 5.31%), significantly greater than that observed in the AC group (-2.8 ± 4.96 kg, -2.62 ± 4.34%, p=0.002), and corresponding to a weight loss advantage of 2.77 kg (95% CI: 1.01 to 4.54 kg) or 2.75% (95% CI: 1.13% to 4.37%). Conclusion: The 12-week primary care-based ILI program was effective in achieving a clinically meaningful weight reduction (?5%) among Saudi and Arab patients with obesity.

SUBMITTER: Alghamdi RQ

PROVIDER: S-EPMC5556301 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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A randomized controlled trial of a 12-week intensive lifestyle intervention program at a primary care obesity clinic for adults in western Saudi Arabia.

Alghamdi Riyad Q RQ

Saudi medical journal 20170801 8

<h4>Objectives</h4>To assess the ability of a 12-week primary care-based intensive lifestyle intervention (ILI), to facilitate a 5% reduction in baseline weight compared with an education-only active comparator (AC). Methods: A randomized clinical trial was conducted in a primary health care setting in Jeddah, Saudi Arabia between December 2014 and June 2015. Arab participants with obesity, but who were otherwise healthy (n=140), were randomized to the ILI (n=70) or AC (n=70) group. The ILI gro ...[more]

PMID: 28762437

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Project description:BackgroundThe practice of hand hygiene (HH) has prime importance among Health Care Professionals (HCPs) and non-compliance could cause adverse consequences. By keeping the importance of HH in mind, this study aims at investigating the knowledge and attitudes towards HH among medical students and interns at King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA).MethodsThe study includes 453 medical students and interns (189 males & 264 females). This study was completed in three months; from September to November 2017. The World Health Organization (WHO) HH questionnaire was used and data were analyzed on SPSS-21.ResultsTwo-third of the participants 292 (64.2%) had formal training in HH in the last three years. Almost half of the participants 254 (56.1%) had correct knowledge regarding the major course of transmission of potentially detrimental microbes among patients in the healthcare premises. Just 124 (27.4%) of the respondents had the correct knowledge about the most common basis of germs accountable for healthcare-related infections. Females had significantly better knowledge than males regarding the type of HH technique needed before palpation of the abdomen (177(54%) Vs. 151(46%); P < 0.002), before an injection (175(54.5%) Vs. 146(45.5%); P < 0.007), after emptying a bedpan (207(64.7%) Vs. 113(35.3%); P < 0.001), following discarding examination gloves (256(60.4% Vs. 168(39.6%); P < 0.001] and after exposure to blood (200(64.1%) Vs. 112(35.%); P < 0.001). Female participants had better knowledge than males regarding the type of HH actions. Females also had a significantly better attitude towards the importance of HH than males (240(62.5%) Vs. 144(37.5%); P < 0.001).ConclusionThe majority of the participants' knowledge regarding HH was not up to the mark; however, female students had better knowledge compared to male students. The medical students and interns' knowledge and positive attitude towards HH can play a pivotal role in preventing HCPs associated infections and it would overall decrease the infection-related burden on the hospital and governmental budgets. It is suggested that multi-dimensional plans are required to change this low compliance to a higher rate.

Project description:Purpose:Few evidence-based strategies are specifically tailored for disparity populations such as rural adults. Two-way video-conferencing using telemedicine can potentially surmount geographic barriers that impede participation in high-intensity treatment programs offering frequent visits to clinic facilities. We aimed to understand barriers and facilitators of implementing a telemedicine-delivered tertiary-care, rural academic weight-loss program for the management of obesity. Methods:A single-arm study of a 16-week, weight-loss pilot evaluated barriers and facilitators to program participation and exploratory measures of program adoption and staff confidence in implementation and intervention delivery. A program was delivered using video-conferencing within an existing clinical infrastructure. Elements of Consolidated Framework for Implementation Research (CFIR) provided a basis for assessing intervention characteristics, inner and outer settings, and individual characteristics using surveys and semi-structured interviews. We evaluated elements of the RE-AIM model (reach, adoption) to assess staff barriers to success for future scalability. Findings:There were 27 patients and 8 staff completing measures. Using CFIR, the intervention was valuable from a patient participant standpoint; staff equally had positive feelings about using telemedicine as useful for patient care. The RE-AIM framework demonstrated limited reach but willingness to adopt was above average. A significant barrier limiting sustainability was physical space for intervention delivery and privacy and dedicated resources for staff. Scheduling stressors were also a challenge in its implementation. Conclusions:The need to engage staff, enhance organizational culture, and increase reach are major factors for rural health obesity clinics to enhance sustainability of using telemedicine for the management of obesity. Trial registration:Clinicaltrials.gov NCT03309787. Registered on 16 October 2017.

Project description:BackgroundObesity is a risk factor for many chronic diseases, and its prevalence and trends vary among populations. Saudi Arabia shows a greater rise in prevalence than many other countries. We aimed to study the association between several chronic disorders, demographic, and lifestyle factors with increased body mass index (BMI) in the adult population of Jeddah.MethodsData were obtained from a door-to-door cross sectional study. A three-stage stratified cluster sampling technique was adopted. Individuals in selected households agreeing to participate were interviewed to complete a predesigned questionnaire covering demographic and lifestyle variables, medical history, and family history of chronic diseases. This was followed by anthropometric and blood pressure measurements. A random capillary plasma glucose (RPG) was measured, followed by further testing using fasting plasma glucose and glycated hemoglobin (HbA1c) to verify whether participants were normal, diabetic, or prediabetic. Multiple logistic regression analyses were used to adjust for confounding factors.ResultsA total of 1419 individuals were included in the study: 667 men and 752 women. The prevalence of overweight and obesity was 35.1 and 34.8%, respectively, in men, and 30.1% and 35.6%, respectively, in women. Both overweight and obesity increased in prevalence to 60 years of age, and decreased in the oldest age group in both sexes. After adjusting for age, risk of obesity in men was increased with having a postgraduate degree [odds ratio (OR), 95%CI = 2.48, 1.1-5.61] and decreased with increased physical activity (OR, 95%CI = 0.49, 0.26-0.91). Risk of prediabetes and diabetes was increased in obese women (OR, 95%CI = 2.94, 1.34-6.44, and 3.61, 1.58-8.26 respectively), that of hypertension in obese men (OR, 95%CI =2.62, 1.41-4.87), and that of dyslipidemia in both sexes (OR, 95%CI = 2.60, 1.40-4.83 in men, and 2.0, 1.01-3.85 in women). A family history of dyslipidemia was associated with reduced risk of obesity among women (OR, 95%CI = 0.33, 0.12-0.92), whereas, in people with above normal weight (BMI ⩾25), there was increased risks of prediabetes, diabetes, and dyslipidemia among women (OR, 95%CI = 2.50, 1.21-5.17; 3.20, 1.45-7.03, and 1.88, 1.02-3.49, respectively ), and of hypertension among men (OR, 95%CI = 1.80, 1.00-3.23).ConclusionsThe prevalence of overweight and obesity in the Saudi population remain high, indicating ineffectiveness or lack of preventive measures. Risk of prediabetes, diabetes, dyslipidemia, and hypertension increased with increasing BMI, with some sex differences in these associations.

Dataset Information

A randomized controlled trial of a 12-week intensive lifestyle intervention program at a primary care obesity clinic for adults in western Saudi Arabia.

Publications

A randomized controlled trial of a 12-week intensive lifestyle intervention program at a primary care obesity clinic for adults in western Saudi Arabia.

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