Program Can Provide Long-Term Physical and Mental Health Improvement Among Adolescents

 Group of teens talkingSummary: Being overweight or obese or having depressive symptoms can interfere with health and academic performance among young people, yet the number of overweight and obese young people has increased in recent years. To help find the best way to address weight and depression among teens, scientists tested the long-term effectiveness of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) program. The COPE Healthy Lifestyles TEEN program, which involves teacher-led physical activity and positive behavioral skills training, was compared with an attention control program, Healthy Teens. The interventions were presented as part of required health classes in 11 high schools. In all, 779 students aged 14–16 participated in the study.

Researchers measured the two programs’ effects on overweight and obesity, as well as depressive symptoms, at 12 months following the interventions. After these 12 months, students participating in the COPE Healthy Lifestyles TEEN program had lower body mass index than those participating in the Healthy Teens program. None of those in the COPE Healthy Lifestyles TEEN intervention became obese, and only about 5 percent moved from a healthy weight to overweight, whereas 10 percent of those in the Healthy Teens control group moved into overweight or obesity. Among the subgroup of participants with severely elevated depressive symptoms, participants in the COPE Healthy Lifestyles TEEN group improved after 12 months, while depressive symptoms in the Healthy Teens group remained elevated. The researchers concluded that the COPE Healthy Lifestyles TEEN program may help at-risk youth improve their physical and mental health. They also note that the program was delivered by teachers as part of their curriculum, making it easily available to students who may need it the most.

Melnyk BM, Jacobson D, Kelly SA, et al. Twelve-Month Effects of the COPE Healthy Lifestyles TEEN Program on Overweight and Depressive Symptoms in High School Adolescents. J Sch Health. 2015 Dec; 85(12):861-70. PMID: 26522175

Disability Among Informal Caregivers Affects Care Recipients’ Use of Preventive Services

Elderly coupleSummary: Long-term care for those with disabilities is often provided by informal caregivers. However, these caregivers may themselves have functional limitations such as cognitive, mobility, hearing, and vision limitation, which could affect adherence to recommendations for the care recipients’ medical care. To measure this effect, researchers studied informal care provided to adults with disabilities who were age 50 and over, and its relationship to receipt of preventive health services such as flu vaccination, routine physicals, and cholesterol screening. In a nationally representative sample of 14-million caregiver/care recipient pairs, researchers found that 38 percent of the caregivers had at least one functional limitation. Care recipients received fewer preventive health services if their caregivers reported their own functional limitations. The researchers found that caregiver characteristics such as cognitive, mobility, and emotional limitations reduced the percentage of preventive services received by each care recipient. This association study highlights the importance of informal caregivers maintaining their own health to improve the chances that their care recipient will receive recommended preventative services.

Thorpe JM, Thorpe CT, Schulz R, et al. Informal Caregiver Disability and Access to Preventive Care in Care Recipients. Am J Prev Med. 2015 Sep; 49(3):370–9. PMID: 26091932

Magnet Hospitals May Provide Better Surgical Outcomes than Non-Magnet Hospitals

Clinicians consult in a hospitalSummary: In 1994 the American Nurses Credentialing Center established its Magnet Recognition Program, which evaluates hospitals that are committed to improving practices, particularly delivery of nursing care, that lead to enhanced safety, quality, and patient satisfaction. To determine whether Magnet designation is associated with better patient outcomes or whether patient outcomes improve after Magnet designation, researchers analyzed surgical outcomes over a 13-year period among 331 Magnet hospitals, compared with 662 non-Magnet hospitals. The researchers found that patient outcomes were better at Magnet hospitals than at their non-Magnet counterparts. Surgical patients treated at Magnet hospitals were nearly 8 percent less likely to die within 30 days following their procedure, and the patients were also less likely to die if they had postoperative complications. However, mortality rates did not change following Magnet designation. The researchers concluded that the Magnet program recognizes hospitals that deliver high-quality care but does not lead to additional improvements in surgical care following Magnet designation.

Friese CR, Xia R, Ghaferi A, et al. Hospitals In ‘Magnet’ Program Show Better Patient Outcomes On Mortality Measures Compared To Non-'Magnet' Hospitals. Health Aff. 2015 Jun; 34(6):986–92. PMID: 26056204

Many Older People with Hip Fracture Experience Disability Before Fracture

A woman helps an older man use a walkerSummary: The incidence of hip fracture is a growing problem in the United States and globally as the population ages. Individuals with hip fractures are often frail and elderly and may have some level of disability beforehand. Hip fracture is generally treated as an acute injury, with a focus on preventing disability following the fracture. However, it’s possible that the fracture accelerates the person’s existing disability, which would suggest the need to change the focus of post-fracture care. To better understand the prevalence of disability (difficulty walking, climbing stairs, bathing, etc.) prior to hip fracture, scientists analyzed health data from the Health and Retirement Study (HRS) of 857 Americans age 65 and older who experienced hip fracture. The HRS collects information from adults age 50 and older every two years, allowing the researchers to examine the health of the hip fracture study population before and after injury. Two years prior to hip fracture, disability rates among this group were approximately 20 percent. However, starting about 10 months prior to hip fracture, disability rates increased 2.4 percent each month until they reached about 44 percent one month before hip fracture. The researchers suggest that the high rate of pre-hip-fracture disability indicates that post-fracture management should be re-evaluated to focus on the provision of palliative care to address symptom burden within the context of diminished functionality, increased disability, and greater dependence on supportive care.

Smith AK, Cenzer IS, Boscardin JW, et al. Increase in Disability Prevalence Before Hip Fracture. J Am Geriatr Soc. 2015 Oct; 63(10):2029–35. PMID: 26480970

The Effect of Chronic Pain on Interruption and Resumption of Work Goals 

Woman in pain massages her templesSummary: Chronic pain is known to result in work interruptions, but how does such pain affect resumption of work? Researchers followed 131 individuals reporting chronic pain via automated phone calls throughout the day, asking about their pain, pain-related work interruptions, and associated frustration and disappointment, as well as work resumption. Individuals experiencing greater-than-normal disappointment and frustration with pain-related work interruptions during the day were more likely to return to work in the evening. Work resumption was more common for individuals with task-oriented goals, compared to participants with interpersonal-oriented goals. This may be because clients or co-workers are unavailable if work continued in the evening. Additionally, those with full-time employment were less likely than part-time workers to resume work in the evenings after pain-related interruption, potentially because part-time employees may not work consecutive days and are more compelled to complete work within a single workday. These findings identify patterns in pain-related work interruption and resumption that may lead to coordinated approaches to pain and work management.

Okun M, Karoly P, Mun CJ, Kim H. Pain-Contingent Interruption and Resumption of Work Goals: A Within-Day Diary Analysis. J Pain. 2015 Jan; 17(1):65-75. PMID: 26460172

Updated Date: March 3, 2016