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Rae Jean Proescholdbell - One of the best experts on this subject based on the ideXlab platform.

  • using a Holistic Health approach to achieve weight loss maintenance results from the spirited life intervention
    Translational behavioral medicine, 2020
    Co-Authors: Rae Jean Proescholdbell, David E Eagle, Dori M Steinberg, Jia Yao, Timothy W Smith, Grace Y Cai, Elizabeth L Turner
    Abstract:

    Weight-loss maintenance is essential to sustain the Health benefits of weight loss. Studies with lower intensity intervention supports under real-world conditions are lacking. This study examined changes in weight and cardiometabolic biomarkers among Spirited Life participants following initial 12-month weight loss at 12-24 months and 24-42 months. A total of 719 clergy received a wellness intervention, including a 10-week online weight-loss program in the first 12 months and monthly Health coaching throughout 24 months. Mean changes in weight, blood pressure, high-density lipoproteins, and triglycerides were estimated using random effects linear models, accounting for repeated measures. Weight was additionally analyzed in subsamples stratified by body mass index (BMI). At baseline, 17.1% of participants had BMI < 25 kg/m2 and 11.8% had BMI ≥ 40 kg/m2. Mean 12-month weight loss was -2.4 kg (95% CI: -2.8 kg, -2.1 kg). On average, at 42 months, participants regained weight but did not exceed baseline (-0.5 kg, 95% CI: -1.2 kg, 0.2 kg), improvements in triglycerides were completely sustained (-13.9 mg/dL, 95% CI: -18.6 mg/dL, -9.2 mg/dL), and systolic blood pressure improvements remained significant (-1.9 mmHg, 95% CI: -3.0 mmHg, -0.9 mmHg). Participants with a BMI ≥ 40 kg/m2 lost significantly more weight that was sustained at 42 months (-5.8 kg, 95% CI: -8.9 kg, -2.7 kg). The Spirited Life wellness intervention produced weight loss and, for participants with higher levels of obesity, sustained weight-loss maintenance. The intervention was effective for long-term prevention of weight gain among participants with BMI of 25 to ≤40 kg/m2, through 42 months. Wellness interventions such as Spirited Life should be considered for adoption.

  • a 2 year Holistic Health and stress intervention results of an rct in clergy
    American Journal of Preventive Medicine, 2017
    Co-Authors: Rae Jean Proescholdbell, Robin Swift, Edgar H Moore, Gary G Bennett, Redford B Williams, Elizabeth L Turner, Xiangfang Li, David E Eagle, Rachel A Meyer, Melanie Kolkin
    Abstract:

    Introduction This study sought to determine the effect of a 2-year, multicomponent Health intervention (Spirited Life) targeting metabolic syndrome and stress simultaneously. Design An RCT using a three-cohort multiple baseline design was conducted in 2010–2014. Setting/participants Participants were United Methodist clergy in North Carolina, U.S., in 2010, invited based on occupational status. Of invited 1,745 clergy, 1,114 consented, provided baseline data, and were randomly assigned to immediate intervention (n=395), 1-year waitlist (n=283), or 2-year waitlist (n=436) cohorts for a 48-month trial duration. Intervention The 2-year intervention consisted of personal goal setting and encouragement to engage in monthly Health coaching, an online weight loss intervention, a small grant, and three workshops delivering stress management and theological content supporting Healthy behaviors. Participants were not blinded to intervention. Main outcome measures Trial outcomes were metabolic syndrome (primary) and self-reported stress and depressive symptoms (secondary). Intervention effects were estimated in 2016 in an intention-to-treat framework using generalized estimating equations with adjustment for baseline level of the outcome and follow-up time points. Log-link Poisson generalized estimating equations with robust SEs was used to estimate prevalence ratios (PRs) for binary outcomes; mean differences were used for continuous/score outcomes. Results Baseline prevalence of metabolic syndrome was 50.9% and depression was 11.4%. The 12-month intervention effect showed a benefit for metabolic syndrome (PR=0.86, 95% CI=0.79, 0.94, p Conclusions The Spirited Life intervention improved metabolic syndrome prevalence in a population of U.S. Christian clergy and sustained improvements during 24 months of intervention. These findings offer support for long-duration behavior change interventions and population-level interventions that allow participants to set their own Health goals. Trial registration This study is registered at www.clinicaltrials.gov NCT01564719.

  • corrigendum to use of a randomized multiple baseline design rationale and design of the spirited life Holistic Health intervention study contemp clin trials 35 2013 138 152
    Contemporary Clinical Trials, 2014
    Co-Authors: Rae Jean Proescholdbell, Robin Swift, Edgar H Moore, Gary G Bennett, Rachel Blouin, Virginia P Williams, Redford B Williams, David Toole
    Abstract:

    a Duke Global Health Institute and Duke Center for Health Policy and Inequalities Research, Box 90392, Durham, NC 27708-0392, USA b Duke Divinity School, 312 Blackwell St., Suite 101, Noell Building, Durham, NC 27701, USA c Duke University, Department of Psychology & Neuroscience, Box 90086, Durham, NC 27708-0086, USA d Williams LifeSkills, 2020 W. Main Street, Suite 100, Durham, NC 27705, USA e Duke University, Departments of Psychiatry & Behavioral Sciences, Medicine, and Psychology & Neuroscience, Medicine, Behavioral Psychiatry, 2212 Elder St., Durham, NC 27705, USA f Duke Divinity School and Duke Global Health Institute, 312 Blackwell St., Suite 101, Noell Building, Durham, NC 27701, USA

  • use of a randomized multiple baseline design rationale and design of the spirited life Holistic Health intervention study
    Contemporary Clinical Trials, 2013
    Co-Authors: Rae Jean Proescholdbell, Robin Swift, Edgar H Moore, Gary G Bennett, Rachel Blouin, Virginia P Williams, Redford B Williams, David Toole
    Abstract:

    Clergy suffer from high rates of obesity, chronic disease, and depression, and simultaneously underestimate the toll these take on their daily functioning. Health interventions are needed for clergy and may be tailored to their occupational context and theological beliefs. Few studies have sought to improve clergy Health. No prior studies have utilized a randomized design. Spirited Life is a randomized, multiple baseline study that offered enrollment to nearly all United Methodist Church clergy in North Carolina in fall 2010. A total of 1114 clergy (response rate = 64%) enrolled. Using a multiple baseline design, we randomized participants to three cohorts. Each cohort began the Health intervention in one of three consecutive years. The third cohort served as a randomized waitlist control cohort, allowing comparisons between the first and third cohorts. The two-year Spirited Life intervention consists of: 1) a theological underpinning for Health stewardship based on incarnation, grace, and response and delivered during workshops; 2) the stress management program Williams LifeSkills; 3) Naturally Slim, an online weight loss program; 4) phone contact with a Wellness Advocate; and 5) $500 small grants for Health goals. Metabolic syndrome is the primary endpoint. Stress and depressive severity are secondary endpoints. We measured each construct before, twice during, and at the end of the two-year intervention. Study outcomes, to be published after follow-up data are gathered, will provide evidence of the effectiveness of the combined intervention components of Spirited Life. If successful, the intervention may be considered for use with other clergy and faith populations.

  • a theoretical model of the Holistic Health of united methodist clergy
    Journal of Religion & Health, 2011
    Co-Authors: Rae Jean Proescholdbell, Sara Legrand, Amanda Wallace, John James, Christopher Adams, David Toole
    Abstract:

    Culturally competent Health interventions require an understanding of the population’s beliefs and the pressures they experience. Research to date on the Health-related beliefs and experiences of clergy lacks a comprehensive data-driven model of clergy Health. Eleven focus groups with 59 United Methodist Church (UMC) pastors and 29 UMC District Superintendents were conducted in 2008. Participants discussed their conceptualization of Health and barriers to, and facilitators of, Health promotion. Audiotape transcriptions were coded by two people each and analyzed using grounded theory methodology. A model of Health for UMC clergy is proposed that categorizes 42 moderators of Health into each of five levels drawn from the Socioecological Framework: Intrapersonal, Interpersonal, Congregational, United Methodist Institutional, and Civic Community. Clergy Health is mediated by stress and self-care and coping practices. Implications for future research and clergy Health interventions are discussed.

Sabine Koch - One of the best experts on this subject based on the ideXlab platform.

  • achieving Holistic Health for the individual through person centered collaborative care supported by informatics
    Healthcare Informatics Research, 2013
    Co-Authors: Sabine Koch
    Abstract:

    Objectives: This article seeks to describe the current state of informatics supported collaborative care and to point out areas of future research in this highly interdisciplinary field. Methods: In this article, person-centered collaborative care is seen as a concept addressing both the provision of care over organizational borders between Health and social care, and within care teams as well as the changed patient/client-care provider relationship characterized by increased patient/client involvement. Results: From a Health systems perspective, there are several attempts to describe the conceptual and theoretical basis for collaborative care indicating that agreement on core concepts and terminology is difficult. From an informatics perspective, focus is on standardization of clinical content models and terminology to achieve interoperability of information technology systems and to support standardized care pathways. Few examples look into how ad-hoc collaborative care processes can be supported using information technology and informatics standards. Nevertheless, promising examples do exist showing that integrational Information Communication Technology services can be supportive for collaborative care developments. However, the current landscape consists of many fragmented, often technology-driven eHealth solutions targeting specific diagnostic groups in geographically and/or organizationally restricted settings. Conclusions: A systematic approach incorporating organizational, clinical, informatics and social science knowledge is needed to perform further research in areas such as virtual team partnerships, new paradigms of care delivery, data and knowledge management as well as its secure sharing. Also organizational and legal aspects need to be further researched in order to facilitate the coordinated provision of Health and social care to citizens including self-management, utilizing informatics support in a societal context.

  • social care informatics as an essential part of Holistic Health care a call for action
    International Journal of Medical Informatics, 2011
    Co-Authors: Michael Rigby, Sabine Koch, Penny Hill, Debbie Keeling
    Abstract:

    Abstract Purpose The authors identified the need for a cross-disciplinary research view of issues to ensure an integrated citizen-centric support to achieve optimal Health of individual citizens and, in particular, the role of informatics to inform and coordinate support towards integrated and Holistic care. Method An Exploratory Workshop was approved and sponsored by the European Science Foundation. Twenty-three participants from 15 countries attended, covering a full range of Health, social care and informatics professions and disciplines. Results The participants found strong common ground in identifying key issues to be addressed if citizens with compromised Health are to receive integrated and coordinated support to a common set of objectives, while also ensuring appropriate choice and support for citizen, family and other informal carers. At the same time, optimal Health was identified as a fundamental human right, and that achieving this is a necessary priority of a caring society. Moreover, Europe has a commitment to researching and developing Health informatics (e-Health), though not yet giving a priority to this integration of Health and social care. Specifically the following main informatics challenges to be addressed were identified: (1) to identify available information and communication needs related to different scenarios of use in the intersection between Health and social care, (2) to develop and map shared ontologies, and standards for integration and/or brokerage, (3) to enable planned information access and sharing, shaping a system of trust where the patient is an active partner and policies are established considering all partners/interests, (4) to investigate the use of automatic/intelligent knowledge based and context-relevant services, and (5) empowering the citizen (or their selected agent) as co-producer through modern informatics tools, while carefully avoiding selective disempowerment of the most vulnerable. Conclusion The Exploratory Workshop resulted in a unanimous Declaration for action, which is presented appended to this paper.

Debbie Keeling - One of the best experts on this subject based on the ideXlab platform.

  • social care informatics as an essential part of Holistic Health care a call for action
    International Journal of Medical Informatics, 2011
    Co-Authors: Michael Rigby, Sabine Koch, Penny Hill, Debbie Keeling
    Abstract:

    Abstract Purpose The authors identified the need for a cross-disciplinary research view of issues to ensure an integrated citizen-centric support to achieve optimal Health of individual citizens and, in particular, the role of informatics to inform and coordinate support towards integrated and Holistic care. Method An Exploratory Workshop was approved and sponsored by the European Science Foundation. Twenty-three participants from 15 countries attended, covering a full range of Health, social care and informatics professions and disciplines. Results The participants found strong common ground in identifying key issues to be addressed if citizens with compromised Health are to receive integrated and coordinated support to a common set of objectives, while also ensuring appropriate choice and support for citizen, family and other informal carers. At the same time, optimal Health was identified as a fundamental human right, and that achieving this is a necessary priority of a caring society. Moreover, Europe has a commitment to researching and developing Health informatics (e-Health), though not yet giving a priority to this integration of Health and social care. Specifically the following main informatics challenges to be addressed were identified: (1) to identify available information and communication needs related to different scenarios of use in the intersection between Health and social care, (2) to develop and map shared ontologies, and standards for integration and/or brokerage, (3) to enable planned information access and sharing, shaping a system of trust where the patient is an active partner and policies are established considering all partners/interests, (4) to investigate the use of automatic/intelligent knowledge based and context-relevant services, and (5) empowering the citizen (or their selected agent) as co-producer through modern informatics tools, while carefully avoiding selective disempowerment of the most vulnerable. Conclusion The Exploratory Workshop resulted in a unanimous Declaration for action, which is presented appended to this paper.

Michael Rigby - One of the best experts on this subject based on the ideXlab platform.

  • integrating Health and social care informatics to enable Holistic Health care
    Studies in health technology and informatics, 2012
    Co-Authors: Michael Rigby
    Abstract:

    Personalization of Healthcare has a number of claimants, including pHealth. However, to the citizen real personalization is the delivery of integrated support services to maintain their Health and well-being, particularly in times of chronic illness and frailty. The integration of Health and social care support has been identified a key but challenging step in this. The pHealth community faces the choice either of reinforcing the isolation of silos of care and thus fragmentation of service, or of seeking to become a unifying agent though thoughtful and considered development of sharing of monitoring from pHealth devices.

  • social care informatics as an essential part of Holistic Health care a call for action
    International Journal of Medical Informatics, 2011
    Co-Authors: Michael Rigby, Sabine Koch, Penny Hill, Debbie Keeling
    Abstract:

    Abstract Purpose The authors identified the need for a cross-disciplinary research view of issues to ensure an integrated citizen-centric support to achieve optimal Health of individual citizens and, in particular, the role of informatics to inform and coordinate support towards integrated and Holistic care. Method An Exploratory Workshop was approved and sponsored by the European Science Foundation. Twenty-three participants from 15 countries attended, covering a full range of Health, social care and informatics professions and disciplines. Results The participants found strong common ground in identifying key issues to be addressed if citizens with compromised Health are to receive integrated and coordinated support to a common set of objectives, while also ensuring appropriate choice and support for citizen, family and other informal carers. At the same time, optimal Health was identified as a fundamental human right, and that achieving this is a necessary priority of a caring society. Moreover, Europe has a commitment to researching and developing Health informatics (e-Health), though not yet giving a priority to this integration of Health and social care. Specifically the following main informatics challenges to be addressed were identified: (1) to identify available information and communication needs related to different scenarios of use in the intersection between Health and social care, (2) to develop and map shared ontologies, and standards for integration and/or brokerage, (3) to enable planned information access and sharing, shaping a system of trust where the patient is an active partner and policies are established considering all partners/interests, (4) to investigate the use of automatic/intelligent knowledge based and context-relevant services, and (5) empowering the citizen (or their selected agent) as co-producer through modern informatics tools, while carefully avoiding selective disempowerment of the most vulnerable. Conclusion The Exploratory Workshop resulted in a unanimous Declaration for action, which is presented appended to this paper.

David Toole - One of the best experts on this subject based on the ideXlab platform.

  • corrigendum to use of a randomized multiple baseline design rationale and design of the spirited life Holistic Health intervention study contemp clin trials 35 2013 138 152
    Contemporary Clinical Trials, 2014
    Co-Authors: Rae Jean Proescholdbell, Robin Swift, Edgar H Moore, Gary G Bennett, Rachel Blouin, Virginia P Williams, Redford B Williams, David Toole
    Abstract:

    a Duke Global Health Institute and Duke Center for Health Policy and Inequalities Research, Box 90392, Durham, NC 27708-0392, USA b Duke Divinity School, 312 Blackwell St., Suite 101, Noell Building, Durham, NC 27701, USA c Duke University, Department of Psychology & Neuroscience, Box 90086, Durham, NC 27708-0086, USA d Williams LifeSkills, 2020 W. Main Street, Suite 100, Durham, NC 27705, USA e Duke University, Departments of Psychiatry & Behavioral Sciences, Medicine, and Psychology & Neuroscience, Medicine, Behavioral Psychiatry, 2212 Elder St., Durham, NC 27705, USA f Duke Divinity School and Duke Global Health Institute, 312 Blackwell St., Suite 101, Noell Building, Durham, NC 27701, USA

  • use of a randomized multiple baseline design rationale and design of the spirited life Holistic Health intervention study
    Contemporary Clinical Trials, 2013
    Co-Authors: Rae Jean Proescholdbell, Robin Swift, Edgar H Moore, Gary G Bennett, Rachel Blouin, Virginia P Williams, Redford B Williams, David Toole
    Abstract:

    Clergy suffer from high rates of obesity, chronic disease, and depression, and simultaneously underestimate the toll these take on their daily functioning. Health interventions are needed for clergy and may be tailored to their occupational context and theological beliefs. Few studies have sought to improve clergy Health. No prior studies have utilized a randomized design. Spirited Life is a randomized, multiple baseline study that offered enrollment to nearly all United Methodist Church clergy in North Carolina in fall 2010. A total of 1114 clergy (response rate = 64%) enrolled. Using a multiple baseline design, we randomized participants to three cohorts. Each cohort began the Health intervention in one of three consecutive years. The third cohort served as a randomized waitlist control cohort, allowing comparisons between the first and third cohorts. The two-year Spirited Life intervention consists of: 1) a theological underpinning for Health stewardship based on incarnation, grace, and response and delivered during workshops; 2) the stress management program Williams LifeSkills; 3) Naturally Slim, an online weight loss program; 4) phone contact with a Wellness Advocate; and 5) $500 small grants for Health goals. Metabolic syndrome is the primary endpoint. Stress and depressive severity are secondary endpoints. We measured each construct before, twice during, and at the end of the two-year intervention. Study outcomes, to be published after follow-up data are gathered, will provide evidence of the effectiveness of the combined intervention components of Spirited Life. If successful, the intervention may be considered for use with other clergy and faith populations.

  • a theoretical model of the Holistic Health of united methodist clergy
    Journal of Religion & Health, 2011
    Co-Authors: Rae Jean Proescholdbell, Sara Legrand, Amanda Wallace, John James, Christopher Adams, David Toole
    Abstract:

    Culturally competent Health interventions require an understanding of the population’s beliefs and the pressures they experience. Research to date on the Health-related beliefs and experiences of clergy lacks a comprehensive data-driven model of clergy Health. Eleven focus groups with 59 United Methodist Church (UMC) pastors and 29 UMC District Superintendents were conducted in 2008. Participants discussed their conceptualization of Health and barriers to, and facilitators of, Health promotion. Audiotape transcriptions were coded by two people each and analyzed using grounded theory methodology. A model of Health for UMC clergy is proposed that categorizes 42 moderators of Health into each of five levels drawn from the Socioecological Framework: Intrapersonal, Interpersonal, Congregational, United Methodist Institutional, and Civic Community. Clergy Health is mediated by stress and self-care and coping practices. Implications for future research and clergy Health interventions are discussed.