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Biomedical subjects

R A Winett

Publications and source records attributed to R A Winett.

At least 19 recordsLinked to original sources
PubMed2001

Using Internet technology to deliver a behavioral weight loss program.

CONTEXT: Rapid increases in access to the Internet have made it a viable mode for public health intervention. No controlled studies have evaluated this resource for weight loss. OBJECTIVE: To determine whether a structured Internet behavioral weight loss program produces greater initial weight loss and changes in waist circumference than a weight loss education Web site. DESIGN: Randomized, controlled trial conducted from April to December 1999. SETTING AND PARTICIPANTS: Ninety-one healthy, overweight adult hospital employees aged 18 to 60 years with a body mass index of 25 to 36 kg/m(2). Analyses were performed for the 65 who had complete follow-up data. INTERVENTIONS: Participants were randomly assigned to a 6-month weight loss program of either Internet education (education; n = 32 with complete data) or Internet behavior therapy (behavior therapy; n = 33 with complete data). All participants were given 1 face-to-face group weight loss session and access to a Web site with organized links to Internet weight loss resources. Participants in the behavior therapy group received additional behavioral procedures, including a sequence of 24 weekly behavioral lessons via e-mail, weekly online submission of self-monitoring diaries with individualized therapist feedback via e-mail, and an online bulletin board. MAIN OUTCOME MEASURES: Body weight and waist circumference, measured at 0, 3, and 6 months, compared the 2 intervention groups. RESULTS: Repeated-measures analyses showed that the behavior therapy group lost more weight than the education group (P =.005). The behavior therapy group lost a mean (SD) of 4.0 (2.8) kg by 3 months and 4.1 (4.5) kg by 6 months. Weight loss in the education group was 1.7 (2.7) kg at 3 months and 1.6 (3.3) kg by 6 months. More participants in the behavior therapy than education group achieved the 5% weight loss goal (45% vs 22%; P =.05) by 6 months. Changes in waist circumference were also greater in the behavior therapy group than in the education group at both 3 months (P =.001) and 6 months (P =.005). CONCLUSIONS: Participants who were given a structured behavioral treatment program with weekly contact and individualized feedback had better weight loss compared with those given links to educational Web sites. Thus, the Internet and e-mail appear to be viable methods for delivery of structured behavioral weight loss programs.

Adult↗
PubMed2001

Potential health-related benefits of resistance training.

Public health guidelines primarily focus on the promotion of physical activity and steady-state aerobic exercise, which enhances cardiorespiratory fitness and has some impact on body composition. However, research demonstrates that resistance exercise training has profound effects on the musculoskeletal system, contributes to the maintenance of functional abilities, and prevents osteoporosis, sarcopenia, lower-back pain, and other disabilities. More recent seminal research demonstrates that resistance training may positively affect risk factors such as insulin resistance, resting metabolic rate, glucose metabolism, blood pressure, body fat, and gastrointestinal transit time, which are associated with diabetes, heart disease, and cancer. Research also indicates that virtually all the benefits of resistance training are likely to be obtained in two 15- to 20-min training sessions a week. Sensible resistance training involves precise controlled movements for each major muscle group and does not require the use of very heavy resistance. Along with brief prescriptive steady-state aerobic exercise, resistance training should be a central component of public health promotion programs.

Back Injuries↗
PubMed2001

A computerized social cognitive intervention for nutrition behavior: direct and mediated effects on fat, fiber, fruits, and vegetables, self-efficacy, and outcome expectations among food shoppers.

This study examined the direct and mediated impact of a self-administered, computer-based intervention on nutrition behavior self-efficacy, and outcome expectations among supermarket food shoppers. The intervention, housed in kiosks in supermarkets and based on social cognitive theory, used tailored information and self-regulation strategies delivered in 15 brief weekly segments. The study sample (N = 277), stratified and randomly assigned to treatment or control, was 96% female, was 92% White, had a median annual income of about $35,000, and had a mean education of 14. 78 +/- 2.11 years. About 12% of the sample reported incomes of $20,000 or less, and about 20% reported 12 years or fewer of education. Analysis of covariance immediately after intervention and at a 4- to 6-month follow-up found that treatment led to improved levels of fat, fiber, and fruits and vegetables. Treatment also led to higher levels of nutrition-related self-efficacy, physical outcome expectations, and social outcome expectations. Logistic regression analysis determined that the treatment group was more likely than the control group to attain goals for fat, fiber, and fruits and vegetables at posttest and to attain goals for fat at follow-up. Latent variable structural equation analysis revealed self-efficacy and physical outcome expectations mediated treatment effects on nutrition. In addition, physical outcome expectations mediated the effect of self-efficacy on nutrition outcomes. Implications for future computer-based health promotion interventions are discussed.

Adult↗
PubMed2001

Effects of regular and slow speed resistance training on muscle strength.

BACKGROUND: The study assessed a way to increase the intensity and effectiveness of resistance training by comparing training with a slower repetition speed to training with a conventional repetition speed. Slower repetition speed may effectively increase intensity throughout the lifting phase while decreasing momentum. METHODS: Two studies were done with untrained men (N=65) and women (N=82), (mean age=53.6) who trained two to three times per week for eight to 10 weeks on a 13 exercise Nautilus circuit performing one set of each exercise. Participants exclusively trained using regular speed repetitions for 8 to 12 repetitions per set at 7 sec each (2 sec lifting, 1 sec pause, 4 sec lowering) or a Super Slow training protocol where they completed 4 to 6 repetitions per set at 14 sec each (10 sec lifting, 4 sec lowering). All of the participants were tested for either the 10 repetition-maximum (RM) weightload (regular-speed group) or the 5-RM weightload (slow-speed group). RESULTS: In both studies, Super-Slow training resulted in about a 50% greater increase (p<0.001) in strength for both men and women than regular speed training. In Study 1, the Super-Slow training group showed a mean increase of 12.0 kg and the regular speed group showed an increase of 8.0 kg increase (p<0.001). In Study 2, the Super-Slow training group showed a 10.9 kg increase and the regular speed group showed an increase of 7.1 kg (p<0.001). CONCLUSIONS: Super-Slow training is an effective method for middle-aged and older adults to increase strength. Although studies still need to be done with at-risk populations, repetition speed should be considered when prescribing resistance training.

Adult↗
PubMed2000

Examining the validity of exercise guidelines for the prevention of morbidity and all-cause mortality.

Public health guidelines focus on increasing low to moderate physical activity levels in a largely sedentary population. While there is some evidence that inactivity is associated with increased risk of morbidity and mortality, there appears to be much stronger and consistent evidence for a graded inverse relationship between physical fitness and morbidity and mortality. However, epidemiological studies investigating physical fitness have often not directly measured aerobic capacity. This calls into question the specific recommendations that assume a direct relationship between aerobic capacity and risk. Performance on some test protocols can be favorably affected by increases in strength and musculoskeletal changes, in addition to aerobic capacity. Other public health recommendations assume that the volume of training, the total amount of work, or caloric expenditure is the key stimulus for health-protective adaptations. However, there is little evidence to support this long-held axiom. A balance of resistance training and aerobic training is recommended for decreasing morbidity and mortality. A threshold theory of adaptation and training is proposed that potentially can efficiently and effectively enhance aerobic capacity and strength in minimal time.

Exercise↗
PubMed2000

Outcomes of a randomized community-level HIV prevention intervention for women living in 18 low-income housing developments.

OBJECTIVES: Women in impoverished inner-city neighborhoods are at high risk for contracting HIV. A randomized, multisite community-level HIV prevention trial was undertaken with women living in 18 low-income housing developments in 5 US cities. METHODS: Baseline and 12-month follow-up population risk characteristics were assessed by surveying 690 women at both time points. In the 9 intervention condition housing developments, a community-level intervention was undertaken that included HIV risk reduction workshops and community HIV prevention events implemented by women who were popular opinion leaders among their peers. RESULTS: The proportion of women in the intervention developments who had any unprotected intercourse in the past 2 months declined from 50% to 37.6%, and the percentage of women's acts of intercourse protected by condoms increased from 30.2% to 47.2%. Among women exposed to intervention activities, the mean frequency of unprotected acts of intercourse in the past 2 months tended to be lower at follow-up (mean = 4.0) than at baseline (mean = 6.0). These changes were corroborated by changes in other risk indicators. CONCLUSIONS: Community-level interventions that involve and engage women in neighborhood-based HIV prevention activities can bring about reductions in high-risk sexual behaviors.

Adult↗
PubMed2000

Social-cognitive determinants of nutrition behavior among supermarket food shoppers: a structural equation analysis.

A social-cognitive model of nutrition behavior (A. Bandura, 1997) was tested using structural equation modeling of data from 307 food shoppers recruited from 5 supermarkets in Southwest Virginia. The shoppers were participating in the baseline phase of an ongoing nutrition promotion program. As part of the evaluation, data were collected on the self-efficacy and outcome-expectations components of social-cognitive theory as well as on food purchases and intake. The structural analyses presented here support the social-cognitive model. Self-efficacy, physical outcome expectations, age, socioeconomic status, and number of children were important predictors of nutrition behavior among shoppers. Implications for interventions using social-cognitive variables to improve the nutritional content of food purchases and intake are discussed.

Adult↗
PubMed1997

Randomised, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities. Community HIV Prevention Research Collaborative.

BACKGROUND: Community-level interventions may be helpful in population-focused HIV prevention. If members of populations at risk of HIV infection who are popular with other members can be engaged to advocate the benefits of behaviour change to peers, decreases in risk behaviour may be possible. We assessed a community-level intervention to lower the risk of HIV infection, focusing on men patronising gay bars in eight small US cities. METHODS: We used a randomised community-level field design. Four cities received the intervention and four control cities did not. Participants were men from each city who went to gay bars. Men completed surveys about their sexual behaviour on entering the bars during 3-night periods at baseline and at 1-year follow-up. In the control cities, HIV educational materials were placed in the bars. In the intervention cities, we recruited popular homosexual men in the community and trained them to spread behaviour-change endorsements and recommendations to their peers through conversation. FINDINGS: Population-level of risk behaviour decreased significantly in the intervention cities compared with the control cities at 1-year follow-up, after exclusion of surveys completed by transients and men with exclusive sexual partners in a city-level analysis, in the intervention cities we found a reduction in the mean frequency of unprotected anal intercourse during the previous 2 months (baseline 1.68 occasions; follow-up 0.59: p = 0.04) and an increase in the mean percentage of occasions of anal intercourse protected by condoms (baseline 44.7%; follow-up 66.8%, p = 0.02). Increased numbers of condoms taken from dispensers in intervention-city bars corroborated risk-behaviour self-reports. INTERPRETATION: Popular and well-liked members of a community who systematically endorse and recommend risk-reduction behaviour can influence the sexual-risk practices of others in their social networks. Natural styles of communication, such as conversations, brought about population-level changes in risk behaviour.

Adult↗
PubMed1996

Exercise for women.

Explore the source record for details and available documents.

Cholesterol, HDL↗
PubMed1996

HIV risk behaviors among women living in low-income, inner-city housing developments.

OBJECTIVES: This study describes the prevalence and predictors of human immunodeficiency virus (HIV) risk behaviors among women living in low-income, inner-city housing developments. METHODS: Anonymous questionnaires were administered to 671 women living in 10 inner-city, low-income housing developments in five US cities to determine their levels of HIV risk behavior and predictors of HIV risk practices. RESULTS: Approximately one third of women were at high risk for HIV because of the risk behavior of their sexual partners. HIV risk was highest among women who accurately perceived themselves to be at increased HIV risk, held strong beliefs about barriers to condom use, and reported weak behavioral intentions to reduce risk. Women at higher risk were also younger and reported higher rates of alcohol and substance use. CONCLUSIONS: HIV prevention efforts are needed for inner-city women. Interventions should focus on overcoming women's barriers to condom use, strengthening their intentions to change behaviors, and managing the risk related to their use of substances.

Adolescent↗
PubMed1995

A framework for health promotion and disease prevention programs.

There is a disquieting sense that many theoretically based health behavior change programs have been only minimally effective. Part of the problem may be that most current theories have considerable overlap, primarily focus on intraindividual and other individual-level variables, and tend to neglect the environment and issues related to program implementation. A framework is developed for health promotion and disease prevention programs that makes use of epidemiological and health indicator data and Healthy People 2000 goals to prioritize efforts, provides a schema to formulate programs on the basis of timing (prevention) and level of intervention, and addresses the marketing approach to target and implement programs. The framework integrates current theories to guide marketing and phases of research.

Epidemiology↗