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8 recordsLinked to original sources
PubMed2026

Financial incentives and health coaching to improve glycemic outcomes among young adults with type 1 diabetes: A factorial randomized trial (SweetGoals).

AIM: This study aimed to improve glycemic control among young adults with type 1 diabetes (T1D), an at-risk and understudied population. METHOD: N = 300 young adults with T1D recruited nationally were randomized to the factorial combination of (1) financial incentives targeting glucose checking and mealtime behaviors and (2) web health coaching focused on increasing motivation and goal setting for self-management behaviors. All received a smartphone app that accessed device data and provided weekly goal feedback. The intervention lasted 6 months. HbA1c (A1c) was assessed at baseline, +6 months, and +12 months. The mean number of glucose checking and mealtime goals met per week during the intervention were tested as mediators of intervention effects on A1c at 12 months. RESULTS: A1c was significantly reduced from baseline to +12 months across all participants. Indirect effects of both incentives and coaching on A1c reductions were significant and partially mediated by mealtime but not glucose checking goal achievement. There was no synergistic (interaction) effect of incentives and coaching. CONCLUSION: Incentives and coaching both improved critical mealtime behavior but through different strategies. These results suggest that either intervention would be suitable for future testing and dissemination, and that lower cost of incentives may favor their prioritization.

Adolescent↗
PubMed2026

The African Cancer Leaders Institute: a decade of strategic development of the African next generation leaders in cancer care, research, education and advocacy.

Leadership and mentorship play an important role in supporting the career development of health professionals. In many African countries, supervision activities focus on technical and operational aspects rather than catalysing career and leadership development. Thus, mentorship and coaching interventions need to be implemented in African healthcare institutions as components of health systems strengthening strategies. Due to its holistic nature, cancer care involves interprofessional collaborations to develop and provide a problem-solving mindset. It is therefore an area that would benefit from leadership and mentorship, mainly in a limited-resources context. The identified benefits from leadership development in cancer care in Africa led to the creation of the African Cancer Leaders Institute (ACLI) of the African Organization for Research and Training in Cancer (AORTIC), consisting of mentors and trainees from Africa and the USA. ACLI trainees are selected through a competitive application process. During the ACLI biennial meetings, coinciding with the AORTIC conference, trainees, including early-stage/mid-career investigators, oncologists, nurses, advocates and other health professionals, meet to learn about best practices in cancer research, grant writing, scientific reporting, mentor relationships, academic pressures and professional-personal life balance. This paper describes the goals of the ACLI, its mission and achievements, the vision behind creating such important programmes and the benefits of its participants in leadership, coaching and mentorship in improving cancer care in Africa.

Humans↗
PubMed1977

Injuries to the ankle and foot in athletics.

Accurate diagnosis in ligament and ligament-bone injuries of the foot and ankle demands a knowledge of the anatomy and mechanics of the foot and ankle, a good history of the mechanism of injury, clinical examination including fingertip palpation and assessment of stability, and adequate x-ray studies, perferably in the deformed position, with stress films and arthrograms in selected cases. By making an accurate diagnosis, early proper treatment is instituted, the athlete is restored to health sooner, and, almost as important, the athlete and the coach get a more realistic prognosis regarding the end result and duration of disability.

Achilles Tendon↗
PubMed2026

Nurse-Led Home-Based Mobile Health Cardiac Rehabilitation Program for Patients With Chronic Heart Failure: A Randomized Controlled Trial.

This 12-week randomized controlled trial evaluated a nurse-led mHealth intervention for patients with chronic heart failure, conceptually informed by Riegel's middle-range theory of self-care of chronic illness. The program integrated wearable activity tracking with weekly nurse-led behavioral coaching, reflecting the core self-care processes of monitoring, maintenance, and management. Compared with usual care, the intervention significantly improved daily step count, 6-minute walk distance, metabolic equivalents, and left ventricular ejection fraction. Findings highlight the effectiveness of theory-informed, nurse-delivered mHealth strategies in enhancing physical activity and cardiopulmonary function, while underscoring the critical role of advanced practice nurses in home-based chronic disease management.

Aged↗
PubMed2026

Impact of Annual School Fitness Reports on Students' Cardiorespiratory Fitness: A Cluster-Randomized Controlled Trial of Parental Reporting.

BACKGROUND: School-based physical fitness testing is an important population health monitoring tool and has the potential to improve student fitness performance. However, few studies exist on the impact of reporting student fitness to parents. METHODS: Using data from the Fit Study (2014-2017) from 12 California public schools, we used mixed-effects models to compare changes in cardiorespiratory fitness (estimated peak oxygen consumption, calculated from the 1-mile run) and strength (curl-ups and push-ups) over 1 and 2 years between students randomized to having their parents receive an annual fitness report (intervention, n = 1638 students) and control (n = 2070) in grades 5 to 8 (ages 10-15 y). The student sample was 47.9% female, 55.9% Hispanic, and 24.1% Asian. RESULTS: After 1 year, intervention students did not demonstrate differential change compared with control students in estimated peak oxygen consumption (between-group change: -0.03 mL/kg/min; 95% CI, -.367 to 0.302), curl-ups (between-group change: 1.2 curl-ups; 95% CI, -0.306 to 2.660), or push-ups (between-group change: 0.1 push-ups; 95% CI, -0.672 to 0.787). Similarly, no differences were seen after 2 years. CONCLUSION: Sending a 2-page, once-a-year school-based fitness report home to parents-in the absence of environmental changes and/or behavioral coaching and support-does not impact student fitness performance after either 1 or 2 years of reporting.

fitness reporting↗
PubMed2026

Evaluating a coaching intervention for Dementia Care Practice Recommendations in care communities: a cluster randomized controlled trial.

BACKGROUND AND OBJECTIVES: Within care communities, including nursing home and assisted living settings, person-centered dementia care, outlined by the 2018 Alzheimer's Association Dementia Care Practice Recommendations (DCPR), is foundational to quality care and improving staff outcomes. This study evaluates the effectiveness of a 6-month Care Community Coaching Program in enhancing person-centered dementia care and staff outcomes in alignment with the DCPR. RESEARCH DESIGN AND METHODS: A cluster randomized controlled trial was conducted with 77 care communities and 434 staff members-227 from 38 intervention communities and 207 from 39 control communities. Outcomes included employee satisfaction (areas: job satisfaction, team building and communication, scheduling and staffing, training, and management and leadership), person-centered care practices (areas: workplace practices, individualized care and services, caregiver-resident relationships), and dementia care confidence, measured pre- and post-intervention and at 3-month follow-up. A generalized Estimating Equations model was used to estimate intervention effects. RESULTS: Care communities assigned to the coaching intervention showed statistically significant improvements in employee satisfaction and staff perceptions of workplace practices and individualized care. No statistically significant effects on staff perceptions of caregiver-resident relationships or on dementia care confidence were noted. DISCUSSION AND IMPLICATIONS: Findings provide direction for future research and intervention development, including examining coaching's impact on resident quality outcomes, and incorporating skills training into future models. Collectively, findings provide evidence of the effectiveness of a Care Community Coaching Program in improving staff outcomes and person-centered practices, offering a practical path towards improving the lived experience of residents and staff in care communities.

Humans↗
PubMed2026

Use of wearable technologies for physical activity promotion in older adults: A systematic review.

This systematic review, conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251055299), examined the use of wearable technologies for promoting physical activity (PA) in adults aged 60 years and older. Searches across five databases (PubMed, Scopus, Web of Science, CINAHL, Cochrane) identified 2438 records, of which only six randomized controlled trials published between 2021 and 2025 met inclusion criteria, with sample sizes ranging from 36 to 551 participants and mean ages between 65 and 79 years. Given the small number of included studies, findings should be interpreted as preliminary. The studies ranged from the standalone use of commercial trackers (Fitbit, Polar, ActiGraph) to multicomponent interventions combining wearables with physiotherapist feedback, telephone counseling, web-based platforms, or interactive cognitive-motor training. Wearables used alone, as in the REACT trial, produced small or non-significant PA effects. In contrast, interventions integrating devices with personalized feedback, professional support, or digital platforms, such as PROMOTE and TASMANIA, were associated with more consistent improvements in PA, physical function, and cognitive outcomes. Multicomponent programs, such as PEER and ICMT, reported broader benefits, including cognition, balance, and reductions in sedentary behavior, though these findings derive from individual trials and require replication. Risk of bias, assessed with the Cochrane Risk of Bias tool version 2 (RoB 2.0), was rated as "some concerns" for five studies and low for only one, mainly due to gaps in randomization reporting, missing data, and lack of preregistration. Tentatively, and based on a very limited evidence base, wearables may have greater impact when embedded within broader behavioral systems, incorporating feedback, coaching, or interactive components, rather than when used in isolation as passive monitoring tools. Adherence and psychosocial outcomes appeared related to comfort and perceived usefulness among older adults, though larger and more robust trials are needed to confirm these patterns.

Humans↗