[ { "key": "F3N2IGTP", "version": 34, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/F3N2IGTP", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/F3N2IGTP", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1613977, "username": "sstrayer", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/sstrayer", "type": "text/html" } } }, "creatorSummary": "Pool et al.", "parsedDate": "2014-04", "numChildren": 0 }, "data": { "key": "F3N2IGTP", "version": 34, "itemType": "journalArticle", "title": "The impact of physician weight discussion on weight loss in US adults", "creators": [ { "creatorType": "author", "firstName": "Andrew C.", "lastName": "Pool" }, { "creatorType": "author", "firstName": "Jennifer L.", "lastName": "Kraschnewski" }, { "creatorType": "author", "firstName": "Lindsay A.", "lastName": "Cover" }, { "creatorType": "author", "firstName": "Erik B.", "lastName": "Lehman" }, { "creatorType": "author", "firstName": "Heather L.", "lastName": "Stuckey" }, { "creatorType": "author", "firstName": "Kevin O.", "lastName": "Hwang" }, { "creatorType": "author", "firstName": "Kathryn I.", "lastName": "Pollak" }, { "creatorType": "author", "firstName": "Christopher N.", "lastName": "Sciamanna" } ], "abstractNote": "PROBLEM: The increasing prevalence of overweight and obesity in the United States and worldwide is at epidemic levels. Physicians may play a vital role in addressing this epidemic. We aimed to examine the association of a physician's discussion of patients’ weight status with self-reported weight loss. We hypothesized that physician discussion of patients’ being overweight is associated with increased weight loss in patients with overweight and obesity.\nMETHODS: Data analysis of participants (n = 5054) in the National Health and Nutritional Examination Survey (NHANES) in 2005-2008. The main outcome was rates of self-reported weight loss and the association with physicians’ discussion of their patients’ weight status.\nRESULTS: Overweight and obese participants were significantly more likely to report a 5% weight loss in the past year if their doctor had told them they were overweight (adjusted OR (AOR) 1.88; 95% CI 1.45-2.44; AOR 1.79; 95% CI 1.30-2.46, respectively).\nCONCLUSIONS: Physicians’ direct discussion of their patients’ weight status is associated with clinically significant patient weight loss and may be a targetable intervention. Further studies are needed to determine if increasing physician discussion of patients’ weight status leads to significant weight loss.", "publicationTitle": "Obesity Research & Clinical Practice", "publisher": "", "place": "", "date": "2014 Mar-Apr", "volume": "8", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "e131-139", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Obes Res Clin Pract", "DOI": "10.1016/j.orcp.2013.03.003", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1871-403X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24743008\nPMCID: PMC4264677", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Attitude of Health Personnel", "type": 1 }, { "tag": "Body Mass Index", "type": 1 }, { "tag": "Communication", "type": 1 }, { "tag": "Directive Counseling", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Health Behavior", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Logistic Models", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Motivation", "type": 1 }, { "tag": "Nutrition Surveys", "type": 1 }, { "tag": "Overweight", "type": 1 }, { "tag": "Patient Satisfaction", "type": 1 }, { "tag": "Perception", "type": 1 }, { "tag": "Physician-Patient Relations", "type": 1 }, { "tag": "Prevalence", "type": 1 }, { "tag": "Referral and Consultation", "type": 1 }, { "tag": "United States", "type": 1 }, { "tag": "Weight Loss", "type": 1 }, { "tag": "Weight Reduction Programs", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2018-09-14T16:34:04Z", "dateModified": "2018-09-14T16:34:04Z" } }, { "key": "HKMHBAIM", "version": 33, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/HKMHBAIM", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/HKMHBAIM", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1613977, "username": "sstrayer", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/sstrayer", "type": "text/html" } } }, "creatorSummary": "Sutton et al.", "parsedDate": "2003-05", "numChildren": 0 }, "data": { "key": "HKMHBAIM", "version": 33, "itemType": "journalArticle", "title": "Assessing dietary and exercise stage of change to optimize weight loss interventions", "creators": [ { "creatorType": "author", "firstName": "Karen", "lastName": "Sutton" }, { "creatorType": "author", "firstName": "Everett", "lastName": "Logue" }, { "creatorType": "author", "firstName": "David", "lastName": "Jarjoura" }, { "creatorType": "author", "firstName": "Kristin", "lastName": "Baughman" }, { "creatorType": "author", "firstName": "William", "lastName": "Smucker" }, { "creatorType": "author", "firstName": "Cynthia", "lastName": "Capers" } ], "abstractNote": "OBJECTIVE: According to the Transtheoretical Model (TM), tailoring interventions to patients' readiness to change can enhance patient progress and help patients use therapeutic resources more effectively. However, tailoring an intervention depends on accurate assessment of patients' stage of change (SOC). This study describes a multi-item algorithm of SOC (M-SOC) for weight loss-related behaviors that attempts to overcome some of the conceptual and methodological difficulties encountered in previously SOC assessments.\nRESEARCH METHODS: Data were collected from participants randomly assigned to the treatment arm of a clinical trial comparing a TM-based, cognitive-behavioral intervention with enhanced usual care for weight loss.\nRESULTS: The stair-step relationships hypothesized by the TM between assessed SOC and key behavioral measures were found for all algorithms (p < 0.05), indicating that the M-SOC algorithm performs as well as single item algorithms. However, 50% fewer patients were classified in action or maintenance for dietary fat intake and portion control (p < 0.05) by the multiple-item algorithms, providing staging more consistent with the clinical presentation of obese individuals. In addition, logistic regression analyses indicated that the single-item algorithms were not sufficient predictors of these behavioral domains.\nDISCUSSION: To the extent that treatment is guided by assessed SOC, there is potential for a considerable variability in interventions with different approaches to staging. For weight-loss interventions that target portion control and decreased fat intake, the multi-item SOC algorithms seem to be better guides for matching treatments to SOC.", "publicationTitle": "Obesity Research", "publisher": "", "place": "", "date": "May 2003", "volume": "11", "issue": "5", "section": "", "partNumber": "", "partTitle": "", "pages": "641-652", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Obes. Res.", "DOI": "10.1038/oby.2003.92", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1071-7323", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 12740454", "tags": [ { "tag": "Algorithms", "type": 1 }, { "tag": "Behavior Therapy", "type": 1 }, { "tag": "Diet, Reducing", "type": 1 }, { "tag": "Exercise", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Health Behavior", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Life Style", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Models, Psychological", "type": 1 }, { "tag": "Obesity", "type": 1 }, { "tag": "Weight Loss", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2018-09-06T18:30:14Z", "dateModified": "2018-09-06T18:30:14Z" } }, { "key": "Z43AMRN2", "version": 32, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/Z43AMRN2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/Z43AMRN2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1613977, "username": "sstrayer", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/sstrayer", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "Z43AMRN2", "version": 32, "itemType": "webpage", "title": "Identification, Evaluation, and Treatment of Overweight and Obesity in - Books - NCBI", "creators": [], "abstractNote": "", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "https://www.ncbi.nlm.nih.gov/books/NBK2003/?term=Identification%2C%20Evaluation%2C%20and%20Treatment%20of%20Overweight%20and%20Obesity%20in%20Adults", "accessDate": "2018-09-06T18:20:38Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2018-09-06T18:20:38Z", "dateModified": "2018-09-06T18:20:38Z" } }, { "key": "VA99K9A4", "version": 31, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/VA99K9A4", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/VA99K9A4", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1613977, "username": "sstrayer", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/sstrayer", "type": "text/html" } } }, "creatorSummary": "Population et al.", "parsedDate": "2015-02-24", "numChildren": 0 }, "data": { "key": "VA99K9A4", "version": 31, "itemType": "book", "title": "Data from Major Studies of Premature Mortality", "creators": [ { "creatorType": "author", "firstName": "Committee on", "lastName": "Population" }, { "creatorType": "author", "firstName": "Division of Behavioral and Social Sciences and", "lastName": "Education" }, { "creatorType": "author", "firstName": "Board on Health Care", "lastName": "Services" }, { "creatorType": "author", "firstName": "National Research", "lastName": "Council" }, { "creatorType": "author", "firstName": "Institute of", "lastName": "Medicine" } ], "abstractNote": "Understanding the determinants of premature mortality has important implications for public health policy. Research over the last 20 years has shown that preventable factors—factors amenable to change—could account for 40 percent or more of premature deaths (McGinnis and Foege, 1993; Mokdad et al., 2004; Schroeder, 2007). However, new research studies can add to this body of work to reflect more recent mortality and risk factor data. Providing further impetus for examining current studies in this area are recent international comparisons showing that the United States compares poorly with other developed nations in longevity and years of life lost (YLL). Presenters described current data and analyses of the determinants of premature mortality.", "series": "", "seriesNumber": "", "volume": "", "numberOfVolumes": "", "edition": "", "date": "2015/02/24", "publisher": "National Academies Press (US)", "place": "", "originalDate": "", "originalPublisher": "", "originalPlace": "", "format": "", "numPages": "", "ISBN": "", "DOI": "", "citationKey": "", "url": "https://www.ncbi.nlm.nih.gov/books/NBK279981/", "accessDate": "2018-09-06T17:57:46Z", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "en", "libraryCatalog": "www.ncbi.nlm.nih.gov", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2018-09-06T17:57:46Z", "dateModified": "2018-09-06T17:57:46Z" } }, { "key": "UPVC8PL4", "version": 30, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/UPVC8PL4", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/UPVC8PL4", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1613977, "username": "sstrayer", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/sstrayer", "type": "text/html" } } }, "creatorSummary": "Jiles et al.", "parsedDate": "2005-12-02", "numChildren": 0 }, "data": { "key": "UPVC8PL4", "version": 30, "itemType": "journalArticle", "title": "Surveillance for certain health behaviors among states and selected local areas--Behavioral Risk Factor Surveillance System, United States, 2003", "creators": [ { "creatorType": "author", "firstName": "Ruth", "lastName": "Jiles" }, { "creatorType": "author", "firstName": "Elizabeth", "lastName": "Hughes" }, { "creatorType": "author", "firstName": "Wilmon", "lastName": "Murphy" }, { "creatorType": "author", "firstName": "Nicole", "lastName": "Flowers" }, { "creatorType": "author", "firstName": "Melissa", "lastName": "McCracken" }, { "creatorType": "author", "firstName": "Henry", "lastName": "Roberts" }, { "creatorType": "author", "firstName": "Margaret", "lastName": "Ochner" }, { "creatorType": "author", "firstName": "Lina", "lastName": "Balluz" }, { "creatorType": "author", "firstName": "Ali", "lastName": "Mokdad" }, { "creatorType": "author", "firstName": "Laurie", "lastName": "Elam-Evans" }, { "creatorType": "author", "firstName": "Wayne", "lastName": "Giles" } ], "abstractNote": "PROBLEM: Data on health risk behaviors (e.g., cigarette smoking, binge drinking, and physical inactivity) for chronic diseases and use of preventive practices (e.g., influenza and pneumococcal vaccination for adults aged > or =65 years and cholesterol screening) are essential for developing effective health education and intervention programs and policies to prevent morbidity and mortality from chronic diseases. Continuous monitoring of these behaviors and practices at the state, city, and county levels can help public health programs in evaluating progress toward improving their community's health.\nREPORTING PERIOD COVERED: Data collected in 2003 are presented for states, selected metropolitan and micropolitan statistical areas (MMSAs), and their counties.\nDESCRIPTION OF THE SYSTEM: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed telephone survey of the civilian, noninstitutionalized U.S. population aged > or =18 years. All 50 states, the District of Columbia, Guam, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands participated in BRFSS during 2003. Within these states and territories, 105 MMSAs and 153 counties that reported data for at least 500 respondents or a minimum sample size of 19 per weighting class were included in the analyses.\nRESULTS: Prevalence of high-risk behaviors for chronic diseases, awareness of certain medical conditions, and use of preventive health-care services varied substantially by state/territory, MMSA, and county. The proportion of the population that achieved Healthy People 2010 (HP 2010) objectives also varied by state/territory, MMSA, and county. Twelve states, 39 MMSAs, and 65 counties achieved the HP 2010 objective to reduce the proportion of adults who engage in no leisure-time physical activity to 20%. Twenty states, 41 MMSAs, and 63 counties achieved the HP 2010 goal of 50% of adults engaging in moderate physical activity for at least 30 minutes per day. The HP 2010 goal of 30% of adults who engage in vigorous physical activity was achieved by 17 states, 33 MMSAs, and 57 counties. Two states, one MMSA, and one county achieved the HP 2010 current cigarette smoking goal of 12% prevalence. One county achieved the HP 2010 binge drinking goal of 6% prevalence among adults. One MMSA and eight counties achieved the HP 2010 goal of 15% for obesity prevalence. The HP 2010 goal for influenza and pneumococcal vaccination coverage of 90% was not achieved by any state, MMSA, or county. No state, MMSA, or county achieved the HP 2010 objective of 17% prevalence of high cholesterol among adults.\nINTERPRETATION: The findings in this report indicate substantial variation in health risk behaviors and use of preventative services among adults at state and local levels, indicating a need for appropriate public health interventions and continued efforts to evaluate public health programs and policies and health-care-related efforts designed to reduce morbidity and mortality.\nPUBLIC HEALTH ACTION: Data from BRFSS are useful for assessing national health objectives, for identifying and characterizing at risk populations, and for designing and evaluating health promotion and disease prevention programs and policies. The 2003 BRFSS data indicate a continued need to develop and implement health promotion programs for targeting specific behaviors and practices and provides information for measuring progress towards achieving disease prevention and health promotion goals at state and local levels.", "publicationTitle": "Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.: 2002)", "publisher": "", "place": "", "date": "Dec 02, 2005", "volume": "54", "issue": "8", "section": "", "partNumber": "", "partTitle": "", "pages": "1-116", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "MMWR Surveill Summ", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1545-8636", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 16319816", "tags": [ { "tag": "Behavioral Risk Factor Surveillance System", "type": 1 }, { "tag": "Health Behavior", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Preventive Health Services", "type": 1 }, { "tag": "United States", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2018-09-06T17:39:36Z", "dateModified": "2018-09-06T17:39:36Z" } }, { "key": "JJAMD78W", "version": 29, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/JJAMD78W", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/JJAMD78W", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1613977, "username": "sstrayer", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/sstrayer", "type": "text/html" } } }, "creatorSummary": "Committee on Accelerating Progress in Obesity Prevention et al.", "parsedDate": "2012", "numChildren": 0 }, "data": { "key": "JJAMD78W", "version": 29, "itemType": "book", "title": "Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation", "creators": [ { "creatorType": "author", "name": "Committee on Accelerating Progress in Obesity Prevention" }, { "creatorType": "author", "name": "Food and Nutrition Board" }, { "creatorType": "author", "name": "Institute of Medicine" }, { "creatorType": "editor", "firstName": "Dan", "lastName": "Glickman" }, { "creatorType": "editor", "firstName": "Lynn", "lastName": "Parker" }, { "creatorType": "editor", "firstName": "Leslie J.", "lastName": "Sim" }, { "creatorType": "editor", "firstName": "Heather", "lastName": "Del Valle Cook" }, { "creatorType": "editor", "firstName": "Emily Ann", "lastName": "Miller" } ], "abstractNote": "One-third of adults are now obese, and children's obesity rates have climbed from 5 to 17 percent in the past 30 years. The causes of the nation's obesity epidemic are multi-factorial, having much more to do with the absence of sidewalks and the limited availability of healthy and affordable foods than a lack of personal responsibility. The broad societal changes that are needed to prevent obesity will inevitably affect activity and eating environments and settings for all ages. Many aspects of the obesity problem have been identified and discussed; however, there has not been complete agreement on what needs to be done to accelerate progress. Accelerating Progress in Obesity Prevention reviews previous studies and their recommendations and presents five key recommendations to accelerate meaningful change on a societal level during the next decade. The report suggests recommendations and strategies that, independently, can accelerate progress, but urges a systems approach of many strategies working in concert to maximize progress in accelerating obesity prevention. The recommendations in Accelerating Progress in Obesity Prevention include major reforms in access to and opportunities for physical activity; widespread reductions in the availability of unhealthy foods and beverages and increases in access to healthier options at affordable, competitive prices; an overhaul of the messages that surround Americans through marketing and education with respect to physical activity and food consumption; expansion of the obesity prevention support structure provided by health care providers, insurers, and employers; and schools as a major national focal point for obesity prevention. The report calls on all individuals, organizations, agencies, and sectors that do or can influence physical activity and nutrition environments to assess and begin to act on their potential roles as leaders in obesity prevention.", "series": "", "seriesNumber": "", "volume": "", "numberOfVolumes": "", "edition": "", "date": "2012", "publisher": "National Academies Press (US)", "place": "Washington (DC)", "originalDate": "", "originalPublisher": "", "originalPlace": "", "format": "", "numPages": "", "ISBN": "", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/books/NBK201141/", "accessDate": "2018-09-06T17:38:46Z", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "Accelerating Progress in Obesity Prevention", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "NBK201141", "rights": "Copyright 2012 by the National Academy of Sciences. All rights reserved.", "extra": "PMID: 24830053", "tags": [], "collections": [], "relations": {}, "dateAdded": "2018-09-06T17:38:46Z", "dateModified": "2018-09-06T17:38:46Z" } }, { "key": "IP5DDDD4", "version": 27, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/IP5DDDD4", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/IP5DDDD4", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1613977, "username": "sstrayer", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/sstrayer", "type": "text/html" } } }, "creatorSummary": "Goldstein et al.", "parsedDate": "2004-08", "numChildren": 0 }, "data": { "key": "IP5DDDD4", "version": 27, "itemType": "journalArticle", "title": "Multiple behavioral risk factor interventions in primary care. Summary of research evidence", "creators": [ { "creatorType": "author", "firstName": "Michael G.", "lastName": "Goldstein" }, { "creatorType": "author", "firstName": "Evelyn P.", "lastName": "Whitlock" }, { "creatorType": "author", "firstName": "Judith", "lastName": "DePue" }, { "creatorType": "author", "name": "Planning Committee of the Addressing Multiple Behavioral Risk Factors in Primary Care Project" } ], "abstractNote": "BACKGROUND: An important barrier to the delivery of health behavior change interventions in primary care settings is the lack of an integrated screening and intervention approach that can cut across multiple risk factors and help clinicians and patients to address these risks in an efficient and productive manner.\nMETHODS: We review the evidence for interventions that separately address lack of physical activity, an unhealthy diet, obesity, cigarette smoking, and risky/harmful alcohol use, and evidence for interventions that address multiple behavioral risks drawn primarily from the cardiovascular and diabetes literature.\nRESULTS: There is evidence for the efficacy of interventions to reduce smoking and risky/harmful alcohol use in unselected patients, and evidence for the efficacy of medium- to high-intensity dietary counseling by specially trained clinicians in high-risk patients. There is fair to good evidence for moderate, sustained weight loss in obese patients receiving high-intensity counseling, but insufficient evidence regarding weight loss interventions in nonobese adults. Evidence for the efficacy of physical activity interventions is limited. Large gaps remain in our knowledge about the efficacy of interventions to address multiple behavioral risk factors in primary care.\nCONCLUSIONS: We derive several principles and strategies for delivering behavioral risk factor interventions in primary care from the research literature. These principles can be linked to the \"5A's\" construct (assess, advise, agree, assist, and arrange-follow up) to provide a unifying conceptual framework for describing, delivering, and evaluating health behavioral counseling interventions in primary healthcare settings. We also provide recommendations for future research.", "publicationTitle": "American Journal of Preventive Medicine", "publisher": "", "place": "", "date": "Aug 2004", "volume": "27", "issue": "2 Suppl", "section": "", "partNumber": "", "partTitle": "", "pages": "61-79", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am J Prev Med", "DOI": "10.1016/j.amepre.2004.04.023", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0749-3797", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 15275675", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Alcohol Drinking", "type": 1 }, { "tag": "Cardiovascular Diseases", "type": 1 }, { "tag": "Counseling", "type": 1 }, { "tag": "Diet", "type": 1 }, { "tag": "Evidence-Based Medicine", "type": 1 }, { "tag": "Exercise", "type": 1 }, { "tag": "Health Behavior", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Obesity", "type": 1 }, { "tag": "Primary Health Care", "type": 1 }, { "tag": "Risk Factors", "type": 1 }, { "tag": "Smoking", "type": 1 }, { "tag": "Smoking Prevention", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2018-09-06T17:35:22Z", "dateModified": "2018-09-06T17:35:22Z" } }, { "key": "LVZ8R4JZ", "version": 26, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/LVZ8R4JZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/LVZ8R4JZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1613977, "username": "sstrayer", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/sstrayer", "type": "text/html" } } }, "creatorSummary": "Cifuentes et al.", "parsedDate": "2005-08", "numChildren": 0 }, "data": { "key": "LVZ8R4JZ", "version": 26, "itemType": "journalArticle", "title": "Prescription for health: changing primary care practice to foster healthy behaviors", "creators": [ { "creatorType": "author", "firstName": "Maribel", "lastName": "Cifuentes" }, { "creatorType": "author", "firstName": "Douglas H.", "lastName": "Fernald" }, { "creatorType": "author", "firstName": "Larry A.", "lastName": "Green" }, { "creatorType": "author", "firstName": "Linda J.", "lastName": "Niebauer" }, { "creatorType": "author", "firstName": "Benjamin F.", "lastName": "Crabtree" }, { "creatorType": "author", "firstName": "Kurt C.", "lastName": "Stange" }, { "creatorType": "author", "firstName": "Susan B.", "lastName": "Hassmiller" } ], "abstractNote": "PURPOSE: The leading causes of premature death in the United States are linked to 4 behaviors: smoking, unhealthy diet, physical inactivity, and risky alcohol use. We report lessons from 17 exploratory projects funded under Prescription for Health that tested the feasibility of innovative behavior change strategies for at least 2 of these behaviors in primary care practices.\nMETHODS: Seventeen practice-based research networks (PBRNs) implemented and evaluated tools, cues, and techniques in 120 family medicine, internal medicine, pediatric, and nursing practices across an ethnically diverse sample of adults, children, and adolescents in rural and urban settings. We reviewed progress reports and notes from site visits and 3 meetings to generate overarching lessons.\nRESULTS: PBRNs successfully implemented their projects in diverse practices despite reported logistical challenges and practice constraints. The networks showed that distributing the effort across the care team and throughout the practice and community is possible. Although each behavior required specific attention, each did not require its own separate staff and system. Three models emerged as helpful guides for the comprehensive redesign of health behavior counseling, but they require adaptation for use in real-world primary care settings. Traditional methods of collaboration yielded mixed results, making obvious a need for dedicated collaboration funds and a better framework to identify and align high-yield opportunities.\nCONCLUSIONS: These projects confirm the feasibility of health behavior counseling in primary care practice. They also highlight the need for substantive practice redesign, and the value of models and frameworks to guide redesign and collaborative efforts.", "publicationTitle": "Annals of Family Medicine", "publisher": "", "place": "", "date": "2005 Jul-Aug", "volume": "3 Suppl 2", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "S4-11", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Ann Fam Med", "DOI": "10.1370/afm.378", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1544-1717", "archive": "", "archiveLocation": "", "shortTitle": "Prescription for health", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 16049083\nPMCID: PMC1466978", "tags": [ { "tag": "Health Behavior", "type": 1 }, { "tag": "Health Promotion", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Primary Health Care", "type": 1 }, { "tag": "United States", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2018-09-06T17:34:10Z", "dateModified": "2018-09-06T17:34:10Z" } }, { "key": "HBA9Z67L", "version": 25, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/HBA9Z67L", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/HBA9Z67L", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1613977, "username": "sstrayer", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/sstrayer", "type": "text/html" } } }, "creatorSummary": "Ogden et al.", "parsedDate": "2012-02-01", "numChildren": 0 }, "data": { "key": "HBA9Z67L", "version": 25, "itemType": "journalArticle", "title": "Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010", "creators": [ { "creatorType": "author", "firstName": "Cynthia L.", "lastName": "Ogden" }, { "creatorType": "author", "firstName": "Margaret D.", "lastName": "Carroll" }, { "creatorType": "author", "firstName": "Brian K.", "lastName": "Kit" }, { "creatorType": "author", "firstName": "Katherine M.", "lastName": "Flegal" } ], "abstractNote": "CONTEXT: The prevalence of childhood obesity increased in the 1980s and 1990s but there were no significant changes in prevalence between 1999-2000 and 2007-2008 in the United States.\nOBJECTIVES: To present the most recent estimates of obesity prevalence in US children and adolescents for 2009-2010 and to investigate trends in obesity prevalence and body mass index (BMI) among children and adolescents between 1999-2000 and 2009-2010.\nDESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analyses of a representative sample (N = 4111) of the US child and adolescent population (birth through 19 years of age) with measured heights and weights from the National Health and Nutrition Examination Survey 2009-2010.\nMAIN OUTCOME MEASURES: Prevalence of high weight-for-recumbent length (≥95th percentile on the growth charts) among infants and toddlers from birth to 2 years of age and obesity (BMI ≥95th percentile of the BMI-for-age growth charts) among children and adolescents aged 2 through 19 years. Analyses of trends in obesity by sex and race/ethnicity, and analyses of trends in BMI within sex-specific age groups for 6 survey periods (1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, and 2009-2010) over 12 years.\nRESULTS: In 2009-2010, 9.7% (95% CI, 7.6%-12.3%) of infants and toddlers had a high weight-for-recumbent length and 16.9% (95% CI, 15.4%-18.4%) of children and adolescents from 2 through 19 years of age were obese. There was no difference in obesity prevalence among males (P = .62) or females (P = .65) between 2007-2008 and 2009-2010. However, trend analyses over a 12-year period indicated a significant increase in obesity prevalence between 1999-2000 and 2009-2010 in males aged 2 through 19 years (odds ratio, 1.05; 95% CI, 1.01-1.10) but not in females (odds ratio, 1.02; 95% CI, 0.98-1.07) per 2-year survey cycle. There was a significant increase in BMI among adolescent males aged 12 through 19 years (P = .04) but not among any other age group or among females.\nCONCLUSION: In 2009-2010, the prevalence of obesity in children and adolescents was 16.9%; this was not changed compared with 2007-2008.", "publicationTitle": "JAMA", "publisher": "", "place": "", "date": "Feb 01, 2012", "volume": "307", "issue": "5", "section": "", "partNumber": "", "partTitle": "", "pages": "483-490", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "JAMA", "DOI": "10.1001/jama.2012.40", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1538-3598", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22253364", "tags": [ { "tag": "Adolescent", "type": 1 }, { "tag": "Body Mass Index", "type": 1 }, { "tag": "Child", "type": 1 }, { "tag": "Child, Preschool", "type": 1 }, { "tag": "Cross-Sectional Studies", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Infant", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Nutrition Surveys", "type": 1 }, { "tag": "Obesity", "type": 1 }, { "tag": "Prevalence", "type": 1 }, { "tag": "United States", "type": 1 }, { "tag": "Young Adult", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2018-08-24T20:44:48Z", "dateModified": "2018-08-24T20:44:48Z" } }, { "key": "A3TIPXWZ", "version": 24, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/A3TIPXWZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/A3TIPXWZ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/291074/items/TIDBUFMU", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } } }, "data": { "key": "A3TIPXWZ", "version": 24, "parentItem": "TIDBUFMU", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-10-02T19:28:35Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/15068985", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-10-02T19:28:35Z", "dateModified": "2014-10-02T19:28:35Z" } }, { "key": "TIDBUFMU", "version": 24, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/TIDBUFMU", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/TIDBUFMU", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } }, "creatorSummary": "Whitlock et al.", "parsedDate": "2004-04-06", "numChildren": 1 }, "data": { "key": "TIDBUFMU", "version": 24, "itemType": "journalArticle", "title": "Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: a summary of the evidence for the U.S. Preventive Services Task Force", "creators": [ { "creatorType": "author", "firstName": "Evelyn P.", "lastName": "Whitlock" }, { "creatorType": "author", "firstName": "Michael R.", "lastName": "Polen" }, { "creatorType": "author", "firstName": "Carla A.", "lastName": "Green" }, { "creatorType": "author", "firstName": "Tracy", "lastName": "Orleans" }, { "creatorType": "author", "firstName": "Jonathan", "lastName": "Klein" }, { "creatorType": "author", "name": "U.S. Preventive Services Task Force" } ], "abstractNote": "BACKGROUND: Primary health care visits offer opportunities to identify and intervene with risky or harmful drinkers to reduce alcohol consumption.\nPURPOSE: To systematically review evidence for the efficacy of brief behavioral counseling interventions in primary care settings to reduce risky and harmful alcohol consumption.\nDATA SOURCES: Cochrane Database of Systematic Reviews, Database of Research Effectiveness (DARE), MEDLINE, Cochrane Controlled Clinical Trials, PsycINFO, HealthSTAR, CINAHL databases, bibliographies of reviews and included trials from 1994 through April 2002; update search through February 2003.\nSTUDY SELECTION: An inclusive search strategy (alcohol* or drink*) identified English-language systematic reviews or trials of primary care interventions to reduce risky/harmful alcohol use. Twelve controlled trials with general adult patients met our quality and relevance inclusion criteria.\nDATA EXTRACTION: Investigators abstracted study design and setting, participant characteristics, screening and assessment procedures, intervention components, alcohol consumption and other outcomes, and quality-related study details.\nDATA SYNTHESIS: Six to 12 months after good-quality, brief, multicontact behavioral counseling interventions (those with up to 15 minutes of initial contact and at least 1 follow-up), participants reduced the average number of drinks per week by 13% to 34% more than controls did, and the proportion of participants drinking at moderate or safe levels was 10% to 19% greater compared with controls. One study reported maintenance of improved drinking patterns for 48 months.\nCONCLUSIONS: Behavioral counseling interventions for risky/harmful alcohol use among adult primary care patients could provide an effective component of a public health approach to reducing risky/harmful alcohol use. Future research should focus on implementation strategies to facilitate adoption of these practices into routine health care.", "publicationTitle": "Annals of Internal Medicine", "publisher": "", "place": "", "date": "Apr 6, 2004", "volume": "140", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "557-568", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Ann. Intern. Med.", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1539-3704", "archive": "", "archiveLocation": "", "shortTitle": "Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 15068985", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Alcoholism", "type": 1 }, { "tag": "Behavior Therapy", "type": 1 }, { "tag": "Counseling", "type": 1 }, { "tag": "Evidence-Based Medicine", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Mass Screening", "type": 1 }, { "tag": "Primary Health Care", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-10-02T19:28:35Z", "dateModified": "2014-10-02T19:28:35Z" } }, { "key": "4JCXEQPC", "version": 23, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/4JCXEQPC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/4JCXEQPC", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/291074/items/Q5ZS7TPJ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } } }, "data": { "key": "4JCXEQPC", "version": 23, "parentItem": "Q5ZS7TPJ", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-10-02T19:28:01Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/15610331", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-10-02T19:28:01Z", "dateModified": "2014-10-02T19:28:01Z" } }, { "key": "Q5ZS7TPJ", "version": 23, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/Q5ZS7TPJ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/Q5ZS7TPJ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } }, "creatorSummary": "Wee et al.", "parsedDate": "2004-12", "numChildren": 1 }, "data": { "key": "Q5ZS7TPJ", "version": 23, "itemType": "journalArticle", "title": "Assessing the value of weight loss among primary care patients", "creators": [ { "creatorType": "author", "firstName": "Christina C.", "lastName": "Wee" }, { "creatorType": "author", "firstName": "Mary B.", "lastName": "Hamel" }, { "creatorType": "author", "firstName": "Roger B.", "lastName": "Davis" }, { "creatorType": "author", "firstName": "Russell S.", "lastName": "Phillips" } ], "abstractNote": "BACKGROUND: Modest weight loss of 10% of baseline weight is beneficial and achievable for overweight and obese patients. However, whether primary care patients value modest weight loss is unclear.\nOBJECTIVE: To quantify the value patients place on modest weight loss.\nDESIGN: Cross-sectional telephone survey.\nSETTING: Patients at a large hospital-based primary care practice.\nPARTICIPANTS: Three hundred sixty-five primary care patients (60% response rate).\nMEASUREMENTS: Utilities or value for weight loss estimated from willingness to risk death or trade time in exchange for losing different levels of weight (weight loss in pounds equivalent to a 5%, 10%, and 20% reduction in initial weight or to achieve a body mass index [BMI] of 25 kg/m2) using the standard gamble and time tradeoff formats.\nRESULTS: Of respondents, 15% of overweight (BMI, 25 to 29.9 kg/m2) and 42% of obese patients (BMI > or = 30 kg/m2) believed they needed to lose more than 10% of their weight to derive any health benefits. However, 18% of overweight and 33% of obese patients were willing to risk death to lose 10% of their weight. Patients with higher BMI valued higher degrees of weight loss. Among the overall sample, the utilities derived using standard gamble were 0.95 for current weight, 0.96 for 5% weight loss, 0.97 for 10% weight loss, and 0.98 for 20% weight loss; among obese patients, utilities were 0.88, 0.91, 0.93, and 0.96, respectively. Utilities derived using time tradeoff were lower but correlated with utilities derived from standard gamble. Utilities did not vary by education, gender, race, having comorbidities, or smoking.\nCONCLUSIONS: Many primary care patients value modest weight loss. The value placed on loss of 10% body weight among obese patients where utility improved from 0.88 to 0.93 is similar to recovery from major depression. Nevertheless, the majority of patients still do not highly value modest weight loss. Clinicians should emphasize the health benefits of modest weight loss when counseling about weight.", "publicationTitle": "Journal of General Internal Medicine", "publisher": "", "place": "", "date": "Dec 2004", "volume": "19", "issue": "12", "section": "", "partNumber": "", "partTitle": "", "pages": "1206-1211", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Gen Intern Med", "DOI": "10.1111/j.1525-1497.2004.40063.x", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0884-8734", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 15610331 \nPMCID: PMC1492598", "tags": [ { "tag": "Body Mass Index", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Interviews as Topic", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Obesity", "type": 1 }, { "tag": "Patients", "type": 1 }, { "tag": "Primary Health Care", "type": 1 }, { "tag": "Weight Loss", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-10-02T19:28:01Z", "dateModified": "2014-10-02T19:28:01Z" } }, { "key": "NUNINMSN", "version": 22, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/NUNINMSN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/NUNINMSN", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } }, "creatorSummary": "Sturm and Wells", "parsedDate": "2001-05", "numChildren": 1 }, "data": { "key": "NUNINMSN", "version": 22, "itemType": "journalArticle", "title": "Does obesity contribute as much to morbidity as poverty or smoking?", "creators": [ { "creatorType": "author", "firstName": "R.", "lastName": "Sturm" }, { "creatorType": "author", "firstName": "K. B.", "lastName": "Wells" } ], "abstractNote": "The prevalence of obesity is increasing in America, but its impact on morbidity relative to other health risks is unclear. This paper compares the effects of overweight, poverty, smoking and problem drinking on occurrence of chronic conditions and health-related quality of life. The data were collected from a nationally representative household telephone survey of 9585 adults fielded in 1998, using self-reported measures of height and weight, poverty, smoking status, problem drinking, chronic conditions and SF-12 global scales. Regression analyses were used to estimate effects of health risk factors on morbidity. Thirty-six percent of adults are overweight but not obese (25< or =BMI<30) and another 23% are obese (BMI> or =30). Controlling for demographics, obesity is associated with more chronic conditions and worse physical health-related quality of life (P<0.01). Smoking history and poverty predict having chronic conditions, but their effect sizes are significantly smaller. Even after controlling for chronic conditions, obesity predicts physical health-related quality of life, in that case with an effect size similar to poverty. The effect of problem drinking is always smaller. Obesity is highly prevalent and associated with at least as much morbidity as are poverty, smoking and problem drinking. Nevertheless, the latter have achieved more consistent attention in recent decades in clinical practice and public health policy.", "publicationTitle": "Public Health", "publisher": "", "place": "", "date": "May 2001", "volume": "115", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "229-235", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Public Health", "DOI": "10.1038/sj/ph/1900764", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0033-3506", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 11429721", "tags": [ { "tag": "Body Mass Index", "type": 1 }, { "tag": "Data Collection", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Health Behavior", "type": 1 }, { "tag": "Health Status Indicators", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Morbidity", "type": 1 }, { "tag": "Obesity", "type": 1 }, { "tag": "Poverty", "type": 1 }, { "tag": "Prevalence", "type": 1 }, { "tag": "Quality of Life", "type": 1 }, { "tag": "Smoking", "type": 1 }, { "tag": "United States", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-10-02T19:27:03Z", "dateModified": "2014-10-02T19:27:03Z" } }, { "key": "D26WNXIK", "version": 22, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/D26WNXIK", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/D26WNXIK", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/291074/items/NUNINMSN", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } } }, "data": { "key": "D26WNXIK", "version": 22, "parentItem": "NUNINMSN", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-10-02T19:27:03Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/11429721", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-10-02T19:27:03Z", "dateModified": "2014-10-02T19:27:03Z" } }, { "key": "3MWBDZTH", "version": 21, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/3MWBDZTH", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/3MWBDZTH", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/291074/items/ARZ68NBV", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } } }, "data": { "key": "3MWBDZTH", "version": 21, "parentItem": "ARZ68NBV", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-10-02T19:23:02Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/11802257", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-10-02T19:23:02Z", "dateModified": "2014-10-02T19:23:02Z" } }, { "key": "ARZ68NBV", "version": 21, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/ARZ68NBV", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/ARZ68NBV", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } }, "creatorSummary": "Stevens et al.", "parsedDate": "2002-02", "numChildren": 1 }, "data": { "key": "ARZ68NBV", "version": 21, "itemType": "journalArticle", "title": "Randomized trial of a brief dietary intervention to decrease consumption of fat and increase consumption of fruits and vegetables", "creators": [ { "creatorType": "author", "firstName": "Victor J.", "lastName": "Stevens" }, { "creatorType": "author", "firstName": "Russell E.", "lastName": "Glasgow" }, { "creatorType": "author", "firstName": "Deborah J.", "lastName": "Toobert" }, { "creatorType": "author", "firstName": "Njeri", "lastName": "Karanja" }, { "creatorType": "author", "firstName": "K. Sabina", "lastName": "Smith" } ], "abstractNote": "PURPOSE: This study tested the efficacy of a computer-assisted counseling intervention to reduce diet-related cancer risk.\nDESIGN: Randomized controlled trial.\nSUBJECTS: Healthy women HMO members (n = 616) aged 40 to 70.\nINTERVENTION: Participants were randomly assigned to nutrition intervention or an attention-control intervention unrelated to diet. Intervention consisted of two 45-minute counseling sessions plus two 5- to 10-minute follow-up telephone contacts. Counseling sessions included a 20-minute, interactive, computer-based intervention using a touchscreen format. Intervention goals were reducing dietary fat and increasing consumption of fruit, vegetables, and whole grains.\nMEASURES: Twenty-four hour diet recalls and the Fat and Fiber Behavior Questionnaire (FFB).\nRESULTS: Four-month follow-up data were collected from 94% of the intervention participants and 91% of the controls. Testing with a multivariate general linear models analysis showed improvements on all dietary outcome variables. Compared to the control, intervention participants reported significantly less fat consumption (2.35 percentage points less for percentage of energy from fat), significantly greater consumption of fruit and vegetables combined (1.04 servings per day), and a significant reduction in a behavioral measure of fat consumption (.24 point change in the FFB).\nCONCLUSIONS: These 4-month results are comparable to several other moderate-intensity studies showing that, in the appropriate circumstances, moderate-intensity dietary interventions can be efficacious. Study limitations include the short follow-up period and the use of self-reported outcome measures.", "publicationTitle": "American journal of health promotion: AJHP", "publisher": "", "place": "", "date": "2002 Jan-Feb", "volume": "16", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "129-134", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am J Health Promot", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0890-1171", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 11802257", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Behavior Therapy", "type": 1 }, { "tag": "Computers", "type": 1 }, { "tag": "Counseling", "type": 1 }, { "tag": "Dietary Fats", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Follow-Up Studies", "type": 1 }, { "tag": "Fruit", "type": 1 }, { "tag": "Health Maintenance Organizations", "type": 1 }, { "tag": "Health Promotion", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Nutritional Sciences", "type": 1 }, { "tag": "Oregon", "type": 1 }, { "tag": "Questionnaires", "type": 1 }, { "tag": "Vegetables", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-10-02T19:23:02Z", "dateModified": "2014-10-02T19:23:02Z" } }, { "key": "W66K4N3U", "version": 20, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/W66K4N3U", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/W66K4N3U", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/291074/items/MA2E2Z5G", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } } }, "data": { "key": "W66K4N3U", "version": 20, "parentItem": "MA2E2Z5G", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-10-02T19:20:18Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/10910311", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-10-02T19:20:18Z", "dateModified": "2014-10-02T19:20:18Z" } }, { "key": "MA2E2Z5G", "version": 20, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/MA2E2Z5G", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/MA2E2Z5G", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } }, "creatorSummary": "Stafford et al.", "parsedDate": "2000-07", "numChildren": 1 }, "data": { "key": "MA2E2Z5G", "version": 20, "itemType": "journalArticle", "title": "National patterns of physician activities related to obesity management", "creators": [ { "creatorType": "author", "firstName": "R. S.", "lastName": "Stafford" }, { "creatorType": "author", "firstName": "J. H.", "lastName": "Farhat" }, { "creatorType": "author", "firstName": "B.", "lastName": "Misra" }, { "creatorType": "author", "firstName": "D. A.", "lastName": "Schoenfeld" } ], "abstractNote": "CONTEXT: National physician practices related to the clinical recognition and management of obesity are unknown.\nOBJECTIVES: To estimate national patterns of office-based, obesity-related practices and to determine the independent predictors of these practices.\nDESIGN: Serial cross-sectional surveys of physician office visits.\nSETTING: Ambulatory medical care in the United States.\nPATIENTS: We analyzed 55,858 adult physician office visits sampled in the 1995-1996 National Ambulatory Medical Care Surveys. Data from the Third National Health and Nutrition Examination Surveys, 1988-1994 were used to assess and, then, adjust for the underreporting of obesity.\nMAIN OUTCOME MEASURES: Reporting of obesity at office visits and physician counseling for weight loss, exercise, and diet among patients identified as obese.\nRESULTS: Physicians reported obesity in only 8.6% of 1995-1996 National Ambulatory Medical Care Surveys visits. The 22.7% prevalence rate of the Third National Health and Nutrition Examination Surveys, 1988-1994 suggests that physicians reported obesity in only 38% of their obese patients. Among visits by patients identified as obese, physicians frequently provided counseling for weight loss (35.5%), exercise (32.8%), and diet (41.5%). Adjusted for population prevalence; however, each service was provided to no more than one quarter of all obese patients. While patients with obesity-related comorbidities were treated more aggressively, in these patients, weight loss counseling occurred at only 52% of the visits.\nCONCLUSIONS: Specific interventions to address obesity are infrequent in visits to US physicians. Obesity is underreported and interventions are only moderately likely among patients identified as obese, even for those with serious obesity-related comorbidities.", "publicationTitle": "Archives of Family Medicine", "publisher": "", "place": "", "date": "Jul 2000", "volume": "9", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "631-638", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Arch Fam Med", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1063-3987", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 10910311", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Counseling", "type": 1 }, { "tag": "Cross-Sectional Studies", "type": 1 }, { "tag": "Data Collection", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Logistic Models", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Multivariate Analysis", "type": 1 }, { "tag": "Obesity", "type": 1 }, { "tag": "Physician's Practice Patterns", "type": 1 }, { "tag": "Risk Factors", "type": 1 }, { "tag": "United States", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-10-02T19:20:18Z", "dateModified": "2014-10-02T19:20:18Z" } }, { "key": "NUF7XHZD", "version": 19, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/NUF7XHZD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/NUF7XHZD", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } }, "creatorSummary": "Smith et al.", "parsedDate": "2013-03", "numChildren": 1 }, "data": { "key": "NUF7XHZD", "version": 19, "itemType": "journalArticle", "title": "Health information technology in screening and treatment of child obesity: a systematic review", "creators": [ { "creatorType": "author", "firstName": "Anna Jo", "lastName": "Smith" }, { "creatorType": "author", "firstName": "Áine", "lastName": "Skow" }, { "creatorType": "author", "firstName": "Joann", "lastName": "Bodurtha" }, { "creatorType": "author", "firstName": "Sanjay", "lastName": "Kinra" } ], "abstractNote": "BACKGROUND AND OBJECTIVES: Childhood obesity is a major problem in the United States, yet screening and treatment are often inaccessible or ineffective. Health information technology (IT) may improve the quality, efficiency, and reach of chronic disease management. The objective of this study was to review the effect of health IT (electronic health records [EHRs], telemedicine, text message or telephone support) on patient outcomes and care processes in pediatric obesity management.\nMETHODS: Medline, Embase, and the Cochrane Registry of Controlled Trials were searched from January 2006 to April 2012. Controlled trials, before-and-after studies, and cross-sectional studies were included if they used IT to deliver obesity screening or treatment to children aged 2 to 18 and reported impact on patient outcomes (BMI, dietary or physical activity behavior change) or care processes (BMI screening, comorbidity testing, diet, or physical activity counseling). Two independent reviewers extracted data and assessed trial quality.\nRESULTS: Thirteen studies met inclusion criteria. EHR use was associated with increased BMI screening rates in 5 of 8 studies. Telemedicine counseling was associated with changes in BMI percentile similar to that of in-person counseling and improved treatment access in 2 studies. Text message or telephone support was associated with weight loss maintenance in 1 of 3 studies.\nCONCLUSIONS: To date, health IT interventions have improved access to obesity treatment and rates of screening. However, the impact on weight loss and other health outcomes remains understudied and inconsistent. More interactive and time-intensive interventions may enhance health IT's clinical effectiveness in chronic disease management.", "publicationTitle": "Pediatrics", "publisher": "", "place": "", "date": "Mar 2013", "volume": "131", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "e894-902", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Pediatrics", "DOI": "10.1542/peds.2012-2011", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1098-4275", "archive": "", "archiveLocation": "", "shortTitle": "Health information technology in screening and treatment of child obesity", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 23382447", "tags": [ { "tag": "Child", "type": 1 }, { "tag": "Controlled Clinical Trials as Topic", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Mass Screening", "type": 1 }, { "tag": "Medical Informatics", "type": 1 }, { "tag": "Obesity", "type": 1 }, { "tag": "Telemedicine", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 }, { "tag": "Weight Loss", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-10-02T19:18:24Z", "dateModified": "2014-10-02T19:18:24Z" } }, { "key": "C3WFBRQQ", "version": 19, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/C3WFBRQQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/C3WFBRQQ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/291074/items/NUF7XHZD", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } } }, "data": { "key": "C3WFBRQQ", "version": 19, "parentItem": "NUF7XHZD", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-10-02T19:18:24Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/23382447", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-10-02T19:18:24Z", "dateModified": "2014-10-02T19:18:24Z" } }, { "key": "K64ZVU89", "version": 18, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/K64ZVU89", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/K64ZVU89", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/291074/items/XKQK58IB", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } } }, "data": { "key": "K64ZVU89", "version": 18, "parentItem": "XKQK58IB", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-10-02T19:17:20Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/15110061", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-10-02T19:17:20Z", "dateModified": "2014-10-02T19:17:20Z" } }, { "key": "XKQK58IB", "version": 18, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/XKQK58IB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/XKQK58IB", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } }, "creatorSummary": "van Sluijs et al.", "parsedDate": "2004-05", "numChildren": 1 }, "data": { "key": "XKQK58IB", "version": 18, "itemType": "journalArticle", "title": "Stage-based lifestyle interventions in primary care: are they effective?", "creators": [ { "creatorType": "author", "firstName": "Esther M. F.", "lastName": "van Sluijs" }, { "creatorType": "author", "firstName": "Mireille N. M.", "lastName": "van Poppel" }, { "creatorType": "author", "firstName": "Willem", "lastName": "van Mechelen" } ], "abstractNote": "BACKGROUND: To systematically review the literature concerning the effect of stages-of-change-based interventions in primary care on smoking, physical activity, and dietary behavior.\nMETHODS: An extensive search (until July 2002) was performed using the following inclusion criteria: (1) (randomized) controlled trial (RCT/CT), (2) intervention initiated in primary care, (3) and intervention aimed at changing smoking, physical activity, or dietary behavior, and stages-of-change-based outcomes, and (4) behavioral outcomes. Methodologic quality was assessed, and conclusions on the effectiveness at short-, medium-, and long-term follow-up were based on a rating system of five levels of evidence. Odds ratios were calculated when methodologically appropriate.\nRESULTS: A total of 29 trials were selected for inclusion. Thirteen studies included a physical activity intervention, 14 aimed at smoking cessation, and five included a dietary intervention. Overall methodologic quality was good. No evidence was found for an effect on stages of change and actual levels of physical activity. Based on the strength of the evidence, limited to no evidence was found for an effect on stages of change for smoking and smoking quit rates. Odds ratios for quitting smoking showed a positive trend. Strong evidence was found for an effect on fat intake at short- and long-term follow-up. Limited evidence was found for an effect on stages of change for fat intake at short-term follow-up.\nCONCLUSIONS: The scientific evidence for the effect of stages-of-change-based lifestyle interventions in primary care is limited. Limiting aspects in the stages-of-change concept with respect to complex behaviors as physical activity and dietary behavior are discussed.", "publicationTitle": "American Journal of Preventive Medicine", "publisher": "", "place": "", "date": "May 2004", "volume": "26", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "330-343", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am J Prev Med", "DOI": "10.1016/j.amepre.2003.12.010", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0749-3797", "archive": "", "archiveLocation": "", "shortTitle": "Stage-based lifestyle interventions in primary care", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 15110061", "tags": [ { "tag": "Diet", "type": 1 }, { "tag": "Health Promotion", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Life Style", "type": 1 }, { "tag": "Odds Ratio", "type": 1 }, { "tag": "Physical Fitness", "type": 1 }, { "tag": "Primary Health Care", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Smoking Cessation", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-10-02T19:17:20Z", "dateModified": "2014-10-02T19:17:20Z" } }, { "key": "28R523S3", "version": 17, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/28R523S3", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/28R523S3", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } }, "creatorSummary": "Serdula et al.", "parsedDate": "2003-04-09", "numChildren": 1 }, "data": { "key": "28R523S3", "version": 17, "itemType": "journalArticle", "title": "Weight loss counseling revisited", "creators": [ { "creatorType": "author", "firstName": "Mary K.", "lastName": "Serdula" }, { "creatorType": "author", "firstName": "Laura Kettel", "lastName": "Khan" }, { "creatorType": "author", "firstName": "William H.", "lastName": "Dietz" } ], "abstractNote": "", "publicationTitle": "JAMA", "publisher": "", "place": "", "date": "Apr 9, 2003", "volume": "289", "issue": "14", "section": "", "partNumber": "", "partTitle": "", "pages": "1747-1750", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "JAMA", "DOI": "10.1001/jama.289.14.1747", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0098-7484", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 12684339", "tags": [ { "tag": "Algorithms", "type": 1 }, { "tag": "Chronic Disease", "type": 1 }, { "tag": "Counseling", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Obesity", "type": 1 }, { "tag": "Program Development", "type": 1 }, { "tag": "Risk Assessment", "type": 1 }, { "tag": "Weight Loss", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-10-02T19:16:20Z", "dateModified": "2014-10-02T19:16:20Z" } }, { "key": "VQNZJZKQ", "version": 17, "library": { "type": "group", "id": 291074, "name": "WeightAdvisor manuscript", "links": { "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/291074/items/VQNZJZKQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/weightadvisor_manuscript/items/VQNZJZKQ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/291074/items/28R523S3", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2013145, "username": "nstuessyfmc14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/nstuessyfmc14", "type": "text/html" } } } }, "data": { "key": "VQNZJZKQ", "version": 17, "parentItem": "28R523S3", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-10-02T19:16:20Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/12684339", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-10-02T19:16:20Z", "dateModified": "2014-10-02T19:16:20Z" } } ]