Search Results (111)

Background/Objectives: Obesity is a chronic, relapsing disease with a widening gap between clinical need and the availability of specialist care. Artificial intelligence (AI) may enable earlier risk detection, more precise phenotyping, and scalable behavioural support across obesity treatment pathways. This narrative review synthesises contemporary AI applications across the obesity care continuum and evaluates their translational readiness. Methods: A targeted search of PubMed/MEDLINE and Google Scholar (January 2024–January 2026) was conducted, complemented by citation chaining. Evidence was synthesised across four domains: (1) risk prediction and screening, (2) environmental and behavioural determinants, (3) multimodal phenotyping and precision stratification, and (4) AI-enabled lifestyle interventions and behavioural coaching (AIBC). Results: Electronic health record (EHR)-based models demonstrate clinically useful discrimination for early risk identification. Multimodal approaches refine stratification beyond body mass index (BMI)-centric classification. AI-enabled behavioural coaching (AIBC) platforms show emerging evidence of clinically meaningful weight loss, including non-inferiority to human coaching; however, long-term effectiveness, generalisability, and equity remain insufficiently established. Conclusions: AI is positioned to become a core enabler of personalised obesity pathways. Safe translation requires external validation, bias auditing, transparent reporting, human oversight, and post-deployment surveillance aligned with clinical guidelines and regulatory expectations. Full article

During pregnancy, women are more inclined to modify their habits and lifestyle to find a new balance and promote well-being for themselves and the child-to-be. However, the availability of nutritional and psychological support is often limited by stigma, geographic barriers, and a lack of services. Digital health tools are emerging as possible solutions to cover these needs. This study explores the acceptability, feasibility, and user experience of Demetra, a virtual coach based on Acceptance and Commitment Therapy (ACT), designed to promote healthy lifestyles and mental well-being. Fifty pregnant women will be enrolled in the feasibility study of the intervention. It starts with an educational part on the foundations of healthy eating and suggestions about lifestyle habits, followed by a six-week psychoeducational module. Content is delivered through text, audio, and video formats. User experience and engagement will be measured through validated questionnaires and semi-structured interviews. Psychological well-being will be evaluated both before and after the program. The intervention is expected to be well-received, with high levels of satisfaction and engagement, leading to a greater awareness of healthy behaviors, improved psychological flexibility, and enhanced overall well-being. Demetra offers an accessible solution to support women through the transformative experience of motherhood with a multidisciplinary and innovative approach. Full article

Endocrine-disrupting chemical (EDC) exposure from plastics and everyday products is widespread and linked to infertility. We conducted a 3-month uncontrolled feasibility pilot study among five idiopathically infertile couples to assess whether an intensive lifestyle intervention was associated with within-person changes in urinary EDC biomarkers and exploratory changes in reproductive parameters. The intervention was embedded in a film project (“The Plastic Detox”) and integrated personalized education, product substitutions, at-home urine biomonitoring, sperm testing, and weekly coaching. Urine and semen samples were collected at baseline, 6 weeks, and 12 weeks. Linear mixed-effects models were used to estimate biomarker changes. BPA was designated a priori as the primary biomarker endpoint. Directional reductions were observed in urinary bisphenol A (BPA), mono-n-butyl phthalate (MBP), and monobenzyl phthalate (MBzP) over the intervention period. Within-person reductions in products containing ingredients of concern were associated with lower BPA levels. Descriptive upward trends of semen parameters were observed, with the majority of the subfertile men testing >40 million motile sperm/ejaculate after the intervention. Participants had increased environmental health literacy, were more motivated to reduce exposures, and reported improved wellness endpoints. Four couples achieved pregnancy and live birth during follow-up; given the uncontrolled design and small sample size, these outcomes are presented descriptively. Overall, this pilot study demonstrates feasibility and measurable biomarker change, supporting evaluation in larger, controlled trials. Full article

Background: A sedentary behavior and being overweight represent major public health issues associated with both physical and psychological risks. Based on self-determination theory (SDT), the psychoeducational intervention PsicoFIT—a component of the TIGREFIT program—aims to foster motivation toward physical activity, to promote healthy habits, and to reduce psychological ill-being in sedentary adults who are overweight and are fans of a football club. Methods: This protocol corresponds to a longitudinal comparative pragmatic clinical trial, designed in accordance with the recommendations of the SPIRIT Statement. The intervention, preceded by a training program for the coaches involved, will comprise 12 weekly modules delivered in two modalities: (1) face-to-face, through group sessions, and (2) semi face-to-face, through short video capsules hosted on a digital platform. Changes associated with the intervention will be evaluated using hierarchical multiple regression and pre-post comparisons, assessing baseline and post-intervention data within and between the intervention modalities. Primary outcomes will include changes in healthy lifestyle and burnout as indicators of well-being and ill-being, respectively. Secondary outcomes will assess basic psychological needs satisfaction and autonomous motivation as potential mediators of these effects, as well as the coach’s controlling interpersonal style as a possible contextual predictor. The modality of participation will be analyzed as a potential moderator of the observed changes. Finally, the acceptability and perceived contribution of the intervention will be explored through a focus group. Discussion: PsicoFIT will provide a methodological framework for designing interventions within multicomponent programs aimed at promoting healthy lifestyles and psychological well-being in sedentary adults who are overweight, considering the social context of football fandom and allowing for an exploration of the impact of the face-to-face and semi-face-to-face modalities. Future empirical application of the protocol will help verify its effectiveness, guide adaptations across contexts, and contribute to the development of evidence-based interventions. Conclusions: The implementation of PsicoFit will allow for the evaluation of its effectiveness, psychological mechanisms, and delivery modalities, thus guiding future evidence-based interventions in sport. Full article

Background/Objectives: Hypertensive disorders of pregnancy (HDP) increase the risk of cardiovascular disease (CVD), but few studies have explored the efficacy of lifestyle interventions to improve CVD risk post-HDP. This study compared the 6 month (6M) and 12 month (12M) dietary and physical activity outcomes of women post-HDP participating in one of three lifestyle interventions. Methods: This sub-study of the Blood Pressure Postpartum (BP²) randomised controlled trial included participants from six hospitals across Sydney, Australia, randomly assigned to one of three groups: Group 1 (usual care) received general postpartum health information; Group 2 (brief education) received usual care plus an individualised cardiovascular risk assessment and lifestyle counselling; Group 3 (extended lifestyle) received all Group 2 components plus enrolment in a six-month telephone coaching programme. Baseline and post-intervention data were collected at 6M and 12M, respectively. Diet and physical activity were assessed using the NSW Population Health Survey, alongside cardiometabolic measures. Results: Overall, 405 women provided complete 6M and 12M data (Group 1 n = 129, Group 2 n = 137, Group 3 n = 139). From 6M to 12M, Group 3 increased their vegetable serves/day (3.0 vs. 2.0, p = 0.001). No significant changes in fruit intake and physical activity levels were observed among groups. Groups 2 and 3 reported that nutritional information had a greater influence on their food choices at 12M (p = 0.010 and p < 0.001, respectively). At 12M, higher vegetable and fruit intake correlated with lower body mass index (BMI) (p = 0.006, p = 0.003) and waist circumference (p = 0.035, p = 0.014), and increased vigorous and strength exercise correlated with lower BMI (p = 0.005, p = 0.003) and waist circumference (p < 0.001, p < 0.001). Conclusions: Intensive lifestyle interventions improved vegetable intake and nutrition awareness in post-HDP women at 12M, holding promise for long-term cardiometabolic health benefits. Full article

Background: Chronic diseases such as type 2 diabetes mellitus and cardiovascular disease and their cardiometabolic risk factors require management, which includes lifestyle interventions. Rural and remote residents are disproportionately affected by these conditions compared to their urban counterparts. Studies have examined barriers to chronic disease and cardiometabolic risk factor management in urban environments, but rural perspectives remain underexplored, especially in Western Australia (WA) with its vast geography. This study examined rural general practitioners’ (GPs) views on barriers and facilitators to chronic disease and cardiometabolic care in rural WA through lifestyle management. Methods: This qualitative study used semi-structured interviews with 15 rural WA GPs recruited via rural networks using convenience and snowball sampling. Braun and Clarke’s reflexive thematic analysis was used to identify patterns and themes within the qualitative data that addressed the study questions. Results: According to rural general practitioners, major barriers to chronic disease and cardiometabolic risk care included geographic isolation, socioeconomic disadvantage and an obesogenic food environment in rural areas, as well as severe time and financial constraints for GPs and workforce shortages with a high turnover and lack of accessible allied health professionals. Facilitators included co-located multidisciplinary teams, case management/health coaching, better remuneration for complex consultations involving preventive care and upstream policy measures, such as improving healthy food affordability and availability. Conclusion: Rural patients face systemic, geographic and socioeconomic barriers that are substantially greater than those in urban settings; these barriers impact GPs caring for their patients with chronic disease and cardiometabolic risk factors. Targeted solutions to these barriers such as attention to workforce issues, investment in lifestyle coaching approaches and having dedicated case managers, could reduce rural–urban inequities in chronic disease outcomes. Full article

Background/Objectives: Physical inactivity and sedentary lifestyles remain leading behavioral risk factors for chronic disease across generations. Mothers with young children face unique barriers to exercise, including time constraints, fatigue, and limited access to supportive environments. Lion Hearts was developed to address these barriers through a family-centered, community-based approach that integrates physical activity, strength training, and health education. This protocol describes the systematic application of the Intervention Mapping (IM) framework to develop Lion Hearts, a multigenerational CrossFit-based program for mothers and children. Methods: Following the first four steps of the IM framework—needs assessment, matrices, intervention design, and program creation—behavioral determinants were identified through literature review, national data, and community input. The resulting 12-week program integrates twice-weekly family CrossFit sessions, monthly cardiovascular health workshops, and weekly home-based challenges delivered through local affiliates using a train-the-trainer model. Results: IM produced a theoretically grounded and evidence-based intervention targeting individual (self-efficacy, outcome expectations), interpersonal (modeling, relatedness), and environmental (access, social support) determinants. The process resulted in detailed logic models, behavior change matrices, and implementation materials, including family handbooks and coach guides. Conclusions:Lion Hearts represents a scalable, multigenerational approach to CVD prevention that leverages existing community fitness infrastructure. By embedding prevention within family systems and CrossFit affiliates, the program offers a sustainable, replicable model to enhance physical activity, strengthen family health behaviors, and reduce intergenerational CVD risk. Full article

Background/Objectives: Type 2 diabetes (T2D) is a growing health epidemic. Innovative approaches such as digital technologies incorporating peer-supported coaching have shown promise in diabetes prevention. This study aimed to examine the feasibility and effect on weight of a digitally-enabled peer support program in inner-regional Sydney. Methods: A pre-post study of a digitally-enabled peer support initiative promoted weight management and lifestyle changes in participants at risk of T2D in inner-regional Sydney. Participants were recruited primarily from general practices and community groups. Participants received initial guidance, educational videos, goal-setting tools, and self-assessment weights, while volunteer peer support facilitators provided ongoing support through action planning and monthly calls. Baseline and follow-up weights at 6 months were collected to determine program effectiveness, while feasibility was evaluated through short exit interviews and analytic website data. Results: Most eligible participants (92.4%) were recruited through general practice. Program completers (n = 35, 43.8%) reported an average weight reduction of 3.7 kg (SD = 3.9, p < 0.001). Those who used the platform to log at least one achievement saw a greater reduction in weight than those who did not log achievements (mean difference = −2.9 kg, 95% CI −5.6 to −0.1, p = 0.049). Exploratory qualitative analysis of exit interviews revealed challenges surrounding technology, website interaction, scheduling conflicts, data collection, and attrition. Conclusions: Preliminary results indicate that this digital program was associated with significant weight reduction among individuals at risk of diabetes in an inner-regional area of Sydney. Recruitment was most effective via general practices, highlighting the potential for such a program to be promoted through this setting. Full article

Hypertension is a major chronic condition affecting older adults in the United States. The condition imposes clinical and economic burdens. Self-efficacy, or confidence in managing health, is crucial for effective self-management of hypertension. This study explored the relationships between socio-demographics, health status, and confidence in following provider recommendations for controlling hypertension among Medicare beneficiaries. The 2021 Medicare Current Beneficiary Survey was analyzed, including responses from 5838 beneficiaries aged ≥65 years with reported hypertension. A three-level categorical dependent variable ((1) very confident/confident, (2) somewhat confident, and (3) not confident (reference group)) based on provider recommendations for lifestyle changes for hypertension control was created. A survey-weighted multinomial logit model examined associations between socio-demographics and self-reported health status and the dependent variable. Among respondents, 70.8%, 21.4%, and 7.8%, respectively, were very confident/confident, somewhat confident, and not confident in following provider recommendations for lifestyle changes to control hypertension. Beneficiaries with obesity, fair/poor general health, and limitations in basic activities of daily living or instrumental activities of daily living were less likely to report being very confident/confident. The findings of this cross-sectional study highlighted the potential need for targeted support (e.g., tailored health coaching, peer mentoring) of lifestyle changes for at-risk older adults to manage hypertension. Full article

Background: Patients with early-stage (I–IIIA) resectable non-small cell lung cancer (NSCLC) often experience reduced physical activity (PA) after surgery. PA telecoaching may support a more active lifestyle, but evidence in this population is limited. Objective: To evaluate acceptability, feasibility, safety, and actual usage of an automated and manual PA telecoaching program following surgery for NSCLC. Methods: In this multicenter, single-blind study, patients received either an eight-week automated coaching program (ACP) with a customized smartphone app or a manual coaching program (MCP) with weekly phone calls from a coach. Both groups used an activity tracker, linked to their smartphone, to monitor steps and receive feedback. Primary outcomes included acceptability, feasibility, safety and usage, assessed via questionnaires and interviews. Secondary outcomes included objectively measured PA (accelerometry), functional exercise capacity (six-minute walk distance) and symptoms (dyspnea, fatigue) and quality of life, evaluated via questionnaires. Results: Nineteen patients (12 males; 68 ± 6 years; baseline daily steps 7820 ± 2799) were included. The majority (18/19) found the intervention enjoyable, and a minority (6/19) reported minor smartphone issues. All patients wore the activity tracker consistently. No adverse events occurred. The ACP required significantly less coach contact time compared to the MCP (25 ± 14 vs. 54 ± 15 min, p = 0.0003). No other differences in primary outcomes were observed between groups. Changes in secondary outcomes were limited in both groups. Conclusion: PA telecoaching is feasible, well accepted, and safe in patients with NSCLC post-surgery, with excellent activity tracker adherence. The ACP required less coach involvement. However, increasing PA remains challenging, and no conclusions can be made about the effectiveness of telecoaching. Future research should explore longer interventions in larger populations to assess efficacy and long-term outcomes. Full article

Background/Objectives: Evidence-based lifestyle coaching programs have been developed to support people with disabilities in adopting healthy behaviors, and to ultimately contribute to enhancing their overall well-being. However, when implementing such programs in new settings, adaptations may be needed to ensure a successful implementation process. This study aimed to explore professionals’ perceptions on an adapted evidence-informed lifestyle coaching program (Healthy Habits Coaching) for people with physical disabilities to inform the implementation of the program in Dutch rehabilitation and/or community settings. Methods: A qualitative study with semi-structured interviews was conducted. The study was performed from a pragmatic perspective using an integrated knowledge translation approach. Ten professionals who had experience with offering, delivering, and/or implementing lifestyle coaching programs were enrolled. Interview questions focused on participants’ perceptions on implementing the Healthy Habits Coaching in Dutch settings. A directed content analysis was used to analyze the data. Results: Participants highlighted the importance of implementing lifestyle coaching tailored to people with physical disabilities. While participants were generally positive about the implementation of Healthy Habits Coaching, they had mixed opinions on its added value alongside existing lifestyle programs and on the core components, particularly the free coaching model and the use of volunteer coaches with lived experience. Participants underlined that for a successful adoption and implementation, the added value, (scientific) foundation, financial basis, and organizational structure of the program should be clearly communicated. Conclusions: The findings provide directions for how, where, and by whom an adapted lifestyle program (Healthy Habits Coaching) for people with physical disabilities could be implemented in Dutch rehabilitation and community settings. This study demonstrates an example of how an evidence-based lifestyle program can be prepared for implementation in a new setting, presenting an efficient and promising strategy to enhance overall well-being among people with disabilities. Full article

Background: Despite significant advancements in diabetes care, many individuals with type 2 diabetes (T2D) do not receive optimal care and treatment. Digital interventions promoting behavioral changes have shown promising long-term results in supporting healthier lifestyles but are not implemented in most healthcare offerings, maybe due to lack of general practice support and collaboration. This study evaluates the efficacy of the Digital, Individualized, and Collaborative Treatment of T2D in General Practice Based on Decision Aid (DICTA), a randomized controlled trial integrating a patient-centered smartphone application for lifestyle support in conjunction with a clinical decision support (CDS) tool to assist general practitioners (GPs) in optimizing antidiabetic treatment. Methods: The present randomized controlled trial aims to recruit 400 individuals with T2D from approximately 70 GP clinics (GPCs) in Denmark. The GPCs will be cluster-randomized in a 2:3 ratio to intervention or control groups. The intervention group will receive one year of individualized eHealth lifestyle coaching via a smartphone application, guided by patient-reported outcomes (PROs). Alongside this, the GPCs will have access to the CDS tool to optimize pharmacological decision-making through electronic health records. The control group will receive usual care for one year, followed by the same intervention in the second year. Results: The primary outcome is the one-year change in estimated ten-year cardiovascular risk, assessed by SCORE2-Diabetes calculated from age, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol, age at diabetes diagnosis, HbA1c, and eGFR. Conclusions: If effective, DICTA could offer a scalable, digital-first approach for improving T2D management in primary care by combining patient-centered lifestyle coaching with real-time pharmacological clinical decision support. Full article

Background: Obesity in adults is a growing health concern. The principal interventions used in obesity management are lifestyle-change interventions such as diet, exercise, and behavioral therapy. Although they are effective, current treatment options have not succeeded in halting the global rise in the prevalence of obesity or achieving sustained long-term weight maintenance at the population level. E-health and m-health are both integral components of digital health that focus on the use of technology to improve healthcare delivery and outcomes. The use of eHealth/mHealth might improve the management of some of these treatments. Several digital health interventions to manage obesity are currently in clinical trials. Objective: The aim of our systematic review is to evaluate whether digital health interventions (e-Health and m-Health) have effects on changes in anthropometric measures, such as weight, BMI, and waist circumference and behaviors such as energy intake, eating behaviors, and physical activity. Methods: A search was conducted for randomized controlled trials (RCTs) conducted through 4 October 2024 through three databases (Medline, Web of Science, and Scopus). Studies were included if they evaluated digital health interventions (e-Health and m-Health) compared to control groups in overweight or obese adults (BMI ≥ 25 kg/m²) and reported anthropometric or lifestyle behavioral outcomes. Study quality was assessed using the Cochrane Risk of Bias Tool (RoB 2). Meta-analyses were performed using random-effects or fixed-effects models as appropriate, with statistical significance set at p < 0.05. Results: Twenty-two RCTs involving diverse populations (obese adults, overweight individuals, postpartum women, patients with eating disorders) were included. Digital interventions included biofeedback devices, smartphone apps, e-coaching systems, web-based interventions, and mixed approaches. Only waist circumference showed a statistically significant reduction (WMD = −1.77 cm; 95% CI: −3.10 to −0.44; p = 0.009). No significant effects were observed for BMI (WMD = −0.43 kg/m²; p = 0.247), body weight (WMD = 0.42 kg; p = 0.341), or lifestyle behaviors, including physical activity (SMD = −0.01; p = 0.939) and eating behavior (SMD = −0.13; p = 0.341). Body-fat percentage showed a borderline-significant trend toward reduction (WMD = −0.79%; p = 0.068). High heterogeneity was observed across most outcomes (I² > 80%), indicating substantial variability between studies. Quality assessment revealed predominant judgments of “Some Concerns” and “High Risk” across the evaluated domains. Conclusions: Digital health interventions produce modest but significant benefits on waist circumference in overweight and obese adults, without significant effects on other anthropometric or behavioral parameters. The high heterogeneity observed underscores the need for more personalized approaches and future research focused on identifying the most effective components of digital interventions. Digital health interventions should be positioned as valuable adjuncts to, rather than replacements for, established obesity treatments. Their integration within comprehensive care models may enhance traditional interventions through continuous monitoring, real-time feedback, and improved accessibility, but interventions with proven efficacy such as behavioral counseling and clinical oversight should be maintained. Full article

In the United States, at least one in three adults has prediabetes, a condition categorized by blood glucose levels higher than normal but not high enough to be classified as type 2 diabetes. The Centers for Disease Control and Prevention (CDC) recommends a modest weight loss of 5–7%, a reduction in A1C by 0.2%, and at least 150 min of physical activity per week to prevent or delay the onset of type 2 diabetes in individuals with prediabetes. Eat Smart, Move More, Prevent Diabetes (ESMMPD) is a CDC-recognized lifestyle-change program for individuals with prediabetes or at high risk of developing type 2 diabetes. ESMMPD consists of 26 lessons delivered over the course of a year by trained Lifestyle Coaches using Zoom^TM. Participants are taught strategies to implement health-promoting behaviors related to healthy eating, physical activity, and mindfulness into their daily lives. The core components of the program are planning, tracking, and living mindfully. The aim of this article is to provide insights into the development, delivery, and core components of the ESMMPD program for public health practitioners. Full article

The present pilot randomized control study examined the effectiveness of an 8-week stress management and health coaching intervention on perceived stress, healthy routines, sleep quality, self-efficacy, self-esteem and happiness. A total of 38 office employees were randomly assigned to the intervention group (IG, n = 20) or the control group (CG, n = 18) and validated tools were used to assess outcomes. Statistically significant differences in the IG after the 8 weeks were observed in perceived stress (i.e., a decrease in PSS-14 score, p = 0.043), in “Daily Routine”, i.e., an increase in control over the consistent timing of meals and sleep (p = 0.001) and in “Social and Mental Balance”, i.e., an increase in inclination to socialize, balance leisure and personal time and adopt positive thinking or cognitive control over stressors (p = 0.003). These improvements were reflected in an increase in total healthy lifestyle and personal control score (HLPCQ, p = 0.048). Short time and stress management and coaching interventions at workplaces can empower employees to increase control over stressors and to take the first step in adopting healthy behaviors by recognizing bad habits. Furthermore, in building sustainable employment, an empowered employee would participate at an organizational level more actively. Our preliminary results strongly support the idea that primary health care professionals should be educated in health coaching and relaxation techniques. Full article