British Society of Lifestyle Medicine: Founding Principles and Current Achievements.

The British Society of Lifestyle Medicine in the United Kingdom was first established in 2016 partly in response to the 'sick man of Europe' tag applied to our nations due to the increasing prevalence of non-communicable diseases. Today it is contributing to the growing momentum and growing realisation that a new approach is vital for our Nations' health.

Virtual group consultations offer continuity of care globally during Covid-19.

Covid-19 has led to virtual care (mainly telephone consultations) becoming a default worldwide, despite well-documented shortcomings. Published evidence on virtual group consultations is limited, although interest and front-line experience have grown substantially since pandemic onset. Unpublished data are summarised showing feasibility of transitioning care to this model across different countries, care settings and conditions. An international webinar series has supported development and sharing of best practice and representative data on spread and utilisation of virtual groups. This model of care creates time and space for more questions and answers, so once engaged patients become staunch advocates. Group care supports personalised care and lifestyle medicine, which is growing very rapidly. In the current context, even healthcare providers under pressure can implement virtual group consultations. Most virtual group consultations have a facilitator, so this allows roles to be extended and support education of both students and new team members. These can confer greater access, continuity of care, peer support and timely information about Covid-19 and may result in better health outcomes. Given the rapid and widespread implementation of virtual care during this pandemic, data should be shared effectively and methodologically sound observational studies and clinical trials to test safety and effectiveness should be promoted now.

Patterns of trust in sources of health information.

AIMS: To understand the different patterns of trust that exist regarding different sources of information about health issues. METHOD: Data from a large national health lifestyles survey of New Zealanders was examined using a factor analysis of trust toward 24 health information sources (HIS). Differences in trust are compared across a range of demographic variables. RESULTS: Factor analysis identified six different groupings of health information. Variations in trust in sources for health information are identified by age, employment status, level of education, income, sex and ethnic group. CONCLUSIONS: Systematic variations exist in the trust that people report with respect to different sources of health information. Understanding these variations may assist policymakers and other agencies which are responsible for planning the dissemination of health information.

Validation of brief instruments to measure adult fruit and vegetable consumption.

Four brief food frequency questionnaires were developed and validated to measure an adult's usual daily intake of fruit or vegetable servings over the past month. Fifty males and 50 females, aged 25-52 years, completed two fruit instruments, two vegetable instruments, and a dietary history (the reference method). Individual agreement and group mean estimation were assessed. The 5-item fruit instrument and the 15-item vegetable instrument performed best. At an individual level, the 5-item fruit instrument had 64% sensitivity and 88% specificity for assessing goal attainment (≥ 2 fruit servings/day), while the 15-item vegetable instrument had 67% sensitivity and 82% specificity for measuring goal attainment (≥ 3 vegetable servings/day). At a group level, the 15-item vegetable instrument closely estimated mean intake (ratio of geometric means=0.94), while the 5-item fruit instrument overestimated mean intake by 32%. Nevertheless, when it was used to rank participants, reference method fruit servings increased across the quartiles of intake. These two instruments can be used to assess goal attainment. This vegetable instrument can also be used to estimate group mean intakes, while the fruit instrument can be used to rank participants. Used appropriately, these instruments can be used for screening, monitoring, and evaluation purposes in New Zealand public health and clinical settings.

Validated scales to assess adult decisional balance to eat more fruits and vegetables.

A scale to measure adult decisional balance to eat more fruits and vegetables was developed and confirmed, and its psychometric properties were assessed. Two simple random samples of adults ages 25-60 years were selected from a nationally representative sampling frame. The development survey had a 72% response rate (n = 231). The confirmation survey had a 67.4% response rate (n = 2132). In both surveys, a self-administered questionnaire assessed demographics, fruit and vegetable intakes, stages of change, and decisional balance. Principal components analysis with varimax rotation and confirmatory factor analysis were performed. The decisional balance scale had three reliable subscales: "health pros," "non-health pros," and "cons." Model fit was adequate for a "pros" and "cons" hierarchical structure. For both fruits and vegetables, health pros increased significantly between precontemplation and contemplation stages, surpassing the cons. Non-health pros increased significantly between precontemplation and contemplation fruit stages, surpassing the cons in preparation stage. Between precontemplation and action stages, health pros increased (mean effect size = 0.90 [fruit] and 0.80 [vegetables]) and cons decreased (mean effect size = 0.27 [fruit] and 0.35 [vegetables]). Heterogeneity in this sample may have diluted these effect sizes. This decisional balance scale is valid and reliable.

Validated scales to assess adult self-efficacy to eat fruits and vegetables.

PURPOSE: An audience-centered approach was used to develop valid and reliable scales to measure adult self-efficacy to eat fruit and vegetables. DESIGN: Cross-sectional survey of a national population. SETTING: New Zealand. SUBJECTS: A sample of 350 adults ages 25 to 60 years was randomly selected from a nationally representative sampling frame. Overall, 231 questionnaires were returned, producing a 72% response rate. The mean age of subjects was 42.7years; 58% were female; 80% were of European descent; 11% were indigenous Maori. MEASURES: The 76-item, self-administered questionnaire collected data on demographics, fruit and vegetable intakes, stages of change, decisional balance, and self-efficacy (24 items). ANALYSIS: Principal components analysis with oblimin rotation was performed. RESULTS: Principal components analysis yielded three distinct and reliable scales for self-efficacy to eat "vegetables," "fruit," and "fruit and vegetables" (Cronbach alpha = .80, .85, and .73, respectively). These scales were correlated, but only the "vegetable" scale was positively correlated with the "fruit and vegetable" scale (Kendall tau r = 0.30, -0.26 [fruit, "fruit and vegetables"], -0.38 [fruit, vegetable]). As predicted, self-efficacy was associated with intake (r = 0.30 [fruit], 0.34 [vegetables]). CONCLUSION: Assuming the factor structure is confirmed in independent samples, these brief psychometrically sound scales may be used to assess adult self-efficacy to eat fruit and to eat vegetables (separately) but not self-efficacy to eat "fruit and vegetables."