Ilka Lowensteyn's research while affiliated with McGill University and other places

Publications (72)

Article
The pandemic has highlighted the need for accessible and effective health promotion as Canadians are isolated from their communities during social distancing measures. A web-based health promotion program in which participants also received individualized email-based health coaching from medical students has been available during the pandemic to em...
Article
Objective To assess the feasibility and acceptability of using a Sequential Multiple Assignment Randomized Trial (SMART) to optimize the delivery of a web-based, stress management intervention for CVD patients. Methods 59 patients with a CVD and moderate stress were randomized to a self-directed web-based stress management program (n = 30) or the...
Article
Cardiovascular risk assessment has been shown to improve physicians’ and patients’ understanding of an individual’s future risk of cardiovascular disease (CVD). It has also been shown to improve the management of cardiovascular risk factors including hypertension and dyslipidemia. Given the challenges of engaging patients to adhere to healthy lifes...
Article
Full-text available
Background: Current evidence suggests that some of the most effective weight loss approaches are changes in dietary and physical activity behaviors through lifestyle modification programs. The Group Lifestyle Balance (GLB) program is a group-based behavior modification program aimed at changing diet and physical activity for weight loss. It was de...
Preprint
Full-text available
Background: The NIH-developed Diabetes Prevention Program (DPP) is successful in achieving clinically significant weight loss in individuals with overweight/obesity when delivered one-on-one. However, due to high cost of implementation, the long-term effectiveness remains limited. In response, a group-based version of the program, called the Nation...
Preprint
Full-text available
Background: The NIH-developed Diabetes Prevention Program (DPP) is successful in achieving clinically significant weight loss in individuals with overweight/obesity when delivered one-on-one. However, due to high cost of implementation, the long-term effectiveness remains limited. In response, a group-based version of the program, called the Nation...
Article
Background Recent studies show that paternal depression negatively impacts children's behavioral and emotional development. This study determined the prevalence of depressed mood in first-time fathers at 2 and 6 months postpartum and identified associated risk factors. Methods A prospective cohort study with 622 men who completed sociodemographic...
Article
Purpose: To evaluate the results of a workplace wellness program that incorporates gamification principles. Design: In this prospective cohort study, the participation rate and observed health outcomes were evaluated after approximately 2 years. Setting and participants: All permanent employees (n = 775) of a national company located in Canada...
Article
Full-text available
Objective The NIH‐developed Diabetes Prevention Program (DPP) is successful in achieving clinically significant weight loss in individuals with overweight/obesity when delivered one‐on‐one. The group‐based DPP is less effective, with average weight losses of only 3.5%. The objective of this study was to increase weight loss outcomes of the group‐ba...
Article
Objective: Evaluate the impact of an employee wellness program in Canada. Methods: A comprehensive program including web-based lifestyle challenges was evaluated with annual health screenings. Results: Among 730 eligible employees, 688 (94%) registered for the program, 571 (78%) completed a health screening at baseline, and 314 (43%) at 1 year...
Article
Full-text available
Background Up to 18% of men experience depression and/or anxiety during the transition to parenthood. Interventions designed specifically to promote the mental health of men during the transition to parenthood are scarce. Internet-delivered interventions may be acceptable and far-reaching in enhancing mental health, parenting knowledge, and healthy...
Article
Full-text available
This cross-sectional study aims to determine the prevalence and determinants of depressive symptoms in first-time expectant fathers during their partner's third trimester of pregnancy. As part of a prospective study examining depressive symptoms in men over the first postnatal year, 622 men (mean age = 34.3 years, ±5.0 years) completed standardized...
Article
Background: This study analyzed cross-sectional data to examine the prevalence of insomnia and to identify factors associated with insomnia after a myocardial infarction (MI). Methods: The participants were 209 individuals with a recent MI. At approximately 5 weeks post-MI, participants completed standardized self-report measures assessing insom...
Article
ABSTRACT In preparation for developing a website to enhance emotional wellness and healthy lifestyle during the perinatal period, this study examined women’s informational needs and barriers. Seventy-four women who were pregnant or had given birth completed an online survey inquiring about information needs and preferred sources related to psychoso...
Article
Full-text available
Despite the increased risk of cardiovascular disease and type 2 diabetes associated with excess bodyweight, development of a clinically meaningful metric for health professionals remains a challenge. We estimated the years of life lost and the life-years lost from diabetes and cardiovascular disease associated with excess bodyweight. We developed a...
Article
Background Despite the increased risk of cardiovascular disease and type 2 diabetes associated with excess bodyweight, development of a clinically meaningful metric for health professionals remains a challenge. We estimated the years of life lost and the life-years lost from diabetes and cardiovascular disease associated with excess bodyweight.
Article
Full-text available
Background The Diabetes Prevention Program (DPP) is highly effective in promoting weight loss in overweight and obese individuals. However, one-on-one DPP sessions are costly. As a cost-saving alternative, a group version of the DPP, called Group Lifestyle Balance program (GLB), has been developed but has been shown to be less effective. The aim of...
Article
The aim of this research was to describe the impact of a pedometer-based activity program on a subset of nurses in a university-affiliated, multisite health care center in Canada. This study used a longitudinal design with preintervention-postintervention (8 weeks) and follow-up (6 months). At baseline, 60 nurses participated; 51 (85%) remained for...
Article
Recent guidelines from the Canadian Association of Cardiac Rehabilitation highlight the importance of addressing sleep disturbance among participants of cardiac rehabilitation (CR) programs. The primary objective of this study was to examine the relationship between depressive symptoms, health-related quality of life, and sleep disturbance in CR pa...
Article
This study investigated whether the positive behavioral and anthropometric outcomes of a pedometer-based physical activity 8-week challenge were maintained 6 months after the end of the program. It further investigated the motivational profile of those who maintained their physical activity levels in the months following the end of the program and...
Article
Background: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Despite this fact and the development of effective antihypertensive drug therapy, hypertension is often poorly controlled. Community pharmacies are an ideal site for the management of hypertension and other modifiable cardiovascular risk factors. The purpos...
Article
Full-text available
Breast or chest-wall pain (BCP) is prevalent in 20%-50% of breast cancer survivors, and it affects quality of life (QOL). To determine the feasibility and potential efficacy of an exercise program to improve patient QOL and BCP, such a program was offered to breast cancer patients suffering from BCP. The study enrolled 10 breast cancer patients wit...
Article
Current expert guidelines for the treatment of hypertension or dyslipidemia recommend the use of cardiovascular risk assessment to identify high-risk individuals most likely to benefit from risk factor management. The potential uses of risk assessment include reassuring low-risk individuals, motivating high-risk individuals to modify their lifestyl...
Article
The management of cardiovascular risk factors such as hypertension and dyslipidemia is poorly described in many communities, and the benefits associated with tighter control remain unknown. We used data from the 2007 MyHealthCheckup survey to document the treatment gaps and estimated the potential benefits of better adherence to recommended guideli...
Article
(1) To explore moderators of the effects of home-based exercise on reductions in physical and mental fatigue scores in postpartum depressed women and (2) to explore mediators of the intervention on changes in physical fatigue. Eighty-eight women in the postpartum period (4-38 weeks) obtaining a score >or=10 on the Edinburgh Postnatal Depression Sca...
Article
To evaluate whether a 12-week home-based exercise program is more effective than usual care for alleviating depressive symptomology in the postpartum. Eighty-eight women experiencing postpartum depressed mood were randomly assigned to a 12-week home-based exercise program or usual care. Outcomes assessed immediately post-treatment and 3-months post...
Article
The direct health care costs associated with treating hypertension and dyslipidemia continue to grow in most western countries, including Canada. Despite the proven effectiveness of hypertension and lipid therapies to prevent cardiovascular disease, the cost-effectiveness of long-term primary prevention, as currently advocated by Canadian treatment...
Article
Hypertension is common among patients with dyslipidemia but is often poorly treated. The objective of this analysis was to evaluate how a decision aid, used by primary care physicians to improve lipid therapy, impacted on the treatment of hypertension. Data were analyzed from patients enrolled in a randomized trial focusing primarily on the treatme...
Article
Economic analyses of randomized clinical trials often focus only on the results that are observed during the study. However, for many preventive interventions, associated costs and benefits will accrue over a patient's remaining lifetime. To determine the importance of the chosen time horizon, the cost-effectiveness (C/E) of ramipril therapy was ca...
Article
Fatigue is prevalent during the postpartum period and may be heightened in postpartum depressed women. To evaluate the efficacy of a home-based exercise intervention in reducing physical and mental fatigue scores in postpartum depressed women. Eighty-eight women in the postpartum (4-38 weeks) obtaining a score > or =10 on the Edinburgh Postnatal De...
Article
Treatments for hypertension and dyslipidemia to prevent the development of cardiovascular disease compete for the same finite number of health care dollars. Therefore, the potential benefits of treating Canadians without cardiovascular disease or diabetes who would currently be targeted by the national treatment guidelines were estimated and compar...
Article
Economic analyses of drug therapies are highly dependent on the clinical indications for treatment. The cost effectiveness of ramipril has been evaluated in numerous studies, usually based on the results of one specific clinical trial. We estimated the cost effectiveness of this drug across a range of currently accepted therapeutic indications, usi...
Article
Background and objectives: Economic analyses of drug therapies are highly dependent on the clinical indications for treatment. The cost effectiveness of ramipril has been evaluated in numerous studies, usually based on the results of one specific clinical trial. We estimated the cost effectiveness of this drug across a range of currently accepted t...
Article
Potent glucose-lowering medications other than metformin may impede weight loss in type 2 diabetes (T2D). Supervised exercise programs improve glycemic control without significantly enhancing weight loss; their impact on fitness and blood pressure in T2D remains unclear. In this pilot study, 42 type 2 diabetes patients were randomized to (i) libera...
Article
The objectives of this study were a) to evaluate health-related quality of life (HRQoL) among women with postpartum depression, b) examine the association between severity of depressive symptoms and level of impairment in physical and mental HRQoL and c) to identify contributors to physical and mental HRQoL. Seventy-eight women scoring > or =10 on...
Article
Treatment recommendations for fibromyalgia (FM) include regular physical exercise. In this prospective study we examined predictors for adherence to stretching and aerobic exercises in women provided with an individualized home based program. Thirty-nine women kept exercise diaries for 12 weeks. For both types of exercise, women who were less physi...
Article
The Prostate Cancer Prevention Trial demonstrated that finasteride could reduce the incidence of prostate cancer by 25%. However, its use was also associated with an increased risk of high grade cancer resulting in uncertainty surrounding the net benefits of therapy. We used the Montreal Prostate Cancer Model, a validated Markov model of prostate c...
Article
The prevalence of erectile dysfunction (ED) and associated risk factors has been described in many clinical settings, but there is little information regarding men seen by primary care physicians. We sought to identify independent factors associated with ED in a primary care setting. We surveyed a cross-sectional sample of 3921 Canadian men, aged 4...
Article
To determine the efficacy of a 12-week individualized home-based exercise programme on physical functioning, pain severity and psychological distress for women with fibromyalgia (FM). Seventy-nine women with a primary diagnosis of FM were randomized to a 12-week individualized home-based moderate-intensity exercise programme or to a usual care cont...
Article
Study objective: To develop and test a decision aid for patients with hypertension and/or dyslipidemia because a decision aid may assist in pharmaceutical care by providing relevant evidence-based information. Design: Before and after use of a decision aid. Setting: Hypertension clinic of a university hospital and a specialized coronary heart...
Article
Little is known about the epidemiology and possible mental health benefits of leisure-time physical activity (LTPA) for persons with arthritis and other rheumatic conditions. We examined the prevalence of LTPA and its association to generalized distress among Canadians with rheumatic conditions. The 1996-97 National Population Health Survey intervi...
Article
Lifestyle changes are advocated as a first line of treatment for dyslipidemia. However, few studies have directly compared various combinations of diets and exercise. In a randomized controlled pilot study, we compared the standard lifestyle recommendations (NCEP step I diet with regular exercise) and more intense interventions including the NCEP s...
Article
Although exercise training improves cardiovascular disease (CVD) risk factors, few studies have evaluated its potential long-term cost-effectiveness. Using the Cardiovascular Disease Life Expectancy Model, a validated disease simulation model, we calculated the life expectancy of average 35- to 74-year-old Canadians found in the 1992 Canadian Heart...
Article
The Coronary Health Assessment Study (CHAS) was developed to determine the feasibility of using patient-specific, multifactorial computerized coronary risk profiles as a clinical decision aid to support primary prevention of CHD. Study participants included 253 community based physicians, randomized into profile and control groups, and 958 of their...
Article
The American College of Sports Medicine recently published new guidelines to classify individuals at increased risk for coronary heart disease (CHD) before starting a vigorous (> 60% maximum oxygen consumption) exercise program. We compared the prognostic value of the new guidelines to the earlier guidelines. Subjects included men and women over 30...
Article
Objective : To evaluate the ability of doctors in primary care to assess risk patients' risk of coronary heart disease. Design : Questionnaire survey. Setting : Continuing medical education meetings, Ontario and Quebec, Canada. Subjects : Community based doctors who agreed to enrol in the coronary health assessment study. Main outcome measure :...

Citations

... For example, it can also be used as a low intensity first step in a stepped-care approach to mental health treatment (van Straten et al., 2015). This study augments the evidence base on use of lay telephone coaching to treat mental health disorders (McCusker et al., 2022;Lambert et al., 2021). ...
... Although both groups achieved significant weight loss of 9.42% (standard treatment) and 10.63% (implementation added treatment), the differences between the two groups was not statistically significant. There was also no difference in weight regain after 24 months (Knäuper et al., 2020). Both groups had retained approximately 6% weight loss compared to their initial weight. ...
... These associations are consistent with the findings reported by Wynter et al. (2020) in a recent scoping review which showed the link between fathers' sleep problems and their mental health and well-being. Therefore, health professionals should also include interventions focused on the detection, prevention, and management of sleep among the fathers under their care (Da Costa et al., 2019;Wynter et al., 2020). Furthermore, it is advisable to continue investigating sleep in fathers and its associations with their health, given that a significant part of research and clinical practice already focuses on maternal sleep and the mother's health (Coles et al., 2022;Wynter et al., 2020). ...
... Wellnes Program menunjukkan manfaat yang lebih besar di antara karyawan yang berisiko lebih tinggi (Lowensteyn et al., 2019). Karenanya penelitian ini bertujuan untuk mengetahui manfaat dari intervensi faktor risiko penyakit jantung koroner di tempat kerja sehingga program pencegahan serupa dapat dirasakan manfaatnya untuk pekerja, perusahaan dan masyarakat lainnya. ...
... Overall, the study designs, methods for promoting habit formation, and targeted behaviors varied widely, as did results of the interventions. All intervention studies reviewed measured habit automaticity using either the SRHI [46,[60][61][62][63] or SRBAI [38,59,[64][65][66]. All of the studies reviewed included a form of planning intervention or prompts/cues as part of the habit-forming intervention [38,46,59,[61][62][63][64][65][66], and five emphasized repetition or included elements of environmental modification to support context stability [46,60,61,64,66]. ...
... Consistent results were also reported in previous studies of workplace-based hypertension management programs despite different effect sizes. [6][7][8][9][10][11] However, neither the cost nor the costeffectiveness of workplace-based hypertension management programs was reported, although they are essential for policy makers and health planners who are making decisions on whether scarce health care system resources should be allocated to such programs or other priorities. ...
... Our results highlight the importance of family-based interventions that counsel fathers on appropriate ways for supporting their child's health and development and address fathers' partner relationships dynamics (eg, coparenting, improved couples communication, conflict resolution skills) as an approach to reducing paternal stress. 41 When faced with mental health problems, fathers more commonly turned to maladaptive coping behaviours than positive coping behaviours. Overall, alcohol use was the most frequently reported coping behaviour of fathers. ...
... Approximately 55% of patients display varying degrees of sleep disorders four months after MI, which can impede cardiac recovery [2]. Notably, clinical observations have revealed that insomnia, including difficulty staying asleep, is prevalent in individuals post-MI [3]. Furthermore, MI patients with short sleep durations have a higher incidence of major adverse cardiovascular events (MACEs) compared to those without sleep disorders [4,5]. ...
... Given the versatility of the Markov model approach in adopting different types of health states patients can potentially experience, this method was further categorized into health state classifications. These typically included an "alive or dead" state [17,19,32,33,39,51,67], NYHA disease classification [15,23,52,58,68], cardiovascular events [22,26,27,38,44,48,66,72,[74][75][76] and hospitalization states [27,49,66,72,[74][75][76]. Specific Markov model structure was unclear in four studies [34,40,69,73]. Seven studies focused on a two-state Markov approach based around the "alive" and "dead" states [17,19,32,33,39,51,67]. ...
... There is an opportunity to provide pregnant women with links to accurate and appropriate nutrition information online, to help guide them and limit some of the burden on healthcare professionals. 29,39 Potential avenues for further development in this space must continue to be explored, with Ainscough et al. 38 previously highlighting the positive impact of a behavioural-lifestyle intervention facilitated through a smartphone app for pregnant women with overweight and obesity. This type of approach may be particularly pertinent for primiparous women, who we observed to have poorer nutrition knowledge in comparison to those that have experienced pregnancy previously. ...