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Silva-Smith AL, Hanson CL, Neubeck L, Rowat A, McHale S. Physical Activity Interventions Framed by the Health Action Process Approach for Adults with Long-Term Conditions: A Scoping Review. Int J Behav Med 2024:10.1007/s12529-024-10305-2. [PMID: 39009797 DOI: 10.1007/s12529-024-10305-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Interventions that use the Health Action Process Approach (HAPA) model show promise for increasing PA frequency, duration, and intensity. However, there is limited understanding of how HAPA model variables have been operationalized for PA interventions in chronic disease to promote behavior change and sustained PA or whether the phase or continuous form of the HAPA model was used. The aim of this scoping review is to describe how the HAPA model variables for PA interventions were operationalized and provide details of implementation. METHOD We searched five databases to identify studies published between January 1992 and March 2024. We aimed to describe (1) the characteristics of interventions including setting, delivery mode, duration, and content; (2) which HAPA variables were operationalized and the strategies used; and (3) the physical activity measures and outcome effects. RESULTS The search identified 23 interventions in 30 papers (12 protocols, 3 quasi-experimental studies, and 15 randomized controlled trials (RCTs)). Seven of the 15 RCTs reported significant positive effects of the HAPA model on PA behavior outcomes. Interventions operationalized between three and nine HAPA constructs showed significant variability in how the HAPA model is used in intervention research. PA measures varied from self-report to validated objective instruments. CONCLUSION We found a lack of clarity in decisions about which HAPA constructs were included in interventions. The wide variability in operationalized HAPA constructs made it challenging to compare interventions. Researchers should provide more detail about intervention design and implementation procedures to enhance transparency.
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Affiliation(s)
- Amy L Silva-Smith
- Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences, University of Colorado at Colorado Spring, 1420 Austin Bluffs Parkway, Colorado Springs, CO, USA.
| | - Coral L Hanson
- Centre for Cardiovascular Health, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
| | - Lis Neubeck
- Centre for Cardiovascular Health, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
| | - Anne Rowat
- Nursing & Health Care School, University of Glasgow, 57/504 Oakfield Avenue, Glasgow, G12 8LL, UK
| | - Sheona McHale
- Centre for Cardiovascular Health, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
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Hardcastle SJ, Douglass E, Wilson B, Maxwell-Smith C. Experiences and facilitators of physical activity engagement amongst colorectal and endometrial cancer survivors: the Wearable Activity Technology and Action-Planning (WATAAP) trial. Support Care Cancer 2023; 31:662. [PMID: 37914916 PMCID: PMC10620246 DOI: 10.1007/s00520-023-08137-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE This study explored colorectal and endometrial cancer survivors' experiences of participation in a wearable intervention and the dimensions that influenced intervention engagement and physical activity behaviour change. METHODS Semi-structured interviews (n= 23) were conducted with intervention participants (mean age 65.8 (SD ±7.1) and analysed using thematic analysis. RESULTS Four main themes were identified: (i) commitment, (ii) accountability and monitoring, (iii) routine, (iv) Fitbit as health coach. Those that assigned a higher priority to PA were more likely to schedule PA and be successful in PA change. Those less successful presented more barriers to change and engaged in more incidental PA. The Fitbit acting as health coach was the active ingredient of the intervention. CONCLUSIONS Commitment evidenced through prioritising PA was the foundational dimension that influenced PA engagement. Interventions that foster commitment to PA through increasing the value and importance of PA would be worthwhile. Wearables holds great promise in PA promotion and harnessing the technique of discrepancy between behaviour and goals is likely a valuable behaviour change technique.
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Affiliation(s)
- Sarah J Hardcastle
- Department of Sport and Physical Activity, Sheffield Hallam University, Broomhall, Sheffield, UK.
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia.
| | - Emma Douglass
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Bree Wilson
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Chloe Maxwell-Smith
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Optimising Health and Wellbeing Domain, Enable Institute, Curtin University, Perth, Western Australia, Australia
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Mavragani A, Baniasadi T, Shirkhoda M, Rostam Niakan Kalhori S, Mohammadzadeh N, Roudini K, Ghalehtaki R, Memari F, Jalaeefar A. Remote Monitoring of Colorectal Cancer Survivors Using a Smartphone App and Internet of Things-Based Device: Development and Usability Study. JMIR Cancer 2023; 9:e42250. [PMID: 36790851 PMCID: PMC9978953 DOI: 10.2196/42250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/12/2022] [Accepted: 10/31/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Patients with colorectal cancer who undergo surgery face many postoperative problems. These problems include the risk of relapse, side effects, and long-term complications. OBJECTIVE This study sought to design and develop a remote monitoring system as a technological solution for the postdischarge care of these patients. METHODS This research was conducted in 3 main steps: system feature extraction, system design, and evaluation. After feature extraction from a systematic review, the necessary features were defined by 18 clinical experts in Iran. In the next step, the architecture of the system was designed based on the requirements; the software and hardware parts of the system were embedded in the architecture, then the software system components were drawn using the unified modeling language diagrams, and the details of software system implementation were identified. Regarding the hardware design, different accessible hardware modules were evaluated, and suitable ones were selected. Finally, the usability of the system was evaluated by demonstrating it over a Skype virtual meeting session and using Nilsen's usability principles. RESULTS A total of 21 mandatory features in 5 main categories, including patient information registration, periodic monitoring of health parameters, education, reminders, and assessments, were defined and validated for the system. The software was developed using an ASP.Net core backend, a Microsoft SQL Server database, and an Ionic frontend alongside the Angular framework, to build an Android app. The user roles of the system included 3 roles: physicians, patients, and the system administrator. The hardware was designed to contain an Esp8266 as the Internet of Things module, an MLX90614 infrared temperature sensor, and the Maxim Integrated MAX30101 sensor for sensing the heartbeat. The hardware was designed in the shape of a wristband device using SolidWorks 2020 and printed using a 3D printer. The firmware of the hardware was developed in Arduino with the capability of firmware over the air. In evaluating the software system from the perspective of usability, the system received an average score of 3.8 out of 5 from 4 evaluators. CONCLUSIONS Sensor-based telemonitoring systems for patients with colorectal cancer after surgery are possible solutions that can make the process automatic for patients and caregivers. The apps for remote colorectal patient monitoring could be designed to be useful; however, more research regarding the developed system's implementation in clinic settings and hospitals is required to understand the probable barriers and limitations.
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Affiliation(s)
| | - Tayebeh Baniasadi
- Department of Health Information Technology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammad Shirkhoda
- Department of General Surgery, Subdivision of Surgical Oncology, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh Rostam Niakan Kalhori
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.,Peter L. Reichertz Institute for Medical Informatics (PLRI), Technical University of Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Niloofar Mohammadzadeh
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Roudini
- Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Ghalehtaki
- Department of Radiation Oncology, Cancer Institute, Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoon Memari
- Department of General Surgery, Subdivision of Surgical Oncology, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmohsen Jalaeefar
- Department of General Surgery, Subdivision of Surgical Oncology, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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Wu S, Li G, Du L, Chen S, Zhang X, He Q. The effectiveness of wearable activity trackers for increasing physical activity and reducing sedentary time in older adults: A systematic review and meta-analysis. Digit Health 2023; 9:20552076231176705. [PMID: 37252261 PMCID: PMC10214103 DOI: 10.1177/20552076231176705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
Background Traditional interventions such as education and counseling are successful in increasing physical activity (PA) participation, but are usually labor and resource intensive. Wearable activity trackers can objectively record PA and provide feedback to help users to achieve activity goals and are an increasingly popular tool among adults used to facilitate self-monitoring of PA. However, no reviews systematically explored the roles of wearable activity trackers in older populations. Methods We searched PubMed, Web of Science, Google Scholar, Embase, Cochrane Library, and Scopus from inception to September 10, 2022. Randomized controlled trials were included. Two reviewers independently conducted study selection, data extraction, risk of bias, and certainty of evidence assessment. A random-effects model was used to evaluate the effect size. Results A total of 45 studies with 7144 participants were included. A wearable activity tracker was effective in increasing daily steps (standard mean differences (SMD) = 0.59, 95% confidence interval (CI) (0.44, 0.75)), weekly moderate-to-vigorous PA (MVPA) (SMD = 0.54, 95% CI (0.36, 0.72)), and total daily PA (SMD = 0.21, 95% CI (0.01, 0.40)) and reducing sedentary time (SMD = -0.10, 95% CI (-0.19, -0.01)). Subgroup analysis showed that the effectiveness of wearable activity trackers for daily steps was not influenced by participants and intervention features. However, wearable activity trackers seemed more effective in promoting MVPA of participant's age <70 than participant's age ≥70. In addition, wearable activity trackers incorporated with traditional intervention components (e.g. telephone counseling, goal setting, and self-monitoring) could better promote MVPA than alone use. Short-term interventions potentially achieve better MVPA increase than long-term. Conclusion This review showed that wearable activity trackers are an effective tool to increase PA for the old population and also favor reducing sedentary time. When used together with other interventions, wearable activity trackers can achieve better MVPA increase, especially in the short term. However, how to more effectively improve the effectiveness of wearable activity trackers is an important direction of future research.
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Affiliation(s)
- Shuang Wu
- School of Physical Education, Shandong University, Jinan, China
| | - Guangkai Li
- School of Physical Education, Shandong University, Jinan, China
| | - Litao Du
- School of Physical Education, Shandong University, Jinan, China
| | - Si Chen
- School of Nursing and Rehabilitation,
Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China
| | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
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5
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Nicholson L, Mullan B, Liddelow C. Investigating the role of morningness/eveningness in physical activity engagement. Health Psychol Behav Med 2022; 10:1003-1019. [PMID: 36277117 PMCID: PMC9586684 DOI: 10.1080/21642850.2022.2136183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective Despite being aware of the positive health-related outcomes of physical activity, many people remain inactive. The aim of this study is to apply a combination of constructs from the health action process approach and self-determination theory, as well as habit and morningness/eveningness, to predict physical activity engagement. Methods A prospective design was used to collect data from 136 participants (16–64 years old), at two-time points, one week apart. The sample consisted of 99 women, 36 men and 1 individual who identified as non-binary. Participants preferred time-of-day was measured using the Morningness-Eveningness Stability Scale (MESSi), while physical activity engagement was measured using the International Physical Activity Questionnaire (short-version). Two hierarchical, multiple regressions were conducted, to predict motivation to engage and to directly predict physical activity engagement. Furthermore, a mediation analysis was conducted to determine the effect of planning on physical activity engagement. Results Results showed that younger individuals and those with greater self-efficacy were more motivated to engage while planning directly predicted physical activity engagement. However, morningness/eveningness did not significantly predict engagement. Additionally, planning was found to mediate the motivation-engagement relationship. Conclusion This study demonstrates how planning influences individuals’ physical activity engagement, as well as the role self-efficacy and age play in their motivation to engage. Even though morningness/eveningness was not an important predictor, behaviour change techniques related to action planning and the use of multi-component approaches to behaviour change, could be used in interventions focused on increasing individuals’ physical activity engagement.
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Affiliation(s)
- Lauren Nicholson
- School of Population Health, Curtin University, Perth, Australia
- Enable Institute, Curtin University, Perth, Australia
| | - Barbara Mullan
- School of Population Health, Curtin University, Perth, Australia
- Enable Institute, Curtin University, Perth, Australia
- WACPRU, Curtin University, Perth, Australia
| | - Caitlin Liddelow
- Global Alliance for Mental Health and Sport, School of Psychology, University of Wollongong, Wollongong, Australia
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Hou B, Li L, Zheng L, Qi Y, Zhou S. Linking Exercise Intention to Exercise Action: The Moderating Role of Self-Efficacy. Front Psychol 2022; 13:921285. [PMID: 35910992 PMCID: PMC9326305 DOI: 10.3389/fpsyg.2022.921285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/08/2022] [Indexed: 11/23/2022] Open
Abstract
As physical exercise benefits both physical and psychological health of college students, it is important to promote the habit of physical exercise among them. This study adopted the Health Action Process Approach (HAPA) model to understand the exercise intention–action link and determine the moderating role of self-efficacy. We recruited 242 students from a university in China and asked them to complete a six-wave survey. The survey results indicated that exercise intention was positively related to both coping planning and action planning, which pave the way to performing the action of exercise. However, such mediation effects varied under conditions of self-efficacy. Participants with high self-efficacy exhibited stronger relationships between intention and planning, and between planning and action. The study results suggest that planning has a time-lagged mediation effect in the relationship between intention and action. Additionally, the findings shed light on the moderating role of self-efficacy, which can be useful in developing health-promotion strategies for college students.
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Affiliation(s)
- Bin Hou
- School of Public Administration, Fujian Normal University, Fuzhou, China
| | - Linqian Li
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Lei Zheng
- School of Economics and Management, Fuzhou University, Fuzhou, China
- *Correspondence: Lei Zheng
| | - Yating Qi
- Graduate School of Education, University of California, Los Angeles, Los Angeles, CA, United States
- Yating Qi
| | - Song Zhou
- School of Psychology, Fujian Normal University, Fuzhou, China
- Song Zhou
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7
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Edbrooke L, Khaw P, Freimund A, Carpenter D, McNally O, Joubert L, Loeliger J, Traill A, Gough K, Mileshkin L, Denehy L. ENhAncing Lifestyle Behaviors in EndometriaL CancEr (ENABLE): A Pilot Randomized Controlled Trial. Integr Cancer Ther 2022; 21:15347354211069885. [PMID: 35045735 PMCID: PMC8785429 DOI: 10.1177/15347354211069885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Endometrial cancer is associated with the highest comorbid disease burden of any cancer. The aim of this trial was to assess the feasibility and safety of an allied health intervention during adjuvant treatment. METHODS A mixed-methods pilot randomized (2:1) controlled trial with concealed allocation and assessor-blinding. Eligibility criteria: adjuvant endometrial cancer treatment scheduled, disease stage I-IIIC1, ECOG 0-2 and able to perform unsupervised physical activity (PA). Participants received usual care and 8 sessions of weekly, individualized, lifestyle education (diet and PA) with behavior change and social support (intervention group), delivered predominantly by telehealth, or usual care alone. Feasibility outcomes: recruitment and consent rates, decline reasons, program acceptability, intervention adherence and retention. RESULTS 22/44 eligible patients (50%, 95%CI: 36%, 64%) were recruited over 10 months (14 intervention, 8 usual care). The recruitment rate was 2.2 patients/month (95%CI: 1.4, 3.3). Patients who declined had too much going on (7/22, 32%) or were not interested (6/22, 27%). Mean (SD) age and BMI were 63.2 years (6.8) and 31.9 kg/m2 (6.7). A majority were FIGO stage I (15/22, 68%) and received vaginal brachytherapy (14/22, 64%). Adherence was high, 11/14 (79%, 95%CI: 52%, 92%) participants attended >70% of scheduled sessions. Retention was 100% (95%CI: 85%, 100%) at 9 weeks, however completion of objective measures was impacted by COVID-19 restrictions. Telehealth and online questionnaires enabled participation. No serious adverse events occurred. CONCLUSION The intervention was acceptable to participants with high levels of adherence and retention. Trial findings will be used to design a future RCT. TRIAL REGISTRATION The trial was registered on www.anzctr.org.au (ACTRN12619000631101) 29/04/2019.
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Affiliation(s)
- Lara Edbrooke
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Pearly Khaw
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Alison Freimund
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | - Orla McNally
- The University of Melbourne, Parkville, VIC, Australia.,The Royal Women's Hospital, Parkville, VIC, Australia
| | - Lynette Joubert
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | - Anya Traill
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Karla Gough
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Linda Mileshkin
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Linda Denehy
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
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Ayyoubzadeh SM, Shirkhoda M, R Niakan Kalhori S, Mohammadzadeh N, Zakerabasali S. A Smartphone Remote Monitoring App to Follow Up Colorectal Cancer Survivors: Requirement Analysis. JMIR Cancer 2022; 8:e18083. [PMID: 34989685 PMCID: PMC8771344 DOI: 10.2196/18083] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/24/2020] [Accepted: 10/03/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Colorectal cancer survivors face multiple challenges after discharge. eHealth may potentially support them by providing tools such as smartphone apps. They have lots of capabilities to exchange information and could be used for remote monitoring of these patients. OBJECTIVE In this study, we addressed the required features for apps designed to follow up colorectal cancer patients based on survivors' and clinical experts' views. METHODS A mixed methods study was conducted. Features of related apps were extracted through the literature; the features were categorized, and then, they were modified. A questionnaire was designed containing the features listed and prioritized based on the MoSCoW (Must have, Should have, Could have, Won't have) technique and an open question for each category. The link to the questionnaire was shared among clinical experts in Iran. The answers were analyzed using the content validity ratio (CVR), and based on the value of this measure, the minimum feature set of a monitoring app to follow up patients with colorectal cancer was addressed. In addition, a telephone interview with colorectal cancer survivors was conducted to collect their viewpoints regarding a remote monitoring system for colorectal cancer cases. RESULTS The questionnaire contained 10 sections evaluating 9 categories of features. The questionnaire was completed by 18 experts. The minimum set of features in the app was identified as patient information registration, sign and symptom monitoring, education, reminders, and patient evaluation (0.42 < CVR < 0.85). Features including physical activity, personalized advice, and social network did not achieve the minimum score (-0.11 < CVR < 0.39). We interviewed 9 colorectal cancer survivors. Information registration, sign and symptom monitoring, education, and personalized advice were the features with high priority from the survivors' perspectives. Scheduling, shopping, and financial support features were emphasized by survivors in the interview. CONCLUSIONS The requirement set could be used to design an app for the targeted population or patients affected by other cancers. As the views from both survivors and clinical experts were considered in this study, the remote system may more adequately fulfill the need for follow-up of survivors. This eases the patients' and health care providers' communication and interaction.
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Affiliation(s)
- Seyed Mohammad Ayyoubzadeh
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Department of Surgery, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh R Niakan Kalhori
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.,Peter L. Reichertz Institute for Medical Informatics, Technical University Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Niloofar Mohammadzadeh
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayyeh Zakerabasali
- Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Characteristics of Asian-American Breast Cancer Survivors Retained in a 3-Month Technology-Based Intervention. Cancer Nurs 2022; 45:E766-E774. [PMID: 34661563 PMCID: PMC9001739 DOI: 10.1097/ncc.0000000000001025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Technology-based intervention programs are known to be effective in approaching socially excluded groups or racial/ethnic minorities, including this specific population. However, the retention of participants in technology-based intervention studies is far more complicated and challenging compared with conventional studies targeting racial/ethnic minorities. OBJECTIVE This study aimed to identify the complex characteristics of the groups within Asian American breast cancer survivors who were successfully retained in a 3-month technology-based intervention study. METHODS This secondary analysis of the data from a larger ongoing intervention study included 155 Asian American breast cancer survivors. Major variables were measured using multiple instruments including the questions on characteristics of the participants, the Personal Resource Questionnaire, perceived isolation, Memorial Symptom Assessment Scale-Short Form, Cancer Behavior Inventory, 34-item Supportive Care Needs Survey Short Form, and Functional Assessment of Cancer Therapy Scale-Breast Cancer. Data analyses were done through χ2 tests, t tests, and decision tree analyses. RESULTS The retention rates differed by subethnicity (P = .025), immigration age (P < .001), and stage of breast cancer (P = .003). The decision tree indicated four groups with the highest probability of retention: (a) those who were diagnosed with stage II, III, or IV breast cancer, (b) those who immigrated to the United States after turning 31 years old, and (c) those who had high perceived barriers. CONCLUSION This study provides directions for future retention strategies for technology-based interventions among Asian American breast cancer survivors. IMPLICATIONS FOR PRACTICE Participants' characteristics need to be considered in developing retain strategies for technology-based interventions among Asian American breast cancer survivors.
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10
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Hardcastle SJ, Maxwell-Smith C, Hagger MS. Predicting physical activity change in cancer survivors: an application of the Health Action Process Approach. J Cancer Surviv 2021; 16:1176-1183. [PMID: 34518960 DOI: 10.1007/s11764-021-01107-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Previous research has not examined the utility of the Health Action Process Approach (HAPA) to predict physical activity (PA) change in cancer survivors. The aim of the study was to investigate the efficacy of a HAPA-based model in predicting temporal change in moderate-to-vigorous physical activity (MVPA) in cancer survivors. METHODS Participants enrolled in the Wearable Activity Technology and Action Planning (WATAAP) trial completed validated questionnaires (n = 64) to assess HAPA constructs (action and maintenance self-efficacy, outcome expectancies, action planning, risk perceptions, and intention) and wore an ActiGraph to measure PA at baseline, 12 weeks, and 24 weeks later. Data were analyzed using variance-based structural equation modeling with residualized change scores for model variables. RESULTS Consistent with predictions, changes in action self-efficacy (β = 0.490, p < 0.001, ES = 0.258) and risk perceptions (β = 0.312, p = 0.003, ES = 0.099) were statistically significant predictors of intention change over time. Changes in intention (β = 0.217, p = 0.029, ES = 0.040) and action planning (β = 0.234, p = 0.068, ES = 0.068) predicted changes in MVPA. Overall, the model accounted for significant variance in intention (R2 = 0.380) and MVPA (R2 = 0.228) change. CONCLUSIONS Changes in intention and action planning were important correlates of MVPA change over 24 weeks. Further, changes in action self-efficacy and risk perceptions predicted changes in intention. IMPLICATIONS FOR CANCER SURVIVORS interventions that foster risk perceptions and self-efficacy, strengthen intentions, and promote action planning may be effective in promoting sustained PA change in cancer survivors.
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Affiliation(s)
- Sarah J Hardcastle
- School of Health and Human Performance, Dublin City University, Dublin, Ireland.
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia.
| | | | - Martin S Hagger
- Department of Psychological Sciences and Health Sciences Research Institute, University of California, Merced, CA, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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11
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McCormack C, Kehoe B, Hardcastle SJ, McCaffrey N, McCarren A, Gaine S, McCullagh B, Moyna N. Pulmonary hypertension and home-based (PHAHB) exercise intervention: protocol for a feasibility study. BMJ Open 2021; 11:e045460. [PMID: 33972341 PMCID: PMC8112432 DOI: 10.1136/bmjopen-2020-045460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Novel therapies for pulmonary hypertension (PH) have improved survival and slowed disease progression. However, patients still present with symptoms of exertional dyspnoea and fatigue, which impacts their ability to perform activities of daily living, reduces exercise tolerance and impairs their quality of life (QoL). Exercise training has shown to be safe and effective at enhancing QoL and physical function in PH patients, yet it remains an underused adjunct therapy. Most exercise training for PH patients has been offered through hospital-based programmes. Home-based exercise programmes provide an alternative model that has the potential to increase the availability and accessibility of exercise training as an adjunct therapy in PH. The purpose of this study is to investigate the feasibility, acceptability, utility and safety of a novel remotely supervised home-based PH exercise programme. METHODS Single arm intervention with a pre/post comparisons design and a follow-up maintenance phase will be employed. Eligible participants (n=25) will be recruited from the Mater Misericordiae University Hospital PH Unit. Participants will undergo a 10-week home-based exercise programme, with induction training, support materials, telecommunication support and health coaching sessions followed by a 10-week maintenance phase. The primary outcomes are feasibility, acceptability, utility and safety of the intervention. Secondary outcomes will include the impact of the intervention on exercise capacity, physical activity, strength, health-related QoL and exercise self-efficacy. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Mater Misericordiae Institutional Review Board REF:1/378/2032 and Dublin City University Research Ethics DCUREC/2018/246. A manuscript of the results will be submitted to a peer-reviewed journal and results will be presented at conferences, community and consumer forums and hospital research conferences. TRIAL REGISTRATION NUMBER ISRCTN83783446; Pre-results.
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Affiliation(s)
- Ciara McCormack
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Brona Kehoe
- Department of Sport & Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - Sarah J Hardcastle
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | | | - Andrew McCarren
- Insight Centre for Data Analytics, Dublin City University, Dublin, Ireland
| | - Sean Gaine
- Respiratory Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Brian McCullagh
- Respiratory Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Niall Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
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12
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Hardcastle SJ, Maxwell-Smith C, Hince D, Bulsara MK, Boyle T, Tan P, Levitt M, Salama P, Mohan GRKA, Salfinger S, Makin G, Tan J, Platell C, Cohen PA. The wearable activity technology and action-planning trial in cancer survivors: Physical activity maintenance post-intervention. J Sci Med Sport 2021; 24:902-907. [PMID: 34016536 DOI: 10.1016/j.jsams.2021.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 03/15/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The study objective was to assess whether moderate-to-vigorous intensity physical activity (MVPA) change in cancer survivors (n = 68, mean age = 64 years) was maintained 12-weeks following the Wearable Activity Technology and Action Planning (WATAAP) intervention. Secondary aims were to assess the effects of the intervention on blood pressure (BP) and body mass index (BMI), and to explore group differences between baseline and 24-weeks. DESIGN Randomized controlled trial. METHODS MVPA and sedentary behaviour were assessed using an accelerometer at baseline, the end of the intervention (12-weeks), and at 24-weeks. Generalised linear mixed models with random effects were used to examine between-group and within-group changes in MVPA, sedentary behaviour, BP and BMI. RESULTS MVPA was significantly higher in the intervention group compared with the control group at 24-weeks following adjustment for known confounders (141.4 min/wk. (95% CI = 9.1 to 273.8), p = 0.036). At 24-weeks participants in the intervention group had maintained their increased levels of MVPA (change from 12-weeks = 8.8 min/wk.; 95% CI = -43 to 61; p = 0.74). The reduction in MVPA in the control group over the first 12-weeks was also maintained at 24-weeks (5.4 min/wk.; 95% CI = -3.6 to 4.6; p = 0.80). Secondary outcomes did not differ between groups at 24-weeks. CONCLUSIONS Our results suggest distance-based interventions using wearable technology produce increases in MVPA that endure at least 12-weeks after the intervention is completed.
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Affiliation(s)
- Sarah J Hardcastle
- School of Health and Human Performance, Dublin City University, Dublin, Ireland; Institute for Health Research, University of Notre Dame, Western Australia, Australia.
| | - Chloé Maxwell-Smith
- School of Psychology, Curtin University, Bentley, Western Australia, Australia
| | - Dana Hince
- Institute for Health Research, University of Notre Dame, Western Australia, Australia
| | - Max K Bulsara
- Institute for Health Research, University of Notre Dame, Western Australia, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia Cancer Research Institute, Adelaide, Australia
| | - Patrick Tan
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Michael Levitt
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Paul Salama
- St John of God Murdoch Hospital, Murdoch, Western Australia, Australia
| | | | - Stuart Salfinger
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Gregory Makin
- St John of God Murdoch Hospital, Murdoch, Western Australia, Australia
| | - Jason Tan
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Cameron Platell
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia; School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Paul A Cohen
- Institute for Health Research, University of Notre Dame, Western Australia, Australia; St John of God Subiaco Hospital, Subiaco, Western Australia, Australia; School of Medicine, University of Western Australia, Crawley, Western Australia, Australia; Women Centre, West Leederville, Western Australia, Australia
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13
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Hajna S, Sharp SJ, Cooper AJM, Williams KM, van Sluijs EMF, Brage S, Griffin SJ, Sutton S. Effectiveness of Minimal Contact Interventions: An RCT. Am J Prev Med 2021; 60:e111-e121. [PMID: 33612170 PMCID: PMC7899959 DOI: 10.1016/j.amepre.2020.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 08/24/2020] [Accepted: 10/05/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Around 23% of adults worldwide are insufficiently active. Wearable devices paired with virtual coaching software could increase physical activity. The effectiveness of 3 minimal contact interventions (paper-based physical activity diaries, activity trackers, and activity trackers coupled with virtual coaching) in increasing physical activity energy expenditure and cardiorespiratory fitness were compared over 12 weeks among inactive adults. METHODS This was an open label, parallel-group RCT. Inactive adults (aged ≥18 years, N=488) were randomized to no intervention (Control; n=121), paper-based diary (Diary; n=124), activity tracker (Activity Band; n=122), or activity tracker plus virtual coaching (Activity Band PLUS; n=121) groups. Coprimary outcomes included 12-week changes in physical activity energy expenditure and fitness (May 2012-January 2014). Analyses were conducted in 2019-2020. RESULTS There were no differences between groups overall (physical activity energy expenditure: p=0.114, fitness: p=0.417). However, there was a greater increase in physical activity energy expenditure (4.21 kJ/kg/day, 95% CI=0.42, 8.00) in the Activity Band PLUS group than in the Diary group. There were also greater decreases in BMI and body fat percentage in the Activity Band PLUS group than in the Control group (BMI= -0.24 kg/m2, 95% CI= -0.45, -0.03; body fat= -0.48%, 95% CI= -0.88, -0.08) and in theActivity Band PLUS group than in the Diary group (BMI= -0.30 kg/m2, 95% CI= -0.50, -0.09; body fat= -0.57%, 95% CI= -0.97, -0.17). CONCLUSIONS Coupling activity trackers with virtual coaching may facilitate increases in physical activity energy expenditure compared with a traditional paper‒based physical activity diary intervention and improve some secondary outcomes compared with a traditional paper‒based physical activity diary intervention or no intervention. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov ISRCTN31844443.
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Affiliation(s)
- Samantha Hajna
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Stephen J Sharp
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Andrew J M Cooper
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Kate M Williams
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Esther M F van Sluijs
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Soren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Simon J Griffin
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
| | - Stephen Sutton
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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14
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Hardcastle SJ, Jiménez-Castuera R, Maxwell-Smith C, Bulsara MK, Hince D. Fitbit wear-time and patterns of activity in cancer survivors throughout a physical activity intervention and follow-up: Exploratory analysis from a randomised controlled trial. PLoS One 2020; 15:e0240967. [PMID: 33075100 PMCID: PMC7571692 DOI: 10.1371/journal.pone.0240967] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/05/2020] [Indexed: 12/16/2022] Open
Abstract
Objective There has been growing interest in the use of smart wearable technology to promote physical activity (PA) behaviour change. However, little is known concerning PA patterns throughout an intervention or engagement with trackers. The objective of the study was to explore patterns of Fitbit-measured PA and wear-time over 24-weeks and their relationship to changes in Actigraph-derived moderate-to-vigorous PA (MVPA). Methods Twenty-nine intervention participants (88%) from the wearable activity technology and action-planning (WATAAP) trial in colorectal and endometrial cancer survivors accepted a Fitbit friend request from the research team to permit monitoring of Fitbit activity. Daily steps and active minutes were recorded for each participant over the 12-week intervention and throughout the follow-up period to 24-weeks. Accelerometer (GT9X) derived MVPA was assessed at end of intervention (12-weeks) and end of follow-up (24-weeks). Results Fitbit wear-time over the 24-weeks of data was remarkably consistent, with median adherence score of 100% for all weeks. During the intervention, participants recorded a median 8006 steps/day. Daily step count was slightly increased through week-13 to week-24 with a median of 8191 steps/day (p = 0.039). Actigraph and Fitbit derived measures were highly correlated but demonstrated poor agreement overall. Fitbit measured activity was closest to MVPA measured using Freedson cut-points as no bias was observed. Conclusions Step count was maintained throughout the trial displaying promise for the effectiveness of smart-wearable interventions to reduce sedentary behaviour beyond the intervention period. Further worthwhile work should compare more advanced smart-wearable technology with accelerometers in order to improve agreement and explore less resource-intensive methods to assess PA that could be scalable.
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Affiliation(s)
- Sarah J. Hardcastle
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
- * E-mail:
| | | | - Chloé Maxwell-Smith
- School of Psychology, Curtin University, Bentley, Perth, Western Australia, Australia
| | - Max K. Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Dana Hince
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
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15
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Maxwell-Smith C, Hagger MS, Kane R, Cohen PA, Tan J, Platell C, Makin GB, Saunders C, Nightingale S, Lynch C, Sardelic F, McCormick J, Hardcastle SJ. Psychological correlates of physical activity and exercise preferences in metropolitan and nonmetropolitan cancer survivors. Psychooncology 2020; 30:221-230. [PMID: 32920935 DOI: 10.1002/pon.5553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Interventions to increase physical activity (PA) in cancer survivors have often adopted a "one-size-fits-all" approach and may benefit from being tailored to psychological constructs associated with behavior. The study objective was to investigate the exercise preferences and psychological constructs related to PA among cancer survivors. METHODS Posttreatment colorectal, endometrial, and breast cancer survivors (n = 183) living in metropolitan and nonmetropolitan areas completed survey measures of PA, exercise preferences, attitudes, self-efficacy, perceived behavioral control (PBC), and intention toward PA. RESULTS A structural equation model with adequate fit and quality indices revealed that instrumental attitude and self-efficacy were related to PA intention. Intention was related to behavior and mediated the relationship between self-efficacy and behavior. Preferred exercise intensity was related to self-efficacy, PBC, attitudes, and intention, while preferred exercise company was related to self-efficacy and PBC. Participants preferred moderate-intensity PA (71%), specifically self-paced (52%) walking (65%) in an outdoor environment (58%). CONCLUSIONS Since instrumental attitude and self-efficacy were associated with PA, incorporating persuasive communications targeting attitudes in PA interventions may promote PA participation. As cancer survivors who prefer low-intensity exercise and exercising with others report lower self-efficacy and PBC, interventions targeting confidence and successful experience in this group may also be warranted.
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Affiliation(s)
- Chloe Maxwell-Smith
- School of Psychology, Curtin University, Perth, Western Australia, Australia.,Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Martin S Hagger
- School of Psychological Sciences, University of California, Merced, USA.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Robert Kane
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Paul A Cohen
- St John of God Hospital, Subiaco, Western Australia, Australia
| | - Jason Tan
- St John of God Hospital, Subiaco, Western Australia, Australia
| | - Cameron Platell
- St John of God Hospital, Subiaco, Western Australia, Australia
| | | | | | | | - Craig Lynch
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Frank Sardelic
- Tamara Private Hospital, Tamworth, New South Wales, Australia
| | | | - Sarah J Hardcastle
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia.,School of Health and Human Performance, Dublin City University, Dublin, Ireland
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16
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Henriksen A, Sand AS, Deraas T, Grimsgaard S, Hartvigsen G, Hopstock L. Succeeding with prolonged usage of consumer-based activity trackers in clinical studies: a mixed methods approach. BMC Public Health 2020; 20:1300. [PMID: 32854671 PMCID: PMC7457262 DOI: 10.1186/s12889-020-09406-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lack of physical activity (PA) is a risk factor for death and non-communicable disease. Despite this, more than one fourth of adults worldwide do not follow PA guidelines. As part of a feasibility study to test a complex intervention for increasing PA, we included a consumer-based activity tracker (AT) as a tool to measure PA outcomes and to track heart rate during exercise sessions. The aim of the present study was to identify factors that increase wear time when using a consumer-based AT for monitoring of participants in clinical research. METHODS Sixteen participants aged 55-74 years, with obesity, sedentary lifestyle, and elevated cardiovascular risk were recruited to a 12-month feasibility study. Participants wore a Polar M430 AT to collect continuous PA data during a six-month intervention followed by 6 months of follow-up. We performed quantitative wear time analysis, tested the validity of the AT, and completed two rounds of qualitative interviews to investigate how individual wear-time was linked to participant responses. RESULTS From 1 year of tracking, mean number of valid wear days were 292 (SD = 86), i.e. 80%. The Polar M430 provides acceptable measurements for total energy expenditure. Motivations for increased wear time were that participants were asked to wear it and the ability to track PA progress. Perceived usefulness included time keeping, heart rate- and sleep tracking, becoming more conscious about day-to-day activity, and improved understanding of which activity types were more effective for energy expenditure. Sources of AT annoyance were measurement inaccuracies and limited instruction for use. Suggestions for improvement were that the AT was big, unattractive, and complicated to use. CONCLUSIONS Adherence to wearing a consumer-based AT was high. Results indicate that it is feasible to use a consumer-based AT to measure PA over a longer period. Potential success factors for increased wear time includes adequate instruction for AT use, allowing participants to choose different AT designs, and using trackers with accurate measurements. To identify accurate trackers, AT validation studies in the target cohort may be needed. TRIAL REGISTRATION U.S. National Library of Medicine, Clinical Trial registry: NCT03807323 ; Registered 16 September 2019 - Retrospectively registered.
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Affiliation(s)
- André Henriksen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Anne-Sofie Sand
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trygve Deraas
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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17
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Maxwell-Smith C, Cohen PA, Platell C, Tan J, Saunders C, Nightingale S, Lynch C, Sardelic F, McCormick J, Hardcastle SJ. "To be there for my family" and "Keep my independence": Metropolitan and Non-Metropolitan Cancer Survivors' Health Behaviour Motives. Support Care Cancer 2020; 29:1969-1976. [PMID: 32827055 DOI: 10.1007/s00520-020-05690-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/14/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE Cancer survivors are at risk of comorbidities and mortality, and those living outside of metropolitan areas are particularly susceptible given poorer socioeconomic, health and support resources. As engagement in health behaviours is affected by participants' autonomous motives, investigation of the motives of cancer survivors in metropolitan and non-metropolitan areas could elucidate the values and reasons for practising health behaviours, allowing programs to be tailored to these motives. METHODS Metropolitan (n = 103) and non-metropolitan (n = 80) Australian cancer survivors completed a survey item by describing their motives for physical activity and healthy diet change. Inductive thematic analysis of responses was performed to establish themes across health behaviour motives. RESULTS Analyses revealed four themes: to be able to, longevity, psychological health and appearance. Survivors primarily referred to being able to enjoy family, leisure activities, travel and staying independent, with these motives often linked to longevity. Motives were similar across locations; however, those in non-metropolitan locations reported continuation of work and pain relief more frequently. Female survivors more often reported weight loss. CONCLUSIONS A predominant motive for health behaviour change in cancer survivors across geographical location was the ability to enjoy family and engage in leisure and work activities. Programs aiming to promote health behaviours in cancer survivors might consider framing interventions accordingly by emphasizing benefits of longevity and maintaining independence.
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Affiliation(s)
- Chloé Maxwell-Smith
- School of Psychology, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia. .,Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia.
| | - Paul A Cohen
- St John of God Hospital, Subiaco, Western Australia, Australia.,Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Cameron Platell
- St John of God Hospital, Subiaco, Western Australia, Australia.,University of Western Australia Medical School, University of Western Australia, Crawley, Western Australia, Australia
| | - Jason Tan
- Women Centre, West Leederville, Western Australia, Australia
| | - Christobel Saunders
- St John of God Hospital, Subiaco, Western Australia, Australia.,University of Western Australia Medical School, University of Western Australia, Crawley, Western Australia, Australia
| | | | - Craig Lynch
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Frank Sardelic
- Tamara Private Hospital, Tamworth, New South Wales, Australia
| | | | - Sarah J Hardcastle
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia.,School of Health and Human Performance, Dublin City University, Dublin, Ireland
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Ayyoubzadeh SM, R. Niakan Kalhori S, Shirkhoda M, Mohammadzadeh N, Esmaeili M. Supporting colorectal cancer survivors using eHealth: a systematic review and framework suggestion. Support Care Cancer 2020; 28:3543-3555. [DOI: 10.1007/s00520-020-05372-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/20/2020] [Indexed: 01/01/2023]
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19
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Vallance JK, Nguyen NH, Moore MM, Reeves MM, Rosenberg DE, Boyle T, Milton S, Friedenreich CM, English DR, Lynch BM. Effects of the ACTIVity And TEchnology (ACTIVATE) intervention on health-related quality of life and fatigue outcomes in breast cancer survivors. Psychooncology 2019; 29:204-211. [PMID: 31763746 DOI: 10.1002/pon.5298] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The ACTIVATE Trial examined the efficacy of a wearable-based intervention to increase physical activity and reduce sedentary behavior in breast cancer survivors. This paper examines the effects of the intervention on health-related quality of life (HRQoL) and fatigue at 12 weeks (T2; end of intervention) and 24 weeks (T3; follow-up). METHODS Inactive and postmenopausal women who had completed primary treatment for stage I-III breast cancer were randomized to intervention or waitlist control. Physical activity and sedentary behavior were measured by Actigraph and activPAL accelerometers at baseline (T1), end of the intervention (T2), and 12 weeks follow-up (T3). HRQoL and fatigue were measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B) and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). Primary intervention effects were evaluated comparing intervention and waitlist group at T2 using repeated measures mixed effects models. RESULTS Overall, 83 women were randomized and trial retention was high (94%). A 4.6-point difference in fatigue score was observed between groups at T2 (95% CI: 1.3, 7.8) indicating improvement in fatigue profiles in the intervention group. In within groups analyses, the intervention group reported a 5.1-point increase in fatigue from baseline to T2 (95% CI: 2.0, 8.2) and a 3.3-point increase from baseline to T3 (95% CI: 0.1, 6.41). CONCLUSIONS Despite small improvements in fatigue profiles, no effects on HRQoL were observed. While the ACTIVATE Trial was associated with improvements in physical activity and sedentary behavior, more intensive or longer duration interventions may be needed to facilitate changes in HRQoL.
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Affiliation(s)
- Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Nga H Nguyen
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melissa M Moore
- Medical Oncology, St Vincent's Hospital, Melbourne, Victoria, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marina M Reeves
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Terry Boyle
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Shakira Milton
- Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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20
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Psychometric properties of the Connor-Davidson Resilience Scale in women with breast cancer. Int J Clin Health Psychol 2019; 20:81-89. [PMID: 32021622 PMCID: PMC6994746 DOI: 10.1016/j.ijchp.2019.11.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/18/2019] [Indexed: 12/28/2022] Open
Abstract
The aim was to analyse the psychometric properties of the 10-item version of the Connor-Davidson Resilience Scale (CD-RISC 10©) in breast cancer patients. Method: A sample of 169 Spanish women who had undergone surgery for breast cancer completed the CD-RISC 10©, along with questionnaires assessing life satisfaction, emotional intelligence, self-esteem, and positive and negative affect. Results: Confirmatory Factor Analysis supported a single-factor structure with adequate fit indices. Reliability was analysed by calculating McDonald’s omega coefficient, which yielded a value of .83. Validity evidence based on relationships with other variables was provided by positive and significant correlations between scores on the CD-RISC 10© and scores on emotional intelligence (clarity and repair), life satisfaction, self-esteem and positive affect, and by a negative and significant correlation with negative affect. The majority of these correlations were above |.50|. Conclusions: The CD-RISC 10© has satisfactory psychometric properties and is a suitable tool for measuring resilience in patients with cancer. The instrument is quick and easy to apply and may be used in both clinical and research contexts.
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Maxwell-Smith C, Hince D, Cohen PA, Bulsara MK, Boyle T, Platell C, Tan P, Levitt M, Salama P, Tan J, Salfinger S, Makin G, Mohan GRKA, Jiménez-Castuera R, Hardcastle SJ. A randomized controlled trial of WATAAP to promote physical activity in colorectal and endometrial cancer survivors. Psychooncology 2019; 28:1420-1429. [PMID: 30980691 DOI: 10.1002/pon.5090] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of this study was to ascertain whether wearable technology coupled with action planning was effective in increasing physical activity (PA) in colorectal and endometrial cancer survivors at cardiovascular risk. METHODS Sixty-eight survivors who had cardiovascular risk factors and were insufficiently active were randomized to intervention and control arms. Intervention participants were given a wearable tracker for 12 weeks, two group sessions, and a support phone call. Participants in the control arm received print materials describing PA guidelines. Assessments at baseline and 12 weeks measured triaxial and uniaxial estimates of moderate-vigorous physical activity (MVPA), sedentary behaviour, blood pressure, and body mass index (BMI). RESULTS The intervention group significantly increased MVPA by 45 min/wk compared with a reduction of 21 min/wk in the control group. Group by time interactions were significant for minutes of MVPA (F1,126 = 5.14, P = 0.025). For those with diastolic hypertension, there was a significant group by time interaction (F1,66 = 4.89, P = 0.031) with a net reduction of 9.89 mm Hg in the intervention group. CONCLUSIONS Significant improvements in MVPA were observed following the intervention. The results display promise for the use of pragmatic, low-intensity interventions using wearable technology.
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Affiliation(s)
| | - Dana Hince
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia
| | - Paul A Cohen
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia
- Faculty of Medical and Health Sciences, University of Western Australia, Crawley, Western Australia
- Women Western Australia Oncology Menopause Endometriosis New Mothers, West Leederville, Western Australia
- St John of God Subiaco Hospital, Subiaco, Western Australia
| | - Max K Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia
| | - Terry Boyle
- University of South Australia, Adelaide, South Australia
| | - Cameron Platell
- Faculty of Medical and Health Sciences, University of Western Australia, Crawley, Western Australia
- St John of God Subiaco Hospital, Subiaco, Western Australia
| | - Patrick Tan
- St John of God Subiaco Hospital, Subiaco, Western Australia
| | - Michael Levitt
- St John of God Subiaco Hospital, Subiaco, Western Australia
| | - Paul Salama
- St John of God Subiaco Hospital, Subiaco, Western Australia
| | - Jason Tan
- Women Western Australia Oncology Menopause Endometriosis New Mothers, West Leederville, Western Australia
| | | | - Gregory Makin
- St John of God Murdoch Hospital, Murdoch, Western Australia
| | | | | | - Sarah J Hardcastle
- School of Psychology, Curtin University, Perth, Western Australia
- Faculty of Medical and Health Sciences, University of Western Australia, Crawley, Western Australia
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Hardcastle SJ, Hince D, Jiménez-Castuera R, Boyle T, Cavalheri V, Makin G, Tan P, Salfinger S, Tan J, Mohan GR, Levitt M, Cohen PA, Saunders C, Platell C. Promoting physical activity in regional and remote cancer survivors (PPARCS) using wearables and health coaching: randomised controlled trial protocol. BMJ Open 2019; 9:e028369. [PMID: 31129600 PMCID: PMC6538194 DOI: 10.1136/bmjopen-2018-028369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Physically active cancer survivors have substantially less cancer recurrence and improved survival compared with those who are inactive. However, the majority of survivors (70%-90%) are not meeting the physical activity (PA) guidelines. There are also significant geographic inequalities in cancer survival with poorer survival rates for the third of Australians who live in non-metropolitan areas compared with those living in major cities. The primary objective of the trial is to increase moderate-to-vigorous PA (MVPA) among cancer survivors living in regional and remote Western Australia. Secondary objectives are to reduce sedentary behaviour and in conjunction with increased PA, improve quality of life (QoL) in non-metropolitan survivors. Tertiary objectives are to assess the effectiveness of the health action process approach (HAPA) model variables, on which the intervention is based, to predict change in MVPA. METHODS AND ANALYSIS Eighty-six cancer survivors will be randomised into either the intervention or control group. Intervention group participants will receive a Fitbit and up to six telephone health-coaching sessions. MVPA (using Actigraph), QoL and psychological variables (based on the HAPA model via questionnaire) will be assessed at baseline, 12 weeks (end of intervention) and 24 weeks (end of follow-up). A general linear mixed model will be used to assess the effectiveness of the intervention. ETHICS AND DISSEMINATION Ethics approval has been obtained from St John of God Hospital Subiaco (HREC/#1201). We plan to submit a manuscript of the results to a peer-reviewed journal. Results will be presented at conferences, community and consumer forums and hospital research conferences. TRIAL REGISTRATION NUMBER ACTRN12618001743257; pre-results, U1111-1222-5698.
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Affiliation(s)
- Sarah J Hardcastle
- School of Psychology, Curtin University, Bentley, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
- Institute of Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Dana Hince
- Institute of Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | | | - Terry Boyle
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Vinicius Cavalheri
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Greg Makin
- General Surgery, St John of God Murdoch Hospital, Murdoch, Western Australia, Australia
| | - Patrick Tan
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Stuart Salfinger
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Jason Tan
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | | | - Michael Levitt
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Paul A Cohen
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Christobel Saunders
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Cameron Platell
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
- St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
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Bellver-Pérez A, Peris-Juan C, Santaballa-Beltrán A. Effectiveness of therapy group in women with localized breast cancer. Int J Clin Health Psychol 2019; 19:107-114. [PMID: 31193149 PMCID: PMC6517697 DOI: 10.1016/j.ijchp.2019.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 02/05/2019] [Indexed: 11/12/2022] Open
Abstract
Background/Objective Breast cancer causes high levels of anxiety and depression, deteriorating quality of life of patients. Several studies have found that group therapy reduces depression and anxiety also improves the quality of life. The aim of this study is to analyze group therapy effectiveness in emotional state and quality of life in women with breast cancer after finalized medical treatments. Method Participants in this study were 100 adult women diagnosed of breast cancer non-mestastasic and were divided into two types of intervention groups (Self-esteem-Social Skills and Cognitive-Behavioral Therapy). Evaluation instruments were questionnaire Functional Assessment of Breast-cancer Therapy (FACT-B) and Hospital Anxiety and Depression Scale (HADS). Results A statistically significant effect of group therapy in reducing anxiety and depression were observed. Quality of life and emotional well-being significantly improved. These effects remain three months after intervention. Conclusions The results show that the psychological intervention group is efficient to improve emotional state and quality of life of women with breast cancer.
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Affiliation(s)
- Ascensión Bellver-Pérez
- Hospital Pare Jofre Valencia and Departament Personalitat, Avaluació i Tractaments Psicològics. Universitat de València, Spain
| | | | - Ana Santaballa-Beltrán
- Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe de Valencia, Spain
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