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Ahmed S, Lazo Green K, McGarrigle L, Money A, Pendleton N, Todd C. Interventions Based on Behavior Change Techniques to Encourage Physical Activity or Decrease Sedentary Behavior in Community-Dwelling Adults Aged 50-70: Systematic Review With Intervention Component Analysis. J Aging Phys Act 2024; 32:554-577. [PMID: 38663855 DOI: 10.1123/japa.2023-0140] [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: 05/04/2023] [Revised: 11/27/2023] [Accepted: 02/10/2024] [Indexed: 07/18/2024]
Abstract
Increasing physical activity (PA) and/or decreasing sedentary behaviors is important in the delay and prevention of long-term conditions. PA can help maintain function and independence and decrease the need for hospitalization/institutionalization. Activity rates often decline in later life resulting in a need for interventions that encourage uptake and adherence through the use of Behavior Change Techniques (BCTs). We conducted a systematic review of the evidence for interventions that included BCTs in community-dwelling adults with a mean age of 50-70. The review followed PRISMA guidelines. The interventions were psychosocial, nonpharmacological, and noninvasive interventions utilizing components based on BCTs that evaluated change in PA and/or sedentary behavior. Intervention Component Analysis (ICA) was used to synthesize effectiveness of intervention components. Twelve randomized controlled trials were included in this review. The mean sample age was 50-64. Thirteen BCTs were used across all studies, and the most commonly used techniques were goals and planning, feedback and monitoring, and natural consequences. Seven intervention components linked with BCTs were found: personalized goal setting, tailored feedback from facilitators, on-site and postintervention support, education materials and resources, reinforcing change on behavior and attitudes, self-reported monitoring, and social connectedness. All components, except for social connectedness, were associated with improved health behavior and PA levels. The interventions that use BCTs have incorporated strategies that reinforce change in behavior and attitudes toward PA.
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Affiliation(s)
- Saima Ahmed
- National Institute of Health and Care Research Applied Research Collaboration-Greater Manchester (NIHR ARC-GM), The University of Manchester, Manchester, United Kingdom
- Healthy Ageing Research Group (HARG), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing (MICRA), Manchester, United Kingdom
| | - Kimberly Lazo Green
- Healthy Ageing Research Group (HARG), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing (MICRA), Manchester, United Kingdom
| | - Lisa McGarrigle
- Healthy Ageing Research Group (HARG), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing (MICRA), Manchester, United Kingdom
| | - Annemarie Money
- National Institute of Health and Care Research Applied Research Collaboration-Greater Manchester (NIHR ARC-GM), The University of Manchester, Manchester, United Kingdom
- Healthy Ageing Research Group (HARG), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing (MICRA), Manchester, United Kingdom
| | - Neil Pendleton
- National Institute of Health and Care Research Applied Research Collaboration-Greater Manchester (NIHR ARC-GM), The University of Manchester, Manchester, United Kingdom
- Healthy Ageing Research Group (HARG), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing (MICRA), Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Chris Todd
- National Institute of Health and Care Research Applied Research Collaboration-Greater Manchester (NIHR ARC-GM), The University of Manchester, Manchester, United Kingdom
- Healthy Ageing Research Group (HARG), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing (MICRA), Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Zhao W, Wang Y, Cao C, Zeng Z, Jin L, Liu Z, Duan M, Dong Y, Zhang J, Shuai Y, Wang N, Zhang Y, Deng G, He J, Zhao X, Zheng W, Yang W, Xiao J. The feasibility and efficacy of a community-based multifactorial intervention to improve the cardiovascular risk factor control among patients with type 2 diabetes: A 2-year cluster randomized trial. Medicine (Baltimore) 2022; 101:e31943. [PMID: 36595814 PMCID: PMC9794231 DOI: 10.1097/md.0000000000031943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
TRIAL DESIGN Our study is to investigate the feasibility and effectiveness of multiple cardiovascular factors intervention (MFI) in type 2 diabetes patients in China's primary care setting. METHODS We performed a cluster randomized trial to compare the proportion of patients achieved the targets between usual care group (control, 9 sites, n = 868) and MFI group (8 sites, n = 739) among patients with type 2 diabetes in primary care setting. Logistic regression model with random effects was used to estimate the association of the effect of intervention and the proportion achieved the targets. RESULTS At baseline, the end of 1 year, and 2 years follow-up, the proportion of patients achieved all 3 target goals (HbA1c < 7.0%, blood pressure < 130/80 mm Hg and low-density lipoprotein cholesterol < 2.6 mmol/L) were 5.7%, 5.9%, 5.7% in the control group and 5.9%, 10.6%, 12.3% in the MFI group. After adjusting sex, age, diabetes duration, body mass index, HbA1c, blood pressure, and low-density lipoprotein cholesterol at baseline, there was no difference between the 2 groups (OR (95% CI): 1.27 (0.38-4.27) and 1.86 (0.79-4.38) for the first year and second year, respectively). When stratified by payment method, the patients with medical insurance or public expenses had a higher proportion achieved target goals (6.9% vs 16.4%, OR (95% CI): 2.30 (1.04-5.08)) in the second year. CONCLUSIONS The controlling of cardiovascular risk factor targets remains suboptimal among patients with type 2 diabetes in primary care setting. MFI in type 2 diabetes improved cardiovascular disease risk profile, especially in the patients with medical insurance.
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Affiliation(s)
- Wenhui Zhao
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yanlei Wang
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Chenxiang Cao
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ziqiang Zeng
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lixia Jin
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Zhaoxiang Liu
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Min Duan
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yanan Dong
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | | | - Ying Shuai
- China-Japan Friendship Hospital, Beijing, China
| | - Na Wang
- China-Japan Friendship Hospital, Beijing, China
| | - Yajing Zhang
- Beijing Pinggu District Hospital, Beijing, China
| | - Guixia Deng
- Beijing Pinggu District Yukou Community Central Health Center, Beijing, China
| | - Jiquan He
- Beijing Pinggu District Xiagezhuang Township Hospital, Beijing, China
| | - Xinghua Zhao
- Beijing Huairou District Yangsong Township Hospital, Beijing, China
| | - Wenli Zheng
- Beijing Daxing District Yinghai Community Central Health Center, Beijing, China
| | | | - Jianzhong Xiao
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
- *Correspondence: Jianzhong Xiao, MD, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No.168 Litang Road, Changping District, Beijing 102218, China (e-mail: )
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Segura-Jiménez V, Biddle SJH, De Cocker K, Khan S, Gavilán-Carrera B. Where Does the Time Go? Displacement of Device-Measured Sedentary Time in Effective Sedentary Behaviour Interventions: Systematic Review and Meta-Analysis. Sports Med 2022; 52:2177-2207. [PMID: 35567719 DOI: 10.1007/s40279-022-01682-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Research has shown the effectiveness of sedentary behaviour interventions on reducing sedentary time. However, no systematic review has studied where the reduced sedentary time after such interventions is displaced to. OBJECTIVE Our objective was to synthesize the evidence from interventions that have reduced sedentary behaviour and test the displacement of sedentary time into physical activity (light physical activity [LPA], moderate-to-vigorous physical activity [MVPA], standing, and stepping). METHODS Two independent researchers performed a systematic search of the EBSCOhost, PubMed, Scopus, and Web of Science electronic databases. Meta-analyses were performed to examine the time reallocated from sedentary behaviour to physical activity during working time and the whole day in intervention trials (randomized/non-randomized controlled/non-controlled). RESULTS A total of 36 studies met all the eligibility criteria and were included in the systematic review, with 26 studies included in the meta-analysis. Interventions showed a significant overall increase in worksite LPA (effect size [ES] 0.24; 95% confidence interval [CI] 0.05 to 0.43; P < 0.013) and daily LPA (ES 0.62; 95% CI 0.34 to 0.91; P = 0.001). A statistically significant increase in daily MVPA was observed (ES 0.47; 95% CI 0.26 to 0.67; P < 0.001). There was a significant overall increase in worksite standing time (ES 0.76; 95% CI 0.56 to 0.95; P < 0.001), daily standing time (ES 0.52; 95% CI 0.38 to 0.65; P < 0.001), and worksite stepping time (ES 0.12; 95% CI 0.04 to 0.20; P = 0.002). CONCLUSIONS Effective interventions aimed at reducing sedentary behaviour result in a consistent displacement of sedentary time to LPA and standing time, both at worksites and across the whole day, whereas changes in stepping time or MVPA are dependent on the intervention setting. Strategies to reduce sedentary behaviour should not be limited to worksite settings, and further efforts may be required to promote daily MVPA. TRIAL REGISTRATION PROSPERO registration number CRD42020153958.
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Affiliation(s)
- Víctor Segura-Jiménez
- Hospital Universitario Virgen de las Nieves of Granada, Granada, Spain. .,Instituto de Investigación Biosanitaria ibs.GRANADA, Avda. de Madrid, 15, 18012, Granada, Spain. .,GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain. .,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain.
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Katrien De Cocker
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia.,Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Shahjahan Khan
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia.,School of Sciences, University of Southern Queensland, Toowoomba, QLD, Australia.,Asian University of Bangladesh, Ashulia, Dhaka, Bangladesh
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
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Stark AL, Geukes C, Dockweiler C. Digital Health Promotion and Prevention in Settings: Scoping Review. J Med Internet Res 2022; 24:e21063. [PMID: 35089140 PMCID: PMC8838600 DOI: 10.2196/21063] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/16/2020] [Accepted: 12/02/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Digital technologies are increasingly integrating into people's daily living environments such as schools, sport clubs, and health care facilities. These settings play a crucial role for health promotion and prevention because they affect the health of their members, as the World Health Organization has declared. Implementing digital health promotion and prevention in settings offers the opportunity to reach specific target groups, lower the costs of implementation, and improve the health of the population. Currently, there is a lack of scientific evidence that reviews the research on digital health promotion and prevention in settings. OBJECTIVE This scoping review aims to provide an overview of research targeting digital health promotion and primary prevention in settings. It assesses the range of scientific literature regarding outcomes such as applied technology, targeted setting, and area of health promotion or prevention, as well as identifies research gaps. METHODS The scoping review was conducted following the Levac, Colquhoun, and O'Brien framework. We searched scientific databases and gray literature for articles on digital setting-based health promotion and prevention published from 2010 to January 2020. We included empirical and nonempirical publications in English or German and excluded secondary or tertiary prevention and health promotion at the workplace. RESULTS From 8888 records, the search resulted in 200 (2.25%) included publications. We identified a huge diversity of literature regarding digital setting-based health promotion and prevention. The variety of technology types extends from computer- and web-based programs to mobile devices (eg, smartphone apps) and telemonitoring devices (sensors). We found analog, digital, and blended settings in which digital health promotion and prevention takes place. The most frequent analog settings were schools (39/200, 19.5%) and neighborhoods or communities (24/200, 12%). Social media apps were also included because in some studies they were defined as a (digital) setting. They accounted for 31.5% (63/200) of the identified settings. The most commonly focused areas of health promotion and prevention were physical activity (81/200, 40.5%), nutrition (45/200, 22.5%), and sexual health (34/200, 17%). Most of the interventions combined several health promotion or prevention methods, including environmental change; providing information, social support, training, or incentives; and monitoring. Finally, we found that the articles mostly reported on behavioral rather than structural health promotion and prevention. CONCLUSIONS The research field of digital health promotion and prevention in settings is heterogeneous. At the same time, we identified research gaps regarding the absence of valid definitions of relevant terms (eg, digital settings) and the lack of literature on structural health promotion and prevention in settings. Therefore, it remains unclear how digital technologies can contribute to structural (or organizational) changes in settings. More research is needed to successfully implement digital technologies to achieve health promotion and prevention in settings.
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Affiliation(s)
- Anna Lea Stark
- School of Public Health, Centre for ePublic Health, Bielefeld University, Bielefeld, Germany
| | - Cornelia Geukes
- School of Public Health, Centre for ePublic Health, Bielefeld University, Bielefeld, Germany
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Hassen HY, Ndejjo R, Musinguzi G, Van Geertruyden JP, Abrams S, Bastiaens H. Effectiveness of community-based cardiovascular disease prevention interventions to improve physical activity: A systematic review and meta-regression. Prev Med 2021; 153:106797. [PMID: 34508731 DOI: 10.1016/j.ypmed.2021.106797] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 12/14/2022]
Abstract
Cardiovascular diseases (CVDs) remain a leading cause of morbidity and mortality globally. Despite preventive community-based interventions (CBIs) seem efficacious in reducing CVD risks, a comprehensive up-to-date synthesis on the effectiveness of such interventions in improving physical activity (PA) is lacking. We performed a systematic review and meta-analysis of community-based CVD preventive interventions aimed at improving PA level. MEDLINE, EMBASE, CINAHL, Cochrane register and PSYCINFO databases were searched in October 2019 for studies reported between January 2000 and June 2019. We assessed the methodological quality of included studies using the Cochrane risk of bias tools. We performed a random-effects meta-analysis and meta-regression to pool estimates of various effect measures. Results are reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline. Our study protocol was registered in the PROSPERO database (CRD42019119885). A total of 44 randomized and 20 non-randomized controlled studies involving 98,919 participants were included. Meta-analyses found that CBIs improved the odds of attaining the recommended PA level (at least 150 min of moderate and vigorous PA (MVPA)/week) at 12 month (OR: 1.62; 95%CI: 1.25-2.11) and 18 to 24 months of follow-up (OR: 1.46; 95%CI: 1.12-1.91). Furthermore, interventions were effective in improving metabolic equivalents of task at 12 month (standardized mean difference (SMD): 0.28; 95% CI: 0.03-0.53), MVPA time at 12 to 18 months (SMD: 0.34; 95%CI: 0.05-0.64), steps per day (SMD: 0.32; 95%CI: 0.08-0.55), and sitting time (SMD: -0.25; 95%CI: -0.34 to -0.17). Subgroup analyses found that interventions in low- and middle-income countries showed a greater positive effect on attainment of recommended PA level (OR: 1.40; 95%CI: 1.02-1.92) than those in high-income countries (OR: 1.31; 95%CI: 0.96-1.78). Moreover, interventions targeting high-risk groups showed greater effectiveness than those targeting the general population (OR: 1.76; 95%CI: 1.30-2.39 vs. 1.17; 95%CI: 0.89-1.55). In conclusion, community-based CVD preventive interventions have a positive impact on improving the PA level, albeit that relevant studies in lower-middle and low-income countries are limited. With the rising burden of CVDs, rolling out CBIs targeting the general population and high-risk groups are needed to control the growing CVD-burden.
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Affiliation(s)
- Hamid Yimam Hassen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium.
| | - Rawlance Ndejjo
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium; Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Geofrey Musinguzi
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium; Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Jean-Pierre Van Geertruyden
- Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium
| | - Steven Abrams
- Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium; Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, Hasselt University, Diepenbeek 3590, Belgium
| | - Hilde Bastiaens
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium; Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium
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Fraysse F, Post D, Eston R, Kasai D, Rowlands AV, Parfitt G. Physical Activity Intensity Cut-Points for Wrist-Worn GENEActiv in Older Adults. Front Sports Act Living 2021; 2:579278. [PMID: 33521631 PMCID: PMC7843957 DOI: 10.3389/fspor.2020.579278] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose: This study aims to (1) establish GENEActiv intensity cutpoints in older adults and (2) compare the classification accuracy between dominant (D) or non-dominant (ND) wrist, using both laboratory and free-living data. Methods: Thirty-one older adults participated in the study. They wore a GENEActiv Original on each wrist and performed nine activities of daily living. A portable gas analyzer was used to measure energy expenditure for each task. Testing was performed on two occasions separated by at least 8 days. Some of the same participants (n = 13) also wore one device on each wrist during 3 days of free-living. Receiver operating characteristic analysis was performed to establish the optimal cutpoints. Results: For sedentary time, both dominant and non-dominant wrist had excellent classification accuracy (sensitivity 0.99 and 0.97, respectively; specificity 0.91 and 0.86, respectively). For Moderate to Vigorous Physical Activity (MVPA), the non-dominant wrist device had better accuracy (ND sensitivity: 0.90, specificity 0.79; D sensitivity: 0.90, specificity 0.64). The corresponding cutpoints for sedentary-to-light were 255 and 375 g · min (epoch independent: 42.5 and 62.5 mg), and those for the light-to-moderate were 588 and 555 g · min (epoch-independent: 98.0 and 92.5 mg) for the non-dominant and dominant wrist, respectively. For free-living data, the dominant wrist device resulted in significantly more sedentary time and significantly less light and MVPA time compared to the non-dominant wrist.
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Affiliation(s)
- François Fraysse
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Dannielle Post
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Roger Eston
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Daiki Kasai
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Alex V Rowlands
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, United Kingdom.,Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Gaynor Parfitt
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
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Effects of a six-week mobile app versus paper book intervention on quality of life, symptoms, and self-care in patients with fibromyalgia: a randomized parallel trial. Braz J Phys Ther 2020; 25:428-436. [PMID: 33248904 DOI: 10.1016/j.bjpt.2020.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/23/2020] [Accepted: 10/26/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The ProFibro application (app) was developed as a Mobile Health resource to promote self-care in fibromyalgia management. OBJECTIVE This study aimed to assess the effects of the use of the ProFibro app for six weeks compared to the use of a traditional paper book of similar content to improve health-related quality of life, symptoms, and self-care agency in individuals with fibromyalgia. METHODS Forty individuals with fibromyalgia were included in this randomized, single-blind, parallel trial. One group received intervention content using the ProFibro app on a smartphone while the other received similar information using a paper book. Participants were assessed at baseline and after six weeks. The primary outcome was the Revised Fibromyalgia Impact Questionnaire. Secondary outcomes were Widespread Pain Index, Pain Visual Analog Scale, Symptom Severity Scale, and Appraisal of Self-Care Agency Scale - Revised. RESULTS No differences in changes were found between groups at the end of the treatment for any outcome. Both groups showed improvements in symptom severity. CONCLUSIONS The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. Both groups showed improvements from baseline on severity of symptoms, suggesting that the self-care program using a mobile app or a paper book may be beneficial for individuals with fibromyalgia.
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de Oliveira Silva D, Rathleff MS, Holden S, Bell E, Azevedo F, Pazzinatto MF, Barton C. Patients and clinicians managing patellofemoral pain should not rely on general web-based information. Phys Ther Sport 2020; 45:176-180. [PMID: 32810696 DOI: 10.1016/j.ptsp.2020.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/11/2020] [Accepted: 07/14/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the credibility and accuracy of PFP-specific web-based content. DESIGN Cross-sectional evaluation of web-based information. METHODS The study protocol was registered with PROSPERO (CRD42018088671). Two search engines (Google and Bing) were used to search for websites offering information about PFP. Two reviewers assessed the websites for credibility-related and PFP-specific content. PFP-specific content was evaluated according to agreement with current international PFP consensus statements. Based on this, content was rated as (i) Accurate/Clearly described; (ii) Partially accurate/Description lacks clarity; (iii) Inaccurate/Misleading description; or (iv) Not mentioned. RESULTS After exclusion of duplicates, forty online websites were included in our analyses. 43% of websites did not mention their source of information, and 48% did not mention if the source material was peer-reviewed. Misleading/inaccurate information was most commonly found in the definition of PFP (20% websites) and clinical examination (15%). Twenty-two percent of websites recommended surgery as treatment. The item most frequently rated as accurate/clearly described was PFP terminology (87.5%). CONCLUSION This study highlights missing, inaccurate or poorly described web-based PFP information. Due to the commonality of PFP and potential for improving self-management, there is an urgent need to develop more accurate and comprehensive web-based patient education resources for PFP.
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Affiliation(s)
- Danilo de Oliveira Silva
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Sao Paulo State University (UNESP), School of Science and Technology, Presidente Prudente, Brazil.
| | - Michael Skovdal Rathleff
- Center for General Practice at Aalborg University, Aalborg, Denmark; SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Sinead Holden
- Center for General Practice at Aalborg University, Aalborg, Denmark; SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Emily Bell
- Sao Paulo State University (UNESP), School of Science and Technology, Presidente Prudente, Brazil
| | - Fábio Azevedo
- Sao Paulo State University (UNESP), School of Science and Technology, Presidente Prudente, Brazil
| | - Marcella Ferraz Pazzinatto
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Sao Paulo State University (UNESP), School of Science and Technology, Presidente Prudente, Brazil
| | - Christian Barton
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
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9
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Blackburn NE, Wilson JJ, McMullan II, Caserotti P, Giné-Garriga M, Wirth K, Coll-Planas L, Alias SB, Roqué M, Deidda M, Kunzmann AT, Dallmeier D, Tully MA. The effectiveness and complexity of interventions targeting sedentary behaviour across the lifespan: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:53. [PMID: 32334631 PMCID: PMC7183680 DOI: 10.1186/s12966-020-00957-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/13/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Evidence suggests that sedentary behaviour (SB) is associated with poor health outcomes. SB at any age may have significant consequences for health and well-being and interventions targeting SB are accumulating. Therefore, the need to review the effects of multicomponent, complex interventions that incorporate effective strategies to reduce SB are essential. METHODS A systematic review and meta-analysis were conducted investigating the impact of interventions targeting SB across the lifespan. Six databases were searched and two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias and complexity of each of the included studies. RESULTS A total of 77 adult studies (n=62, RCTs) and 84 studies (n=62, RCTs) in children were included. The findings demonstrated that interventions in adults when compared to active controls resulted in non-significant reductions in SB, although when compared to inactive controls significant reductions were found in both the short (MD -56.86; 95%CI -74.10, -39.63; n=4632; I2 83%) and medium-to-long term (MD -20.14; 95%CI -34.13, -6.16; n=4537; I2 65%). The findings demonstrated that interventions in children when compared to active controls may lead to relevant reductions in daily sedentary time in the short-term (MD -59.90; 95%CI -102.16, -17.65; n=267; I2 86%), while interventions in children when compared to inactive controls may lead to relevant reductions in the short-term (MD -25.86; 95%CI -40.77, -10.96; n=9480; I2 98%) and medium-to-long term (MD -14.02; 95%CI -19.49, -8.55; n=41,138; I2 98%). The assessment of complexity suggested that interventions may need to be suitably complex to address the challenges of a complex behaviour such as SB, but demonstrated that a higher complexity score is not necessarily associated with better outcomes in terms of sustained long-term changes. CONCLUSIONS Interventions targeting reductions in SB have been shown to be successful, especially environmental interventions in both children and adults. More needs to be known about how best to optimise intervention effects. Future intervention studies should apply more rigorous methods to improve research quality, considering larger sample sizes, randomised controlled designs and valid and reliable measures of SB.
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Affiliation(s)
- Nicole E Blackburn
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom.
| | - Jason J Wilson
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
| | - Ilona I McMullan
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
| | - Paolo Caserotti
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA), Syddansk Universitet, Odense, Denmark
| | - Maria Giné-Garriga
- Department of Sport Sciences, Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Katharina Wirth
- Agaplesion Bethesda Clinic Ulm, Geriatric Centre Ulm/Alb-Donau, Ulm, Germany
- Department of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Laura Coll-Planas
- Fundació Salut i Envelliment-Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Sergi Blancafort Alias
- Fundació Salut i Envelliment-Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Marta Roqué
- Fundació Salut i Envelliment-Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Manuela Deidda
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW), University of Glasgow, Glasgow, United Kingdom
| | - Andrew T Kunzmann
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Dhayana Dallmeier
- Agaplesion Bethesda Clinic Ulm, Geriatric Centre Ulm/Alb-Donau, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Mark A Tully
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
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Bartels SL, van Knippenberg RJ, Dassen FC, Asaba E, Patomella AH, Malinowsky C, Verhey FR, de Vugt ME. A narrative synthesis systematic review of digital self-monitoring interventions for middle-aged and older adults. Internet Interv 2019; 18:100283. [PMID: 31890630 PMCID: PMC6926211 DOI: 10.1016/j.invent.2019.100283] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/23/2019] [Accepted: 09/23/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Self-monitoring is crucial to raise awareness for own behaviors and emotions, and thus facilitate self-management. The composition of self-monitoring within interventions, however, varies and guidelines are currently unavailable. This review aimed to provide a comprehensive overview of technology-based self-monitoring interventions that intend to improve health in middle-aged and older adults (>45 years). METHODS Five online databases were systematically searched and articles were independently screened. A narrative synthesis of 26 studies with 21 unique interventions was conducted. Primary focus lay on the composition of self-monitoring within interventions, including technology used, health-aspects monitored, and type of feedback provided. Secondly, the usability of/adherence to the self-monitoring treatment, intervention effects, and their sustainability were examined. FINDINGS Studies concentrated on middle-aged adults (mean of 51 years). Mobile technologies seem necessary to ensure flexible self-monitoring in everyday life. Social health aspects were rarely monitored. Mechanisms and the sustainability of intervention effect are understudied. CONCLUSION Digital self-monitoring technologies hold promise for future trials as they seem suitable to understand and support health-related self-management. Key elements including automatic and personal feedback following the blended care principle were highlighted and may guide study designs. Prospectively, research is especially needed to study sustained self-monitoring to support disease prevention and lasting lifestyle changes.
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Affiliation(s)
- Sara Laureen Bartels
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Postbus 616, 6200 MD, Maastricht, the Netherlands
| | - Rosalia J.M. van Knippenberg
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Postbus 616, 6200 MD, Maastricht, the Netherlands
| | - Fania C.M. Dassen
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Postbus 616, 6200 MD, Maastricht, the Netherlands
| | - Eric Asaba
- Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Fack 23 200, SE-141 83 Huddinge, Sweden
| | - Ann-Helen Patomella
- Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Fack 23 200, SE-141 83 Huddinge, Sweden
| | - Camilla Malinowsky
- Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Fack 23 200, SE-141 83 Huddinge, Sweden
| | - Frans R.J. Verhey
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Postbus 616, 6200 MD, Maastricht, the Netherlands
| | - Marjolein E. de Vugt
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Postbus 616, 6200 MD, Maastricht, the Netherlands
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Ghanvatkar S, Kankanhalli A, Rajan V. User Models for Personalized Physical Activity Interventions: Scoping Review. JMIR Mhealth Uhealth 2019; 7:e11098. [PMID: 30664474 PMCID: PMC6352015 DOI: 10.2196/11098] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 10/01/2018] [Accepted: 10/26/2018] [Indexed: 02/06/2023] Open
Abstract
Background Fitness devices have spurred the development of apps that aim to motivate users, through interventions, to increase their physical activity (PA). Personalization in the interventions is essential as the target users are diverse with respect to their activity levels, requirements, preferences, and behavior. Objective This review aimed to (1) identify different kinds of personalization in interventions for promoting PA among any type of user group, (2) identify user models used for providing personalization, and (3) identify gaps in the current literature and suggest future research directions. Methods A scoping review was undertaken by searching the databases PsycINFO, PubMed, Scopus, and Web of Science. The main inclusion criteria were (1) studies that aimed to promote PA; (2) studies that had personalization, with the intention of promoting PA through technology-based interventions; and (3) studies that described user models for personalization. Results The literature search resulted in 49 eligible studies. Of these, 67% (33/49) studies focused solely on increasing PA, whereas the remaining studies had other objectives, such as maintaining healthy lifestyle (8 studies), weight loss management (6 studies), and rehabilitation (2 studies). The reviewed studies provide personalization in 6 categories: goal recommendation, activity recommendation, fitness partner recommendation, educational content, motivational content, and intervention timing. With respect to the mode of generation, interventions were found to be semiautomated or automatic. Of these, the automatic interventions were either knowledge-based or data-driven or both. User models in the studies were constructed with parameters from 5 categories: PA profile, demographics, medical data, behavior change technique (BCT) parameters, and contextual information. Only 27 of the eligible studies evaluated the interventions for improvement in PA, and 16 of these concluded that the interventions to increase PA are more effective when they are personalized. Conclusions This review investigates personalization in the form of recommendations or feedback for increasing PA. On the basis of the review and gaps identified, research directions for improving the efficacy of personalized interventions are proposed. First, data-driven prediction techniques can facilitate effective personalization. Second, use of BCTs in automated interventions, and in combination with PA guidelines, are yet to be explored, and preliminary studies in this direction are promising. Third, systems with automated interventions also need to be suitably adapted to serve specific needs of patients with clinical conditions. Fourth, previous user models focus on single metric evaluations of PA instead of a potentially more effective, holistic, and multidimensional view. Fifth, with the widespread adoption of activity monitoring devices and mobile phones, personalized and dynamic user models can be created using available user data, including users’ social profile. Finally, the long-term effects of such interventions as well as the technology medium used for the interventions need to be evaluated rigorously.
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Affiliation(s)
- Suparna Ghanvatkar
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
| | - Atreyi Kankanhalli
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
| | - Vaibhav Rajan
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
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