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Design of the Rural LEAP randomized trial: An evaluation of extended-care programs for weight management delivered via group or individual telephone counseling. Contemp Clin Trials 2018; 76:55-63. [PMID: 30408606 DOI: 10.1016/j.cct.2018.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/01/2018] [Accepted: 11/04/2018] [Indexed: 11/24/2022]
Abstract
Obesity is a major contributor to the greater prevalence of chronic disease morbidity and mortality observed in rural versus nonrural areas of the U.S. Nonetheless, little research attention has been given to modifying this important driver of rural/urban disparities in health outcomes. Although lifestyle treatments produce weight reductions of sufficient magnitude to improve health, the existing research is limited with respect to the long-term maintenance of treatment effects and the dissemination of services to underserved populations. Recent studies have demonstrated the feasibility of delivering lifestyle programs through the infrastructure of the U.S. Cooperative Extension Service (CES), which has >2900 offices nationwide and whose mission includes nutrition education and health promotion. In addition, several randomized trials have shown that supplementing lifestyle treatment with extended-care programs consisting of either face-to-face sessions or individual telephone counseling can improve the maintenance of weight loss. However, both options entail relatively high costs that inhibit adoption in rural communities. The delivery of extended care via group-based telephone intervention may represent a promising, cost-effective alternative that is well suited to rural residents who tend to be isolated, have heightened concerns about privacy, and report lower quality of life. The Rural Lifestyle Eating and Activity Program (Rural LEAP) is a randomized trial, conducted via CES offices in rural communities, targeted to adults with obesity (n = 528), and designed to evaluate the effectiveness and cost-effectiveness of extended-care programs delivered via group or individual telephone counseling compared to an education control condition on long-term changes in body weight.
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Creasy SA, Rogers RJ, Davis KK, Gibbs BB, Kershaw EE, Jakicic JM. Effects of supervised and unsupervised physical activity programmes for weight loss. Obes Sci Pract 2017; 3:143-152. [PMID: 28713583 PMCID: PMC5478811 DOI: 10.1002/osp4.107] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 11/12/2022] Open
Abstract
Objectives Physical activity is important for weight management. However, it remains unclear what type of physical activity prescription/programme is optimal for increasing physical activity during a standard behavioural weight loss intervention. This study examined changes in physical activity after a 12‐week supervised programme prescribed in minutes per week (SUP‐PA), an unsupervised programme prescribed in minutes per week (UNSUP‐PA) and an unsupervised programme prescribed in steps per day (STEP). Methods Fifty‐two adults who were overweight or obese (age: 43.5 ± 10.1 years, BMI: 31.5 ± 3.5 kg·m−2) were randomized to STEP (n = 18), UNSUP‐PA (n = 17) and SUP‐PA (n = 17). Subjects attended weekly in‐person group intervention sessions and were prescribed a calorie‐restricted diet (1,200–1,800 kcals·day−1) combined with increased physical activity (150 min·week−1 or 10,000 steps·day−1 with 2,500 brisk steps·day−1). Results All three groups significantly increased moderate‐to‐vigorous physical activity (STEP: 80.6 ± 218.5 min·week−1, UNSUP‐PA: 112.9 ± 180.4 min·week−1 and SUP‐PA: 151.1 ± 174.0 min·week−1, p < 0.001) with no differences between groups (p = 0.94) or group by time interaction (p = 0.81). In addition, there were no significant differences in weight loss between the groups (p = 0.81). Conclusions In this short‐term study, all three physical activity programmes increased physical activity and elicited modest weight loss when combined with a standard behavioural weight loss intervention.
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Affiliation(s)
- S A Creasy
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA.,Division of Endocrinology, Metabolism and Diabetes University of Colorado Anschutz Medical Campus Aurora CO USA
| | - R J Rogers
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA
| | - K K Davis
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA
| | - B B Gibbs
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA
| | - E E Kershaw
- Division of Endocrinology and Metabolism University of Pittsburgh Pittsburgh PA USA
| | - J M Jakicic
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA
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3
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Mazzuca P, Montesi L, Mazzoni G, Grazzi G, Micheli MM, Piergiovanni S, Pazzini V, Forlani G, Maietta Latessa P, Marchesini G. Supervised vs. self-selected physical activity for individuals with diabetes and obesity: the Lifestyle Gym program. Intern Emerg Med 2017; 12:45-52. [PMID: 27424279 DOI: 10.1007/s11739-016-1506-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 07/11/2016] [Indexed: 12/17/2022]
Abstract
The effectiveness of different programs of physical activity outside randomized studies is difficult to determine. We carried out an audit in two different units where either a supervised physical activity (PA) program or a self-selected PA program was in use in individuals with type 2 diabetes or obesity. The supervised PA cohort (n = 101) received progressive gym training (120 min, twice a week for 13 weeks) by a dedicated team, with nutritional counseling during resting periods. The self-selected PA cohort (n = 69) was enrolled in a 13-week cognitive-behavioral program (120 min/week, in groups of 12-15 individuals), chaired by an expert team. Body weight and physical fitness (6-min walk test) were measured at baseline and after 6 and 12 months. Outcome measures were attrition, weight loss ≥10 % initial body weight, 10 % increase in 6-min walk test; their association with a PA program was tested by logistic regression analysis. Attrition rate was lower in the supervised PA group (28 vs. 45 % than in the self-selected cohort, P = 0.023). After adjustment for confounders, the supervised PA program was associated with a lower risk of attrition at 1 year (odds ratio 0.45; 95 % confidence interval, 0.21-0.98) at logistic regression analysis. Body weight similarly decreased in both groups (more rapidly in the supervised PA cohort); also physical fitness improved in a similar way, and no differences in achieved targets of body weight (supervised, 31 %; self-selected, 18 %; P = 0.118) or fitness (supervised, 62 %; self-selected, 49 %; P = 0.312) were demonstrated. Different PA programs produce very similar health benefits, but an initially supervised program has lower attrition rates, which might translate into better outcomes in the long term.
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Affiliation(s)
- Paolo Mazzuca
- Unit of Internal Medicine, Diabetes and Metabolic Disease Center, Romagna Health District, Rimini, Italy
| | - Luca Montesi
- Department of Medical and Surgical Sciences, "Alma Mater Studiorum" University, Bologna, Italy
| | - Gianni Mazzoni
- Public Health Department and University Center for Sport-Applied Biomedical Studies, Ferrara, Italy
| | - Giovanni Grazzi
- Public Health Department and University Center for Sport-Applied Biomedical Studies, Ferrara, Italy
| | - Maria Maddalena Micheli
- Public Health Department and University Center for Sport-Applied Biomedical Studies, Ferrara, Italy
| | | | | | - Giulia Forlani
- Department of Medical and Surgical Sciences, "Alma Mater Studiorum" University, Bologna, Italy
| | | | - Giulio Marchesini
- Department of Medical and Surgical Sciences, "Alma Mater Studiorum" University, Bologna, Italy.
- Unit of Metabolic Diseases, "Alma Mater Studiorum" University, S. Orsola-Malpighi Hospital, Via Massarenti, 9, I-40135, Bologna, Italy.
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Bechshøft RL, Reitelseder S, Højfeldt G, Castro-Mejía JL, Khakimov B, Ahmad HFB, Kjær M, Engelsen SB, Johansen SMB, Rasmussen MA, Lassen AJ, Jensen T, Beyer N, Serena A, Perez-Cueto FJA, Nielsen DS, Jespersen AP, Holm L. Counteracting Age-related Loss of Skeletal Muscle Mass: a clinical and ethnological trial on the role of protein supplementation and training load (CALM Intervention Study): study protocol for a randomized controlled trial. Trials 2016; 17:397. [PMID: 27507236 PMCID: PMC4977774 DOI: 10.1186/s13063-016-1512-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 07/08/2016] [Indexed: 12/12/2022] Open
Abstract
Background Aging is associated with decreased muscle mass and functional capacity, which in turn decrease quality of life. The number of citizens over the age of 65 years in the Western world will increase by 50 % over the next four decades, and this demographic shift brings forth new challenges at both societal and individual levels. Only a few longitudinal studies have been reported, but whey protein supplementation seems to improve muscle mass and function, and its combination with heavy strength training appears even more effective. However, heavy resistance training may reduce adherence to training, thereby attenuating the overall benefits of training. We hypothesize that light load resistance training is more efficient when both adherence and physical improvement are considered longitudinally. We launched the interdisciplinary project on Counteracting Age-related Loss of Skeletal Muscle Mass (CALM) to investigate the impact of lifestyle changes on physical and functional outcomes as well as everyday practices and habits in a qualitative context. Methods We will randomize 205 participants older than 65 years to be given 1 year of two daily nutrient supplements with 10 g of sucrose and 20 g of either collagen protein, carbohydrates, or whey. Further, two groups will perform either heavy progressive resistance training or light load training on top of the whey supplement. Discussion The primary outcome of the CALM Intervention Study is the change in thigh cross-sectional area. Moreover, we will evaluate changes in physical performance, muscle fiber type and acute anabolic response to whey protein ingestion, sensory adaptation, gut microbiome, and a range of other measures, combined with questionnaires on life quality and qualitative interviews with selected subjects. The CALM Intervention Study will generate scientific evidence and recommendations to counteract age-related loss of skeletal muscle mass in elderly individuals. Trial registration ClinicalTrials.gov NCT02034760. Registered on 10 January 2014. ClinicalTrials.gov NCT02115698. Registered on 14 April 2014. Danish regional committee of the Capital Region H-4-2013-070. Registered on 4 July 2013. Danish Data Protection Agency 2012-58-0004 – BBH-2015-001 I-Suite 03432. Registered on 9 January 2015.
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Affiliation(s)
- Rasmus Leidesdorff Bechshøft
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Reitelseder
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Grith Højfeldt
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark
| | | | - Bekzod Khakimov
- Department of Food Science, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Hajar Fauzan Bin Ahmad
- Department of Food Science, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Michael Kjær
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark
| | - Søren Balling Engelsen
- Department of Food Science, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Morten Arendt Rasmussen
- Department of Food Science, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Aske Juul Lassen
- SAXO Institute, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark
| | - Tenna Jensen
- SAXO Institute, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark
| | - Nina Beyer
- Musculoskeletal Rehabilitation Research Unit, Department of Physical and Occupational Therapy, Bispebjerg Hospital, Copenhagen, Denmark
| | - Anja Serena
- Arla Foods Ingredients Group P/S, Viby J, Denmark
| | | | - Dennis Sandris Nielsen
- Department of Food Science, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Lars Holm
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark. .,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Hochberg LS, Murphy KD, O'Brien PE, Brennan L. Laparoscopic Adjustable Gastric Banding (LAGB) Aftercare Attendance and Attrition. Obes Surg 2015; 25:1693-702. [PMID: 25670531 DOI: 10.1007/s11695-015-1597-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Regular aftercare attendance following laparoscopic adjustable gastric banding (LAGB) is associated with greater weight loss and fewer post-surgical complications. Despite high reported rates of attrition from LAGB aftercare, the reasons for non-attendance have not been previously explored. The present study aimed to explore patient-reported barriers to LAGB aftercare attendance, and the perceived helpfulness of potential attrition-reducing strategies, in both regular attendees and non-attendees of aftercare. METHODS One hundred and seventy-nine participants (107 regular attendees and 72 non-attendees) completed a semi-structured questionnaire, assessing barriers to attrition (101 items) and usefulness of attrition prevention strategies (14 items). RESULTS Findings indicate that both regular attendees and non-attendees experience multiple barriers to aftercare attendance. Non-attendees generally reported that barriers had a greater impact on their aftercare attendance. There was evidence for some level of acceptability for attrition-reducing strategies suggesting that LAGB patients may be receptive to such strategies. CONCLUSIONS Current findings highlight the importance of assessing barriers to treatment in both attendees and non-attendees. It is proposed that addressing barriers that differentiate non-attendees from attendees may be most effective in reducing attrition from aftercare.
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Affiliation(s)
- Lisa S Hochberg
- Centre for Obesity Research and Education, Monash University, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia,
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6
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Befort CA, Klemp JR, Fabian C, Perri MG, Sullivan DK, Schmitz KH, Diaz FJ, Shireman T. Protocol and recruitment results from a randomized controlled trial comparing group phone-based versus newsletter interventions for weight loss maintenance among rural breast cancer survivors. Contemp Clin Trials 2014; 37:261-71. [PMID: 24486636 PMCID: PMC3992482 DOI: 10.1016/j.cct.2014.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/21/2014] [Accepted: 01/24/2014] [Indexed: 01/12/2023]
Abstract
Obesity is a risk factor for breast cancer recurrence and death. Women who reside in rural areas have higher obesity prevalence and suffer from breast cancer treatment-related disparities compared to urban women. The objective of this 5-year randomized controlled trial is to compare methods for delivering extended care for weight loss maintenance among rural breast cancer survivors. Group phone-based counseling via conference calls addresses access barriers, is more cost-effective than individual phone counseling, and provides group support which may be ideal for rural breast cancer survivors who are more likely to have unmet support needs. Women (n=210) diagnosed with Stage 0 to III breast cancer in the past 10 years who are ≥ 3 months out from initial cancer treatments, have a BMI 27-45 kg/m(2), and have physician clearance were enrolled from multiple cancer centers. During Phase I (months 0 to 6), all women receive a behavioral weight loss intervention delivered through group phone sessions. Women who successfully lose 5% of weight enter Phase II (months 6 to 18) and are randomized to one of two extended care arms: continued group phone-based treatment or a mail-based newsletter. During Phase III, no contact is made (months 18 to 24). The primary outcome is weight loss maintenance from 6 to 18 months. Secondary outcomes include quality of life, serum biomarkers, and cost-effectiveness. This study will provide essential information on how to reach rural survivors in future efforts to establish weight loss support for breast cancer survivors as a standard of care.
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Affiliation(s)
- Christie A. Befort
- University of Kansas Medical Center 3901 Rainbow Blvd, Kansas City, KS, USA ; ; ;
| | - Jennifer R. Klemp
- University of Kansas Medical Center 3901 Rainbow Blvd, Kansas City, KS, USA ; ; ;
| | - Carol Fabian
- University of Kansas Medical Center 3901 Rainbow Blvd, Kansas City, KS, USA ; ; ;
| | | | - Debra K. Sullivan
- University of Kansas Medical Center 3901 Rainbow Blvd, Kansas City, KS, USA ; ; ;
| | - Kathryn H. Schmitz
- University of Pennsylvania, Perelman School of Medicine 423 Guardian Drive, Philadelphia, PA 19104
| | - Francisco J. Diaz
- University of Kansas Medical Center 3901 Rainbow Blvd, Kansas City, KS, USA ; ; ;
| | - Theresa Shireman
- University of Kansas Medical Center 3901 Rainbow Blvd, Kansas City, KS, USA ; ; ;
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Dalle Grave R, Centis E, Marzocchi R, El Ghoch M, Marchesini G. Major factors for facilitating change in behavioral strategies to reduce obesity. Psychol Res Behav Manag 2013; 6:101-10. [PMID: 24124398 PMCID: PMC3794892 DOI: 10.2147/prbm.s40460] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
It is very unlikely that our obesity-promoting environment will change in the near future. It is therefore mandatory to improve our knowledge of the main factors associated with successful adoption of obesity-reducing behaviors. This may help design more powerful procedures and strategies to facilitate the adoption of healthy lifestyles in a "toxic" environment favoring the development of a positive energy balance. The aim of this review is to describe the main factors associated with successful adoption of obesity-reducing behaviors and to describe the most recent development, limits, and outcomes of lifestyle modification programs. The evidence regarding predictors of weight loss and weight loss maintenance remains largely incomplete. It is necessary to develop strategies matching treatments to patients' needs to improve successful weight loss and its maintenance. How to detect and how to address these needs is a continuous, challenging, research problem.
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Affiliation(s)
- Riccardo Dalle Grave
- Department of eating and weight Disorders, Villa Garda Hospital, Garda VR, Bologna, Italy
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8
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Can weight loss improve migraine headaches in obese women? Rationale and design of the Women's Health and Migraine (WHAM) randomized controlled trial. Contemp Clin Trials 2013; 35:133-44. [PMID: 23524340 DOI: 10.1016/j.cct.2013.03.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 03/08/2013] [Accepted: 03/10/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Research demonstrates a link between migraine and obesity. Obesity increases the risk of frequent migraines and is associated with migraine prevalence among reproductive-aged women. These findings are substantiated by several plausible mechanisms and emerging evidence of migraine improvements after surgical and non-surgical weight loss. However, no previous study has examined the effect of weight loss on migraine within a treatment-controlled framework. The WHAM trial is an RCT to test the efficacy of behavioral weight loss as a treatment for migraine. STUDY DESIGN Overweight/obese women (n=140; BMI=25.0-49.9 kg/m(2)) who meet international diagnostic criteria for migraine and record ≥3 migraines and 4-20 migraine days using a smartphone-based headache diary during a 4-week baseline period, will be randomly assigned to 4 months of either group-based behavioral weight loss (intervention) or migraine education (control). Intervention participants will be taught strategies to increase physical activity and consume fewer calories in order to lose weight. Control participants will receive general education on migraine symptoms/triggers and various treatment approaches. Both groups will use smartphones to record their headaches for 4 weeks at baseline, after the 16-week treatment period, and at the end of a 16-week follow-up period. Changes in weight and other potential physiological (inflammation), psychological (depression), and behavioral (diet and physical activity) mediators of the intervention effect will also be assessed. CONCLUSION The WHAM trial will evaluate the efficacy of a standardized behavioral weight loss intervention for reducing migraine frequency, and the extent to which weight loss and other potential mediators account for intervention effects.
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9
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Steeves JA, Bassett DR, Fitzhugh EC, Raynor HA, Thompson DL. Can sedentary behavior be made more active? A randomized pilot study of TV commercial stepping versus walking. Int J Behav Nutr Phys Act 2012; 9:95. [PMID: 22866941 PMCID: PMC3487755 DOI: 10.1186/1479-5868-9-95] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 07/25/2012] [Indexed: 12/29/2022] Open
Abstract
Background There is a growing problem of physical inactivity in America, and approximately a quarter of the population report being completely sedentary during their leisure time. In the U.S., TV viewing is the most common leisure-time activity. Stepping in place during TV commercials (TV Commercial Stepping) could increase physical activity. The purpose of this study was to examine the feasibility of incorporating physical activity (PA) into a traditionally sedentary activity, by comparing TV Commercial Stepping during 90 min/d of TV programming to traditional exercise (Walking). Methods A randomized controlled pilot study of the impact of 6 months of TV Commercial Stepping versus Walking 30 min/day in adults was conducted. 58 sedentary, overweight (body mass index 33.5 ± 4.8 kg/m2) adults (age 52.0 ± 8.6 y) were randomly assigned to one of two 6-mo behavioral PA programs: 1) TV Commercial Stepping; or 2) Walking 30 min/day. To help facilitate behavior changes participants received 6 monthly phone calls, attended monthly meetings for the first 3 months, and received monthly newsletters for the last 3 months. Using intent-to-treat analysis, changes in daily steps, TV viewing, diet, body weight, waist and hip circumference, and percent fat were compared at baseline, 3, and 6 mo. Data were collected in 2010–2011, and analyzed in 2011. Results Of the 58 subjects, 47 (81%) were retained for follow-up at the completion of the 6-mo program. From baseline to 6-mo, both groups significantly increased their daily steps [4611 ± 1553 steps/d vs. 7605 ± 2471 steps/d (TV Commercial Stepping); 4909 ± 1335 steps/d vs. 7865 ± 1939 steps/d (Walking); P < 0.05] with no significant difference between groups. TV viewing and dietary intake decreased significantly in both groups. Body weight did not change, but both groups had significant decreases in percent body fat (3-mo to 6-mo), and waist and hip circumference (baseline to 6-mo) over time. Conclusions Participants in both the TV Commercial Stepping and Walking groups had favorable changes in daily steps, TV viewing, diet, and anthropometrics. PA can be performed while viewing TV commercials and this may be a feasible alternative to traditional approaches for increasing daily steps in overweight and obese adults. Trial Registration This study is registered at ClinicalTrials.gov, NCT01342471
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Affiliation(s)
- Jeremy A Steeves
- Cancer Prevention Fellowship Program, National Cancer Institute, 6120 Executive Boulevard, Bethesda, MD, 20892, USA.
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Bond DS, Raynor HA, Phelan S, Steeves J, Daniello R, Wing RR. The Relationship between Physical Activity Variety and Objectively Measured Moderate-to-Vigorous Physical Activity Levels in Weight Loss Maintainers and Normal-Weight Individuals. J Obes 2012; 2012:812414. [PMID: 22506103 PMCID: PMC3306916 DOI: 10.1155/2012/812414] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 11/09/2011] [Accepted: 11/09/2011] [Indexed: 11/30/2022] Open
Abstract
Given the importance of physical activity (PA) for weight control, identifying strategies to achieve higher PA levels is imperative. We hypothesized that performing a greater variety of self-reported moderate-to-vigorous activities (MVPAs) would relate to higher objectively measured MVPA minutes in two groups who were successfully maintaining their body weight: weight loss maintainers (WLM/n = 226) and normal-weight individuals (NW/n = 169). The Paffenbarger Questionnaire and RT3 accelerometer were used to determine variety/number of different MVPAs performed and MVPA minutes, respectively. The variety/number of different activities performed by WLM and NW was similar (1.8 ± 1.2 versus 1.7 ± 1.2, P = 0.52). Regression analyses showed that greater variety (P < 0.01) and WLM status (P < 0.05) were each positively related to greater MVPA minutes/day and meeting the ≥250 MVPA minutes/week guideline for long-term weight maintenance. The association between greater variety and higher MVPA was similar in NW and WLM. Future studies should test whether variety can facilitate engagement in higher MVPA levels for more effective weight control.
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Affiliation(s)
- Dale S. Bond
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
- *Dale S. Bond:
| | - Hollie A. Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN 37996, USA
| | - Suzanne Phelan
- Department of Kinesiology, California Polytechnic University, San Luis Obispo, CA 93407, USA
| | - Jeremy Steeves
- Department of Nutrition, University of Tennessee, Knoxville, TN 37996, USA
| | - Richard Daniello
- The Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI 02903, USA
| | - Rena R. Wing
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
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11
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Gothe NP, Mullen SP, Wójcicki TR, Mailey EL, White SM, Olson EA, Szabo AN, Kramer AF, McAuley E. Trajectories of change in self-esteem in older adults: exercise intervention effects. J Behav Med 2011; 34:298-306. [PMID: 21222223 PMCID: PMC3118401 DOI: 10.1007/s10865-010-9312-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Accepted: 12/20/2010] [Indexed: 11/28/2022]
Abstract
This 12-month, 2 arm, single blind randomized controlled exercise trial examined relationships among changes in multidimensional self-esteem as a function of intervention mode (i.e., walking vs. flexibility-toning-balance). Data were collected on three equidistant occasions (baseline, 6 and 12 months). One-hundred seventy-nine older adults (M(age) = 66.38) began the study and 145 completed assessments at all time points. Participants completed measures of physical and global self-esteem as well as demographic information. There were no significant group differences at baseline on these demographic indicators or esteem variables. Data were analyzed using linear and parallel process growth modeling procedures. Results supported the position that across both groups, domain-level (i.e., physical self-worth) was dependent upon sub-domain-level (i.e., perceived attractiveness, strength, and condition) esteem change. Furthermore, greater improvements were observed in the flexibility-toning-balance group, in terms of perceived strength and attractiveness esteem, compared to the walking group. Our findings support theoretically-based predictions and extend the literature showing unique psychological responses conditional on specific types of physical activities.
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Affiliation(s)
- Neha P. Gothe
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Sean P. Mullen
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Thomas R. Wójcicki
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Emily L. Mailey
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Siobhan M. White
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Erin A. Olson
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Amanda N. Szabo
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Arthur F. Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL 61801, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
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12
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Abstract
BACKGROUND Obesity is one of the dilemmas of the recent century and imposes huge costs related to its complications and diseases on people and societies. This study aims to investigate whether recording and monitoring weight and its changes can modify eating habits and therefore weight control. METHODS This is a quasi-experimental interventional study. Seventy nine of the staff of the University of Social Welfare and Rehabilitation (USWR) were randomly placed in two intervention (N=40) and control (39) groups. A standard weight scale and height meter was used to measure weight, height and body mass index (BMI). For the intervention group, weight was measured, recorded and announced to the participants twice a week for 3 months. For the control group, weight measurement and recording was done once in the beginning of the study and once at the end of the study. Data were analyzed using SPSS ver.11.5 and compared between groups. RESULTS There were no significant differences in the average age between the groups. Mean pre-intervention weight was 87.08±10.9 Kg and 85.83±16.44 Kg in the intervention and control groups, respectively and was not significantly different. Mean post-intervention weight was 83.5 Kg in the intervention group, which was significantly different from pre-intervention weight. Mean post-intervention weight was 86.31 Kg in the control group that was not significantly different from pre-intervention weight. CONCLUSION Recording and monitoring weight and its changes in overweight people can affect weight control since knowledge and insight about weight may motivate people to modify their eating habits. We therefore recommend this strategy as an adjuvant to weight control programs.
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Hansen D, Dendale P, van Loon LJC, Meeusen R. The impact of training modalities on the clinical benefits of exercise intervention in patients with cardiovascular disease risk or type 2 diabetes mellitus. Sports Med 2011; 40:921-40. [PMID: 20942509 DOI: 10.2165/11535930-000000000-00000] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise training intervention represents an effective means to reduce adipose tissue mass, improve glycaemic control and increase whole-body oxygen uptake capacity (VO(2peak)) in obesity, metabolic syndrome, type 2 diabetes mellitus (T2DM) and heart disease patients. In this manuscript, we review the impact of different exercise training modalities on clinical benefits of prolonged exercise intervention in these patient (sub)populations. By changing training modalities, significantly greater clinical benefits can be obtained. Greater training frequency and longer programme duration is associated with greater reduction in adipose tissue mass in obesity patients. A greater training frequency (up to 2 days/week) and a longer programme duration (up to 38 weeks) seems to be associated with greater improvements in VO(2peak) in heart disease patients. Longer programme duration and addition of resistance-type exercise further improve glycaemic control in T2DM patients. The first line of evidence seems to indicate that high-intensity interval exercise training has a greater impact on VO(2peak) in heart disease patients and insulin sensitivity in subjects with metabolic syndrome, but not on adipose tissue mass in obese subjects. However, it remains unclear whether addition of resistance-type exercise and continuous higher-intensity endurance-type exercise training are accompanied by greater improvements in VO(2peak) in heart disease patients. Furthermore, the impact of training session duration/volume on adipose tissue mass loss and glycaemic control in obesity and T2DM patients, respectively, is currently unknown. The impact of training frequency on glycaemic control remains to be investigated in T2DM patients.
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Grave RD, Calugi S, Centis E, Marzocchi R, Ghoch ME, Marchesini G. Lifestyle modification in the management of the metabolic syndrome: achievements and challenges. Diabetes Metab Syndr Obes 2010; 3:373-85. [PMID: 21437107 PMCID: PMC3047997 DOI: 10.2147/dmsott.s13860] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Lifestyle modification based on behavior therapy is the most important and effective strategy to manage the metabolic syndrome. Modern lifestyle modification therapy combines specific recommendations on diet and exercise with behavioral and cognitive strategies. The intervention may be delivered face-to-face or in groups, or in groups combined with individual sessions. The main challenge of treatment is helping patients maintain healthy behavior changes in the long term. In the last few years, several strategies have been evaluated to improve the long-term effect of lifestyle modification. Promising results have been achieved by combining lifestyle modification with pharmacotherapy, using meals replacement, setting higher physical activity goals, and long-term care. The key role of cognitive processes in the success/failure of weight loss and maintenance suggests that new cognitive procedures and strategies should be included in the traditional lifestyle modification interventions, in order to help patients build a mind-set favoring long-term lifestyle changes. These new strategies raise optimistic expectations for an effective treatment of metabolic syndrome with lifestyle modifications, provided public health programs to change the environment where patients live support them.
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Affiliation(s)
| | - Simona Calugi
- Department of Eating & Weight Disorder, Villa Garda Hospital, Garda (VR), Italy
| | - Elena Centis
- Unit of Metabolic Diseases & Clinical Dietetics, Alma Mater Studiorum – University of Bologna, Bologna, Italy
| | - Rebecca Marzocchi
- Unit of Metabolic Diseases & Clinical Dietetics, Alma Mater Studiorum – University of Bologna, Bologna, Italy
| | - Marwan El Ghoch
- Department of Eating & Weight Disorder, Villa Garda Hospital, Garda (VR), Italy
| | - Giulio Marchesini
- Unit of Metabolic Diseases & Clinical Dietetics, Alma Mater Studiorum – University of Bologna, Bologna, Italy
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Mediano MFF, Barbosa JSDO, Moura AS, Willett WC, Sichieri R. A randomized clinical trial of home-based exercise combined with a slight caloric restriction on obesity prevention among women. Prev Med 2010; 51:247-52. [PMID: 20654643 PMCID: PMC2939161 DOI: 10.1016/j.ypmed.2010.07.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 07/10/2010] [Accepted: 07/14/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The study investigated the effectiveness of home-based exercise combined with a slight caloric restriction on weight change during 12 months in non-obese women. METHODS A randomized clinical trial with a factorial design was conducted from 2003 to 2005. Two hundred three middle-aged women (Rio de Janeiro/Brazil), 25-45 years, were randomly assigned to one of two groups: control (CG) and home-based exercise (HB). The HB group received a booklet on aerobic exercise that could be practiced at home (3 times/week-40 min/session), in low-moderate intensity, during 12 months. Both groups received dietary counseling aimed at a slight energy restriction of 100-300 calories per day. RESULTS The HB experienced a greater weight loss in the first 6 months (-1.4 vs. -0.8 kg; p=0.04), but after 12 months there was no differences between groups (-1.1 vs. -1.0; p=0.20). Of the serum biochemical markers, HDL cholesterol showed major change, with an increase at month 12 of 18.3mg/dl in the HB compared to 9.5 in the CG (p<0.01). CONCLUSION Home-based exercise promoted greater weight reduction during the first 6 months after which no further benefits are observed. Continuous favorable changes in HDL cholesterol after 1 year suggest that home-based exercise promote health benefits.
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Affiliation(s)
- Mauro Felippe Felix Mediano
- Applied Physiology to Physical Education Laboratory, Rio de Janeiro State University, Rio de Janeiro, Brazil.
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Abstract
Osteoarthritis (OA) is a common chronic disease and there is a need for treatments that can be provided for the course of the disease with minimal adverse side effects. Exercise is a safe intervention in patients with knee OA with few contraindications or adverse events. Obesity is the most modifiable risk factor for knee OA. The mechanisms by which obesity affects OA are of great concern to researchers and clinicians who manage this disease. This article reviews the physiologic and mechanical consequences of obesity and exercise on older adults with knee OA, the effects of long-term weight loss and exercise interventions, and the utility and feasibility of translating these results to clinical practice.
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Affiliation(s)
- Stephen P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, USA.
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Butryn ML, Wadden TA, Rukstalis MR, Bishop-Gilyard C, Xanthopoulos MS, Louden D, Berkowitz RI. Maintenance of weight loss in adolescents: current status and future directions. J Obes 2010; 2010:789280. [PMID: 21274275 PMCID: PMC3022201 DOI: 10.1155/2010/789280] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 10/20/2010] [Accepted: 11/14/2010] [Indexed: 12/19/2022] Open
Abstract
There is a dearth of research on the long-term efficacy and safety of treatments for adolescent obesity. This narrative review examined several approaches to treatment, focusing on long-term effectiveness data in adolescents, as well as relevant findings from studies of adults. The available research suggests that lifestyle modification has promise in obese adolescents, although it is not clear that any particular dietary or physical activity approach is more effective than another. Meal replacements are quite effective in adults and deserve further research in adolescents. Extending the length of treatment to teach weight loss maintenance skills is likely to improve long-term outcomes in adolescents, and delivering treatment via the Internet or telephone is a novel way of doing so. Treatment that combines lifestyle modification with the medication orlistat generally appears to be safe but only marginally superior to lifestyle modification alone. More research is needed on the management of adolescent obesity, which has been overlooked when compared with research on the treatment of obesity in children and adults.
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Affiliation(s)
- Meghan L. Butryn
- Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
| | - Thomas A. Wadden
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Chanelle Bishop-Gilyard
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Child and Adolescent Psychiatry, The Children's Hospital of Philadelphia, 3440 Market Street, Suite 410, Philadelphia, PA 19104, USA
| | - Melissa S. Xanthopoulos
- Department of Child and Adolescent Psychiatry, The Children's Hospital of Philadelphia, 3440 Market Street, Suite 410, Philadelphia, PA 19104, USA
| | - Delroy Louden
- Anguilla Community College, George Hill British West Indies, PA 19104, USA
| | - Robert I. Berkowitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Child and Adolescent Psychiatry, The Children's Hospital of Philadelphia, 3440 Market Street, Suite 410, Philadelphia, PA 19104, USA
- *Robert I. Berkowitz:
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Paul-Ebhohimhen V, Avenell A. A systematic review of the effectiveness of group versus individual treatments for adult obesity. Obes Facts 2009; 2:17-24. [PMID: 20054200 PMCID: PMC6444750 DOI: 10.1159/000186144] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Both group and individual modes of delivery are employed for obesity treatments. Commercial weight loss groups commonly employ group-based delivery, while many clinical based settings employ one-to-one delivery. We systematically reviewed randomised controlled trials of treatments for adult obesity to compare the effectiveness of group-based to individual-based modes of treatment delivery. METHODS We searched 7 electronic databases and 2 journals and reviewed secondary references, based on a priori criteria to systematically review: randomised controlled trials of obesity treatments, participants with BMI >or=28 kg/m(2), age >or=18 years, comparison groups including at least 1 group-based and 1 individual-based treatment group, and follow-up >or=1 year. We extracted data and conducted meta-analysis of weight change. RESULTS Eleven comparison groups from 5 qualifying trials were obtained, representing a total participant pool of 336. Significantly greater (p = 0.03) weight change at 12 months was found in group-based over individualbased treatment, and sub-analyses showed that increased effectiveness was associated with the use of financial reward and psychologist-led interventions. CONCLUSION Group-based interventions were more effective than individual-based interventions among a predominantly female participant pool receiving psychologist-led interventions. Future studies to explore differences by professional group and interventions among men, which are accompanied by economic evaluation, are recommended.
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Jacobs AD, Ammerman AS, Ennett ST, Campbell MK, Tawney KW, Aytur SA, Marshall SW, Will JC, Rosamond WD. Effects of a tailored follow-up intervention on health behaviors, beliefs, and attitudes. J Womens Health (Larchmt) 2004; 13:557-68. [PMID: 15257847 DOI: 10.1089/1540999041281016] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The high rates of relapse that tend to occur after short-term behavioral interventions indicate the need for maintenance programs that promote long-term adherence to new behavior patterns. Computer-tailored health messages that are mailed to participants or given in brief telephone calls offer an innovative and time-efficient alternative to ongoing face-to-face contact with healthcare providers. METHODS Following a 1-year behavior change program, 22 North Carolina health departments were randomly assigned to a follow-up intervention or control condition. Data were collected from 1999 to 2001 by telephone-administered surveys at preintervention and postintervention for 511 low-income, midlife adult women enrolled in the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program at local North Carolina health departments. During the year after the behavior change program, intervention participants were mailed six sets of computer-tailored health messages and received two computer-tailored telephone counseling sessions. Main outcomes of dietary and physical activity behaviors, beliefs, and attitudes were measured. RESULTS Intervention participants were more likely to move forward into more advanced stages of physical activity change (p = 0.02); control participants were more likely to increase their level of dietary social support at follow-up (p = 0.05). Both groups maintained low levels of reported saturated fat and cholesterol intake at follow-up. No changes were seen in physical activity in either group. CONCLUSIONS Mailed computer-tailored health messages and telephone counseling calls favorably modified forward physical activity stage movement but did not appreciably affect any other psychosocial or behavioral outcomes.
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Affiliation(s)
- Alissa D Jacobs
- Department of Nutrition, University of North Carolina at Chapel Hill, 27599, USA
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