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Shankaranarayana AM, Jagadish A, Nimmy J, Natarajan M, Janssen H, Solomon JM. Non-therapeutic strategies to promote physical activity of stroke survivors in hospital settings: A systematic review. J Bodyw Mov Ther 2023; 36:192-202. [PMID: 37949559 DOI: 10.1016/j.jbmt.2023.07.009] [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: 02/01/2022] [Revised: 05/11/2023] [Accepted: 07/04/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To systematically summarize the evidence of strategies other than therapy to promote physical activity in hospital settings. METHODS Studies testing the various strategies to promote the physical activity of stroke survivors in different hospital settings, including stroke units, hospitals and rehabilitation centres were included. Two independent reviewers screened, extracted data, and assessed the study quality. Quality assessments were performed using standardized checklists. Data synthesis was done from the selected articles and results were reported. RESULTS Of the 3396 records retrieved from database searches, 12 studies (n = 529 participants) were included. All the studies were of moderate to good quality. The strategies were grouped into five categories: i) physical environment, ii) device-based feedback, iii) self-management approaches, iv) family presence, and v) education. Physical environmental and device-based feedback were the most common strategies to promote physical activity after a stroke in a hospital setting. Strategies such as family presence and education improved physical activity levels, whereas device-based feedback showed mixed results. CONCLUSION Despite the importance of physical activity in early stroke, there is limited literature present to enhance activity levels. Physical environment and device-based feedback were the two most common strategies used in acute stroke survivors. The impact of these strategies remain suboptimal to be considered as effective intervention methods to enhance physical activity.
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Affiliation(s)
- Apoorva M Shankaranarayana
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; Centre for Comprehensive Stroke Rehabilitation and Research (CCSRR), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Akhila Jagadish
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; Centre for Comprehensive Stroke Rehabilitation and Research (CCSRR), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Josephine Nimmy
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Manikandan Natarajan
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; Centre for Comprehensive Stroke Rehabilitation and Research (CCSRR), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Heidi Janssen
- School of Health Sciences, The University of Newcastle, Australia
| | - John M Solomon
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; Centre for Comprehensive Stroke Rehabilitation and Research (CCSRR), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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Logan G, Somers C, Baker G, Connell H, Gray S, Kelly P, McIntosh E, Welsh P, Gray CM, Gill JMR. Benefits, risks, barriers, and facilitators to cycling: a narrative review. Front Sports Act Living 2023; 5:1168357. [PMID: 37795314 PMCID: PMC10546027 DOI: 10.3389/fspor.2023.1168357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
There is large potential to increase cycling participation worldwide. Participation in cycling is associated with lower risk of mortality from any cause, and incidence of cardiovascular disease and type 2 diabetes, as well as positive mental health and well-being. The largest potential for health gains likely to come from increasing participation amongst those who do not currently cycle regularly, rather than encouraging those who already cycle regularly to cycle more. Replacing car journeys with cycling can lead to reductions in air pollution emissions and lower pollutant exposure to the general population. Important gaps and uncertainties in the existing evidence base include: the extent to which the health benefits associated with cycling participation are fully causal due to the observational nature of much of the existing evidence base; the real-world economic cost-benefits of pragmatic interventions to increase cycling participation; and the most effective (combination of) approaches to increase cycling participation. To address these uncertainties, large-scale, long-term randomised controlled trials are needed to: evaluate the effectiveness, and cost-effectiveness, of (combinations of) intervention approaches to induce sustained long-term increases in cycling participation in terms of increases in numbers of people cycling regularly and number of cycling journeys undertaken, across a range of population demographic groups; establish the effects of such interventions on relevant outcomes related to health and wellbeing, economic productivity and wider societal impacts; and provide more robust quantification of potential harms of increasing cycling participation, such as collision risks.
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Affiliation(s)
- Greig Logan
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Camilla Somers
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Hayley Connell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stuart Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma McIntosh
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jason M. R. Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
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Bellanger W, Peurois M, Connan L, Navasiolava N, Missud D, Py T, Bègue C. Comparing physical activity prescription with verbal advice for general practice patients with cardiovascular risk factors: results from the PEPPER randomised controlled trial. BMC Public Health 2023; 23:1402. [PMID: 37475036 PMCID: PMC10360325 DOI: 10.1186/s12889-023-16302-6] [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: 10/04/2021] [Accepted: 07/12/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Regular physical activity improves health and quality of life for people with cardiovascular risk factors. However, few studies have demonstrated the applicability of strategies in health care to promote physical activity. OBJECTIVE To evaluate if a written physical activity prescription combined with pedometer increases physical activity over one year compared with verbal advice in patients with cardiovascular disease risk in primary care. METHODS The randomised-controlled, interventional, 12-month PEPPER study recruited patients aged 35 to 74 years, having quarterly followed-ups for hypertension, dyslipidaemia, or diabetes, and judged insufficiently active. Seventeen practices randomised patients into either the experimental group, who received a written, personalised prescription for daily step numbers, pedometer and logbook, or control group, who received verbal advice to do at least 15 min of rapid walking or equivalent daily. The primary outcome was the change in total weekly energy expenditure measured using an accelerometer at 3 months. The secondary outcomes were changes in step count, physical activity levels, quality of life, perceived obstacles to physical activity, and biomedical indicators at 3 and 12 months. RESULTS One hundred and twenty-one participants were randomised. Although, weekly energy expenditure did not differ between the prescription and verbal instruction group, the estimated time spent doing moderate-intensity activity was significantly higher in the prescription group than the verbal group by an average of four minutes/week (p = 0.018)(95% CI [0.7 - 7.4]) reaching 48 min after 12 months (95% CI: 8 - 89). Similarly, this was associated with a clinically, higher average step number of 5256 steps/week increase over a year (95% CI: 660 - 9852). Among the most sedentary subgroup, walking less than 5000 steps/day at baseline, an 8868 steps/week (95% CI [2988 - 14700]) increase was observed in the prescription group. CONCLUSION Prescribing physical activity did not significantly modify total weekly energy expenditure, but slightly increased moderate-intensity activity duration and step counts, particularly among the most sedentary participants. Prescribing personalised physical activity goals encourages sedentary patients to engage in physical activity. TRIAL REGISTRATION The PEPPER trial is registered in the US National Institutes of Health Clinical Trials Registry under number NCT02317003 (15/12/2014).
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Affiliation(s)
- William Bellanger
- Department of General Practice, University of Angers, 49000, Angers, France
| | - Matthieu Peurois
- Department of General Practice, University of Angers, 49000, Angers, France.
- University of Angers, Univ Rennes, EHESP, Inserm, IRSET-ESTER,, SFR ICAT, 49000, Angers, France.
| | - Laurent Connan
- Department of General Practice, University of Angers, 49000, Angers, France
| | - Nastassia Navasiolava
- University of Angers, CHU Angers, CRC, INSERM, CNRS, MITOVASC, Equipe CarMe, SFR ICAT, 49000, Angers, France
| | - David Missud
- Department of General Practice, University of Angers, 49000, Angers, France
| | - Thibaut Py
- Department of General Practice, University of Angers, 49000, Angers, France
| | - Cyril Bègue
- Department of General Practice, University of Angers, 49000, Angers, France
- University of Angers, Univ Rennes, EHESP, Inserm, IRSET-ESTER,, SFR ICAT, 49000, Angers, France
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Jose KA, Sharman MJ, Stanesby O, Greaves S, Venn AJ, Blizzard L, Palmer A, Cooper K, Williams J, Cleland VJ. Incentivising public transport use for physical activity gain: process evaluation of the COVID-19 disrupted trips4health randomised controlled trial. Int J Behav Nutr Phys Act 2022; 19:157. [PMID: 36550500 PMCID: PMC9772596 DOI: 10.1186/s12966-022-01394-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Partnering with a public transport (PT) provider, state government, and local government, the single-blinded randomised controlled trial, trips4health, investigated the impact of PT use incentives on transport-related physical activity (PA) in Tasmania, Australia. The intervention involved 16-weeks of incentives (bus trip credits) for achieving weekly PT use targets, supported by weekly text messages. This study objective was to conduct a process evaluation of the COVID-19 disrupted trips4health study. METHODS The Medical Research Council UK's framework for complex public health interventions guided the process evaluation. Participant reach, acceptability, fidelity and feasibility were evaluated. Administrative and post-intervention survey data were analysed descriptively. Semi-structured interviews with intervention participants (n = 7) and PT provider staff (n = 4) were analysed thematically. RESULTS Due to COVID-19, trips4health was placed on hold (March 2020) then stopped (May 2020) as social restrictions impacted PT use. At study cessation, 116 participants (approximately one third of target sample) had completed baseline measures, 110 were randomised, and 64 (n = 29 in the intervention group; n = 35 in the control group) completed post-intervention measures. Participants were 18 - 80 years (average 44.5 years) with females (69%) and those with tertiary education (55%) over-represented. The intervention was delivered with high fidelity with 96% of bus trip credits and 99% of behavioural text messages sent as intended. Interviewed PT staff said implementation was highly feasible. Intervention participant acceptability was high with 90% reporting bus trip incentives were helpful and 59% reporting the incentives motivated them to use PT more. From a total of 666 possible bus trip targets, 56% were met with 38% of intervention participants agreeing and 41% disagreeing that 'Meeting the bus trip targets was easy'. Interviews and open-ended survey responses from intervention participants revealed incentives motivated bus use but social (e.g., household member commitments) and systemic (e.g., bus availability) factors made meeting bus trip targets challenging. CONCLUSIONS trips4health demonstrated good acceptability and strong fidelity and feasibility. Future intervention studies incentivising PT use will need to ensure a broader demographic is reached and include more supports to meet PT targets. TRIAL REGISTRATION ACTRN12619001136190 .
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Affiliation(s)
- K. A. Jose
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania Australia
| | - M. J. Sharman
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania Australia
| | - O. Stanesby
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania Australia
| | - S. Greaves
- grid.1013.30000 0004 1936 834XInstitute of Transport and Logistic Studies, The University of Sydney, Butlin Avenue, Darlington, Camperdown, New South Wales 2006 Australia
| | - A. J. Venn
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania Australia
| | - L. Blizzard
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania Australia
| | - A. Palmer
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania Australia
| | - K. Cooper
- Metro Tasmania, 212 Main Road, Moonah, Hobart, Tasmania 7009 Australia
| | - J. Williams
- Public Health Services, Department of Health, Tasmanian Government, 2/25 Argyle Street, Hobart, 7001 Australia
| | - V. J. Cleland
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania Australia
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Doğru OC, Webb TL, Norman P. Can behavior change techniques be delivered via short text messages? Transl Behav Med 2022; 12:979-986. [PMID: 36190350 DOI: 10.1093/tbm/ibac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Despite significant advancements in behavioral science it is unclear whether behavior change techniques (or BCTs) can be delivered to large numbers of people in a cost-effective and reliable way. The current study investigated whether it is possible to reliably deliver BCTs using short text messages. Short text messages were designed to deliver each of the 93 BCTs specified in the BCT taxonomy v1. Following initial coding and refinement by the team, a Delphi study with a panel of 15 experts coded which BCT each short text message was designed to deliver and also rated whether they were likely to be understood by recipients and easily converted to target different behaviors. After two iterations, the experts correctly assigned 66 of the 93 messages to the BCT that they were designed to deliver and indicated that these messages were likely to be easy to apply to a range of behaviors and understood by recipients. Experts were not able to identify which BCT 27 of the messages were designed to deliver and it was notable that some clusters of BCTs (e.g., "Goals and planning") were easier to deliver via short text messages than other clusters (e.g., "Scheduled consequences"). The findings suggest that short text messages can be a reliable way to deliver many, but not all, BCTs. The implications of the current study are discussed with respect to the delivery of specific BCTs and clusters of the taxonomy, as well as the need to test the acceptability of interventions delivered via short messages and the impact of messages on behavior.
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Affiliation(s)
- Onur Cem Doğru
- Department of Psychology, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Thomas L Webb
- Department of Psychology, The University of Sheffield, Sheffield, UK
| | - Paul Norman
- Department of Psychology, The University of Sheffield, Sheffield, UK
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Teran-Escobar C, Duché S, Bouscasse H, Isoard-Gatheur S, Juen P, Lacoste L, Lyon-Caen S, Mathy S, Ployon E, Risch A, Sarrazin P, Slama R, Tabaka K, Treibich C, Chardonnel S, Chalabaev A. InterMob: a 24-month randomised controlled trial comparing the effectiveness of an intervention including behavioural change techniques and free transport versus an intervention including air pollution awareness-raising on car use reduction among regular car users living in Grenoble, France. BMC Public Health 2022; 22:1763. [PMID: 36114537 PMCID: PMC9482286 DOI: 10.1186/s12889-022-14099-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Frequent car use contributes to health and environmental issues such as air pollution, climate change and obesity. Active and sustainable mobility (bike, walk, public transport, car sharing) may address these issues. Different strategies have been implemented in past research, involving hard levers, aimed at modifying the economical or geographical context (e.g., free public transport), and soft levers, aimed at modifying psychological processes (e.g., personalised transport advice). However, few studies have combined both hard and soft levers. In addition, few have used robust methodologies (e.g., randomised controlled trials), followed behavioural changes in the long-term, and been anchored in behaviour change theories. InterMob aims to address these limits by implementing a 24-month randomised controlled trial including hard and soft levers. The objectives of InterMob are to a) evaluate the effectiveness of an experimental arm versus an active controlled arm, and b) identify the processes of mobility change. Methods Regular car users living in Grenoble (N = 300) will be recruited and randomised to one of the two arms. The experimental arm consists in a six-month intervention combining hard levers (free access to transport/bikes), and soft levers (e.g., personalised transport advice). The control arm consists in a six-month intervention aimed at raising awareness on air pollution and its health effects. Both arms will include eight evaluation weeks (spread out over 24 months) based on a GPS, an accelerometer, and a pollution sensor. Moreover, participants will complete mobility logbooks and surveys measuring psychological constructs, socio-economical, and socio-spatial characteristics. Discussion InterMob will assess the effectiveness of two interventions aimed at reducing car use within regular car users in the short-, mid- and long-term. Moreover, InterMob will allow to better understand the psychological processes of behaviour change, and the socio-economical and geographical conditions under which the intervention is efficient in reducing car use. Finally, the benefits of mobility change in terms of physical activity, quality of life, and exposure to pollution will be quantified. Trial registration ClinicalTrials.gov: NCT05096000 on 27/10/2021 (retrospectively registered). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14099-4.
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Swartz MC, Lewis ZH, Deer RR, Stahl AL, Swartz MD, Christopherson U, Basen-Engquist K, Wells SJ, Silva HC, Lyons EJ. Feasibility and Acceptability of an Active Video Game-Based Physical Activity Support Group (Pink Warrior) for Survivors of Breast Cancer: Randomized Controlled Pilot Trial. JMIR Cancer 2022; 8:e36889. [PMID: 35994321 PMCID: PMC9446134 DOI: 10.2196/36889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Survivors of breast cancer with functional limitations have a 40% higher mortality rate than those without. Despite the known benefits of physical activity (PA), <40% of survivors of breast cancer meet the recommendations for PA. The combination of active video games (AVGs) and group-based PA counseling may hold potential for motivating PA adoption and improving physical function. However, this method has not been widely studied in survivors of breast cancer. OBJECTIVE We aimed to determine the feasibility and acceptability of a group AVG-based multicomponent PA intervention and estimate its effect size and variability on PA and physical function in female survivors of breast cancer in a clinic setting. METHODS Female survivors of breast cancer (N=60) were recruited through the clinic and randomly assigned to the intervention group (12 weekly sessions) or the control group (existing support group). The intervention group received game-based pedometers and participated in weekly group AVG sessions, PA behavioral coaching, and survivorship navigation discussions. A participant manual with weekly reflection worksheets was provided to reinforce the coaching lessons and promote self-led PA. The control group received conventional pedometers and participated in an existing breast cancer support group. Feasibility was assessed by enrollment rate (≥50%), retention rate (≥80%), group attendance rate (75% attending ≥9 sessions [intervention group]), and the number of technological issues and adverse events. Acceptability was measured by participants' attitudes (from strongly disagree=1 to strongly agree=5) toward the use of AVGs and the overall program. The outcomes included PA (accelerometers) and physical function (Short Physical Performance Battery and gait speed). Analysis of covariance was used to determine differences in PA and physical function between the groups. The Cohen d and its 95% CI determined the effect size and variability, respectively. All the analyses followed the intention-to-treat principle. RESULTS Participants were an average of 57.4 (SD 10.5) years old, 70% (42/60) White, and 58% (35/60) off treatment. The enrollment rate was 55.9% (66/118). Despite substantial long-term hurricane-related disruptions, we achieved an 80% (48/60) retention. The intervention group's attendance rate was 78% (14/18), whereas the control group's attendance rate was 53% (9/17). Of the 26 game-based pedometers, 3 (12%) were damaged or lost. No study-related adverse events occurred. Acceptability items were highly rated. Steps (β=1621.64; P=.01; d=0.72), Short Physical Performance Battery (β=.47; P=.01; d=0.25), and gait speed (β=.12; P=.004; d=0.48) had a significant intervention effect. CONCLUSIONS The intervention was feasible and acceptable in this population despite the occurrence of a natural disaster. Pilot results indicate that group AVG sessions, PA coaching, and survivorship navigation produced moderate effects on PA and physical functioning. AVGs with PA counseling can potentially be used in existing breast cancer support groups to encourage PA and improve physical function. TRIAL REGISTRATION ClinicalTrials.gov NCT02750241; https://clinicaltrials.gov/ct2/show/NCT02750241.
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Affiliation(s)
- Maria C Swartz
- Department of Pediatrics-Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Zakkoyya H Lewis
- Department of Kinesiology & Health Promotion, California State Polytechnic University, Pomona, Pomona, CA, United States
| | - Rachel R Deer
- Department of Nutrition, Metabolism and Rehabilitation Sciences, Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, United States
| | - Anna L Stahl
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | - Michael D Swartz
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | - Ursela Christopherson
- Department of Nutrition, Metabolism and Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX, United States
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Stephanie J Wells
- Department of Pediatrics-Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - H Colleen Silva
- Department of Surgery, The University of Texas Medical Branch, Houston, TX, United States
| | - Elizabeth J Lyons
- Department of Nutrition, Metabolism and Rehabilitation Sciences, Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, United States
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Willems M, de Jong J, Overwijk A, Hilgenkamp TIM, van der Schans CP, Waninge A. Behaviour change techniques used in lifestyle support of adults with mild intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1327-1335. [PMID: 35734872 DOI: 10.1111/jar.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 03/27/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Professional caregivers are important in the daily support of lifestyle change for adults with mild intellectual disabilities; however, little is known about which behaviour change techniques (BCTs) are actually used. This study aims to gain insight in their use for lifestyle behaviour change using video observations. METHODS Professional caregivers (N = 14) were observed in daily work supporting adults with mild intellectual disabilities. Videos were analysed using the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy and BCTs utilised were coded. RESULTS Twenty one out of 40 BCTs were used by professional caregivers. The BCTs 'Information about others' approval', 'Identification as role model', 'Rewards on successful behaviour', 'Review behavioural goals' and 'Instructions on how to perform the behaviour' were most employed. CONCLUSION Professional caregivers used BCTs to support healthier lifestyle behaviour of adults with mild intellectual disabilities. However, most promising of them as defined previous by professionals were rarely used by professional caregivers.
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Affiliation(s)
- Mariël Willems
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Johan de Jong
- School of Sports Studies, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Annelies Overwijk
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thessa I M Hilgenkamp
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Physical Therapy Department, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Mazéas A, Chalabaev A, Blond M, Pereira B, Duclos M. Digital intervention promoting physical activity among obese people (DIPPAO) randomised controlled trial: study protocol. BMJ Open 2022; 12:e058015. [PMID: 35710254 PMCID: PMC9204413 DOI: 10.1136/bmjopen-2021-058015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Physical inactivity and excessive sedentary behaviours are major preventable causes in both the development and the treatment of obesity and type 2 diabetes mellitus (T2DM). Nevertheless, current programmes struggle to engage and sustain physical activity (PA) of patients over long periods of time. To overcome these limitations, the Digital Intervention Promoting Physical Activity among Obese people randomised controlled trial (RCT) aims to evaluate the effectiveness of a group-based digital intervention grounded on gamification strategies, enhanced by social features and informed by the tenets of the self-determination theory and the social identity approach. METHODS AND ANALYSIS This trial is a two-arm parallel RCT testing the effectiveness of the Kiplin digital intervention on obese and patients with T2DM in comparison to the usual supervised PA programme of the University Hospital of Clermont-Ferrand, France. A total of 50 patients will be randomised to one of the two interventions and will follow a 3-month programme with a 6-month follow-up postintervention. The primary outcome of the study is the daily step count change between the baseline assessment and the end of the intervention. Accelerometer data, self-reported PA, body composition and physical capacities will also be evaluated. To advance our understanding of complex interventions like gamified and group-based ones, we will explore several psychological mediators relative to motivation, enjoyment, in-group identification or perceived weight stigma. Finally, to assess a potential superior economic efficiency compared with the current treatment, we will conduct a cost-utility analysis between the two conditions. A mixed-model approach will be used to analyse the change in outcomes over time. ETHICS AND DISSEMINATION The research protocol has been reviewed and approved by the Local Human Protection Committee (CPP Ile de France XI, No 21 004-65219). Results will inform the Kiplin app development, be published in scientific journals and disseminated in international conferences. TRIAL REGISTRATION NUMBER NCT04887077.
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Affiliation(s)
- Alexandre Mazéas
- SENS, Univ. Grenoble Alpes, 38000 Grenoble, France
- Department of Human Nutrition, INRAE Centre Clermont-Auvergne-Rhône-Alpes, Clermont-Ferrand, France
- Kiplin, Nantes, France
| | | | | | - Bruno Pereira
- Department of Biostatistics Unit (DRCI), University Hospital Centre, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Human Nutrition, INRAE Centre Clermont-Auvergne-Rhône-Alpes, Clermont-Ferrand, France
- Department of Sport Medicine and Functional Exploration, University Hospital Centre, Clermont-Ferrand, France
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10
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Crawshaw J, Li AH, Garg AX, Chassé M, Grimshaw JM, Presseau J. Identifying behaviour change techniques within randomized trials of interventions promoting deceased organ donation registration. Br J Health Psychol 2021; 27:822-843. [PMID: 34889488 DOI: 10.1111/bjhp.12575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/29/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Increasing deceased organ donation registration may increase the number of available organs for transplant to help save lives. This study aimed to identify which behaviour change techniques (BCTs; or 'active ingredients') are reported within randomized trials of interventions promoting deceased organ donation registration and of those, which are associated with a larger intervention effect. METHODS We conducted a secondary analysis of 45 trials included in a Cochrane systematic review of deceased organ donation registration interventions. Two researchers used the BCT Taxonomy v1 to independently code intervention content in all trial groups. Outcome data were pooled and we used meta-regression to explore associations between individual and combinations of recurring BCTs and effect on registration intention and/or registration behaviour. RESULTS A total of 27 different BCTs (mean = 3.7, range = 1-9) were identified in intervention groups across the 45 trials. The five most common BCTs were: 'Information about health consequences' (71%); 'Instruction on how to perform the behaviour' (47%); 'Salience of consequences' (40%); 'Adding objects to the environment' (28%); and 'Credible source' (27%). Comparator groups in 20/45 trials also included identifiable BCTs (n = 12, mean = 3.1, range = 1-7). Meta-regression revealed that a combination of the three most common BCTs was associated with a larger intervention effect size for registration behaviour (k = 8, β = .19, p = .02). CONCLUSIONS Trials of deceased organ donation registration interventions focus predominantly on providing information, instruction, and a means to register. While potentially effective, a much wider set of possible BCTs could be leveraged to address known barriers to registration.
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Affiliation(s)
- Jacob Crawshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ontario, Canada
| | - Alvin H Li
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada
| | - Amit X Garg
- Lawson Health Research Institute, London, Ontario, Canada.,Institute for Clinical Evaluative Sciences (ICES), London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,Division of Nephrology, Western University, London, Ontario, Canada
| | - Michaël Chassé
- Department of Medicine (Critical Care), University of Montreal Hospital, Quebec, Canada
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, Ontario, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ontario, Canada.,School of Psychology, University of Ottawa, Ontario, Canada
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11
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Steel C, Crist K, Grimes A, Bejarano C, Ortega A, Hibbing PR, Schipperijn J, Carlson JA. Validity of a Global Positioning System-Based Algorithm and Consumer Wearables for Classifying Active Trips in Children and Adults. JOURNAL FOR THE MEASUREMENT OF PHYSICAL BEHAVIOUR 2021; 4:321-332. [PMID: 36237517 PMCID: PMC9555805 DOI: 10.1123/jmpb.2021-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To investigate the convergent validity of a global positioning system (GPS)-based and two consumer-based measures with trip logs for classifying pedestrian, cycling, and vehicle trips in children and adults. METHODS Participants (N = 34) wore a Qstarz GPS tracker, Fitbit Alta, and Garmin vivosmart 3 on multiple days and logged their outdoor pedestrian, cycling, and vehicle trips. Logged trips were compared with device-measured trips using the Personal Activity Location Measurement System (PALMS) GPS-based algorithms, Fitbit's SmartTrack, and Garmin's Move IQ. Trip- and day-level agreement were tested. RESULTS The PALMS identified and correctly classified the mode of 75.6%, 94.5%, and 96.9% of pedestrian, cycling, and vehicle trips (84.5% of active trips, F1 = 0.84 and 0.87) as compared with the log. Fitbit and Garmin identified and correctly classified the mode of 26.8% and 17.8% (22.6% of active trips, F1 = 0.40 and 0.30) and 46.3% and 43.8% (45.2% of active trips, F1 = 0.58 and 0.59) of pedestrian and cycling trips. Garmin was more prone to false positives (false trips not logged). Day-level agreement for PALMS and Garmin versus logs was favorable across trip modes, though PALMS performed best. Fitbit significantly underestimated daily cycling. Results were similar but slightly less favorable for children than adults. CONCLUSIONS The PALMS showed good convergent validity in children and adults and were about 50% and 27% more accurate than Fitbit and Garmin (based on F1). Empirically-based recommendations for improving PALMS' pedestrian classification are provided. Since the consumer devices capture both indoor and outdoor walking/running and cycling, they are less appropriate for trip-based research.
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Affiliation(s)
- Chelsea Steel
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Katie Crist
- Department of Family Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Amanda Grimes
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Carolina Bejarano
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Adrian Ortega
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Paul R Hibbing
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Jasper Schipperijn
- Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, Children's Mercy Hospital, University of Missouri Kansas City, Kansas City, MO, USA
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12
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Hammond FM, Zafonte RD, Tang Q, Jang JH. Carbamazepine for Irritability and Aggression after Traumatic Brain Injury: A Randomized, Placebo-Controlled Study. J Neurotrauma 2021; 38:2238-2246. [PMID: 33563104 DOI: 10.1089/neu.2020.7530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study tested the hypothesis that carbamazepine (CBZ) reduces irritability/aggression among individuals >6 months post-traumatic brain injury (TBI). Seventy individuals were enrolled in a parallel-group, randomized, double-blind, placebo-controlled, forced-titration trial of CBZ (n = 35) versus placebo (n = 35). Participants were randomly assigned to receive CBZ or placebo 42 days with outcome assessed at baseline and Day 42. Dose was titrated up to 400 mg CBZ or placebo equivalent two times daily. Symptoms of irritability and aggression were measured using the Neuropsychiatric Inventory Irritability (NPI-I) and Aggression (NPI-A) domains as a composite measure (NPI-I/A). Global impression of change was recorded from participant, observer, and study clinician. The CBZ group did not differ significantly from the placebo group (p = 0.60 and 0.59 for NPI-I/A observer and participant ratings, respectively). High placebo effects were observed with minimal clinically important difference in observer NPI-I/A 57% in CBZ group and 77% in placebo group (p = 0.09). Findings were similar for participant ratings. Eighteen of 35 had therapeutic CBZ level ≥4. Therapeutic sample analysis revealed similar high placebo response and non-significant differences except clinician ratings favoring CBZ. Non-serious adverse events occurred more frequently in the CBZ group with greater nervous system effects. CBZ up to 400 mg two times daily was not superior to placebo at reducing irritability/aggression according observers and participants. Large placebo effects may have masked the detection of differences. Clinician rating metrics suggest benefit, and thus, CBZ should remain a treatment option for the experienced brain injury clinician. Data are provided that may aid treatment decisions.
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Affiliation(s)
- Flora M Hammond
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Atrium Health, Charlotte, North Carolina, USA
- Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
| | - Ross D Zafonte
- Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Qing Tang
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jeong Hoon Jang
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
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13
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Overwijk A, van der Putten AAJ, van der Schans CP, Willems M, Hilgenkamp TIM, Waninge A. Use of behaviour change techniques by direct support professionals to support healthy lifestyle behaviour for people with moderate to profound intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1048-1056. [PMID: 33295116 PMCID: PMC8359235 DOI: 10.1111/jar.12845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/22/2020] [Accepted: 11/12/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Behaviour change techniques (BCTs) can be employed to support a healthy lifestyle for people with intellectual disabilities. The aim of this study is to determine whether and which BCTs are used by direct support professionals (DSPs) for supporting healthy lifestyle behaviour of people with moderate to profound intellectual disabilities. METHOD Direct support professionals (n = 18) were observed in their daily work using audio-visual recordings. To code BCTs, the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy was employed. RESULTS Direct support professionals used 33 BCTs out of 42. The most used BCTs were as follows: 'feedback on performance', 'instructions on how to perform the behaviour', 'doing together', 'rewards on successful behaviour', 'reward effort towards behaviour', 'DSP changes environment', 'graded tasks', 'prompt practice' and 'model/demonstrate behaviour'. CONCLUSIONS Although a variety of BCTs is used by DSPs in their support of people with moderate to profound intellectual disabilities when facilitating healthy lifestyle behaviour, they rely on nine of them.
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Affiliation(s)
- Annelies Overwijk
- Research Group Healthy AgeingAllied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
- Department of Health PsychologyUniversity Medical Centre GroningenUniversity of GroningenGroningenThe Netherlands
| | | | - Cees P. van der Schans
- Research Group Healthy AgeingAllied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
- Department of Health PsychologyUniversity Medical Centre GroningenUniversity of GroningenGroningenThe Netherlands
- Department of Rehabilitation MedicineUniversity Medical Centre GroningenUniversity of GroningenGroningenThe Netherlands
| | - Mariël Willems
- Research Group Healthy AgeingAllied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
| | - Thessa I. M. Hilgenkamp
- Department of General PracticeIntellectual Disability MedicineErasmus MCUniversity Medical Centre RotterdamRotterdamThe Netherlands
- Department of Physical TherapyUniversity of NevadaLas VegasNVUSA
| | - Aly Waninge
- Research Group Healthy AgeingAllied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
- Department of Health PsychologyUniversity Medical Centre GroningenUniversity of GroningenGroningenThe Netherlands
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14
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Overwijk A, Hilgenkamp TIM, Schans CP, Putten AAJ, Waninge A. Needs of Direct Support Professionals to Support People With Intellectual Disabilities in Leading a Healthy Lifestyle. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2021. [DOI: 10.1111/jppi.12383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Annelies Overwijk
- Research Group Healthy Ageing, Allied Health Care and Nursing Hanze University of Applied Sciences Groningen the Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen Groningen the Netherlands
| | - Thessa I. M. Hilgenkamp
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC University Medical Center Rotterdam the Netherlands
- Department of Physical Therapy University of Nevada Las Vegas USA
| | - Cees P. Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing Hanze University of Applied Sciences Groningen the Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen Groningen the Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen Groningen the Netherlands
| | - Annette A. J. Putten
- Department of Inclusive and Special Needs Education University of Groningen Groningen the Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing Hanze University of Applied Sciences Groningen the Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen Groningen the Netherlands
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15
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Niven A, Ryde GC, Wilkinson G, Greenwood C, Gorely T. The Effectiveness of an Annual Nationally Delivered Workplace Step Count Challenge on Changing Step Counts: Findings from Four Years of Delivery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105140. [PMID: 34066211 PMCID: PMC8150609 DOI: 10.3390/ijerph18105140] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/03/2021] [Accepted: 05/08/2021] [Indexed: 11/26/2022]
Abstract
Paths for All’s 8-week online Workplace Step Count Challenge (SCC) is a flagship program of Scotland’s National Walking Strategy. The aim of this study was to examine changes in step counts throughout the duration of the SCC, across four years of delivery. Participants were those who registered for the 2015–2018 SCCs, and reported demographic data at registration. Participants self-reported their device-measured step count for each day of the SCC. Following data screening, mean daily steps for each week were calculated. Linear mixed models (R nlme procedure), controlling for the within subject nature of the step count measure, were used to explore changes in steps over time. Gender and age group (<45 years; ≥45 years) were entered into a subsequent model. Separate models were created for each year of the SCC and for all years combined. Participants (n = 10,183) were predominantly women (76.8%), aged <45 (54.6%) and ≥45 years. In general, steps increased each week compared to week 1 (p < 0.001), with a significant increase evident at all but seven of 28 data points. Across the four years of SCC, the increase in steps at week 8 compared to week 1 ranged from 506 to 1223 steps per day, making a substantial contribution to the recommended physical activity levels for health. There was no consistent age or gender effect. The findings provide support for the continued investment in such workplace interventions.
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Affiliation(s)
- Ailsa Niven
- Physical Activity for Health Research Centre, Institute of Sport, PE and Health Sciences, University of Edinburgh, Holyrood Road, Edinburgh EH8 8AQ, UK
- Correspondence:
| | - Gemma Cathrine Ryde
- Division of Sport, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK; (G.C.R.); (G.W.)
| | - Guy Wilkinson
- Division of Sport, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK; (G.C.R.); (G.W.)
| | - Carl Greenwood
- Paths for All, Kintail House, Forthside Way, Stirling FK8 1QZ, UK;
| | - Trish Gorely
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Old Perth Road, Inverness IV3 5SQ, UK;
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16
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Lee D. Knowledge Gaps in Mobile Health Research for Promoting Physical Activity in Adults With Autism Spectrum Disorder. Front Psychol 2021; 12:635105. [PMID: 33841267 PMCID: PMC8024466 DOI: 10.3389/fpsyg.2021.635105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/01/2021] [Indexed: 12/27/2022] Open
Abstract
A growing body of research highlights that adults with autism spectrum disorder (ASD) have poor health outcomes, yet effective health interventions are lacking for this population. While mobile health applications demonstrate potential for promoting physical activity (PA) in adults with ASD, scientific evidence for supporting this tool’s long-term effectiveness on PA behavior change remains inconclusive. This study aimed to provide the latest information on PA research and the prospective role of mobile health applications for promoting PA in adults with ASD. A literature review demonstrated that a few available studies show contradictory results regarding PA levels in adults with ASD, and behavior change techniques and gamification-guided mobile health applications can be promising tactics to leverage autism’s strengths and increase PA in these individuals. Optimizing design decisions based on needs analysis and user feedback is crucial to identifying and developing a sustainable mobile health intervention for PA promotion in adults with ASD.
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Affiliation(s)
- Daehyoung Lee
- Department of Applied Human Sciences, University of Minnesota Duluth, Duluth, MN, United States
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17
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Nicholas JC, Ntoumanis N, Smith BJ, Quested E, Stamatakis E, Thøgersen-Ntoumani C. Development and feasibility of a mobile phone application designed to support physically inactive employees to increase walking. BMC Med Inform Decis Mak 2021; 21:23. [PMID: 33478495 PMCID: PMC7819207 DOI: 10.1186/s12911-021-01391-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 01/10/2021] [Indexed: 01/21/2023] Open
Abstract
Background Physical inactivity is a global health concern. mHealth interventions have become increasingly popular, but to date, principles of effective communication from Self-Determination Theory have not been integrated with behavior change techniques to optimize app effectiveness. We outline the development of the START app, an app combining SDT principles and 17 purposefully chosen BCTs to support inactive office employees to increase their walking during a 16-week randomized controlled trial. We also explored acceptability, engagement with, associations between app usage and behavioral engagement, and perceived impact of the app in supporting behavior change.
Methods Following development, fifty insufficiently physically active employees (M age = 44.21 ± 10.95 years; BMI = 29.02 ± 5.65) were provided access and instructions on use of the app. A mixed methods design was used to examine feasibility of the app, including the User Mobile App Rating Scale, app engagement data, step counts, and individual interviews. Linear mixed modeling and inductive thematic analysis were used to analyze quantitative and qualitative data, respectively. Results Walkers rated the app quality favorably (M = 3.68 out of 5). Frequency of entering step counts (i.e., frequency of self-monitoring) on a weekly basis positively predicted weekly step counts measured via Fitbits at both the between-and within-individual levels. App features (entering daily step counts, reminders, and motivational messages) were perceived to assist walkers in fostering goal achievement by building competence and via self-monitoring. Conclusions The START app may be a useful component of walking interventions designed to increase walking in the workplace. Apps designed to promote walking behavior may be effective if they target users’ competence and integrate BCTs. Trial Registration: This study was part of a pilot larger randomized controlled trial, in which a component of the intervention involved the use of the mobile app. The trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12618000807257) on 11 May 2018 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375049&isReview=true.
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Affiliation(s)
- Joanna Catherine Nicholas
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.,Western Australian Academy of Performing Arts, Edith Cowan University, Mount Lawley, Perth, WA, 6050, Australia
| | - Nikos Ntoumanis
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Brendan John Smith
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Eleanor Quested
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre L6 West, Hub D17, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Cecilie Thøgersen-Ntoumani
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
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18
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Carlin T, Vuillerme N. Step and Distance Measurement From a Low-Cost Consumer-Based Hip and Wrist Activity Monitor: Protocol for a Validity and Reliability Assessment. JMIR Res Protoc 2021; 10:e21262. [PMID: 33439138 PMCID: PMC7840275 DOI: 10.2196/21262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/02/2020] [Accepted: 07/14/2020] [Indexed: 11/13/2022] Open
Abstract
Background Self-tracking via wearable and mobile technologies is becoming an essential part of personal health management. At this point, however, little information is available to substantiate the validity and reliability of low-cost consumer-based hip and wrist activity monitors, with regard more specifically to the measurements of step counts and distance traveled while walking. Objective The aim of our study is to assess the validity and reliability of step and distance measurement from a low-cost consumer-based hip and wrist activity monitor specific in various walking conditions that are commonly encountered in daily life. Specifically, this study is designed to evaluate whether and to what extent validity and reliability could depend on the sensor placement on the human body and the walking task being performed. Methods Thirty healthy participants will be instructed to wear four PBN 2433 (Nakosite) activity monitors simultaneously, with one placed on each hip and each wrist. Participants will attend two experimental sessions separated by 1 week. During each experimental session, two separate studies will be performed. In study 1, participants will be instructed to complete a 2-minute walk test along a 30-meter indoor corridor under 3 walking speeds: very slow, slow, and usual speed. In study 2, participants will be required to complete the following 3 conditions performed at usual walking speed: walking on flat ground, upstairs, and downstairs. Activity monitor measured step count and distance values will be computed along with the actual step count (determined from video recordings) and distance (measured using a measuring tape) to determine validity and reliability for each activity monitor placement and each walking condition. Results Participant recruitment and data collection began in January 2020. As of June 2020, we enrolled 8 participants. Dissemination of study results in peer-reviewed journals is expected in spring 2021. Conclusions To the best of our knowledge, this is the first study that examines the validity and reliability of step and distance measurement during walking using the PBN 2433 (Nakosite) activity monitor. Results of this study will provide beneficial information on the effects of activity monitor placement, walking speed, and walking tasks on the validity and reliability of step and distance measurement. We believe such information is of utmost importance to general consumers, clinicians, and researchers. International Registered Report Identifier (IRRID) DERR1-10.2196/21262
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Affiliation(s)
- Thomas Carlin
- AGEIS, University Grenoble Alpes, Grenoble, France.,LabCom Telecom4Health, University Grenoble Alpes & Orange Labs, Grenoble, France
| | - Nicolas Vuillerme
- AGEIS, University Grenoble Alpes, Grenoble, France.,LabCom Telecom4Health, University Grenoble Alpes & Orange Labs, Grenoble, France.,Institut Universitaire de France, Paris, France
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19
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Shizuma H, Abe T, Kanbara K, Amaya Y, Mizuno Y, Saka-Kochi Y, Fukunaga M. Interoception and alexithymia are related to differences between the self-reported and the objectively measured physical activity in patients with chronic musculoskeletal pain. J Psychosom Res 2021; 140:110324. [PMID: 33278660 DOI: 10.1016/j.jpsychores.2020.110324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/27/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Patients with chronic musculoskeletal pain (CMP) have difficulty estimating their level of physical activity (PA). Factors associated with this difficulty have yet to be identified; however, identification could allow for increased accuracy in large-scale PA surveys, and enhanced self-management. The purpose of this study was to determine the relationship of interoception and alexithymia with differences between self-reported and objectively measured PA, and investigate factors as they relate to accurately self-reporting PA. METHODS A cross-sectional survey of 33 patients with CMP and 32 healthy individuals was conducted from July 2018 to June 2019. We measured differences in Moderate to Vigorous Physical Activity (D-MVPA) using an accelerometer and self-report. A heartbeat tracking task (HTT) was used to measure interoception, and alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20). RESULTS The CMP group (median 43.5 min/day, IQR 20.6-77.6) showed significantly higher D-MVPA values than the control group (median 22.5 min/day, IQR 6.7-34.9) (p < .001). In patients with CMP, D-MVPA positively correlated with TAS-20 (rho = 0.470, p = .006) and correlated negatively with HTT (rho = -0.390, p = .025). CONCLUSION Inaccurate self-reported measurements of PA in patients with CMP are associated with alexithymia and interoception. This finding suggests that behavioral interventions targeting alexithymia and interoception in CMP patients could lead to improved self-monitoring.
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Affiliation(s)
- Hisaharu Shizuma
- Department of Psychosomatic and General Internal Medicine, Kansai Medical University, Japan; Department of Education, Kyoto college of medical and health, Japan.
| | - Tetsuya Abe
- Department of Psychosomatic and General Internal Medicine, Kansai Medical University, Japan.
| | - Kenji Kanbara
- Department of Psychosomatic and General Internal Medicine, Kansai Medical University, Japan; Psychosomatic Medicine, Department of Clinical Psychology, Kagawa University Faculty of Medicine, Japan.
| | - Yusaku Amaya
- Department of Psychosomatic and General Internal Medicine, Kansai Medical University, Japan; Faculty of Rehabilitation, Shijonawate Gakuen University, Japan.
| | - Yasuyuki Mizuno
- Department of Psychosomatic and General Internal Medicine, Kansai Medical University, Japan.
| | - Yukie Saka-Kochi
- Department of Psychosomatic and General Internal Medicine, Kansai Medical University, Japan.
| | - Mikihiko Fukunaga
- Department of Psychosomatic and General Internal Medicine, Kansai Medical University, Japan.
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20
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Abstract
The transportation sector accounts for about a quarter of global greenhouse gas emissions. Previous research suggests that major life events may be “windows of opportunity” for travel behaviour change. Our scoping review examined the effects of seven events (transitions to secondary school, post-secondary studies, labour market, marriage, parenthood, retirement, and relocation) on travel behaviours. Five databases were searched (MEDLINE, APA PsycINFO, Web of Science, SportDISCUS, and ProQuest Dissertations and Theses) and 80 articles met inclusion criteria. Relocation was the most commonly examined event (with 51 studies). Findings illustrate that moving to compact neighbourhoods (with shorter commute distance/travel time, greater walkability/access to destinations) was associated with shifts towards sustainable travel modes (e.g., walking, cycling, and transit). Relocation might be particularly conducive to implementing scalable sustainable transportation interventions, as all six interventions with appropriate statistical power were effective. Entry into the labour market was generally associated with increased car use and declines in sustainable transportation. Qualitative studies suggested that attitudes towards cycling may become negative during adolescence, while attitudes towards driving improve, highlighting a need for concerted action. Evidence for other events was less consistent. Research in developing countries remain scarce and further intervention research is needed to enhance quality of evidence.
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21
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MacPherson MM, Dineen TE, Cranston KD, Jung ME. Identifying Behaviour Change Techniques and Motivational Interviewing Techniques in Small Steps for Big Changes: A Community-Based Program for Adults at Risk for Type 2 Diabetes. Can J Diabetes 2020; 44:719-726. [DOI: 10.1016/j.jcjd.2020.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/01/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
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Düking P, Tafler M, Wallmann-Sperlich B, Sperlich B, Kleih S. Behavior Change Techniques in Wrist-Worn Wearables to Promote Physical Activity: Content Analysis. JMIR Mhealth Uhealth 2020; 8:e20820. [PMID: 33211023 PMCID: PMC7714647 DOI: 10.2196/20820] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/13/2020] [Accepted: 09/02/2020] [Indexed: 12/21/2022] Open
Abstract
Background Decreasing levels of physical activity (PA) increase the incidences of noncommunicable diseases, obesity, and mortality. To counteract these developments, interventions aiming to increase PA are urgently needed. Mobile health (mHealth) solutions such as wearable sensors (wearables) may assist with an improvement in PA. Objective The aim of this study is to examine which behavior change techniques (BCTs) are incorporated in currently available commercial high-end wearables that target users’ PA behavior. Methods The BCTs incorporated in 5 different high-end wearables (Apple Watch Series 3, Garmin Vívoactive 3, Fitbit Versa, Xiaomi Amazfit Stratos 2, and Polar M600) were assessed by 2 researchers using the BCT Taxonomy version 1 (BCTTv1). Effectiveness of the incorporated BCTs in promoting PA behavior was assessed by a content analysis of the existing literature. Results The most common BCTs were goal setting (behavior), action planning, review behavior goal(s), discrepancy between current behavior and goal, feedback on behavior, self-monitoring of behavior, and biofeedback. Fitbit Versa, Garmin Vívoactive 3, Apple Watch Series 3, Polar M600, and Xiaomi Amazfit Stratos 2 incorporated 17, 16, 12, 11, and 11 BCTs, respectively, which are proven to effectively promote PA. Conclusions Wearables employ different numbers and combinations of BCTs, which might impact their effectiveness in improving PA. To promote PA by employing wearables, we encourage researchers to develop a taxonomy specifically designed to assess BCTs incorporated in wearables. We also encourage manufacturers to customize BCTs based on the targeted populations.
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Affiliation(s)
- Peter Düking
- Integrative and Experimental Exercise Science, Department of Sport Science, Würzburg, Germany
| | - Marie Tafler
- Department of Psychology I, University of Würzburg, Würzburg, Germany
| | | | - Billy Sperlich
- Integrative and Experimental Exercise Science, Department of Sport Science, Würzburg, Germany
| | - Sonja Kleih
- Department of Psychology I, University of Würzburg, Würzburg, Germany
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Lee D, Frey GC, Min A, Kim B, Cothran DJ, Bellini S, Han K, Shih PC. Usability inquiry of a gamified behavior change app for increasing physical activity and reducing sedentary behavior in adults with and without autism spectrum disorder. Health Informatics J 2020; 26:2992-3008. [PMID: 32951500 DOI: 10.1177/1460458220952909] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The purpose of this study was to conduct the first usability inquiry of a gamified, behavior change theory-guided mobile app PuzzleWalk for increasing physical activity and reducing sedentary behavior in adults with and without autism spectrum disorder (ASD). Eighteen adults with and without ASD participated in a mixed-methods study that consisted of cognitive walkthrough, system usability assessment, and qualitative interviews. The results of the system usability testing indicated satisfactory quality of the PuzzleWalk system that can be readily applicable to both adults with and without ASD. Several notable issues were identified from the qualitative interviews that address critical insights into unique health and social needs in adults with ASD. Future work is warranted to examine the long-term effects of the PuzzleWalk system on increasing physical activity and reducing sedentary behavior in adults with and without ASD in real-world settings.
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24
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Kim B, Lee D, Min A, Paik S, Frey G, Bellini S, Han K, Shih PC. PuzzleWalk: A theory-driven iterative design inquiry of a mobile game for promoting physical activity in adults with autism spectrum disorder. PLoS One 2020; 15:e0237966. [PMID: 32911501 PMCID: PMC7482920 DOI: 10.1371/journal.pone.0237966] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 08/06/2020] [Indexed: 12/02/2022] Open
Abstract
Primary symptoms of adults with autism spectrum disorder (ASD), such as pervasive social deficits in social interaction and communication, cause adults with ASD to adopt a sedentary lifestyle. Meanwhile, gamified and behavioral theory-based interventions have been shown to improve physical activity in a fun and unobtrusive way. In this paper, we describe the iterative design inquiry process of PuzzleWalk, a gamified, physical activity-promoting mobile app designed for adults with ASD. We report the design rationales and lessons learned across four user-centered design phases with ASD experts and adults with ASD, including user requirement gathering, iterative participatory design, usability evaluation, and field deployment. The design insights generated from this work could inform future research focusing on designing sociotechnical systems, games, and interventions for people with ASD.
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Affiliation(s)
- Bogoan Kim
- Department of Software and Computer Engineering, Ajou University, Suwon, Republic of Korea
- Department of Artificial Intelligence, Ajou University, Suwon, Republic of Korea
| | - Daehyoung Lee
- Department of Applied Human Sciences, University of Minnesota Duluth, Duluth, Minnesota, United States of America
| | - Aehong Min
- Department of Informatics, Indiana University, Bloomington, Indiana, United States of America
| | - Seungwon Paik
- Department of Software and Computer Engineering, Ajou University, Suwon, Republic of Korea
- Department of Artificial Intelligence, Ajou University, Suwon, Republic of Korea
| | - Georgia Frey
- Department of Kinesiology, Indiana University, Bloomington, Indiana, United States of America
| | - Scott Bellini
- Department of Counseling and Educational Psychology, Indiana University, Bloomington, Indiana, United States of America
| | - Kyungsik Han
- Department of Software and Computer Engineering, Ajou University, Suwon, Republic of Korea
- Department of Artificial Intelligence, Ajou University, Suwon, Republic of Korea
| | - Patrick C. Shih
- Department of Informatics, Indiana University, Bloomington, Indiana, United States of America
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25
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Sharman MJ, Ball K, Greaves S, Jose KA, Morse M, Blizzard CL, Wells G, Venn AJ, Palmer AJ, Lester D, Williams J, Harpur S, Cleland VJ. trips4health: Protocol of a single-blinded randomised controlled trial incentivising adults to use public transport for physical activity gain. Contemp Clin Trials Commun 2020; 19:100619. [PMID: 32775761 PMCID: PMC7394862 DOI: 10.1016/j.conctc.2020.100619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/01/2020] [Accepted: 07/12/2020] [Indexed: 12/03/2022] Open
Abstract
Background Public transport (PT) users typically accumulate more physical activity (PA) than private motor vehicle users yet redressing physical inactivity through transport-related PA (TRPA) interventions has received limited attention. Further, incentive-based strategies can increase leisure-time PA but their impact on TRPA, is unclear. This study's objective is to determine the impact of an incentive-based strategy on TRPA in a regional Australian setting. Methods trips4health is a single-blinded randomised controlled trial with a four-month intervention phase and subsequent six-month maintenance phase. Participants will be randomised to: an incentives-based intervention (bus trip credit for reaching bus trip targets, weekly text messages to support greater bus use, written PA guidelines); or an active control (written PA guidelines only). Three hundred and fifty adults (≥18 years) from southern Tasmania will be recruited through convenience methods, provide informed consent and baseline information, then be randomised. The primary outcome is change in accelerometer measured average daily step count at baseline and four- and ten-months later. Secondary outcomes are changes in: measured and self-reported travel behaviour (e.g. PT use), PA, sedentary behaviour; self-reported and measured (blood pressure, waist circumference, height, weight) health; travel behaviour perspectives (e.g. enablers/barriers); quality of life; and transport-related costs. Linear mixed model regression will determine group differences. Participant and PT provider level process evaluations will be conducted and intervention costs to the provider determined. Discussion trips4health will determine the effectiveness of an incentive-based strategy to increase TRPA by targeting PT use. The findings will enable evidence-informed decisions about the worthwhileness of such strategies. Trial registration ACTRN12619001136190. Universal trial number U1111-1233-8050.
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Affiliation(s)
- M J Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - K Ball
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - S Greaves
- Institute of Transport and Logistic Studies, The University of Sydney, Sydney, New South Wales, Australia
| | - K A Jose
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - M Morse
- Metro Tasmania, Hobart, Tasmania, Australia
| | - C L Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - G Wells
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - A J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - A J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - D Lester
- Local Government Association of Tasmania, Hobart, Tasmania, Australia
| | - J Williams
- Department of Health, Tasmanian Government, Hobart, Tasmania, Australia
| | - S Harpur
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - V J Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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26
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Cramp F, Thomas R, Haase AM, Domaille M, Manns S, Swales C, Hurfurt J, Walsh NE. Promoting engagement in physical activity in early rheumatoid arthritis: A proof-of-concept intervention study. Musculoskeletal Care 2020; 18:487-500. [PMID: 32666652 DOI: 10.1002/msc.1493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE(S) The aim of this study is to test the feasibility and acceptability of promoting engagement in physical activity in early rheumatoid arthritis (PEPA-RA) to inform a future trial. DESIGN A 'proof of concept' study was carried out. SETTING This study was conducted in community hospitals delivered by musculoskeletal primary care physiotherapists. PARTICIPANTS Participants were 12 adults with rheumatoid arthritis (RA) diagnosed 6-24 months previously (nine females, three males; mean age 58 years, range 23-79). INTERVENTION The intervention consisted of five sessions, that is, four group sessions and one individual session facilitated by a physiotherapist over 12 weeks including patient education and support for behaviour change as well as supervised practical exercise. MAIN OUTCOMES The main outcomes were attendance, completion of outcome measures, adverse events, and participant and physiotherapist feedback views relating to the intervention. RESULTS Overall attendance was 85%, with sessions missed due to illness or RA flare. Outcome measure completion ranged from 83% to 100%. There were no clinically meaningful changes in pain or function at 12 weeks, but mean 6-min walk distance improved from 394 to 440 m. No serious adverse events were reported, and participants were generally positive about the intervention. Suggested minor modifications for the group sessions included venue accessibility and ensuring that physical activity time was protected. Several participants indicated that they would have liked to receive the intervention earlier following diagnosis. CONCLUSIONS PEPA-RA and the outcomes appear feasible and acceptable. Overall, small beneficial effects were noted at 12 weeks for most outcomes. Challenges to recruitment resulted in a smaller than anticipated sample size, and the majority of participants were active at baseline indicating that future recruitment needs to target less active individuals.
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Affiliation(s)
- Fiona Cramp
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Rachel Thomas
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Anne M Haase
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.,School for Policy Studies, University of Bristol, Bristol, UK.,School of Health, Victoria University of Wellington, PO Box 600, Wellington, 6140, New Zealand
| | - Melissa Domaille
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.,University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Manns
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Caroline Swales
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.,Patient Research Partner, Bristol, UK
| | - Judy Hurfurt
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.,Patient Research Partner, Bristol, UK
| | - Nicola E Walsh
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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27
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Wibowo RA, Kelly P, Baker G. The effect of smartphone application interventions on physical activity level among university/college students: a systematic review protocol. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1756125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Rakhmat Ari Wibowo
- Department of Physiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Paul Kelly
- Physical Activity for Health Research Center, Moray House School of Education, University of Edinburgh, Edinburgh, UK
| | - Graham Baker
- Physical Activity for Health Research Center, Moray House School of Education, University of Edinburgh, Edinburgh, UK
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28
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Hulkkonen M, Mielonen T, Prisle NL. The atmospheric impacts of initiatives advancing shifts towards low-emission mobility: A scoping review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 713:136133. [PMID: 32041018 DOI: 10.1016/j.scitotenv.2019.136133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/05/2019] [Accepted: 12/13/2019] [Indexed: 06/10/2023]
Abstract
In an urban environment, people's daily traffic choices are reflected in emissions and the resulting local air composition, or air quality. Traffic contributes to the emissions of both carbon dioxide (CO2), affecting climate, and particulate matter (PM), affecting atmospheric chemistry and human health. While the development of city infrastructure is not in the hands of individuals, it is their transport mode choices that constitute traffic. In this scoping review we analyse 108 initiatives from around the world potentially influencing individual travel behaviour and producing changes in the shares of different transport modes (modal shifts). The targets, types and techniques of initiatives are identified. Examples of economic, regulative, structural and persuasive initiatives are included. Special focus is on whether the impacts on CO2 emissions, PM emissions and/or PM concentrations have been quantitatively evaluated, and on the quality and results of the evaluations. We observe that a variety of targets can motivate actions that lead to modal shifts and emission reductions. The results indicate that the level of atmospheric evaluations is low: absolute or relative changes in emissions and/or concentrations had been evaluated for only 31% (N = 34) of the reviewed initiatives, with substantial heterogeneity in quality. Sanctions, such as congestion charge and restrictions, have more likely been evaluated in peer reviewed analyses than incentives. Scientific evaluations of impacts on ambient PM concentrations are especially scarce (N = 4), although Air Quality is the primary target of 13% of actions and secondary target for at least 12%. We discuss the determinants of success and failure, when it comes to different types of initiatives, emission reductions and evaluations. A high-quality evaluation of atmospheric impacts captures the following: correct data about the modal shift (rate and direction), exclusion of external factors affecting the shift and emissions, and possible indirect impacts of the shift.
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Affiliation(s)
- Mira Hulkkonen
- University of Oulu, P.O. Box 8000, FI-90014 Oulu, Finland.
| | - Tero Mielonen
- Kuopio Unit, Finnish Meteorological Institute, P.O. Box 1627, Kuopio FI-70211, Finland
| | - Nønne L Prisle
- University of Oulu, P.O. Box 8000, FI-90014 Oulu, Finland
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29
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Kelly P, Williamson C, Baker G, Davis A, Broadfield S, Coles A, Connell H, Logan G, Pell JP, Gray CM, Gill JM. Beyond cycle lanes and large-scale infrastructure: a scoping review of initiatives that groups and organisations can implement to promote cycling for the Cycle Nation Project. Br J Sports Med 2020; 54:1405-1415. [PMID: 32269057 PMCID: PMC7677468 DOI: 10.1136/bjsports-2019-101447] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2020] [Indexed: 11/11/2022]
Abstract
Background/objectives Cycling has well-established positive relationships with health. Evidence suggests that large-scale infrastructure and built-environment initiatives to promote cycling are likely to be necessary but not sufficient to maximise cycling participation. Smaller-scale initiatives that can be implemented by organisations (eg, employers) and groups (eg, community groups) are therefore also important, but the full range of feasible activities to promote cycling is not known. We aimed to scope the literature and map organisational, social and individual level activities to increase cycling. Methods Design: Scoping review following an established five-stage process. Eligibility criteria: Studies or publicly available reports describing cycling promotion initiatives deemed feasible for organisations or groups to implement. Sources of evidence and selection: (i) online databases (Ovid (Medline), Ovid (Embase), SportDISCUS (Ebscohost), ProQuest, Web of Science), (ii) existing systematic reviews, (iii) expert stakeholder consultation. Results We extracted data from 129 studies and reports, from 20 different countries, identifying 145 cycling promotion initiatives. From these initiatives we identified 484 actions within 93 action types within 33 action categories under the nine intervention functions described by Michie et al. Environmental restructuring (micro-level), enablement, education and persuasion were the functions with the most action types, while coercion, modelling and restriction had the fewest action types. Conclusion This is the first comprehensive map to summarise the broad range of action types feasible for implementation within organisation/group-based cycling promotion initiatives. The map will be a critical tool for communities, employers, practitioners and researchers in designing interventions to increase cycling.
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Affiliation(s)
- Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Chloë Williamson
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Adrian Davis
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK.,Transport Research Institute, Edinburgh Napier University, Edinburgh, UK
| | | | | | - Hayley Connell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Greig Logan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jason Mr Gill
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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30
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Thøgersen-Ntoumani C, Quested E, Smith BS, Nicholas J, McVeigh J, Fenton SAM, Stamatakis E, Parker S, Pereira G, Gucciardi DF, Ntoumanis N. Feasibility and preliminary effects of a peer-led motivationally-embellished workplace walking intervention: A pilot cluster randomized trial (the START trial). Contemp Clin Trials 2020; 91:105969. [PMID: 32114186 DOI: 10.1016/j.cct.2020.105969] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/19/2020] [Accepted: 02/22/2020] [Indexed: 11/18/2022]
Abstract
Walking interventions can be effective in increasing physical activity amongst physically inactive employees. However, despite their promising potential regarding sustainability and scalability, peer-led workplace walking interventions have not been tested. We evaluated a peer-led workplace group walking intervention designed to engage physically inactive employees. A 16-week pilot cluster randomized controlled trial consisted of enhanced (5 worksites; n = 50 participants) and minimal treatment (3 worksites; n = 47) conditions. All participants were provided with a Fitbit Zip and information on health benefits of walking. Enhanced treatment participants had access to a mobile phone app incorporating behavior change techniques, were trained on principles of autonomous motivation, and had a peer leader trained in a motivationally supportive communication style. Feasibility assessments included recruitment and drop-out rates, assessment completion rates, training acceptability (walkers and peer leaders), and intervention acceptability (walkers only). Outcomes assessed included movement-related behaviors (assessed via activPAL devices), cardio-metabolic risk factors, motivation to walk, and well-being, and these measures were taken at baseline and post-intervention. The results supported intervention feasibility. Preliminary efficacy evidence was mixed. Markers of cardio-metabolic risk improved in the enhanced treatment only. Autonomous motivation increased in both conditions. There were no changes in step counts, standing, and sitting time, or well-being. Further fine tuning is needed before a definitive RCT. Australian and New Zealand Clinical Trials Registry: ACTRN12618000807257.
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Affiliation(s)
- C Thøgersen-Ntoumani
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia.
| | - E Quested
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
| | - B S Smith
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
| | - J Nicholas
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
| | - J McVeigh
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - S A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, England
| | - E Stamatakis
- Charles Perkins Centre, School of Public Health, University of Sydney, Sydney, Australia
| | - S Parker
- Centre for Transformative Work Design, Future of Work Institute, Curtin University, Perth, Australia
| | - G Pereira
- School of Public Health, Curtin University, Perth, Australia
| | - D F Gucciardi
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - N Ntoumanis
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
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31
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Tiitinen S, Ilomäki S, Laitinen J, Korkiakangas EE, Hannonen H, Ruusuvuori J. Developing theory- and evidence-based counseling for a health promotion intervention: A discussion paper. PATIENT EDUCATION AND COUNSELING 2020; 103:234-239. [PMID: 31447199 DOI: 10.1016/j.pec.2019.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 08/10/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
Although the use of theories and evidence is often stressed in the development of health promotion interventions, this does not guarantee the success of an intervention. Thus, we need to reflect on intervention development processes that use different types of theories and evidence. In this paper, we provide a reflective discussion on how we identified evidence-based behavior change techniques and counseling themes for a health promotion intervention. In addition, we discuss the challenges that we encountered and what we learned during the process: a) a lack of previous research and meta-analyses, b) inconsistencies in evidence, c) integrating evidence and theories that have different starting points, and d) collaborating with researchers who represent different evidence and theories. During the process, we benefitted from having the clear goal of conducting evidence- and theory-based work. We solved the challenges by, for example, utilizing different types of evidence and being reflective about the reasons behind any inconsistencies in the evidence. In retrospect, we would have benefitted from closer collaboration between the teams that worked separately with different evidence. These kinds of reflective descriptions of development processes and the challenges encountered during them may help other researchers and professionals avoid encountering the same challenges.
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Affiliation(s)
- Sanni Tiitinen
- Tampere University, FI-33014 Tampere University, Tampere, Finland
| | - Sakari Ilomäki
- Tampere University, FI-33014 Tampere University, Tampere, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, 00032 Finnish Institute of Occupational Health, P.O. Box 18, Oulu, Finland
| | | | - Heli Hannonen
- Finnish Institute of Occupational Health, 00032 Finnish Institute of Occupational Health, P.O. Box 18, Oulu, Finland
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32
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Fischer X, Donath L, Zahner L, Faude O, Gerber M. Exploring psychosocial mediators of remote physical activity counselling: a secondary analysis of data from a 1-year randomized control trial (Movingcall). J Behav Med 2019; 43:271-285. [PMID: 31620974 DOI: 10.1007/s10865-019-00112-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/05/2019] [Indexed: 01/14/2023]
Abstract
The present study investigated whether psychosocial determinants mediate the effect of a telephone coaching intervention on physical activity levels. Two hundred eighty-eight adults were randomly assigned to a six-month telephone coaching intervention (n = 12 calls) or a control group receiving a single written recommendation. Seven psychosocial determinants as defined in the MoVo model as well as objective and self-reported physical activity levels were measured after 6 and 12 months. Participants also reported which taught intervention strategies (behavior change techniques) they perceived as most useful. Structural equation modeling was used to determine the mediating role of psychosocial determinants. Up to 227 participants with complete data on psychosocial determinants and physical activity were included in the mediation analyses. Compared to the control group, a greater increase in self-reported and objectively assessed physical activity levels was observed the coaching intervention group. The mediation analyses showed that the intervention had a positive effect on self-efficacy, outcome expectations and intention strength after 6 months and on action planning and barrier management after 6 and 12 months. Increases in objectively assessed physical activity after 6 months were mediated by increased barrier management. None of the other psychosocial determinants worked as mediating factors on self-reported or objectively assessed physical activity. The participants perceived 'action planning' and 'problem solving' as the most useful strategies to increase their physical activity levels. Further understanding of working mechanisms of remote physical activity promotion is needed.
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Affiliation(s)
- Xenia Fischer
- Department of Sport, Exercise and Health, University of Basel, 4052, Basel, Switzerland.
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, 50933, Cologne, Germany
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, 4052, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, 4052, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, 4052, Basel, Switzerland
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33
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Hunter RF, Gough A, Murray JM, Tang J, Brennan SF, Chrzanowski-Smith OJ, Carlin A, Patterson C, Longo A, Hutchinson G, Prior L, Tully MA, French DP, Adams J, McIntosh E, Xin Y, Kee F. A loyalty scheme to encourage physical activity in office workers: a cluster RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background
Increasing physical activity in the workplace can provide physical and mental health benefits for employees and economic benefits for the employer through reduced absenteeism and increased productivity. However, there is limited evidence on effective behaviour change interventions in workplace settings that led to maintained physical activity. This study aimed to address this gap and contribute to the evidence base for effective and cost-effective workplace interventions.
Objectives
To determine the effectiveness and cost-effectiveness of the Physical Activity Loyalty scheme, a multicomponent intervention based on concepts similar to those that underpin a high-street loyalty card, which was aimed at encouraging habitual physical activity behaviour and maintaining increases in mean number of steps per day.
Design
A cluster randomised controlled trial with an embedded economic evaluation, behavioural economic experiments, mediation analyses and process evaluation.
Setting
Office-based employees from public sector organisations in Belfast and Lisburn city centres in Northern Ireland.
Participants
A total of 853 participants [mean age 43.6 years (standard deviation 9.6 years); 71% of participants were female] were randomly allocated by cluster to either the intervention group or the (waiting list) control group.
Intervention
The 6-month intervention consisted of financial incentives (retail vouchers), feedback and other evidence-based behaviour change techniques. Sensors situated in the vicinity of the workplaces allowed participants to monitor their accumulated minutes of physical activity.
Main outcome measures
The primary outcome was mean number of steps per day recorded using a sealed pedometer (Yamax Digiwalker CW-701; Yamax, Tasley, UK) worn on the waist for 7 consecutive days and at 6 and 12 months post intervention. Secondary outcomes included health, mental well-being, quality of life, work absenteeism and presenteeism, and the use of health-care resources.
Results
The mean number of steps per day were significantly lower for the intervention group than the control group [6990 mean number of steps per day (standard deviation 3078) vs. 7576 mean number of steps per day (standard deviation 3345), respectively], with an adjusted mean difference of –336 steps (95% confidence interval –612 to –60 steps; p = 0.02) at 6 months post baseline, but not significantly lower at 12 months post baseline. There was a small but significant enhancement of mental well-being in the intervention group (difference between groups for the Warwick–Edinburgh Mental Wellbeing Scale of 1.34 points, 95% confidence interval 0.48 to 2.20 points), but not for the other secondary outcomes. An economic evaluation suggested that, overall, the scheme was not cost-effective compared with no intervention. The intervention was £25.85 (95% confidence interval –£29.89 to £81.60) more costly per participant than no intervention and had no effect on quality-adjusted life-years (incremental quality-adjusted life-years –0.0000891, 95% confidence interval –0.008 to 0.008).
Limitations
Significant restructuring of participating organisations during the study resulted in lower than anticipated recruitment and retention rates. Technical issues affected intervention fidelity.
Conclusions
Overall, assignment to the intervention group resulted in a small but significant decline in the mean pedometer-measured steps per day at 6 months relative to baseline, compared with the waiting list control group. The Physical Activity Loyalty scheme was deemed not to be cost-effective compared with no intervention, primarily because no additional quality-adjusted life-years were gained through the intervention. Research to better understand the mechanisms of physical activity behaviour change maintenance will help the design of future interventions.
Trial registration
Current Controlled Trials ISRCTN17975376.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ruth F Hunter
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Aisling Gough
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Jennifer M Murray
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Jianjun Tang
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Sarah F Brennan
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | | | | | - Chris Patterson
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Alberto Longo
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - George Hutchinson
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - Lindsay Prior
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - David P French
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Jean Adams
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Yiqiao Xin
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frank Kee
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
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Telephone-Based Coaching and Prompting for Physical Activity: Short- and Long-Term Findings of a Randomized Controlled Trial (Movingcall). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142626. [PMID: 31340528 PMCID: PMC6678542 DOI: 10.3390/ijerph16142626] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/18/2019] [Accepted: 07/20/2019] [Indexed: 12/15/2022]
Abstract
This study analyzed the short- and long-term efficacy of telephone coaching and short message service (SMS) prompting for physical activity (PA) promotion. Two-hundred-and-eighty-eight adults (age: 42 ± 11 years) were assigned randomly to three intervention arms: The intervention groups received 12 bi-weekly telephone calls with (coaching and SMS group) or without (coaching group) additional SMS prompts (n = 48 SMS). The control group received a single written PA recommendation. Self-reported and objective moderate-to-vigorous physical activity (MVPA) levels were assessed by a structured interview and by accelerometer at baseline, after the intervention (6 months), as well as after a no-contact follow-up (12 months). At post-test, self-reported MVPA increased by 173 min/week (95% CI 95 to 252) in the coaching group and by 165 min/week (95% CI 84 to 246) in the coaching and SMS group compared to control. These group differences remained similar in the follow-up test. For the objectively assessed MVPA, the coaching group increased by 32 min/week (95% CI 0.1 to 63) and the coaching and SMS group by 34 min/week (95% CI 1.6 to 66) compared to the control group. In the follow-up test, the objective MVPA levels of the intervention groups no longer differed from baseline, but group differences persisted as the control group decreased below baseline. Additional SMS prompts did not result in a further increase in PA. Telephone coaching can be considered an effective tool for PA promotion.
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Willett M, Duda J, Fenton S, Gautrey C, Greig C, Rushton A. Effectiveness of behaviour change techniques in physiotherapy interventions to promote physical activity adherence in lower limb osteoarthritis patients: A systematic review. PLoS One 2019; 14:e0219482. [PMID: 31291326 PMCID: PMC6619772 DOI: 10.1371/journal.pone.0219482] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/25/2019] [Indexed: 01/02/2023] Open
Abstract
Background Lower limb osteoarthritis (OA) causes high levels of individual pain and disability and is an increasing socio-economic burden to global healthcare systems. Physical Activity interventions are commonly provided by physiotherapists to help patients with lower limb OA manage their clinical symptoms. Objective To identify and evaluate the effectiveness of behavioural change techniques (BCTs) within physiotherapy interventions to increase physical activity (PA) adherence in patients with lower limb OA. Design A systematic review was conducted, following Cochrane guidelines according to a published and registered protocol (CRD42016039932). Two independent researchers conducted searches, determined eligibility, assessed risk of bias (Cochrane tool), intervention fidelity (NIHBCC checklist), and coded randomised controlled trials (RCTs) for BCTs (V1 taxonomy). BCT effectiveness ratios were calculated and RCT risk of bias and intervention fidelity were summarised narratively. Data sources A highly sensitive search strategy was conducted on Medline, Embase, PsycINFO, CENTRAL, CINAHL and PEDro and grey literature databases from inception to January 2nd, 2018. Reference lists of included RCTs and relevant articles were reviewed, and a citation search was conducted using Web of Science. Eligibility criteria for selecting studies RCTs that evaluated the effectiveness of a physiotherapy intervention that incorporated ≥1 BCT that promoted home or community-based PA adherence in patients with lower limb osteoarthritis. Results Twenty-four RCTs (n = 2366 participants) of variable risk of bias (RoB) (5 low; 7 moderate; 12 high) and poor intervention reporting from 10 countries were included. Heterogeneity of intervention BCTs and PA adherence outcome measures precluded meta-analysis. Thirty-one distinct BCTs were identified in 31 interventions across RCTs. In general, BCTs demonstrated higher effectiveness ratios for short-term and long-term PA adherence compared with medium-term outcomes. The BCTs ‘behavioural contract’, ‘non-specific reward’, ‘patient-led goal setting’ (behaviour), ‘self-monitoring of behaviour’, and ‘social support (unspecified) demonstrated the highest effectiveness ratios across time points to promote PA adherence. Conclusions BCTs demonstrate higher short and long-term than medium-term effectiveness ratios. Further research involving low RoB RCTs incorporating transparently reported interventions with pre-specified BCTs aimed at optimising lower limb OA patient PA adherence is required.
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Affiliation(s)
- Matthew Willett
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- * E-mail:
| | - Joan Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom
| | - Sally Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom
| | - Charlotte Gautrey
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Carolyn Greig
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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Vetrovsky T, Vetrovska K, Bunc V. A qualitative exploration of the experiences of primary care patients engaged in email counseling meant to increase physical activity. ACTA GYMNICA 2019. [DOI: 10.5507/ag.2019.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Missud DC, Parot-Schinkel E, Connan L, Vielle B, Huez JF. Physical activity prescription for general practice patients with cardiovascular risk factors-the PEPPER randomised controlled trial protocol. BMC Public Health 2019; 19:688. [PMID: 31159805 PMCID: PMC6547598 DOI: 10.1186/s12889-019-7048-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 05/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The health benefits of physical exercise have been shown to be important in the prevention of cardiovascular diseases in patients with hypertension, dyslipidaemia or diabetes. However, few strategies have demonstrated efficacy and practicality in the promotion of physical exercise among this group of patients in general practice. METHODS The PEPPER clinical study is a randomised controlled trial to evaluate the efficacy over a period of 12 months, in terms of physical activity level, of an intervention based on structured information delivery, a personalised written physical activity prescription in number of steps per day, a pedometer and a pedometer logbook, in 35 to 74-year-old patients with cardiovascular risk factors. 140 patients will be recruited in 15 GP practices and randomised in the intervention group or in the control group where patients will receive verbal advice of physical exercise. The primary outcome is the change at three months in total energy expenditure measured by an accelerometer over a 7-day period. Secondary outcomes include changes at 3 and 12 months in physical activity levels (accelerometer and International Physical Activity Questionnaire), quality of life (SF-36), blood pressure, weight, waist circumference, perceived obstacles to physical activity and patient compliance with the recommended strategy. Both groups will be compared using mixed models. DISCUSSION The results are expected at the end of 2019. If the intervention proves effective in durably increasing the level of physical activity, this strategy could be tested in a larger trial to examine its impact on cardiovascular diseases. TRIAL REGISTRATION US National Institutes of Health Clinical Trials Registry NCT02317003 , December 15, 2014.
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Affiliation(s)
| | - Elsa Parot-Schinkel
- Centre Hospitalier Universitaire d'Angers, Cellule Méthodologie et Biostatistiques, Angers, France
| | | | - Bruno Vielle
- Centre Hospitalier Universitaire d'Angers, Cellule Méthodologie et Biostatistiques, Angers, France
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Abstract
This commentary argues that health psychology, as a scientific discipline, needs to address the negative consequences of Anthropocene by helping individuals, communities and health systems to produce proactive efforts and prepare effective responses strategies for climate change consequences. The commentary addresses the following questions: How to demarcate health psychology at Anthropocene age? What are the best mitigation and adaptation behaviors for health and environment? How to help the environmental migrants and future climate refugees? How to develop a more resilient and adapted health care systems? Should we be in and out of health psychology? In conclusion, health psychologists and academics have to move forward helping individuals, communities and health systems to radically develop lower-carbon lifestyles in a sustainable society.
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Affiliation(s)
- P Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montreal, Canada.,Research Center, University Institute of Mental Health at Montreal, Montreal, Canada
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Aittasalo M, Tiilikainen J, Tokola K, Suni J, Sievänen H, Vähä-Ypyä H, Vasankari T, Seimelä T, Metsäpuro P, Foster C, Titze S. Socio-Ecological Natural Experiment with Randomized Controlled Trial to Promote Active Commuting to Work: Process Evaluation, Behavioral Impacts, and Changes in the Use and Quality of Walking and Cycling Paths. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091661. [PMID: 31086071 PMCID: PMC6540220 DOI: 10.3390/ijerph16091661] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 11/16/2022]
Abstract
Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. In Phase 1, 11 workplaces (1823 employees) from Area 1 were exposed to environmental improvements in walking and cycling paths. In Phase 2, five more workplaces (826 employees) were recruited from Area 2 and all workplaces were randomized into experimental group (EXP) promoting ACW with social and behavioral strategies and comparison group (COM) participating only in data collection. Process and impact evaluation with questionnaires, travel diaries, accelerometers, traffic calculations, and auditing were conducted. Statistics included Wilcoxon Signed Ranks Test, Mann-Whitney U-test, and after-before differences with 95% confidence intervals (95% CI). After Phase 1, positive change was seen in the self-reported number of days, which the employees intended to cycle part of their journey to work in the following week (p = 0.001). After Phase 2, intervention effect was observed in the proportion of employees, who reported willingness to increase walking (8.7%; 95% CI 1.8 to 15.6) and cycling (5.5%; 2.2 to 8.8) and opportunity to cycle part of their journey to work (5.9%; 2.1 to 9.7). To conclude, the intervention facilitated employees’ motivation for ACW, which is the first step towards behavior change.
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Affiliation(s)
- Minna Aittasalo
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Johanna Tiilikainen
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Kari Tokola
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Jaana Suni
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Harri Sievänen
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Henri Vähä-Ypyä
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Timo Seimelä
- Department of Transport and Streets, City of Tampere, Frenckellinaukio 2, PL 487, 33101 Tampere, Finland.
| | - Pasi Metsäpuro
- Department of Mobility and Transport, WSP Finland Ltd., Kelloportinkatu 1 D, 33100 Tampere, Finland.
| | - Charlie Foster
- Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, 8 Priory Road, Bristol BS81TZ, UK.
| | - Sylvia Titze
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010 Graz, Austria.
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Felsberg DT, Maher JP, Rhea CK. The State of Behavior Change Techniques in Virtual Reality Rehabilitation of Neurologic Populations. Front Psychol 2019; 10:979. [PMID: 31139106 PMCID: PMC6518969 DOI: 10.3389/fpsyg.2019.00979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/12/2019] [Indexed: 01/06/2023] Open
Abstract
Background: Neurologic rehabilitation aims to restore function, address barriers to activity, and improve quality of life in those with injury to the nervous system. Virtual reality (VR) has emerged as a useful tool to enhance neurorehabilitation interventions and outcomes. However, the manner in which VR-based neurorehabilitation has been manipulated to optimize outcomes using theory-based frameworks has not been documented. Behavior Change Techniques (BCTs) are described as the smallest active ingredient in an intervention aimed to change behavior via theoretically-proposed pathways. The purpose of this review was to investigate the ways VR is being used in neurorehabilitation to improve upright mobility, and systematically code those VR interventions for active BCTs. Methods: Keyword searches were performed using database searches of PubMed, SPORTDiscus, and psycINFO. The search yielded 32 studies for inclusion. Coding for BCTs was conducted using the Behavior Change Techniques Taxonomy v1 (BCTTv1). Results: Behavioral Practice, Graded Tasks, Biofeedback, and Explicit Feedback were the most commonly used BCTs. All studies reported improvements in motor performance outcomes. However, none of the studies investigated the efficacy of each component of their VR intervention making it difficult to point to the most effective components of VR interventions overall. Conclusions: This review suggests that investigation into the specific components of VR interventions, along with purposeful implementation and reporting of BCTs will help improve understanding of the efficacy of VR as a neurorehabilitation tool. Future research could benefit from incorporating BCTs into the design process of VR interventions to produce optimal rehabilitation potential.
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Affiliation(s)
- Danielle T Felsberg
- Virtual Environment for Assessment and Rehabilitation (VEAR) Lab, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jaclyn P Maher
- Physical Activity and Lifetime Wellness Lab, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Christopher K Rhea
- Virtual Environment for Assessment and Rehabilitation (VEAR) Lab, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, United States
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Salmon VE, Hewlett S, Walsh NE, Kirwan JR, Morris M, Urban M, Cramp F. Developing a group intervention to manage fatigue in rheumatoid arthritis through modifying physical activity. BMC Musculoskelet Disord 2019; 20:194. [PMID: 31054567 PMCID: PMC6500086 DOI: 10.1186/s12891-019-2558-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/09/2019] [Indexed: 11/19/2022] Open
Abstract
Background Fatigue is a major symptom of rheumatoid arthritis (RA). There is some evidence that physical activity (PA) may be effective in reducing RA fatigue. However, few PA interventions have been designed to manage fatigue and there is limited evidence of end-user input into intervention development. The aim of this research was to co-design an intervention to support self-management of RA fatigue through modifying PA. Methods A series of studies used mixed methodological approaches to co-design a fatigue management intervention focused on modifying PA based on UK Medical Research Council guidance, and informed by the Behaviour Change Wheel theoretical framework. Development was based on existing evidence, preferences of RA patients and rheumatology healthcare professionals, and practical issues regarding intervention format, content and implementation. Results The resulting group-based intervention consists of seven sessions delivered by a physiotherapist over 12 weeks. Each session includes an education and discussion session followed by supervised PA chosen by the participant. The intervention is designed to support modification and maintenance of PA as a means of managing fatigue. This is underpinned by evidence-based behaviour change techniques that might support changes in PA behaviour. Intervention delivery is interactive and aims to enhance capability, opportunity and motivation for PA. Conclusion This study outlines stages in the systematic development of a theory-based intervention designed through consultation with RA patients and healthcare professionals to reduce the impact of RA fatigue. The feasibility of future evaluation of the intervention should now be determined.
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Affiliation(s)
- Victoria E Salmon
- Institute of Health Research, University of Exeter College of Medicine and Health, College House, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - Sarah Hewlett
- Faculty of Health & Applied Sciences, University of the West of England, Blackberry Hill, Bristol, BS16 1DD, UK.,Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Nicola E Walsh
- Faculty of Health & Applied Sciences, University of the West of England, Blackberry Hill, Bristol, BS16 1DD, UK
| | - John R Kirwan
- Academic Rheumatology, University of Bristol, University of Bristol, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK.,Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Maria Morris
- Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Marie Urban
- Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin St, Bristol, BS2 8HW, UK
| | - Fiona Cramp
- Faculty of Health & Applied Sciences, University of the West of England, Blackberry Hill, Bristol, BS16 1DD, UK
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Audrey S, Fisher H, Cooper A, Gaunt D, Metcalfe C, Garfield K, Hollingworth W, Procter S, Gabe-Walters M, Rodgers S, Gillison F, Davis A, Insall P. A workplace-based intervention to increase levels of daily physical activity: the Travel to Work cluster RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background
There may be opportunities for working adults to accumulate recommended physical activity levels (≥ 150 minutes of moderate-intensity physical activity in bouts of ≥ 10 minutes throughout the week) during the commute to work. Systematic reviews of interventions to increase active transport indicate that studies are predominantly of poor quality, rely on self-report and lack robust statistical analyses.
Objectives
To assess the effectiveness, cost and consequences of a behavioural intervention to increase walking during the commute to work.
Design
A multicentre, parallel-arm, cluster randomised controlled trial incorporating economic and process evaluations. Physical activity outcomes were measured using accelerometers and GPS (Global Positioning System) receivers at baseline and the 12-month follow-up.
Setting
Workplaces in seven urban areas in south-west England and south Wales.
Participants
Employees (n = 654) in 87 workplaces.
Interventions
Workplace-based Walk to Work promoters were trained to implement a 10-week intervention incorporating key behaviour change techniques.
Main outcome measures
The primary outcome was the daily number of minutes of moderate to vigorous physical activity (MVPA). Secondary outcomes included MVPA during the commute, overall levels of physical activity and modal shift (from private car to walking). Cost–consequences analysis included employer, employee and health service costs and consequences. Process outcomes included barriers to, and facilitators of, walking during the daily commute.
Results
There was no evidence of an intervention effect on MVPA at the 12-month follow-up [adjusted difference in means 0.3 minutes, 95% confidence interval (CI) –5.3 to 5.9 minutes]. The intervention cost was on average, £181.97 per workplace and £24.19 per participating employee. In comparison with car users [mean 7.3 minutes, standard deviation (SD) 7.6 minutes], walkers (mean 34.3 minutes, SD 18.6 minutes) and public transport users (mean 25.7 minutes, SD 14.0 minutes) accrued substantially higher levels of daily MVPA during the commute. Participants who walked for ≥ 10 minutes during their commute were more likely to have a shorter commute distance (p < 0.001). No access to a car (p < 0.001) and absence of free workplace car parking (p < 0.01) were independently related to walking to work and using public transport. Higher quality-of-life scores were observed for the intervention group in a repeated-measures analysis (mean 0.018, 95% CI 0.000 to 0.036; scores anchored at 0 indicated ‘no capability’ and scores anchored at 1 indicated ‘full capability’).
Conclusions
Although this research showed that walking to work and using public transport are important contributors to physical activity levels in a working population, the behavioural intervention was insufficient to change travel behaviour. Broader contextual factors, such as length of journey, commuting options and availability of car parking, may influence the effectiveness of behavioural interventions to change travel behaviour. Further analyses of statistical and qualitative data could focus on physical activity and travel mode and the wider determinants of workplace travel behaviour.
Trial registration
Current Controlled Trials ISRCTN15009100.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 11. See the NIHR Journals Library website for further project information. Living Streets, a UK charity promoting everyday walking, provided funding for the intervention booklets and free pedometers for distribution to participants in the intervention group.
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Affiliation(s)
- Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Harriet Fisher
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ashley Cooper
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Daisy Gaunt
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Chris Metcalfe
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kirsty Garfield
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - William Hollingworth
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sunita Procter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Sarah Rodgers
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Adrian Davis
- Faculty of Business and Law, University of the West of England, Bristol, UK
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Murray JM, French DP, Patterson CC, Kee F, Gough A, Tang J, Hunter RF. Predicting Outcomes from Engagement With Specific Components of an Internet-Based Physical Activity Intervention With Financial Incentives: Process Analysis of a Cluster Randomized Controlled Trial. J Med Internet Res 2019; 21:e11394. [PMID: 31002304 PMCID: PMC6498305 DOI: 10.2196/11394] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/28/2018] [Accepted: 01/06/2019] [Indexed: 01/12/2023] Open
Abstract
Background Investigating participant engagement and nonusage attrition can help identify the likely active ingredients of electronic health interventions. Research on engagement can identify which intervention components predict health outcomes. Research on nonusage attrition is important to make recommendations for retaining participants in future studies. Objective This study aimed to investigate engagement and nonusage attrition in the Physical Activity Loyalty (PAL) scheme, a 6-month complex physical activity intervention in workplaces in Northern Ireland. The intervention included financial incentives with reward redemption and self-regulation techniques. Specific objectives were (1) to determine whether engagement in specific intervention components predicted physical activity at 6 months, (2) to determine whether engagement in specific intervention components predicted targeted mediators at 6 months, and (3) to investigate predictors of nonusage attrition for participants recording daily activity via the PAL scheme physical activity monitoring system and logging onto the website. Methods Physical activity was assessed at baseline and 6 months using pedometers (Yamax Digiwalker CW-701, Japan). Markers of engagement and website use, monitoring system use, and reward redemption were collected throughout the scheme. Random-effects generalized least-squares regressions determined whether engagement with specific intervention components predicted 6-month physical activity and mediators. Cox proportional hazards regressions were used to investigate predictors of nonusage attrition (days until first 2-week lapse). Results A multivariable generalized least-squares regression model (n=230) showed that the frequency of hits on the website’s monitoring and feedback component (regression coefficient [b]=50.2; SE=24.5; P=.04) and the percentage of earned points redeemed for financial incentives (b=9.1; SE=3.3; P=.005) were positively related to 6-month pedometer steps per day. The frequency of hits on the discussion forum (b=−69.3; SE=26.6; P=.009) was negatively related to 6-month pedometer steps per day. Reward redemption was not related to levels of more internal forms of motivation. Multivariable Cox proportional hazards regression models identified several baseline predictors associated with nonusage attrition. These included identified regulation (hazard ratio [HR] 0.88, 95% CI 0.81-0.97), recovery self-efficacy (HR 0.88, 95% CI 0.80-0.98), and perceived workplace environment safety (HR 1.07, 95% CI 1.02-1.11) for using the physical activity monitoring system. The EuroQoL health index (HR 0.33, 95% CI 0.12-0.91), financial motivation (HR 0.93, 95% CI 0.87-0.99), and perceived availability of physical activity opportunities in the workplace environment (HR 0.96, 95% CI 0.93-0.99) were associated with website nonusage attrition. Conclusions Our results provide evidence opposing one of the main hypotheses of self-determination theory by showing that financial rewards are not necessarily associated with decreases in more internal forms of motivation when offered as part of a complex multicomponent intervention. Identifying baseline predictors of nonusage attrition can help researchers to develop strategies to ensure maximum intervention adherence. Trial Registration ISRCTN Registry ISRCTN17975376; http://www.isrctn.com/ISRCTN17975376 (Archived by WebCite at http://www.webcitation.org/76VGZsZug)
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Affiliation(s)
- Jennifer M Murray
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - David P French
- Manchester Centre of Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Christopher C Patterson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Frank Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Aisling Gough
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Jianjun Tang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Ruth F Hunter
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
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Self-monitoring to increase physical activity in patients with cardiovascular disease: a systematic review and meta-analysis. Aging Clin Exp Res 2019; 31:163-173. [PMID: 29714027 DOI: 10.1007/s40520-018-0960-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 04/21/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS It is important to encourage physical activity in patients with cardiovascular disease (CVD), and self-monitoring is considered to contribute to increased physical activity. However, the effects of self-monitoring on CVD patients remain to be established. In this study, we examined the influence of self-monitoring on physical activity of patients with CVD via a systematic review and meta-analysis. METHODS Screening of randomized controlled trials only was undertaken twice on PubMed (date of appraisal: August 29, 2017). The inclusion criteria included outpatients with CVD, interventions for them, daily step counts as physical activity included in the outcome, and self-monitoring included in the intervention. Assessments of the risk of bias and meta-analysis in relation to the mean change of daily step counts were conducted to verify the effects of self-monitoring. RESULTS From 205 studies retrieved on PubMed, six studies were included, with the oldest study published in 2005. Participants included 693 patients of whom 541 patients completed each study program. Their mean age was 60.8 years, and the ratio of men was 79.6%. From these 6 studies, a meta-analysis was conducted with 269 patients of 4 studies including only RCTs with step counts in the intervention group and the control group, and self-monitoring significantly increased physical activity (95% confidence interval, 1916-3090 steps per day, p < 0.05). The average intervention period was about 5 months. Moreover, four studies involved intervention via the internet, and five studies confirmed the use of self-monitoring combined with other behavior change techniques. CONCLUSION The results suggest that self-monitoring of physical activity by patients with CVD has a significantly positive effect on their improvement. Moreover, the trend toward self-monitoring combined with setting counseling and activity goals, and increased intervention via the internet, may lead to the future development and spread of self-monitoring for CVD patients.
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Fischer X, Donath L, Zwygart K, Gerber M, Faude O, Zahner L. Coaching and Prompting for Remote Physical Activity Promotion: Study Protocol of a Three-Arm Randomized Controlled Trial (Movingcall). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030331. [PMID: 30691013 PMCID: PMC6388245 DOI: 10.3390/ijerph16030331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 11/16/2022]
Abstract
Background. Physical inactivity is currently seen as one of the biggest global public health issue. Remote physical activity (PA) promotion programs are expected to be effective if they are individually tailored and include behavior change techniques, personal coaching, and regular prompting. However, it is still not fully understood which intervention components are most effective. This paper describes the rationale and design of a study on an individually tailored remote PA promotion program comparing the efficacy of coaching and prompting with a single written advice. Methods. In total, 288 adults (age 20 to 65 years) were randomly assigned to three different intervention arms of a 6-month-long PA promotion program. A minimal intervention group received a single written PA recommendation. The two remaining groups either received telephone coaching sessions (n = 12 calls) with or without additional short message service (SMS) prompting (n = 48 SMSs for each participant). Data assessment took place at baseline, at the end of the intervention, and after a six-month follow-up-period. The primary outcome of the study was self-reported PA. Objectively assessed PA, psychosocial determinants of PA, well-being, body mass index (BMI), and adherence were assessed as secondary outcomes. Conclusion. Findings of this three-arm study will provide insight into the short and long-term effects of coaching and prompting for PA promotion.
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Affiliation(s)
- Xenia Fischer
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, 50933 Köln, Germany.
| | - Kimberly Zwygart
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
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Howlett N, Trivedi D, Troop NA, Chater AM. Are physical activity interventions for healthy inactive adults effective in promoting behavior change and maintenance, and which behavior change techniques are effective? A systematic review and meta-analysis. Transl Behav Med 2019; 9:147-157. [PMID: 29506209 PMCID: PMC6305562 DOI: 10.1093/tbm/iby010] [Citation(s) in RCA: 213] [Impact Index Per Article: 42.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at follow-up (behavior change maintenance), to identify behavior change techniques (BCT) within, and report on fidelity. Included studies were randomized controlled trials, targeting healthy inactive adults, aiming to change physical activity and/or sedentary behavior, with a minimum postintervention follow-up of 6 months, using 16 databases from 1990. Two reviewers independently coded risk of bias, the "Template for Intervention Description and Replication" (TIDieR) checklist, and BCTs. Twenty-six studies were included; 16 pooled for meta-analysis. Physical activity interventions were effective at changing behavior (d = 0.32, 95% confidence intervals = 0.16-0.48, n = 2,346) and maintaining behavior change after 6 months or more (d = 0.21, 95% confidence intervals = 0.12-0.30, n = 2,190). Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity intervention effectiveness was associated with the BCTs "Biofeedback," "Demonstration of the behavior," "Behavior practice/rehearsal," and "Graded tasks." At follow-up, effectiveness was associated with using "Action planning," "Instruction on how to perform the behavior," "Prompts/cues," "Behavior practice/rehearsal," "Graded tasks," and "Self-reward." Fidelity was only documented in one study. Good evidence was found for behavior change maintenance effects in healthy inactive adults, and underlying BCTs. This review provides translational evidence to improve research, intervention design, and service delivery in physical activity interventions, while highlighting the lack of fidelity measurement.
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Affiliation(s)
- Neil Howlett
- Department of Psychology and Sport Sciences, University of Hertfordshire, Herts AL, UK
| | - Daksha Trivedi
- Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL, UK
| | - Nicholas A Troop
- Department of Psychology and Sport Sciences, University of Hertfordshire, Herts AL, UK
| | - Angel Marie Chater
- Department of Psychology and Sport Sciences, University of Hertfordshire, Herts AL, UK
- Institute for Sport and Physical Activity Research (ISPAR), School of Sport Science and Physical Activity, Faculty of Education and Sport, University of Bedfordshire, Bedford, UK
- UCL School of Pharmacy, Centre for Behavioural Medicine, Research Department of Practice and Policy, University College London, London, UK
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Willems M, Waninge A, Jong J, Hilgenkamp TIM, Schans CP. Exploration of suitable behaviour change techniques for lifestyle change in individuals with mild intellectual disabilities: A Delphi study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:543-557. [DOI: 10.1111/jar.12548] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 09/27/2018] [Accepted: 10/28/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Mariël Willems
- Research group Healthy Ageing Allied Health Care and Nursing, Hanzehogeschool Groningen Groningen The Netherlands
| | - Aly Waninge
- Research group Healthy Ageing Allied Health Care and Nursing, Hanzehogeschool Groningen Groningen The Netherlands
| | - Johan Jong
- School of Sports Studies Hanzehogeschool Groningen Groningen The Netherlands
| | - Thessa I. M. Hilgenkamp
- Department of General Practice, Intellectual Disability Medicine Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
| | - Cees P. Schans
- Research group Healthy Ageing Allied Health Care and Nursing, Hanzehogeschool Groningen Groningen The Netherlands
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Alghafri TS, Alharthi SM, Al-Farsi Y, Alrawahi AH, Bannerman E, Craigie AM, Anderson AS. 'MOVEdiabetes': a cluster randomized controlled trial to increase physical activity in adults with type 2 diabetes in primary health in Oman. BMJ Open Diabetes Res Care 2018; 6:e000605. [PMID: 30487976 PMCID: PMC6235057 DOI: 10.1136/bmjdrc-2018-000605] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/27/2018] [Accepted: 10/16/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This study examined the impact of a multicomponent intervention to increase physical activity (PA) in adults with type 2 diabetes (T2D) in Oman. RESEARCH DESIGN AND METHODS This is a cluster randomized controlled trial in eight primary health centers. Participants were physically inactive, aged ≥18 years, and with no contraindication to PA. Patients attending intervention health centers (n=4) received the 'MOVEdiabetes' intervention, which consisted of personalized, individual face-to-face consultations by dietitians. Pedometers and monthly telephone WhatsApp messages were also used. Patients attending comparison health centers received usual care. The primary outcome was change in PA [Metabolic Equivalent(MET).min/week] after 12 months assessed by the Global Physical Activity Questionnaire. The secondary outcomes were changes in daily step counts, sitting time, weight, body mass index, glycated hemoglobin, blood pressure and lipids. RESULTS Of the 232 participants (59.1% female, mean (SD) age 44.2 (8.1) years), 75% completed the study. At 12 months, the mean change in MET.min/week was +631.3 (95% CI 369.4 to 893.2) in the intervention group (IG) vs +183.2 (95% CI 83.3 to 283.0) in the comparison group, with a significant between-group difference of +447.4 (95% CI 150.7 to 744.1). The odds of meeting PA recommendations were 1.9 times higher in the IG (95% CI 1.2 to 3.3). Significant between-group differences in favor of IG were detected for mean steps/day (+757, 95% CI 18 to 1531) and sitting time hours/ per day (-1.5, 95% CI -2.4 to -0.7). Clinical measures of systolic and diastolic blood pressure and triglycerides also showed significant intervention effects. CONCLUSIONS 'MOVEdiabetes' was effective in increasing PA, the likelihood of meeting PA recommendations, and providing cardioprotective benefits in adults with T2D attending primary care.
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Affiliation(s)
| | | | - Yahya Al-Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Abdul Hakeem Alrawahi
- Department of Planning and Studies, Research Section, Oman Medical Specialty Board, Muscat, Oman
| | - Elaine Bannerman
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Angela M Craigie
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
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49
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Oliveira CB, Franco MR, Maher CG, Ferreira PH, Morelhão PK, Damato TM, Gobbi C, Pinto RZ. Physical Activity–Based Interventions Using Electronic Feedback May Be Ineffective in Reducing Pain and Disability in Patients With Chronic Musculoskeletal Pain: A Systematic Review With Meta-Analysis. Arch Phys Med Rehabil 2018; 99:1900-1912. [DOI: 10.1016/j.apmr.2017.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/13/2017] [Accepted: 10/16/2017] [Indexed: 11/25/2022]
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Ek A, Alexandrou C, Delisle Nyström C, Direito A, Eriksson U, Hammar U, Henriksson P, Maddison R, Trolle Lagerros Y, Löf M. The Smart City Active Mobile Phone Intervention (SCAMPI) study to promote physical activity through active transportation in healthy adults: a study protocol for a randomised controlled trial. BMC Public Health 2018; 18:880. [PMID: 30012116 PMCID: PMC6048804 DOI: 10.1186/s12889-018-5658-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background The global pandemic of physical inactivity represents a considerable public health challenge. Active transportation (i.e., walking or cycling for transport) can contribute to greater total physical activity levels. Mobile phone-based programs can promote behaviour change, but no study has evaluated whether such a program can promote active transportation in adults. This study protocol presents the design and methodology of The Smart City Active Mobile Phone Intervention (SCAMPI), a randomised controlled trial to promote active transportation via a smartphone application (app) with the aim to increase physical activity. Methods/design A two-arm parallel randomised controlled trial will be conducted in Stockholm County, Sweden. Two hundred fifty adults aged 20–65 years will be randomised to either monitoring of active transport via the TRavelVU app (control), or to a 3-month evidence-based behaviour change program to promote active transport and monitoring of active travel via the TRavelVU Plus app (intervention). The primary outcome is moderate-to-vigorous intensity physical activity (MVPA in minutes/day) (ActiGraph wGT3x-BT) measured post intervention. Secondary outcomes include: time spent in active transportation measured via the TRavelVU app, perceptions about active transportation (the Transport and Physical Activity Questionnaire (TPAQ)) and health related quality of life (RAND-36). Assessments are conducted at baseline, after the completed intervention (after 3 months) and 6 months post randomisation. Discussion SCAMPI will determine the effectiveness of a smartphone app to promote active transportation and physical activity in an adult population. If effective, the app has potential to be a low-cost intervention that can be delivered at scale. Trial registration ClinicalTrials.gov NCT03086837; 22 March, 2017.
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Affiliation(s)
- Anna Ek
- Department of Biosciences and Nutrition, Karolinska Institutet, Group MLÖ, 141 83, Huddinge, Sweden.
| | - Christina Alexandrou
- Department of Biosciences and Nutrition, Karolinska Institutet, Group MLÖ, 141 83, Huddinge, Sweden
| | - Christine Delisle Nyström
- Department of Biosciences and Nutrition, Karolinska Institutet, Group MLÖ, 141 83, Huddinge, Sweden.,Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Artur Direito
- Centre for Behaviour Change, University College London, Alexandra House, 17-19 Queen Square, London, WC1N 3AR, UK
| | - Ulf Eriksson
- Trivector Traffic, Barnhusgatan 16, 111 23, Stockholm, Sweden
| | - Ulf Hammar
- Institute of Environmental Medicine, C6, Biostatistics, Karolinska Institutet, 210, 171 77, Stockholm, PO, Sweden
| | - Pontus Henriksson
- Department of Biosciences and Nutrition, Karolinska Institutet, Group MLÖ, 141 83, Huddinge, Sweden
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Eugeniahemmet T2, 171 76, Stockholm, Sweden.,Clinic of Endocrinology, Metabolism and Diabetes, Department of Medicine, Karolinska University Hospital, 141 86, Huddinge, Sweden
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Group MLÖ, 141 83, Huddinge, Sweden
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