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Rodrigues B, Carraça EV, Francisco BB, Nobre I, Cortez-Pinto H, Santos I. Theory-based physical activity and/or nutrition behavior change interventions for cancer survivors: a systematic review. J Cancer Surviv 2024; 18:1464-1480. [PMID: 37133640 PMCID: PMC11424668 DOI: 10.1007/s11764-023-01390-5] [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: 02/10/2023] [Accepted: 04/19/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Theory-based interventions aimed at promoting health behavior change in cancer survivors seem to be effective but remain scarce. More information on intervention features is also needed. This review aimed to synthesize the evidence from randomized controlled trials evaluating the efficacy of theory-based interventions (and its features) on physical activity (PA) and/or diet behaviors in cancer survivors. METHODS A systematic search in three databases (PubMed, PsycInfo, and Web of Science) identified studies that (i) targeted adult cancer survivors and (ii) included theory-based randomized controlled trials designed to influence PA, diet, or weight management. A qualitative synthesis of interventions' effectiveness, extensiveness of theory use, and applied intervention techniques was conducted. RESULTS Twenty-six studies were included. Socio-Cognitive Theory was the most used theory, showing promising results in PA-only trials and mixed findings in multiple-behavior interventions. Mixed findings were observed for interventions based on the Theory of Planned Behavior and Transtheoretical Model. Limited findings were found in diet-only interventions. A large variability in the extensiveness of theory use, and in intervention techniques was found. Further research is required to understand how and why these interventions offer promise for improving behavior. CONCLUSIONS Theory-based interventions seem to improve PA and diet behaviors in cancer survivors. Further studies, including thorough intervention descriptions, are needed to confirm these findings and identify the optimal features and content of lifestyle theory-based interventions for cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS This systematic review can contribute to the development of more effective interventions to promote long-term adherence to healthy lifestyle behaviors.
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Affiliation(s)
- Bruno Rodrigues
- Centro de Investigação em Atividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Eliana V Carraça
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal
| | - Beatriz B Francisco
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
| | - Inês Nobre
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Helena Cortez-Pinto
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
- Clínica Universitária de Gastrenterologia, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
- Departamento de Gastrenterologia, CHULN - Hospital de Santa Maria, Lisboa, Portugal
| | - Inês Santos
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal.
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal.
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
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Yu H, Zhu T, Tian J, Zhang G, Wang P, Chen J, Shen L. Physical activity and self-efficacy in college students: the mediating role of grit and the moderating role of gender. PeerJ 2024; 12:e17422. [PMID: 38803579 PMCID: PMC11129692 DOI: 10.7717/peerj.17422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/28/2024] [Indexed: 05/29/2024] Open
Abstract
Background There is a paucity of knowledge concerning the psychological variables that serve to facilitate the connection between physical activity and self-efficacy, and the factors capable of moderating these pathways. This study aimed to examine the relationship between physical activity and self-efficacy among college students, with a focus on the mediating effect of grit and the moderating effect of gender. Methods This study recruited 3,228 undergraduate students from a university in Shanghai, China. They completed the General Self-Efficacy Scale, the Short Grit Scale, and the International Physical Activity Questionnaire. Statistical analysis was conducted using SPSS 26.0 and the Process v4.0 plugin. Results Physical activity had both a direct effect on self-efficacy (β = 0.07, 95% CI [0.04-0.11]) and an indirect effect through the two dimensions of grit: perseverance of effort (β = 0.06, 95% CI [0.04-0.07]) and consistency of interest (β = 0.03, 95% CI [0.02-0.04]). The mediating effect explained 53.27% of the total effect. Furthermore, gender moderated the relationship between perseverance of effort and self-efficacy, with a stronger effect observed in males (β = 0.08, t = 3.27, p < 0.01). Conclusion The results revealed that grit is an underlying psychological mechanism that links physical activity and self-efficacy. Moreover, gender moderates the effect of perseverance of effort on self-efficacy, with a stronger effect observed in males. These findings have practical implications for educators to design tailored physical activity interventions that foster grit and self-efficacy among college students.
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Affiliation(s)
- Hongyan Yu
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Tingfei Zhu
- Psychological Counseling Center, Shanghai Jiao Tong University, Shanghai, China
| | - Jianing Tian
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Gang Zhang
- Shenzhen Shangbu Middle School, Shenzhen, China
| | - Peng Wang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Junxiong Chen
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Liqun Shen
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
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Schmitt L, Weber A, Venitz L, Leuchter M. Preschool teachers' pedagogical content knowledge predicts willingness to scaffold early science learning. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2023; 93:1034-1052. [PMID: 37248560 DOI: 10.1111/bjep.12618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/27/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND The importance of diagnostic and scaffolding activities for early science learning has been shown consistently. However, preschool teachers scarcely engage in them. We developed an instrument to assess preschool teachers' willingness to engage in diagnostic and scaffolding activities in science learning situations and examined its relation with teachers' knowledge, beliefs and practice. AIMS We validate an instrument to assess willingness to engage in scaffolding and diagnostic activities and study the interplay between willingness, learning beliefs, content knowledge (CK) and pedagogical content knowledge (PCK) in the context of science learning, particularly block play. SAMPLE(S) A total of N = 151 preschool teachers from 41 kindergartens in Germany participated in our study. METHODS Preschool teachers completed a questionnaire, which took approximately 1 hour of time. We drew a subsample of N = 73 teachers and observed their practice during a 30 min block play episode. RESULTS With our instrument, we were able to distinguish between preschool teachers' willingness to diagnose and to scaffold. Preschool teachers' co-constructivist beliefs and PCK predicted willingness to engage in diagnosing, PCK also predicted willingness to engage in scaffolding. Associations between learning beliefs and practice were inconsistent. CONCLUSIONS Our study highlights aspects of the association between preschool teachers' PCK and their willingness to engage in diagnosing and scaffolding. However, we found inconsistencies between preschool teachers' beliefs and practice, which call for further clarification.
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Affiliation(s)
- Lukas Schmitt
- Department of Children and Youth Education, RPTU Kaiserslautern-Landau, Landau, Germany
| | - Anke Weber
- Computer-Based Assessment Research Group, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Laura Venitz
- Department of Children and Youth Education, RPTU Kaiserslautern-Landau, Landau, Germany
| | - Miriam Leuchter
- Department of Children and Youth Education, RPTU Kaiserslautern-Landau, Landau, Germany
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Bill V, Wilke A, Sonsmann F, Rocholl M. What is the current state of research concerning self-efficacy in exercise behaviour? Protocol for two systematic evidence maps. BMJ Open 2023; 13:e070359. [PMID: 37532475 PMCID: PMC10401211 DOI: 10.1136/bmjopen-2022-070359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
INTRODUCTION Knowing about a risk factor is not sufficient to ensure corresponding behaviour as additional psychological factors play a role. Self-efficacy is one of the major factors. This also applies to physical activity and exercise behaviour, which is a major public health topic in both primary and secondary prevention. The amount of research on self-efficacy in exercise behaviour is high yet remains uncharted. This protocol presents the research design for two systematic evidence maps on self-efficacy in exercise behaviour in (1) primary prevention and (2) secondary prevention. These maps will thus provide a comprehensive overview over the current state in published empirical research as a starting point for future researchers. METHODS AND ANALYSIS The databases Medline (via PubMed) and PsycINFO (via EbscoHost) will be searched using the search terms 'self-efficacy' and any of the search terms 'sport' and 'exercise' in titles and abstracts. All empirical research studies which have measured self-efficacy in relation to exercise behaviour will be included. The primary prevention systematic evidence map will aggregate all studies on healthy humans and the secondary prevention systematic evidence map will include all studies on humans with a pre-existing condition. We will extract and present the data points authors, title, year, sample size (N), age groups, surveyed sport and method of measuring self-efficacy in both systematic evidence maps. Moreover, we will extract and present the target group in the systematic evidence map on primary prevention and the pre-existing condition in the systematic evidence map on secondary prevention. In addition to a data table, we will create freely accessible evidence maps in the form of graphs. ETHICS AND DISSEMINATION Since this is a protocol, an ethics approval is not required for the presented and planned work. The results of the two systematic evidence maps will be disseminated via publication in international peer-reviewed journals. In addition, data will be shared in detail via the Open Science Framework platform.
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Affiliation(s)
- Vanessa Bill
- Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabruck, Germany
| | - Annika Wilke
- Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabruck, Germany
| | - Flora Sonsmann
- Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabruck, Germany
| | - Marc Rocholl
- Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabruck, Germany
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Fretz KM. Recommendations to bolster adherence in cognitive behavioral therapy for insomnia: a self-efficacy approach. Transl Behav Med 2023; 13:206-211. [PMID: 36688474 PMCID: PMC10105881 DOI: 10.1093/tbm/ibac104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Lay SummaryThe safest and most effective treatment for chronic insomnia is Cognitive Behavioural Therapy for Insomnia (CBT-I). People sometimes struggle to adhere to, or follow the steps, involved in CBT-I because they are challenging (i.e., restricting time in bed to induce sleepiness, getting out of bed when not sleeping). These steps are based on sleep science and research shows that more closely adhering to them relates to better sleep improvements. One way that clinicians can help patients completing CBT-I improve their adherence to the difficult treatment steps is to promote their self-efficacy, or belief that they can effectively complete the treatment steps. Inspired by tried-and-true health promotion techniques rooted in Social Cognitive Theory, this paper describes concrete recommendations that clinicians can use to improve their patients’ self-efficacy when completing CBT-I. These recommendations include suggestions such as setting positive treatment expectations, discussing with patients how to set up for success when completing the treatment steps at home, and how to work with potential barriers to treatment. If clinicians can help boost patients’ self-efficacy, they may be able to carry out the treatment steps of CBT-I more effectively, and ultimately experience more benefits.
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Yang HM, Choo J. Effects of a parent-led childhood obesity management program for socioeconomically vulnerable families: A randomised controlled trial. Collegian 2023. [DOI: 10.1016/j.colegn.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Meditation and Yoga for Irritable Bowel Syndrome: A Randomized Clinical Trial. Am J Gastroenterol 2023; 118:329-337. [PMID: 36422517 PMCID: PMC9889201 DOI: 10.14309/ajg.0000000000002052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/09/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Delivered in person, yoga is effective in managing irritable bowel syndrome (IBS) symptoms. The evidence for efficacy, feasibility, and safety of virtually delivered yoga for patients with IBS is unknown. METHODS Adults diagnosed with IBS were randomized to either Hatha yoga intervention of 8 weekly online classes delivered virtually or an advice-only control group and assessed at baseline and postintervention. We used an unadjusted ANOVA to determine differences between and within groups on the primary outcome (decrease of ≥50 points in IBS Symptom Severity Scale [IBS-SSS]) and secondary outcomes (quality of life, anxiety and depression, fatigue, somatic symptoms, perceived stress, COVID-19 stress, and self-compassion). We assessed feasibility through recruitment and attrition rates, adherence, participant satisfaction, and safety (i.e., adverse events). RESULTS Seventy-nine people participated (mean age 45.4 years [SD = 14.0], 92% women, 20% attrition rate). IBS-SSS decreased significantly in the treatment group (Δ change = 54.7, P = 0.028), but not in the control group (Δ change = 22.6, P = 0.277). Fourteen patients (37%) in the yoga group reached a clinically relevant decrease of ≥50 points on the IBS-SSS postintervention compared with 8 patients (20%) in the control group ( P = 0.242). No significant difference was found between groups in IBS-SSS score postintervention ( P = 0.149), but significant differences in favor of the treatment group for quality of life ( P = 0.030), fatigue ( P = 0.035), and perceived stress ( P = 0.040) were identified. The yoga program demonstrated feasibility. Intention to practice yoga decreased significantly in both groups from baseline to postintervention ( P < 0.001). However, the decline in intention did not correlate with practice minutes. DISCUSSION Virtually delivered yoga is safe and feasible, and effective in reducing IBS symptoms. Based on the primary end point, the intervention was not superior to an advice-only control group.
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McMahon J, Thompson DR, Brazil K, Ski CF. An eHealth intervention (ManGuard) to reduce cardiovascular disease risk in male taxi drivers: protocol for a feasibility randomised controlled trial. Pilot Feasibility Stud 2022; 8:209. [PMID: 36104740 PMCID: PMC9472349 DOI: 10.1186/s40814-022-01163-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 08/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Men are at higher risk then women of developing cardiovascular disease (CVD), and male taxi drivers are a particularly high-risk group because of their typically unhealthy behaviours, such as poor eating habits, smoking and sedentary lifestyle. However, only two studies of behavioural interventions targeting taxi drivers have been identified, one of which reported a high attrition rate. Therefore, an eHealth intervention co-designed by taxi drivers may prove more acceptable and effective. The aim of this study is to assess the feasibility an eHealth intervention (ManGuard) to reduce CVD risk in male taxi drivers. Methods A randomised wait-list controlled trial will be conducted with a sample of 30 male taxi drivers to establish feasibility, including recruitment, engagement, and retention rates. Program usability and participant satisfaction will be assessed by a survey completed by all participants at 3 months after allocation. Additionally, an in-depth qualitative process evaluation to explore acceptability of the intervention will be conducted with a subset of participants by semi-structured telephone interviews. Preliminary efficacy of ManGuard for improving key CVD-related outcomes will be assessed, including biomarkers (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and total/HDL cholesterol ratio), blood pressure, anthropometry (body mass index, body fat percentage, and waist circumference), physical activity (accelerometery, and self-report) and psychosocial status (health-related quality of life, self-efficacy, and social support). Outcomes will be assessed at baseline, 7 weeks, and 3 months after group allocation. The wait-list control group will be offered access to the intervention at the completion of data collection. Discussion eHealth interventions show potential for promoting behaviour change and reducing CVD risk in men, yet there remains a paucity of robust evidence pertaining to male taxi drivers, classified as a high-risk group. This study uses a randomised controlled trial to assess the feasibility of ManGuard for reducing CVD risk in male taxi drivers. It is envisaged that this study will inform a fully powered trial that will determine the effectiveness of eHealth interventions for this high risk and underserved population. Trial registration This trial has been registered prospectively on the ISRCTN registry on 5 January 2022, registration number ISRCTN29693943 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01163-4.
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D’Silva A, Marshall DA, Vallance JK, Nasser Y, Taylor LM, Lazarescu A, Raman M. Gastroenterologist and Patient Attitudes Toward Yoga as a Therapy for Irritable Bowel Syndrome: An Application of the Theory of Planned Behaviour. J Can Assoc Gastroenterol 2022; 6:17-25. [PMID: 36789144 PMCID: PMC9915057 DOI: 10.1093/jcag/gwac028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives To identify irritable bowel syndrome (IBS) patients' attitudes, subjective norms, perceived control and intention to practice yoga and gastroenterologists' attitudes and current yoga recommendations for their patients with IBS. Methods Gastroenterologists and IBS patients completed online surveys including Theory of Planned Behaviour (TPB) constructs. Among IBS patients, multiple linear regression determined the multivariate associations between TPB variables and intention to practice yoga while controlling for significant socio-demographic variables. Gastroenterologists were asked about their attitudes and current yoga recommendations for patients with IBS. Chi-square analyses examined associations between gastroenterologists' demographics and recommending yoga. Binomial logistic regression described associations between attitude variables and current yoga recommendations. Results For patients (n = 109), controllability (β = 0.5, P < 0.001), affective attitude (β = 0.4, P < 0.05) and self-efficacy (β = 0.3, P < 0.05) were significantly associated with intention to do yoga in the regression model. TPB variables explained 34% of the variance in patients' intentions to practice yoga. The binomial regression analysis revealed that gastroenterologists (n = 79) who have confidence in recommending yoga (39%) were seven times more likely to recommend it (odds ratio = 7.3, P = 0.002) and those who agreed yoga improves IBS symptom severity (54%) were 10 times more likely to recommend yoga (odds ratio = 10.1, P < 0.001). Most (86%) wanted more evidence to support efficacy of yoga for IBS and 44% asked for more knowledge on how to refer a patient. Conclusion Controllability, affective attitude and self-efficacy predicted IBS patients' intentions to practice yoga. Although gastroenterologists believed yoga is safe and beneficial for IBS patients, most do not recommend yoga due to lack of confidence and scientific evidence.
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Affiliation(s)
- Adrijana D’Silva
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada,Arthur J.E. Child Chair, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Yasmin Nasser
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lorian M Taylor
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Adriana Lazarescu
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Maitreyi Raman
- Correspondence: Maitreyi Raman, MD, Faculty of Medicine, University of Calgary, 6D33 TRW Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada, e-mail:
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Spring B, Stump TK, Battalio SL, McFadden HG, Fidler Pfammatter A, Alshurafa N, Hedeker D. Digitally characterizing the dynamics of multiple health behavior change. Health Psychol 2021; 40:897-908. [PMID: 33570978 PMCID: PMC8355237 DOI: 10.1037/hea0001057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE We applied the ORBIT model to digitally define dynamic treatment pathways whereby intervention improves multiple risk behaviors. We hypothesized that effective intervention improves the frequency and consistency of targeted health behaviors and that both correlate with automaticity (habit) and self-efficacy (self-regulation). METHOD Study 1: Via location scale mixed modeling we compared effects when hybrid mobile intervention did versus did not target each behavior in the Make Better Choices 1 (MBC1) trial (n = 204). Participants had all of four risk behaviors: low moderate-vigorous physical activity (MVPA) and fruit and vegetable consumption (FV), and high saturated fat (FAT) and sedentary leisure screen time (SED). Models estimated the mean (location), between-subjects variance, and within-subject variance (scale). RESULTS Treatment by time interactions showed that location increased for MVPA and FV (Bs = 1.68, .61; ps < .001) and decreased for SED and FAT (Bs = -2.01, -.07; ps < .05) more when treatments targeted the behavior. Within-subject variance modeling revealed group by time interactions for scale (taus = -.19, -.75, -.17, -.11; ps < .001), indicating that all behaviors grew more consistent when targeted. METHOD Study 2: In the MBC2 trial (n = 212) we examined correlations between location, scale, self-efficacy, and automaticity for the three targeted behaviors. RESULTS For SED, higher scale (less consistency) but not location correlated with lower self-efficacy (r = -.22, p = .014) and automaticity (r = -.23, p = .013). For FV and MVPA, higher location, but not scale, correlated with higher self-efficacy (rs = .38, .34, ps < .001) and greater automaticity (rs = .46, .42, ps < .001). CONCLUSIONS Location scale mixed modeling suggests that both habit and self-regulation changes probably accompany acquisition of complex diet and activity behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - Tammy K. Stump
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - Samuel L. Battalio
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - H. Gene McFadden
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | | | - Nabil Alshurafa
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago
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McMahon J, Thompson DR, Pascoe MC, Brazil K, Ski CF. eHealth interventions for reducing cardiovascular disease risk in men: A systematic review and meta-analysis. Prev Med 2021; 145:106402. [PMID: 33388336 DOI: 10.1016/j.ypmed.2020.106402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/02/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
Men remain at a higher risk of developing cardiovascular disease (CVD) than women and behavioral risk factor modification is an important preventive measure. However, engaging men in behavior change interventions is challenging. Although men often indicate a preference for gender-specific information and support, this rarely occurs. eHealth interventions have the potential to address this gap, though their effectiveness for reducing CVD risk in men is unclear. Therefore, the aim of this systematic review and meta-analysis was to evaluate the effectiveness of eHealth interventions for reducing CVD risk in men. A search of published randomised controlled trials with no date restrictions up to July 2020 was conducted to identify those targeting at least two major CVD risk factors. Nine trials were identified and reviewed. Study quality ranged from low to unclear, with one trial at a high risk of bias. Compared to those in a control group or receiving printed materials, participants randomised to an eHealth intervention had statistically significant improvements in BMI (Z=-2.75, p=0.01), body weight (Z=-3.25, p=0.01), waist circumference (Z=-2.30, p=0.02) and systolic (Z=-3.57, p=0.01) and diastolic (Z=-3.56, p=0.01) blood pressure. Though less evident, there were also improvements in physical activity and diet in favour of the intervention group. This review suggests that eHealth interventions can reduce CVD risk in adult men through behavior change. However, we were unable to determine the association between intervention characteristics and outcomes. Also, overall, participant adherence to the intervention was poor. Both of these issues should be considered in future studies.
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Affiliation(s)
- James McMahon
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Michaela C Pascoe
- Institute for Health & Sport, Victoria University, Melbourne, Australia
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK; Integrated Care Academy, University of Suffolk, Ipswich, UK.
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Lim Y, Lee H, Kim DH, Kim YD. [Applying Extended Theory of Planned Behavior for Lung Cancer Patients Undergone Pulmonary Resection: Effects on Self-Efficacy for Exercise, Physical Activities, Physical Function, and Quality of Life]. J Korean Acad Nurs 2020; 50:66-80. [PMID: 32131074 DOI: 10.4040/jkan.2020.50.1.66] [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: 05/07/2019] [Revised: 12/05/2019] [Accepted: 01/19/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection. METHODS This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann-Whitney U test, t-test, and generalized estimation equations (GEE). RESULTS There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=-2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component. CONCLUSION The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.
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Affiliation(s)
- Yeonjung Lim
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Haejung Lee
- College of Nursing, Pusan National University, Yangsan, Korea.
| | - Do Hyung Kim
- Pulmonary Medicine Center, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yeong Dae Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan, Korea
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13
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French DP, Banafa R, Williams S, Taylor C, Brown LJE. How Does the Understanding, Experience, and Enactment of Self-Regulation Behaviour Change Techniques Vary with Age? A Thematic Analysis. Appl Psychol Health Well Being 2020; 13:239-260. [PMID: 33075200 DOI: 10.1111/aphw.12243] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Self-regulatory behaviour change techniques (BCTs) appear less effective in promoting physical activity amongst older than younger adults. This study aimed to identify reasons for this by examining how participants of different ages understand, experience, and use these BCTs. METHODS Twelve participants (aged 39-75) in a walking intervention study were interviewed twice: immediately post-intervention and 3 months later to examine understanding and enactment of self-regulation BCTs. Thematic analysis was used, organised using the framework approach. RESULTS Participants acknowledged the importance of setting realistic goals and found pedometers useful. In older adults, the use of goal setting was influenced by previous experience in work settings of this BCT. Occupational status appeared to influence the participants' responses to action planning, irrespective of age, with retired participants preferring not to restrict themselves to specific times. Self-monitoring with diaries appeared to be more useful in assisting the memory of older adults. For most BCTs, differences in understanding and enactment were apparent according to participant age. CONCLUSIONS Problems with using self-regulation BCTs were apparent, which appeared more common with older adults. Occupational status, cognitive status, or a perceived lack of value of physical activity or of some BCTs are all promising explanations that warrant further investigation.
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Affiliation(s)
| | - Rehab Banafa
- University of Manchester, UK.,Jeddah Institute for Speech and Hearing and Medical Rehabilitation, Saudi Arabia
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14
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Karimy M, Higgs P, Abadi SS, Armoon B, Araban M, Rouhani MR, Zamani-Alavijeh F. Oral health behavior among school children aged 11-13 years in Saveh, Iran: an evaluation of a theory-driven intervention. BMC Pediatr 2020; 20:476. [PMID: 33050893 PMCID: PMC7552527 DOI: 10.1186/s12887-020-02381-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 10/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background Good oral health (OH) is essential for physical, social, mental health, and overall quality of life. This study assessed the usefulness of the theory of planned behavior (TPB) in changing oral health-related behaviors among school children aged 11–13 years in Saveh, Iran. Methods In this descriptive before and after study, participants were sixth-grade students at single sex primary schools in Saveh city, Iran. We recruited 356 school children in 2019. Using simple random sampling, a male and a female school per district were allocated to the experimental group and the remaining schools to the control group. Our planned oral health education consisted of four one-hour training sessions over 1 week. The first session familiarized the participants with important information about OH. In the second session, we applied a brain storming exercise to identify the benefits and barriers to flossing and brushing. In the third session, a short film about correct brushing and dental flossing technique was shown and research team also used role-playing to correct any mistakes. In the final session students were taught about the importance and the application of OH planning and given forms to help plan for brushing. Results Participants for the study included 356 students (180 in the experimental group and 176 in the control group) who completed the post-test questionnaire. The mean age ± standard deviation was 11.55 years ±0.93 in the experimental group and 11.58 years ±1.01 in the control group. After the intervention, the paired t-test indicated a significant difference between the mean and standard deviation of the action plan and coping plan constructs in the experimental group before and after the intervention (p < 0.05). Covariance analysis indicated a significant difference between scores of intervention and control groups under statistical control of post-test in two groups (covariate) after a peer-led education program (post-test) (p < 0.05). Conclusion A shortage of professional health workers in education settings together with the ease, usefulness and low-cost of this peer-led method, suggest further steps should be taken to implement it more widely to improve and enhance primary school aged students’ oral health behavior.
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Affiliation(s)
- Mahmood Karimy
- Department of Public Health, Faculty of Health, Social Determinants of Health Research Center, Saveh University of medical sciences, Saveh, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Shaghaygh Solayman Abadi
- Department of Public Health, Faculty of Health, Social Determinants of Health Research Center, Saveh University of medical sciences, Saveh, Iran
| | - Bahram Armoon
- Department of Public Health, Faculty of Health, Social Determinants of Health Research Center, Saveh University of medical sciences, Saveh, Iran.
| | - Marzieh Araban
- Department of health education and promotion, Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Reza Rouhani
- Internal medicine department, faculty of medicine, Arak University of medical sciences, Arak, Iran
| | - Fereshteh Zamani-Alavijeh
- Department of health education and promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Caso D, Carfora V, Capasso M, Oliano D, Conner M. Using Messages Targeting Psychological versus Physical Health Benefits to Promote Walking Behaviour: A Randomised Controlled Trial. Appl Psychol Health Well Being 2020; 13:152-173. [PMID: 32945103 DOI: 10.1111/aphw.12224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aimed to test the efficacy of a messaging intervention targeting psychological or physical benefits plus goal setting and self-monitoring strategies to promote walking activity in the university context. METHODS Two hundred and thirty university students from the University of Naples Federico II were randomly allocated to one of four conditions: physical health messages + self-monitoring, psychological health (well-being) messages + self-monitoring, self-monitoring, and no messages. All three intervention conditions were exposed to goal setting (doing at least 7,000 steps a day) and participants were required to monitor their daily progress through the specific step counting app. Participants' walking activity and related psychological variables were assessed at T1 and T2. We ran ANCOVAs and mediation analysis to test our research questions and hypotheses. Analyses were based on the N = 156 who completed all measures at both time points. RESULTS Participants in the three experimental (message) conditions reported improvement in psychological variables and behaviour. In particular, the messages focused on the physical health benefits, combined with self-monitoring, were the most effective. CONCLUSIONS Our study provides new information on the factors that could be usefully targeted to promote walking activity (i.e. intention, past behaviour, action control, and persuasive messages on the physical benefits of walking).
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16
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Tang MY, Smith DM, Mc Sharry J, Hann M, French DP. Behavior Change Techniques Associated With Changes in Postintervention and Maintained Changes in Self-Efficacy For Physical Activity: A Systematic Review With Meta-analysis. Ann Behav Med 2020; 53:801-815. [PMID: 30534971 DOI: 10.1093/abm/kay090] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Self-efficacy is an important determinant of physical activity but it is unclear how best to increase self-efficacy for physical activity and to maintain these changes. PURPOSE This systematic review aimed to identify which specific behavior change techniques (BCTs), BCT clusters, and number of BCTs were associated with changes in postintervention and maintained changes in self-efficacy for physical activity across all adult populations. METHODS A systematic search yielded 180 randomized trials (204 comparisons) which reported changes in self-efficacy. BCTs were coded using the BCT Taxonomy v1. Hierarchical cluster analysis explored the clustering of BCTs. Meta-analyses and moderator analyses examined whether the presence and absence of individual BCTs in interventions were associated with effect-size changes for self-efficacy. RESULTS Small intervention effects were found for postintervention self-efficacy for physical activity (d = 0.26; 95% CI: [0.21, 0.31]; I2 = 75.8 per cent). "Information about social, environmental, and emotional consequences" was associated with higher effect sizes, whereas "social support (practical)" was associated with lower effect sizes. Small and nonsignificant effects were found for maintained changes in self-efficacy for physical activity (d = 0.08; CI: [-0.05, 0.21]; I2 = 83.8 per cent). Lack of meaningful clustering of BCTs was found. A significant positive relationship was found between number of BCTs and effect sizes for maintained changes in self-efficacy for physical activity. CONCLUSIONS There does not appear to be a single effective approach to change self-efficacy for physical activity in all adults: different approaches are required for different populations. Interventions with more BCTs seem more effective at maintaining changes in self-efficacy for physical activity.
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Affiliation(s)
- Mei Yee Tang
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK.,Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
| | - Debbie M Smith
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK.,School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - Jennifer Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Mark Hann
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - David P French
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
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17
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Masheder J, Fjorback L, Parsons CE. "I am getting something out of this, so I am going to stick with it": supporting participants' home practice in Mindfulness-Based Programmes. BMC Psychol 2020; 8:91. [PMID: 32867834 PMCID: PMC7457766 DOI: 10.1186/s40359-020-00453-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/27/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The practice of mindfulness at home is a core component of standard eight-week mindfulness-based programmes (MBP). Teachers of mindfulness courses require an understanding of the factors that need to be addressed to support participants in establishing and maintaining a mindfulness practice. METHOD Here, we present a review of seven factors that we argue are important for participants' practice of mindfulness. We use the well-established model of Behaviour Change, the COM-B model (Capability, Opportunity, Motivation and Behaviour) to organise and consider these factors. For each factor, we first present a definition and then a discussion in relation to psychological, health and Buddhist literature. We illustrate the importance of each factor with quotes from MBP participant interviews. RESULTS We discuss participants' Capability (planning/commitment, physical space), Opportunity (social support, the relationship with the teacher) and Motivation (readiness for self-care, beliefs about practice, self-efficacy, experiencing the rewards of practice), and how these lead to the target Behaviour (mindfulness practice). CONCLUSIONS Our understanding, as teachers and researchers, of how best to support and guide participants during MBPs is at an early stage. We draw out practical lessons around each of the seven factors for mindfulness teachers in supporting participants' home practice.
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Affiliation(s)
| | | | - Christine E Parsons
- Danish Center for Mindfulness, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Interacting Minds Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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18
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Pastor-Mira MA, López-Roig S, Martínez-Zaragoza F, Lledó A, Velasco L, León E, Écija Gallardo C, Peñacoba C. Promoting unsupervised walking in women with fibromyalgia: a randomized controlled trial. PSYCHOL HEALTH MED 2020; 26:487-498. [PMID: 32544346 DOI: 10.1080/13548506.2020.1774068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The objective of this study is to test the efficacy of a group motivational plus implementation intentions intervention in promoting adherence to an unsupervised walking program recommended for fibromyalgia, compared to an implementation intentions condition and to an active control condition. A triple-blind, randomized, longitudinal study with measures at baseline, short (seven weeks post-intervention), mid (12 weeks) and long-term (36 weeks) is performed. Data are analyzed using multilevel longitudinal growth curve two-level modelling. Participants are 157 women with fibromyalgia. In the short-term, adherence to the minimum and to the standard walking program (primary outcome measures) is explained by time (both p <.001), motivational plus implementation intentions intervention (both p <.001) and by their interaction (both p <.001). Regarding the secondary outcomes, only physical function is explained by time (p <.001), motivational plus implementation intentions intervention (p <.05) and by their interaction (p <.05). Motivational plus implementation intentions intervention achieve the promotion of walking as an exercise in the short-term; furthermore, physical function of the women in this condition is better than in the other two intervention groups, which is a relevant outcome from a rehabilitation point of view. However, more studies are needed to maintain the exercise at mid and long-term.
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Affiliation(s)
- María A Pastor-Mira
- Department of Behavioral Sciences & Health, Miguel Hernández University, Spain
| | - Sofía López-Roig
- Department of Behavioral Sciences & Health, Miguel Hernández University, Spain
| | | | - Ana Lledó
- Department of Behavioral Sciences & Health, Miguel Hernández University, Spain
| | - Lilian Velasco
- Department of Medicine & Surgery, Psychology, Preventive Medicine & Public Health, Rey Juan Carlos University, Spain
| | - Eva León
- Department of Behavioral Sciences & Health, Miguel Hernández University, Spain
| | - Carmen Écija Gallardo
- Department of Medicine & Surgery, Psychology, Preventive Medicine & Public Health, Rey Juan Carlos University, Spain
| | - Cecilia Peñacoba
- Department of Medicine & Surgery, Psychology, Preventive Medicine & Public Health, Rey Juan Carlos University, Spain
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19
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Fortune J, Norris M, Stennett A, Kilbride C, Lavelle G, Hendrie W, de Souza L, Abdul M, Brewin D, David L, Anokye N, Victor C, Ryan JM. 'I can do this': a qualitative exploration of acceptability and experiences of a physical activity behaviour change intervention in people with multiple sclerosis in the UK. BMJ Open 2020; 10:e029831. [PMID: 32144172 PMCID: PMC7064077 DOI: 10.1136/bmjopen-2019-029831] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The purpose of this study was to explore the experiences of people with multiple sclerosis (MS) who participated in iStep-MS, a feasibility randomised controlled trial of a behaviour change intervention that aimed to increase physical activity and reduce sedentary behaviour. DESIGN A qualitative approach was undertaken embedded in the feasibility randomised controlled trial. One-to-one semi-structured interviews were conducted and analysed using Framework analysis. SETTING Participants were recruited from a single MS therapy centre in the southeast of England, UK. PARTICIPANTS Sixty people with MS were randomly allocated in a 1:1 ratio to the intervention or usual care. Following a purposive sampling strategy, 15 participants from the intervention arm undertook 1:1 semi-structured interviews. INTERVENTIONS The iStep-MS intervention consisted of four therapist-led sessions over 12 weeks, supported by a handbook and pedometer. RESULTS Three themes were identified from the data. "I can do this": developing competence in physical activity highlights the enhanced physical activity confidence gained through goal setting and accomplishment. "I felt valued": the nurturing culture provides an overview of the supportive and non-judgemental environment created by the programme structure and therapeutic relationship. Finally, "What can I do?": empowered enactment describes the transition from the supported iStep-MS intervention to intrinsically motivated physical activity enactment. CONCLUSIONS Overall, this study supports the acceptability of the iStep-MS intervention and identified key areas that supported participants to be physically active. TRIAL REGISTRATION NUMBER ISRCTN15343862.
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Affiliation(s)
- Jennifer Fortune
- University of Dublin Trinity College, Dublin, Ireland
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Meriel Norris
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Andrea Stennett
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Cherry Kilbride
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Grace Lavelle
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | | | - Lorraine de Souza
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | | | | | | | - Nana Anokye
- Health Economics Research Group, Brunel University London, Uxbridge, UK
| | - Christina Victor
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Jennifer M Ryan
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
- Department of Public Health and Epidemiology, RCSI, Dublin, Ireland
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20
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Kadir MA, Rundle-Thiele S. Reported theory use in walking interventions: a literature review and research agenda. Health Promot Int 2020; 34:601-615. [PMID: 29452362 DOI: 10.1093/heapro/day003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There is mixed evidence with some suggesting walking can be increased up to the recommended level through interventions based on behaviour change models and others showing partial or no effects [Arbour and Ginis (A randomised controlled trial of the effects of implementation intentions on women's walking behaviour. Psychol Health, 2009;24:49-65); Merom et al. (Can a motivational intervention overcome an unsupportive environment for walking-findings from the Step-by-Step Study. Ann Behav Med 2009;38:137-46); Ornes and Ransdell (A pilot study examining exercise self-efficacy as a mediator for walking behavior in college-age women. Perceptual Motor Skills, 2010;110:1098-104)]. Taken together, prior studies suggest that ongoing research attention is warranted. Walking behaviour change intervention studies were searched using key search words 'walking promotion' and 'pedometer' in the PubMed database. Initially, 87 articles were found and 25 walking behaviour change interventions were reviewed to focus attention on reported theory use. Results of the review suggest that interventions that are theoretically underpinned may be no more effective than their counterparts. The Transtheoretical Model (TTM) and Social Cognitive Models were most frequently reported with positive effects noted for TTM use. The review also indicates that using single theory may be better than using multiple theories in a single intervention.
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Affiliation(s)
- Mohammad Abdul Kadir
- Social Marketing @ Griffith, and Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, and Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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21
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Mead MP, Irish LA. Application of health behaviour theory to sleep health improvement. J Sleep Res 2019; 29:e12950. [PMID: 31758596 DOI: 10.1111/jsr.12950] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 12/20/2022]
Abstract
Although sleep hygiene is often used for broad sleep health promotion efforts, sleep hygiene education programmes are largely ineffective. These programmes are limited by their lack of a theoretical foundation. Health behaviour theory (HBT) has been used for decades to successfully predict and modify many health behaviours, but its use in the study of sleep health is rare. The purpose of this review is threefold. First, four dominant HBTs will be introduced. Second, the brief literature on HBT and sleep health will be reviewed. Lastly, a translational research agenda will be proposed. The present review concludes that HBT shows potential in both the prediction and modification of sleep health, and that there are several short- and long- term research goals to advance these efforts.
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Affiliation(s)
| | - Leah A Irish
- North Dakota State University, Fargo, North Dakota.,Sanford Center for Biobehavioral Research, Fargo, North Dakota
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22
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Williams SL, McSharry J, Taylor C, Dale J, Michie S, French DP. Translating a walking intervention for health professional delivery within primary care: A mixed-methods treatment fidelity assessment. Br J Health Psychol 2019; 25:17-38. [PMID: 31746091 PMCID: PMC7003875 DOI: 10.1111/bjhp.12392] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/24/2019] [Indexed: 01/26/2023]
Abstract
Objectives Existing fidelity studies of physical activity interventions are limited in methodological quality and rigour, particularly those delivered by health care providers in clinical settings. The present study aimed to enhance and assess the fidelity of a walking intervention delivered by health care providers within general practice in line with the NIH Behavior Change Consortium treatment fidelity framework. Design Two practice nurses and six health care assistants delivered a theory‐based walking intervention to 63 patients in their own practices. A cross‐sectional mixed‐methods study assessed fidelity related to treatment delivery and treatment receipt, from the perspectives of health care providers and patients. Methods All providers received training and demonstrated delivery competence prior to the trial. Delivery of intervention content was coded from audio‐recordings using a standardized checklist. Qualitative interviews with 12 patients were conducted to assess patient perspectives of treatment receipt and analysed using framework analysis. Results Overall, 78% of intervention components were delivered as per the protocol (range 36–91%), with greater fidelity for components requiring active engagement from patients (e.g., completion of worksheets). The qualitative data highlighted differences in patients’ comprehension of specific intervention components. Understanding of, and engagement with, motivational components aimed at improving self‐efficacy was poorer than for volitional planning components. Conclusions High levels of fidelity of delivery were demonstrated. However, patient‐, provider‐, and component‐level factors impacted on treatment delivery and receipt. We recommend that methods for the enhancement and assessment of treatment fidelity are consistently implemented to enhance the rigour of physical activity intervention research. Statement of contribution What is already known on this subject? Physical activity interventions delivered within primary care by health professionals have so far demonstrated limited impact on behaviour change initiation and maintenance. Treatment fidelity enhancement and assessment strategies can support the successful translation of behaviour change interventions into real‐life settings. Few studies have examined treatment fidelity within the context of physical activity interventions, particularly within clinical settings, and existing fidelity studies are limited by methodological quality and rigour.
What does this study add? High levels of fidelity were found for a physical activity intervention delivered in primary care. Patient‐, provider‐, and component‐level factors may impact on treatment delivery and receipt. The implementation of best practice fidelity recommendations can support near‐optimal fidelity.
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Affiliation(s)
| | - Jennifer McSharry
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland
| | - Claire Taylor
- Public Health Warwickshire, Warwickshire County Council, Warwick, UK
| | - Jeremy Dale
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - David P French
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, UK
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23
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Celis-Morales CA, Gray S, Petermann F, Iliodromiti S, Welsh P, Lyall DM, Anderson J, Pellicori P, Mackay DF, Pell JP, Sattar N, Gill JMR. Walking Pace Is Associated with Lower Risk of All-Cause and Cause-Specific Mortality. Med Sci Sports Exerc 2019; 51:472-480. [PMID: 30303933 DOI: 10.1249/mss.0000000000001795] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Walking pace is associated with all-cause and cardiovascular disease (CVD) mortality. Whether this association extends to other health outcomes and whether it is independent of total amount of time walked are currently unknown. Therefore, the aim of this study was to investigate whether usual walking pace is associated with a range of health outcomes. METHODS UK Biobank participants (318,185 [54%] women) age 40 to 69 yr were included. Walking pace and total walking time were self-reported. The outcomes comprised: all-cause mortality as well as incidence and mortality from CVD, respiratory disease and cancer. The associations were investigated using Cox proportional hazard models. RESULTS Over a mean of 5.0 yr [ranging from 3.3 to 7.8], 5890 participants died, 18,568 developed CVD, 5430 respiratory disease and 19,234 cancer. In a fully adjusted model, compared to slow pace walkers, men and women, respectively, with a brisk pace having lower risk of mortality from all-causes (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.69-0.90 and HR, 0.73; 95% CI, 0.62-0.85), CVD (HR, 0.62; 95% CI, 0.50-0.76 and HR, 0.80; 95% CI, 0.73-0.88), respiratory disease (HR, 0.58; 95% CI, 0.43-0.78 and HR, 0.66; 95% CI, 0.57-0.77), chronic obstructive pulmonary disease (HR, 0.26; 95% CI, 0.12-0.56 and HR, 0.28; 95% CI, 0.16-0.49). No associations were found for all-cause cancer, colorectal, and breast cancer. However, brisk walking was associated with a higher risk of prostate cancer. CONCLUSIONS Walking pace is associated with lower risk of a wide range of important health conditions, independently of overall time spent walking.
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Affiliation(s)
- Carlos A Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Stuart Gray
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Fanny Petermann
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Stamatina Iliodromiti
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Paul Welsh
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Donald M Lyall
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Jana Anderson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Pierpaolo Pellicori
- Robertson Centre for Biostatistics & Clinical Trials, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Daniel F Mackay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Jason M R Gill
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
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24
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Pastor-Mira MA, López-Roig S, Peñacoba C, Sanz-Baños Y, Lledó A, Velasco L. Predicting walking as exercise in women with fibromyalgia from the perspective of the theory of planned behavior. Women Health 2019; 60:412-425. [DOI: 10.1080/03630242.2019.1662869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Sofía López-Roig
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | - Cecilia Peñacoba
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Medical Microbiology and Immunology, Faculty of Health Sciences, King Juan Carlos University, Alcorcón, Madrid, Spain
| | - Yolanda Sanz-Baños
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | - Ana Lledó
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | - Lilian Velasco
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Medical Microbiology and Immunology, Faculty of Health Sciences, King Juan Carlos University, Alcorcón, Madrid, Spain
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Bearne L, Galea Holmes M, Bieles J, Eddy S, Fisher G, Modarai B, Patel S, Peacock JL, Sackley C, Volkmer B, Weinman J. Motivating Structured walking Activity in people with Intermittent Claudication (MOSAIC): protocol for a randomised controlled trial of a physiotherapist-led, behavioural change intervention versus usual care in adults with intermittent claudication. BMJ Open 2019; 9:e030002. [PMID: 31446416 PMCID: PMC6720323 DOI: 10.1136/bmjopen-2019-030002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Walking exercise is a recommended but underused treatment for intermittent claudication caused by peripheral arterial disease (PAD). Addressing the factors that influence walking exercise may increase patient uptake of and adherence to recommended walking. The primary aim of this randomised controlled trial (RCT) is to evaluate the efficacy of a physiotherapist-led behavioural change intervention on walking ability in adults with intermittent claudication (MOtivating Structured walking Activity in people with Intermittent Claudication (MOSAIC)) in comparison with usual care. METHODS AND ANALYSIS The MOSAIC trial is a two-arm, parallel-group, single-blind RCT. 192 adults will be recruited from six National Health Service Hospital Trusts. Inclusion criteria are: aged ≥50 years, PAD (Ankle Brachial Pressure Index ≤0.90, radiographic evidence or clinician report) and intermittent claudication (San Diego Claudication Questionnaire), being able and willing to participate and provide informed consent. The primary outcome is walking ability (6 min walking distance) at 3 months. Outcomes will be obtained at baseline, 3 and 6 months by an assessor blind to group allocation. Participants will be individually randomised (n=96/group, stratified by centre) to receive either MOSAIC or usual care by an independent randomisation service. Estimates of treatment effects will use an intention-to-treat framework implemented using multiple regression adjusted for baseline values and centre. ETHICS AND DISSEMINATION This trial has full ethical approval (London-Bloomsbury Research Ethics Committee (17/LO/0568)). It will be disseminated via patient forums, peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ISRCTN14501418.
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Affiliation(s)
- Lindsay Bearne
- Department of Population Health Sciences, King's College London, London, UK
| | - Melissa Galea Holmes
- Department of Population Health Sciences, King's College London, London, UK
- Department of Applied Health Research, University College London, London, UK
| | - Julie Bieles
- Department of Population Health Sciences, King's College London, London, UK
| | - Saskia Eddy
- Department of Population Health Sciences, King's College London, London, UK
| | - Graham Fisher
- Department of Population Health Sciences, King's College London, London, UK
| | - Bijan Modarai
- Academic Department of Vascular Surgery, King's College London, London, UK
| | - Sanjay Patel
- Department of Vascular Surgery, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - Janet L Peacock
- Department of Population Health Sciences, King's College London, London, UK
| | - Catherine Sackley
- Department of Population Health Sciences, King's College London, London, UK
| | - Brittannia Volkmer
- Department of Population Health Sciences, King's College London, London, UK
| | - John Weinman
- Institute of Pharmaceutical Sciences, Kings College London, London, UK
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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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Bernardelli G, Roncaglione C, Damanti S, Mari D, Cesari M, Marcucci M. Adapted physical activity to promote active and healthy ageing: the PoliFIT pilot randomized waiting list-controlled trial. Aging Clin Exp Res 2019; 31:511-518. [PMID: 30019265 DOI: 10.1007/s40520-018-1002-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Physical activities can prevent disability in elderly. AIMS To evaluate the feasibility and impact on physical function of an adapted physical activity (APA) programme in community-dwelling people of ≥ 70 years old. METHODS Non-blinded randomized trial with a waiting list control. Eligible people (n = 186) were randomly allocated to 4 months of weekly APA classes of 45 min or in control group performing usual lifestyle activity. PRIMARY OUTCOME time to walk 400 m. SECONDARY OUTCOMES short physical performance battery (SPPB), pain (visual analogic scale, McGill Questionnaire), Oswestry Disability Index (ODI), Geriatric Depression Scale (GDS), handgrip strength, accesses to Emergency Department and falls. RESULTS Participants were allocated to the intervention (n = 130) or to the control (n = 56) group (80% females aged 75.6 ± 4.6 years). We found statistically significant difference in the time to walk 400 m only in the subgroup intervention with the lower performance at baseline (p for interaction 0.031). SPPB improved and VAS decreased more in the intervention group. No significant differences for McGill questionnaire, ODI, GDS, accesses to ER and falls were showed. DISCUSSION Despite the good rate of attendance (71%) and satisfaction (97%), our APA programme was associated with no benefit on the time to walk 400 m and small benefit on SPPB and VAS. The efficacy of the intervention was likely limited by the short duration and low intensity and by the already good performance of our population at baseline. CONCLUSIONS We designed this initiative as a pilot study intending to implement research of this type in the future.
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Rush CL, Hooker SA, Ross KM, Frers AK, Peters JC, Masters KS. Brief report: Meaning in life is mediated by self-efficacy in the prediction of physical activity. J Health Psychol 2019; 26:753-757. [DOI: 10.1177/1359105319828172] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Meaning and purpose in life are related to a reduced risk of mortality and cardiovascular events, and meaning has been established as a correlate of physical activity. However, it is not clear what mechanisms account for the relationship between meaning and physical activity. A cross-sectional analysis ( N = 94) indicated that self-efficacy in improving physical fitness is a statistically significant mediator of the relationship between meaning and physical activity.
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Affiliation(s)
| | | | | | | | - John C Peters
- Anschutz Health and Wellness Center, University of Colorado, USA
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Gholamnia-Shirvani Z, Ghofranipour F, Gharakhanlou R, Kazemnejad A. "Women and active life": An extended TPB-based multimedia software to boost and sustain physical activity and fitness of Iranian women. Women Health 2018; 58:834-850. [PMID: 28682184 DOI: 10.1080/03630242.2017.1342739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Inactivity is prevalent in women, although regular physical activity (PA) has significant health benefits. Health education interventions based on multimedia software and the extended theory of planned behavior (TPB) with planning may be efficacious in promoting PA. This randomized controlled trial, conducted in 2014, aimed to evaluate theory-based multimedia for increasing and maintaining PA and fitness of 130 military personnel's wives in Tehran, Iran. We randomly selected respondents by multistage cluster sampling. We designed a "Women and Active Life" self-taught DVD-Rom, based on the extended TPB model with action and coping planning. We analyzed theoretical constructs and health-related physical fitness at baseline and 3 and 6 months post-education. Administering educational software raised average developed TPB constructs, cardiorespiratory endurance, and muscular fitness (strength, endurance, and flexibility) in women in the intervention group, which was sustained at follow-up (p < .001). Also, mean body composition (body fat percentage, waist-hip ratio, and body mass index) was reduced with retained reduction at follow-up (p < .001), although no significant change was found in these variables in the control group (p > .05). Using a new communication technology in TPB-directed multimedia led to improved and maintained PA, aerobic and musculoskeletal fitness, and body composition of women.
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Affiliation(s)
- Zeinab Gholamnia-Shirvani
- a Department of Health Education, Faculty of Medical Sciences , Tarbiat Modares University , Tehran , Iran
- b Education Development Center (EDC) , Babol University of Medical Sciences , Babol , Iran
- c Young Researchers and Elite Club , Babol Branch, Islamic Azad University , Babol , Iran
| | - Fazlollah Ghofranipour
- a Department of Health Education, Faculty of Medical Sciences , Tarbiat Modares University , Tehran , Iran
| | - Reza Gharakhanlou
- d Department of Physical Education & Sport, Faculty of Humanities , Tarbiat Modares University , Tehran , Iran
| | - Anoshirvan Kazemnejad
- e Department of Biostatistics, Faculty of Medical Sciences , Tarbiat Modares University , Tehran , Iran
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Sinclair PM, Day J, Levett-Jones T, Kable A. Barriers and facilitators to opportunistic chronic kidney disease screening by general practice nurses. Nephrology (Carlton) 2018; 22:776-782. [PMID: 27436704 DOI: 10.1111/nep.12856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 11/30/2022]
Abstract
AIM Opportunistic screening in general practice (GP) is a cost-effective and viable approach to the early identification of chronic kidney disease (CKD). This study sought to identify the barriers and facilitators to CKD screening practices of GP nurses working in a regional area of New South Wales, Australia. METHODS An eight-item elicitation questionnaire informed by the Theory of Planned Behaviour was administered to a convenience sample of 26 GP nurses. RESULTS Participants identified that the advantages of CKD screening were its early detection and treatment, the reduction of disease burden, and the opportunity to increase awareness and provide disease prevention education. These positive attitudinal beliefs were offset by negative beliefs about the impost of opportunistic screening on nursing time, particularly when there were other competing clinical priorities. Participants reported that practice doctors were wary of the financial costs associated with additional non-claimable services and believed that unfunded services, regardless of patient benefit, were difficult to justify in a private business environment. Screening was enabled in GP settings with existing screening protocols or initiatives, and when patients presented with known risk factors. Barriers to screening were more frequently described and illustrated a strong focus on financial aspects of GP. Without reimbursement through the Medicare Benefits Scheme, screening was not considered an economical use of nursing time. Other competing and billable clinical services took precedence. CONCLUSION The findings of this study can be used to inform the development and evaluation of interventions that target opportunistic CKD screening in the GP setting.
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Affiliation(s)
- Peter M Sinclair
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Jenny Day
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Tracy Levett-Jones
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Ashley Kable
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
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31
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Jo G, Rossow-Kimball B, Lee Y. Effects of 12-week combined exercise program on self-efficacy, physical activity level, and health related physical fitness of adults with intellectual disability. J Exerc Rehabil 2018; 14:175-182. [PMID: 29740549 PMCID: PMC5931151 DOI: 10.12965/jer.1835194.597] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 02/04/2018] [Indexed: 11/23/2022] Open
Abstract
The current study examined the effects of an exercise program on health related physical fitness, self-efficacy, and physical activity levels in adults with intellectual disability. The study used pre- and posttest experimental research design with a control group. Total of 23 adults with intellectual disability were recruited with 12 assigned for the exercise group and 11 for the control group, separately. The measures of health related physical fitness included cardio pulmonary endurance (step-test), body composition (bioelectrical impedance analysis), flexibility (sit and reach), muscle endurance (sit-up), and strength (hand grip strength). Self-efficacy was measured using the physical self-efficacy scale. Accelerometers were used to measure physical activity levels. All variables were measured and evaluated twice at baseline and at the end of the program. The exercise program consisted of band exercises and rhythmic activity for 90 min, twice per week for 12 weeks. After the intervention, significant improvements were found in the experimental group in muscle endurance, self-efficacy, and physical activity levels. An exercise program may be recommended as a nonpharmaceutical method to improve the health of adults with intellectual disabilities.
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Affiliation(s)
- Garam Jo
- Department of Physical Education, Seoul National University, Seoul, Korea
| | | | - Yongho Lee
- Department of Physical Education, Seoul National University, Seoul, Korea
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A school-based intervention program in promoting leisure-time physical activity: trial protocol. BMC Public Health 2018; 18:433. [PMID: 29609570 PMCID: PMC5880013 DOI: 10.1186/s12889-018-5320-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 03/14/2018] [Indexed: 11/26/2022] Open
Abstract
Background Regular participation in moderate-to-vigorous physical activity (MVPA) is important to manage obesity. Physical education (PE) is considered to play an important role in promoting lifelong participation in physical activity (PA) because it provides an existing network where cost-effective interventions can be implemented to produce sustainable change in health behavior. However, the association between compulsory school PA (e.g., PE lessons) and body composition levels has received mixed support in the literature. Therefore, the present study aimed to investigate whether a school-based intervention targeting salient PA benefits and barriers grounded on the theory of planned behavior would promote young people’s participation in MVPA during leisure time and reduce body mass index (BMI) of overweight students. Methods/design A total of 171 students from 3 secondary schools in Singapore underwent the control condition followed by the intervention condition. Both the conditions consisted of PE lessons twice per week over 4 weeks. In the control condition, PE teachers encouraged students to participate in PA during leisure time without providing persuasive message. While in the intervention condition, PE teachers delivered persuasive messages that targeted the salient benefits and barriers associated with PA to the students at the last 5 to 10 min of each PE lesson. PA levels over a week were measured objectively with wrist-mounted GENEActiv Original accelerometers and subjectively with self-reporting questionnaires three times (Baseline, Post 1, and Post 2) in each condition. Student’s self-reported PA level was measured using the Leisure-Time Physical Activity Participation Questionnaire and the International Physical Activity Questionnaire, and their attitudes, intentions, subjective norms and perceived behavior control towards leisure-time PA were measured with a questionnaire based on the theory of planned behavior. Furthermore, students’ intention, determination and willingness to engage in leisure-time PA were compared with the other activity (e.g., doing homework, shopping). Discussion This study will provide the evidence on the effectiveness of a cost-effective school-based intervention on reducing BMI of overweight students through promoting sustained participation in leisure-time PA. It will also address methodological issues on the gaps between objective and subjective measures of PA. Trial registration This trial is registered with the ISRCTN registry (ISRCTN73786157, 26/10/2017, retrospectively registered).
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Efficacy and Mediation of a Theory-Based Physical Activity Intervention for African American Men Who Have Sex with Men: A Randomized Controlled Trial. Ann Behav Med 2018; 51:106-116. [PMID: 27658914 DOI: 10.1007/s12160-016-9832-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Few trials have tested physical-activity interventions among sexual minorities, including African American men who have sex with men (MSM). PURPOSE We examined the efficacy and mediation of the Being Responsible for Ourselves (BRO) physical-activity intervention among African American MSM. METHOD African American MSM were randomized to the physical-activity intervention consisting of three 90-min one-on-one sessions or an attention-matched control intervention and completed pre-intervention, immediately post-intervention, and 6- and 12-month post-intervention audio computer-based surveys. RESULTS Of the 595 participants, 503 completed the 12-month follow-up. Generalized estimating equation models revealed that the intervention increased self-reported physical activity compared with the control intervention, adjusted for pre-intervention physical activity. Mediation analyses suggested that the intervention increased reasoned action approach variables, subjective norm and self-efficacy, increasing intention immediately post-intervention, which increased physical activity during the follow-up period. CONCLUSIONS Interventions targeting reasoned action approach variables may contribute to efforts to increase African American MSM's physical activity. CLINICAL TRIAL REGISTRATION The trial was registered with the ClinicalTrials.gov Identifier NCT02561286 .
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Shao C, Wang J, Liu J, Tian F, Li H. Effect of a Health Belief Model-based education program on patients' belief, physical activity, and serum uric acid: a randomized controlled trial. Patient Prefer Adherence 2018; 12:1239-1245. [PMID: 30046238 PMCID: PMC6054292 DOI: 10.2147/ppa.s166523] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE We aimed to investigate the effect of a Health Belief Model (HBM)-based education program on the perception scores of 5 HBM domains, physical activity, and serum uric acid (SUA) among asymptomatic hyperuricemia (AHU) patients in a randomized controlled trial. METHODS One hundred and ninety-three AHU patients were involved in this prospective experimental interventional study in Shanghai, China. Subjects were randomly divided into interventional or control group. The educational program was designed based on HBM component for the improvement of knowledge and promotion of lifestyle adherence in terms of low-purine diet and physical activity among AHU patients. This program included educational booklets and educational classes. Data were collected from interventional and control group members both before and after the intervention, using a questionnaire covering sociodemographic characteristics, HBM variables, physical activity from the Health-Promoting Lifestyle Profile II, and a check list for recording the subject's SUA values, as well as the body mass index, waist-hip ratio, systolic blood pressure, and diastolic blood pressure. RESULTS In the interventional group, the mean scores of the HBM variables (perceived susceptibility, perceived severity, perceived benefit, perceived barriers, and self-efficacy), SUA values, physical activity, body mass index, and waist-hip ratio were improved significantly after the intervention (p<0.05), whereas no significant differences were detected in the control group between baseline and follow-up measures. CONCLUSION This study showed the importance of the educational program based on the HBM in improving the model constructs and physical activity, as well as in decreasing the SUA values in AHU patients.
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Affiliation(s)
- Chunhai Shao
- Department of Nutrition, Huashan Hospital, Fudan University, Shanghai, People's Republic of China,
| | - Jiwei Wang
- Key Laboratory of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Jingfang Liu
- Department of Nutrition, Huashan Hospital, Fudan University, Shanghai, People's Republic of China,
| | - Fang Tian
- Department of Nutrition, Huashan Hospital, Fudan University, Shanghai, People's Republic of China,
| | - Hua Li
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China,
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Ryan JM, Fortune J, Stennett A, Kilbride C, Anokye N, Victor C, Hendrie W, Abdul M, DeSouza L, Lavelle G, Brewin D, David L, Norris M. Changing physical activity behaviour for people with multiple sclerosis: protocol of a randomised controlled feasibility trial (iStep-MS). BMJ Open 2017; 7:e018875. [PMID: 29146660 PMCID: PMC5695400 DOI: 10.1136/bmjopen-2017-018875] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Although physical activity may reduce disease burden, fatigue and disability, and improve quality of life among people with multiple sclerosis (MS), many people with MS are physically inactive and spend significant time in sedentary behaviour. Behaviour change interventions may assist people with MS to increase physical activity and reduce sedentary behaviour. However, few studies have investigated their effectiveness using objective measures of physical activity, particularly in the long term. Further, interventions that have proven effective in the short term may not be feasible in clinical practice because of the large amount of support provided. The iStep-MS trial aims to determine the safety, feasibility and acceptability of a behaviour change intervention to increase physical activity and reduce sedentary behaviour among people with MS. METHODS AND ANALYSIS Sixty people with MS will be randomised (1:1 ratio) to receive a 12-week intervention or usual care only. The intervention consists of four physical activity consultations with a physiotherapist supported by a handbook and pedometer. Outcomes assessed at baseline, 12 weeks and 9 months are physical activity (ActiGraph wGT3X-BT accelerometer), sedentary behaviour (activPAL3µ), self-reported activity and sitting time, walking capability, fatigue, self-efficacy, participation, quality of life and health service use. The safety of the intervention will be determined by assessing change in pain and fatigue and the incidence of adverse events during the follow-up period. A parallel process evaluation will assess the feasibility and acceptability of the intervention through assessment of fidelity to the programme and semistructured interviews exploring participants' and therapists' experiences of the intervention. The feasibility of conducting an economic evaluation will be determined by collecting data on quality of life and resource use. ETHICS AND DISSEMINATION Research ethics committee approval has been granted from Brunel University London. Results of the trial will be submitted for publication in journals and distributed to people with MS and physiotherapists. TRIAL REGISTRATION NUMBER ISRCTN15343862 (doi 10.1186/ISRCTN15343862). Protocol version: 1.0; Pre-results.
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Affiliation(s)
- Jennifer M Ryan
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Jennifer Fortune
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Andrea Stennett
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Cherry Kilbride
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Nana Anokye
- Health Economics Theme, Institute of Environment, Health and Societies, Brunel University London, London, UK
| | - Christina Victor
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | | | | | - Lorraine DeSouza
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Grace Lavelle
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | | | - Lee David
- 10 Minute CBT, Letchworth Garden City, UK
| | - Meriel Norris
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
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Flowers EP, Freeman P, Gladwell VF. The Development of Three Questionnaires to Assess Beliefs about Green Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101172. [PMID: 28976924 PMCID: PMC5664673 DOI: 10.3390/ijerph14101172] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 09/28/2017] [Accepted: 09/29/2017] [Indexed: 01/22/2023]
Abstract
Green exercise is physical activity that takes place in the presence of natural environments. Despite the promising evidence of the benefits, little is known about how individuals’ thoughts and feelings influence participation in green exercise and subsequent outcomes. The aim of the current research was to develop questionnaires using the Theory of Planned Behaviour as a framework that could both directly and indirectly assess attitudes, subjective norms and perceived behaviour control, along with intention toward green exercise. Confirmatory factor analyses confirmed that the indirect, direct, and intention measures all had good overall model fits when tested on a refinement (n = 253) and validation (n = 230) sample. The questionnaires will contribute towards helping to better understanding individuals’ beliefs about green exercise, how these influence behaviour, and ultimately to enable the development of effective interventions promoting green exercise.
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Affiliation(s)
- Elliott P Flowers
- Centre for Sports and Exercise Science, School or Sport Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ, UK.
| | - Paul Freeman
- Centre for Sports and Exercise Science, School or Sport Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ, UK.
| | - Valerie F Gladwell
- Centre for Sports and Exercise Science, School or Sport Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ, UK.
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Abstract
ABSTRACTPhysical inactivity in older adults presents a significant problem within modern societies globally. Using a mixed-method approach, this study explored strategies for the development and delivery of physical activity (PA) interventions by investigating what behaviour change techniques (BCTs) are useful, and how these techniques should be implemented to be feasible for older adults. Sixty-six older adults completed a survey indicating the most useful BCTs, mapping on to motivational, volitional and automatic factors. Of these, 48 older adults participated in an interview exploring strategies for a PA intervention targeted at older adults. The most useful BCT identified in the survey was autonomy support (61.3%), followed by instruction to perform the behaviour (43.5%) and having a credible source of information about PA (42.6%). The key themes discussed in the interviews included providing support in making an informed choice, instruction on how to perform PA, information about health consequences, social support, goal setting, action and coping plans, behavioural demonstration and practice, and monitoring PA. The interviews also revealed key aspects of programme implementation including face-to-face delivery, followed up with additional materials; low cost; age-appropriate PA level; and individualised approach. Interventions assisting older adults in increasing their PA participation across a range of settings should incorporate BCTs targeting multiple processes, while tailoring their delivery to older adults’ preferences to ensure their feasibility in supporting regular PA engagement.
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Götschi T, de Nazelle A, Brand C, Gerike R. Towards a Comprehensive Conceptual Framework of Active Travel Behavior: a Review and Synthesis of Published Frameworks. Curr Environ Health Rep 2017; 4:286-295. [PMID: 28707281 PMCID: PMC5591356 DOI: 10.1007/s40572-017-0149-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW This paper reviews the use of conceptual frameworks in research on active travel, such as walking and cycling. Generic framework features and a wide range of contents are identified and synthesized into a comprehensive framework of active travel behavior, as part of the Physical Activity through Sustainable Transport Approaches project (PASTA). PASTA is a European multinational, interdisciplinary research project on active travel and health. RECENT FINDINGS Along with an exponential growth in active travel research, a growing number of conceptual frameworks has been published since the early 2000s. Earlier frameworks are simpler and emphasize the distinction of environmental vs. individual factors, while more recently several studies have integrated travel behavior theories more thoroughly. Based on the reviewed frameworks and various behavioral theories, we propose the comprehensive PASTA conceptual framework of active travel behavior. We discuss how it can guide future research, such as data collection, data analysis, and modeling of active travel behavior, and present some examples from the PASTA project.
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Affiliation(s)
- Thomas Götschi
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - Audrey de Nazelle
- Centre for Environmental Policy, Imperial College London, London, UK
| | | | - Regine Gerike
- Institute of Transport Planning and Road Traffic, Technische Universität Dresden, Dresden, Germany
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McDermott MS, Oliver M, Iverson D, Sharma R. Effective techniques for changing physical activity and healthy eating intentions and behaviour: A systematic review and meta-analysis. Br J Health Psychol 2017; 21:827-841. [PMID: 27193530 DOI: 10.1111/bjhp.12199] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 04/18/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The primary aim of this study was to review the evidence on the impact of a change in intention on behaviour and to identify (1) behaviour change techniques (BCTs) associated with changes in intention and (2) whether the same BCTs are also associated with changes in behaviour. METHODS A systematic review was conducted to identify interventions that produced a significant change in intention and assessed the impact of this change on behaviour at a subsequent time point. Each intervention was coded using a taxonomy of BCTs targeting healthy eating and physical activity. A series of meta-regression analyses were conducted to identify effective BCTs. RESULTS In total, 25 reports were included. Interventions had a medium-to-large effect on intentions (d+ = 0.64) and a small-to-medium effect (d+ = 0.41) on behaviour. One BCT, 'provide information on the consequences of behaviour in general', was significantly associated with a positive change in intention. One BCT, 'relapse prevention/coping planning', was associated with a negative change in intention. No BCTs were found to have significant positive effects on behaviour. However, one BCT, 'provide feedback on performance', was found to have a significant negative effect. BCTs aligned with social cognitive theory were found to have significantly greater positive effects on intention (d+ = 0.83 vs. 0.56, p < .05), but not behaviour (d+ = 0.35 vs. 0.23, ns), than those aligned with the theory of planned behaviour. CONCLUSIONS Although the included studies support the notion that a change in intention is associated with a change in behaviour, this review failed to produce evidence on how to facilitate behaviour change through a change in intention. Larger meta-analyses incorporating interventions targeting a broader range of behaviours may be warranted. Statement of contribution What is already known on this subject? Prior research on the causal relationship between intention and behaviour has produced mixed findings. Further experimental research to determine the precise nature of these variables is clearly warranted. However, precise guidance on how to change intention is still lacking. What does this study add? This study aimed to identify behaviour change techniques associated with changes in intention and behaviour. Techniques with positive effects on intention were identified; however, these did not have an impact on behaviour. Larger meta-analyses incorporating interventions targeting a broader range of behaviours may be warranted.
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Affiliation(s)
- Máirtín S McDermott
- Centre for Health and Social Research (CHaSR), Australian Catholic University, Melbourne, Victoria, Australia. .,School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, New South Wales, Australia.
| | - Madalyn Oliver
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, New South Wales, Australia
| | - Don Iverson
- Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Rajeev Sharma
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, New South Wales, Australia
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Bhimani RH, Cross LJS, Taylor BC, Meis LA, Fu SS, Allen KD, Krein SL, Do T, Kerns RD, Burgess DJ. Taking ACTION to reduce pain: ACTION study rationale, design and protocol of a randomized trial of a proactive telephone-based coaching intervention for chronic musculoskeletal pain among African Americans. BMC Musculoskelet Disord 2017; 18:15. [PMID: 28086853 PMCID: PMC5237146 DOI: 10.1186/s12891-016-1363-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 12/13/2016] [Indexed: 11/30/2022] Open
Abstract
Background Rates of chronic pain are rising sharply in the United States and worldwide. Presently, there is evidence of racial disparities in pain treatment and treatment outcomes in the United States but few interventions designed to address these disparities. There is growing consensus that chronic musculoskeletal pain is best addressed by a biopsychosocial approach that acknowledges the role of psychological and environmental factors, some of which differ by race. Methods/Design The primary aim of this randomized controlled trial is to test the effectiveness of a non-pharmacological, self-regulatory intervention, administered proactively by telephone, at improving pain outcomes and increasing walking among African American patients with hip, back and knee pain. Participants assigned to the intervention will receive a telephone counselor delivered pedometer-mediated walking intervention that incorporates action planning and motivational interviewing. The intervention will consist of 6 telephone counseling sessions over an 8–10 week period. Participants randomly assigned to Usual Care will receive an informational brochure and a pedometer. The primary outcome is chronic pain-related physical functioning, assessed at 6 months, by the revised Roland and Morris Disability Questionnaire, a measure recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). We will also examine whether the intervention improves other IMMPACT-recommended domains (pain intensity, emotional functioning, and ratings of overall improvement). Secondary objectives include examining whether the intervention reduces health care service utilization and use of opioid analgesics and whether key contributors to racial/ethnic disparities targeted by the intervention mediate improvement in chronic pain outcomes Measures will be assessed by mail and phone surveys at baseline, three months, and six months. Data analysis of primary aims will follow intent-to-treat methodology. Discussion We will tailor our intervention to address key contributors to racial pain disparities and examine the effects of the intervention on important pain treatment outcomes for African Americans with chronic musculoskeletal pain. Trial registration ClinicalTrials.gov: NCT01983228. Registered 6 November 2013.
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Affiliation(s)
- Rozina H Bhimani
- School of Nursing, AGH Cooperative, University of Minnesota, Minneapolis, MN, USA.,Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, MN, USA
| | - Lee J S Cross
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, MN, USA
| | - Brent C Taylor
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, MN, USA.,Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Laura A Meis
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, MN, USA.,Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Steven S Fu
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, MN, USA.,Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Kelli D Allen
- Center for Health Services Research in Primary Care, Veterans Affairs (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Durham, NC, USA.,Department of Medicine & Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah L Krein
- Center for Clinical Management Research, Veterans Affairs Healthcare System, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Tam Do
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, MN, USA
| | - Robert D Kerns
- Departments of Psychiatry, Neurology and Psychology, Yale University, New Haven, CT, USA.,Pain Research, Informatics, Multimorbidities and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Diana J Burgess
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, MN, USA. .,Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
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Peleg S, Vilchinsky N, Fisher WA, Khaskia A, Mosseri M. Personality Makes a Difference: Attachment Orientation Moderates Theory of Planned Behavior Prediction of Cardiac Medication Adherence. J Pers 2016; 85:867-879. [PMID: 27884040 DOI: 10.1111/jopy.12294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To achieve a comprehensive understanding of patients' adherence to medication following acute coronary syndrome (ACS), we assessed the possible moderating role played by attachment orientation on the effects of attitudes, subjective norms, and perceived behavioral control (PBC), as derived from the Theory of Planned Behavior (TPB; Ajzen, 1991), on intention and reported adherence. METHOD A prospective longitudinal design was employed. During hospitalization, ACS male patients (N = 106) completed a set of self-report questionnaires including sociodemographic variables, attachment orientation, and measures of TPB constructs. Six months post-discharge, 90 participants completed a questionnaire measuring adherence to medication. RESULTS Attachment orientations moderated some of the predictions of the TPB model. PBC predicted intention and reported adherence, but these associations were found to be significant only among individuals with lower, as opposed to higher, attachment anxiety. The association between attitudes and intention was stronger among individuals with higher, as opposed to lower, attachment anxiety. Only among individuals with higher attachment avoidance, subjective norms were negatively associated with intention to take medication. CONCLUSIONS Cognitive variables appear to explain both adherence intention and behavior, but differently, depending on individuals' attachment orientations. Integrating personality and cognitive models may prove effective in understanding patients' health behaviors.
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Schuster L, Kubacki K, Rundle-Thiele S. Understanding caregivers' intentions for their child to walk to school: Further application of the theory of planned behavior. Health Mark Q 2016; 33:307-320. [PMID: 27782792 DOI: 10.1080/07359683.2016.1240521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Increases in childhood obesity have coincided with declines in active transportation to school. This research builds on largely atheoretical extant literature examining factors that influence walk-to-school behavior through application of the theory of planned behavior (TPB). Understanding caregivers' decision for their child to walk to/from school is key to developing interventions to promote this cost-effective and accessible health behavior. The results from an online survey of 512 caregivers provide support for the TPB, highlighting the important role of subjective norms. This suggests marketers should nurture caregivers' perception that important others approve of walking to school.
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Affiliation(s)
- Lisa Schuster
- a School of Advertising, Marketing and Public Relations, QUT Business School , Queensland University of Technology , Brisbane , Australia
| | - Krzysztof Kubacki
- b Griffith Business School and Population & Social Health Research Program, Griffith Health Institute , Griffith University , Nathan , Australia
| | - Sharyn Rundle-Thiele
- b Griffith Business School and Population & Social Health Research Program, Griffith Health Institute , Griffith University , Nathan , Australia
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Physical activity maintenance among Spanish-speaking Latinas in a randomized controlled trial of an Internet-based intervention. J Behav Med 2016; 40:392-402. [PMID: 27752866 DOI: 10.1007/s10865-016-9800-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022]
Abstract
Spanish-speaking Latinas have some of the lowest rates of meeting physical activity guidelines in the U.S. and are at high risk for many related chronic diseases. The purpose of the current study was to examine the maintenance of a culturally and individually-tailored Internet-based physical activity intervention for Spanish-speaking Latinas. Inactive Latinas (N = 205) were randomly assigned to a 6-month Tailored Physical Activity Internet Intervention or a Wellness Contact Control Internet Group, with a 6-month follow-up. Maintenance was measured by assessing group differences in minutes per week of self-reported and accelerometer measured moderate to vigorous physical activity (MVPA) at 12 months after baseline and changes in MVPA between the end of the active intervention (month 6) and the end of the study (month 12). Potential moderators of the intervention were also examined. Data were collected between 2011 and 2014, and were analyzed in 2015 at the University of California, San Diego. The Intervention Group engaged in significantly more minutes of MVPA per week than the Control Group at the end of the maintenance period for both self-reported (mean diff. = 30.68, SE = 11.27, p = .007) and accelerometer measured (mean diff. = 11.47, SE = 3.19, p = .01) MVPA. There were no significant between- or within-group changes in MVPA from month 6 to 12. Greater intervention effects were seen for those with lower BMI (BMI × intervention = -6.67, SE = 2.88, p = .02) and lower perceived places to walk to in their neighborhood (access × intervention = -43.25, SE = 19.07, p = .02), with a trend for less family support (social support × intervention = -3.49, SE = 2.05, p = .08). Acculturation, health literacy, and physical activity related psychosocial variables were not significant moderators of the intervention effect during the maintenance period. Findings from the current study support the efficacy of an Internet-delivered individually tailored intervention for maintenance of MVPA gains over time.
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Barley E, Lawson V. Using health psychology to help patients: theories of behaviour change. ACTA ACUST UNITED AC 2016; 25:924-7. [DOI: 10.12968/bjon.2016.25.16.924] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Elizabeth Barley
- Professor in Health and Wellbeing, College of Nursing, Midwifery and Healthcare, University of West London
| | - Victoria Lawson
- Principal Health Psychologist, Southwark Talking Therapies Service, London
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45
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Yang Y. A dynamic framework on travel mode choice focusing on utilitarian walking based on the integration of current knowledge. JOURNAL OF TRANSPORT & HEALTH 2016; 3:336-345. [PMID: 27747158 PMCID: PMC5061507 DOI: 10.1016/j.jth.2016.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Recently, research on utilitarian walking has gained momentum due to its benefits on both health and the environment. However, our overall understanding of how built and social environments affect travel mode choice (walking or not) is still limited, and most existing frameworks on travel mode choice lack dynamic processes. After a review of several mainstream theories and a number of frameworks, we propose an integrated framework. The basic constructs in the travel mode choice function are utilities, constraints, attitudes, and habits. With a hierarchical structure and heuristic rules, the travel mode choice function is modified by individual characteristics and travel characteristics. The framework explicitly presents several dynamic processes, including the perception process on the environment, attitude formation process, habit formation process, interactions among an individual's own behaviors, interactions among travelers, feedback from travel to the built and social environments, and feedback from other behaviors to the built and social environments. For utilitarian walking, the framework may contribute to the study design, data collection, adoption of new research methods, and provide indications for policy interventions.
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Affiliation(s)
- Yong Yang
- School of Public Health, University of Memphis, Memphis, TN, 38152
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46
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Hubbard G, Munro J, O’Carroll R, Mutrie N, Kidd L, Haw S, Adams R, Watson AJM, Leslie SJ, Rauchhaus P, Campbell A, Mason H, Manoukian S, Sweetman G, Treweek S. The use of cardiac rehabilitation services to aid the recovery of patients with bowel cancer: a pilot randomised controlled trial with embedded feasibility study. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BackgroundColorectal cancer (CRC) survivors are not meeting the recommended physical activity levels associated with improving their chances of survival and quality of life. Rehabilitation could address this problem.ObjectivesThe aims of the Cardiac Rehabilitation In Bowel cancer study were to assess whether or not cardiac rehabilitation is a feasible and acceptable model to aid the recovery of people with CRC and to test the feasibility and acceptability of the protocol design.DesignIntervention testing and feasibility work (phase 1) and a pilot randomised controlled trial with embedded qualitative study (phase 2), supplemented with an economic evaluation. Randomisation was to cardiac rehabilitation or usual care. Outcomes were differences in objective measures of physical activity and sedentary behaviour, self-reported measures of quality of life, anxiety, depression and fatigue. Qualitative work involved patients and clinicians from both cancer and cardiac specialties.SettingThree colorectal cancer wards and three cardiac rehabilitation facilities.ParticipantsInclusion criteria were those who were aged > 18 years, had primary CRC and were post surgery.ResultsPhase 1 (single site) – of 34 patient admissions, 24 (70%) were eligible and 4 (17%) participated in cardiac rehabilitation. Sixteen clinicians participated in an interview/focus group. Modifications to trial procedures were made for further testing in phase 2. Additionally, 20 clinicians in all three sites were trained in cancer and exercise, rating it as excellent. Phase 2 (three sites) – screening, eligibility, consent and retention rates were 156 (79%), 133 (67%), 41 (31%) and 38 (93%), respectively. Questionnaire completion rates were 40 (97.5%), 31 (75%) and 25 (61%) at baseline, follow-up 1 and follow-up 2, respectively. Forty (69%) accelerometer data sets were analysed; 20 (31%) were removed owing to invalid data.Qualitative studyCRC and cardiac patients and clinicians were interviewed. Key themes were benefits and barriers for people with CRC attending cardiac rehabilitation; generic versus disease-specific rehabilitation; key concerns of the intervention; and barriers to participation (CRC participants only).Economic evaluationThe average out-of-pocket expenses of attending cardiac rehabilitation were £50. The costs of cardiac rehabilitation for people with cancer are highly dependent on whether it involves accommodating additional patients in an already existing service or setting up a completely new service.Limitations and conclusionsThe main limitation is that this is a small feasibility and pilot study. The main novel finding is that cardiac rehabilitation for cancer and cardiac patients together is feasible and acceptable, thereby challenging disease-specific rehabilitation models.Future workThis study highlighted important challenges to doing a full-scale trial of cardiac rehabilitation but does not, we believe, provide sufficient evidence to reject the possibility of such a future trial. We recommend that any future trial must specifically address the challenges identified in this study, such as suboptimal consent, completion, missing data and intervention adherence rates and recruitment bias, and that an internal pilot trial be conducted. This should have clear ‘stop–proceed’ rules that are formally reviewed before proceeding to the full-scale trial.Trial registrationCurrent Controlled Trials ISRCTN63510637.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 4, No. 24. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Gill Hubbard
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
| | - Julie Munro
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
| | - Ronan O’Carroll
- School of Natural Sciences, University of Stirling, Stirling, UK
| | - Nanette Mutrie
- Institute for Sport, Physical Education and Health Sciences, Moray House School of Education, University of Edinburgh, Edinburgh, UK
| | - Lisa Kidd
- Faculty of Health and Social Care, Robert Gordon University, Aberdeen, UK
| | - Sally Haw
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
| | - Richard Adams
- Cardiff University School of Medicine, Velindre Hospital, Cardiff, UK
| | - Angus JM Watson
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
- NHS Highland, Raigmore Hospital, Inverness, UK
| | - Stephen J Leslie
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
- NHS Highland, Raigmore Hospital, Inverness, UK
| | - Petra Rauchhaus
- Tayside Clinical Trials Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Anna Campbell
- Edinburgh Napier University, Faculty of Life Science, Sport and Social Sciences, Edinburgh, UK
| | - Helen Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Sarkis Manoukian
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | | | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Hartman SJ, Dunsiger SI, Marinac CR, Marcus BH, Rosen RK, Gans KM. Internet-based physical activity intervention for women with a family history of breast cancer. Health Psychol 2016; 34S:1296-304. [PMID: 26651471 DOI: 10.1037/hea0000307] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Physical inactivity is a modifiable risk factor for breast cancer. Physical activity interventions that can be delivered through the Internet have the potential to increase participant reach. The efficacy of an Internet-based physical activity intervention was tested in a sample of women at an elevated risk for breast cancer. METHOD A total of 55 women with at least 1 first-degree relative with breast cancer (but no personal history of breast cancer) were randomized to a 3-month theoretically grounded Internet-based physical activity intervention or an active control arm. Minutes of moderate to vigorous physical activity, psychosocial mediators of physical activity adoption and maintenance, as well as worry and perceived risk of developing breast cancer were assessed at baseline, 3-month, and 5-month follow up. RESULTS Participants were on average 46.2 (SD = 11.4) years old with a body mass index of 27.3 (SD = 4.8) kg/m2. The intervention arm significantly increased minutes of moderate to vigorous physical activity compared to the active control arm at 3 months (213 vs. 129 min/week) and 5 months (208 vs. 119 min/week; both ps < .001). Regression models indicated that participants in the intervention had significantly higher self-efficacy for physical activity at 3 months (p < .01) and borderline significantly higher self-efficacy at 5 months (p = .05). Baseline breast cancer worry and perceived risk were not associated with physical activity. CONCLUSION Findings from this study suggest that an Internet-based physical activity intervention may substantially increase physical activity in women with a family history of breast cancer.
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Affiliation(s)
- Sheri J Hartman
- Department of Family Medicine and Public Health and Moores Cancer Center, University of California, San Diego
| | - Shira I Dunsiger
- Centers for Behavioral and Preventive Medicine, Miriam Hospital, Brown University
| | | | - Bess H Marcus
- Department of Family Medicine and Public Health, University of California, San Diego
| | - Rochelle K Rosen
- Centers for Behavioral and Preventive Medicine, Miriam Hospital, Brown University
| | - Kim M Gans
- Department of Human Development and Family Studies, University of Connecticut
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Steinmetz H, Knappstein M, Ajzen I, Schmidt P, Kabst R. How Effective are Behavior Change Interventions Based on the Theory of Planned Behavior? ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2016. [DOI: 10.1027/2151-2604/a000255] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Abstract. The theory of planned behavior (TPB) is a prominent framework for predicting and explaining behavior in a variety of domains. The theory is also increasingly being used as a framework for conducting behavior change interventions. In this meta-analysis, we identified 82 papers reporting results of 123 interventions in a variety of disciplines. Our analysis confirmed the effectiveness of TPB-based interventions, with a mean effect size of .50 for changes in behavior and effect sizes ranging from .14 to .68 for changes in antecedent variables (behavioral, normative, and control beliefs, attitude, subjective norm, perceived behavioral control, and intention). Further analyses revealed that the interventions’ effectiveness varied for the diverse behavior change methods. In addition, interventions conducted in public and with groups were more successful than interventions in private locations or focusing on individuals. Finally, we identified gender and education as well as behavioral domain as moderators of the interventions’ effectiveness.
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Affiliation(s)
- Holger Steinmetz
- Department of International Business Studies, University of Paderborn, Germany
| | - Michael Knappstein
- Schumpeter School of Business and Economics, Wuppertal University, Germany
| | - Icek Ajzen
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - Peter Schmidt
- Faculty of Social Science, University of Giessen, Germany
| | - Rüdiger Kabst
- Department of Management, University of Paderborn, Germany
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Hancock J, Jackson S, Johnson AB. The Importance of Dog Ownership: Implications for Long-Term Weight Reduction After Gastric Banding. Am J Lifestyle Med 2016; 11:86-89. [PMID: 30202318 DOI: 10.1177/1559827615606668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Gastric banding (GB) is considered an option to support weight loss for individuals who are unable to lose weight through diet and exercise alone. Exercise is an important element of maintaining gradual weight loss following GB. Dog walking may be one method to encourage exercise and contribute to continued weight loss. Over a 5-year period, 24 individuals aged between 31 and 58 years (21 female; 12 dog-owners) were weighed at 7 time points. Intention to treat MANOVA analysis showed both groups lost a significant amount of weight, F(6, 17) = 15.7, P = .001, ηp2 = .85, but no difference was observed between dog owners and non-dog owners, F(6, 17) = 0.66, P = .68, ηp2 = .19, although from 24 months postbanding, data indicated dog owners appear to weigh less than non-dog owners. Further longitudinal research is warranted beyond 5 year post-GB; and encouraging exercise through dog walking may be a useful adjunct to increasing activity and promoting weight loss following GB.
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Affiliation(s)
- Jude Hancock
- Independent Health Psychologist, United Kingdom (JH).,University of Surrey, Surrey, United Kingdom (SJ).,North Bristol NHS Trust, Bristol, United Kingdom (ABJ)
| | - Sue Jackson
- Independent Health Psychologist, United Kingdom (JH).,University of Surrey, Surrey, United Kingdom (SJ).,North Bristol NHS Trust, Bristol, United Kingdom (ABJ)
| | - Andrew B Johnson
- Independent Health Psychologist, United Kingdom (JH).,University of Surrey, Surrey, United Kingdom (SJ).,North Bristol NHS Trust, Bristol, United Kingdom (ABJ)
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Tanaka C, Naruse T, Taguchi A, Nagata S, Arimoto A, Ohashi Y, Murashima S. Conformity to the neighborhood modifies the association between recreational walking and social norms among middle-aged Japanese people. Jpn J Nurs Sci 2016; 13:451-465. [DOI: 10.1111/jjns.12126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/06/2015] [Accepted: 01/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Chika Tanaka
- Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Takashi Naruse
- Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Atsuko Taguchi
- Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Satoko Nagata
- Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Azusa Arimoto
- Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Yuki Ohashi
- Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Sachiyo Murashima
- Department of Community Health Nursing, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
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