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Cebrick-Grossman JA, Fetherman DL. A Workplace Physical Activity Intervention and a Smartphone App for Overweight and Obese Sedentary Women. Workplace Health Saf 2024:21650799241265131. [PMID: 39169847 DOI: 10.1177/21650799241265131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
BACKGROUND The sedentary aspects of many U.S. occupations and the amount of time American workers spend in the workplace make it an ideal location to implement health promotion programs. METHODS This study assessed the effectiveness of a free smartphone app with a goal-setting feature to increase physical activity (PA) and impact anthropometric, body mass (BM), and body composition (BC) changes among overweight and obese women within a community health workforce. Eighteen overweight and obese (body mass index [BMI] = 32.18 ± 4.48 kg/m2), adult (50.73 ± 8.76 years), female volunteers, tracked daily steps with a free smartphone app (StridekickTM) over an 8-week period. Pre- and post-program body composition (BC) measurements included: relative (%) body fat (BF), fat mass (FM), fat-free mass (FFM), and lean mass (LM), using dual X-ray absorptiometry (DEXA scan), and five anthropometric measurements (biceps, waist, abdomen, hips, and thigh). FINDINGS Pre- to post-program average daily steps resulted in significant anthropometric changes for biceps, hips, and thigh measures, with encouraging changes in FFM, LM, and relative (%) BF. The goal-setting feature of the app did not result in significant differences between the experimental and control groups. No differences were noted in FM, BMI, waist, and abdomen or step goals compared with steps completed. CONCLUSIONS An occupational PA health promotion intervention program that tracked daily steps through the StridekickTM smartphone app resulted in anthropometric, BM, and BC changes. APPLICATION TO PRACTICE The workplace is an ideal location to affect change in health behaviors via a free smartphone app to increase PA and improve health.
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Banerjee S, Kha RT, Rivera DE, Hekler E. Predicting Goal Attainment in Process-Oriented Behavioral Interventions Using a Data-Driven System Identification Approach. JOURNAL OF PROCESS CONTROL 2024; 139:103242. [PMID: 38855126 PMCID: PMC11155415 DOI: 10.1016/j.jprocont.2024.103242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Behavioral interventions (such as those developed to increase physical activity, achieve smoking cessation, or weight loss) can be represented as dynamic process systems incorporating a multitude of factors, ranging from cognitive (internal) to environmental (external) influences. This facilitates the application of system identification and control engineering methods to address questions such as: what drives individuals to improve health behaviors (such as engaging in physical activity)? In this paper, the goal is to efficiently estimate personalized, dynamic models which in turn will lead to control systems that can optimize this behavior. This problem is examined in system identification applied to the Just Walk study that aimed to increase walking behavior in sedentary adults. The paper presents a Discrete Simultaneous Perturbation Stochastic Approximation (DSPSA)-based modeling of the Goal Attainment construct estimated using AutoRegressive with eXogenous inputs (ARX) models. Feature selection of participants and ARX order selection is achieved through the DSPSA algorithm, which efficiently handles computationally expensive calculations. DSPSA can search over large sets of features as well as regressor structures in an informed, principled manner to model behavioral data within reasonable computational time. DSPSA estimation highlights the large individual variability in motivating factors among participants in Just Walk, thus emphasizing the importance of a personalized approach for optimized behavioral interventions.
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Affiliation(s)
- Sarasij Banerjee
- Control Systems Engineering Laboratory, School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ 85287 USA
| | - Rachael T. Kha
- Control Systems Engineering Laboratory, School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ 85287 USA
| | - Daniel E. Rivera
- Control Systems Engineering Laboratory, School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ 85287 USA
| | - Eric Hekler
- Center for Wireless & Population Health Systems, University of California, San Diego (UCSD), La Jolla, CA 92093 USA
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3
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Nicholls N, Watson ED. Get active now or later? The association between physical activity and risk and time preferences. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 73:102650. [PMID: 38648871 DOI: 10.1016/j.psychsport.2024.102650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
Despite the well-established link between physical activity and positive health outcomes, much of the world's population remains inactive. Many people don't invest in health behaviours, such as physical activity, in the present, despite the long-term benefits of this. The aim of this study was to assess the relationship between physical activity levels and risk and time preferences in university students. A maximum likelihood model was used to jointly estimate risk and time preferences (elicited in an incentivised choice experiment), and to examine the relationship between these preferences and self-reported physical activity. Physically inactive people discounted the future significantly more than physically active people did. Physically active people made slightly more risky choices in our risk attitude task, although this directional relationship was not statistically significant. The link between time preferences and physical activity suggests that further research on behavioural strategies such as commitment devices, nudging or temptation bundling may be helpful in increasing physical activity for individuals who discount the future in favour of more immediate benefits.
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Affiliation(s)
- Nicky Nicholls
- Department of Economics, University of Pretoria, Lynnwood Road, Pretoria, South Africa.
| | - Estelle D Watson
- Department of Exercise Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand; Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Zhang W, Zhu Y, Jiang F, Song H. The relationship between self-oriented perfectionism and exercise participation: based on the dualistic model of passion. Front Psychol 2024; 15:1373844. [PMID: 38984289 PMCID: PMC11231426 DOI: 10.3389/fpsyg.2024.1373844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 06/03/2024] [Indexed: 07/11/2024] Open
Abstract
Background During the critical formative years of college, active participation in sports not only helps to alleviate stress, but also promotes the development of healthy habits. Although the multifaceted benefits of exercise have been widely recognized, there is a relative dearth of research on the relationship between personality traits, particularly college students' self-oriented perfectionism (SOP), and exercise participation. Methods A questionnaire survey of 374 college students was conducted using the snowball sampling method. SPSS 26.0 and Mplus 8.3 were employed in this study to analyze the correlations between the variables, and on this basis, the effect of SOP on exercise participation was examined. The study also used 5,000 bootstrap samples and a 95% bias-corrected confidence interval to test the significance of the mediating effects. Results Correlation analysis showed that SOP was positively correlated with exercise participation. Harmonious passion and obsessive passion were positively correlated with SOP, and exercise participation. Further, the results of structural equation analysis revealed that SOP increased exercise participation. Harmonious passion and obsessive passion positively mediated the effect between SOP and exercise participation, respectively. Conclusion This study provides new perspectives to better understand college students' exercise participation, emphasizing the importance of SOP and its influence on exercise participation through harmonious and obsessive passions. These findings have important implications for the development of effective exercise promotion strategies.
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Affiliation(s)
- Weipeng Zhang
- School of Sports Sciences, Tianjin Normal University, Tianjin, China
| | - Yuanjiao Zhu
- Tianjin University of Technology and Education, Tianjin, China
| | - Feng Jiang
- School of Business Administration, Jeonbuk National University, Jeonju, Republic of Korea
| | - Huitao Song
- School of Sports Sciences, Tianjin Normal University, Tianjin, China
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Strohacker K, Sudeck G, Keegan R, Ibrahim AH, Beaumont CT. Contextualising flexible nonlinear periodization as a person-adaptive behavioral model for exercise maintenance. Health Psychol Rev 2024; 18:285-298. [PMID: 37401403 DOI: 10.1080/17437199.2023.2233592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 06/30/2023] [Indexed: 07/05/2023]
Abstract
There is a growing focus on developing person-adaptive strategies to support sustained exercise behaviour, necessitating conceptual models to guide future research and applications. This paper introduces Flexible nonlinear periodisation (FNLP) - a proposed, but underdeveloped person-adaptive model originating in sport-specific conditioning - that, pending empirical refinement and evaluation, may be applied in health promotion and disease prevention settings. To initiate such efforts, the procedures of FNLP (i.e., acutely and dynamically matching exercise demand to individual assessments of mental and physical readiness) are integrated with contemporary health behaviour evidence and theory to propose a modified FNLP model and to show hypothesised pathways by which FNLP may support exercise adherence (e.g., flexible goal setting, management of affective responses, and provision of autonomy/variety-support). Considerations for future research are also provided to guide iterative, evidence-based efforts for further development, acceptability, implementation, and evaluation.
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Affiliation(s)
- Kelley Strohacker
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, USA
| | - Gorden Sudeck
- Institute of Sport Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfacultary Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Richard Keegan
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, Australia
| | - Adam H Ibrahim
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, USA
| | - Cory T Beaumont
- Department of Allied Health, Sport, and Wellness, Baldwin Wallace University, Berea, OH, USA
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Garstang KR, Jackman PC, Healy LC, Cooper SB, Magistro D. What Effect Do Goal Setting Interventions Have on Physical Activity and Psychological Outcomes in Insufficiently Active Adults? A Systematic Review and Meta-Analysis. J Phys Act Health 2024; 21:541-553. [PMID: 38560998 DOI: 10.1123/jpah.2023-0340] [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: 07/06/2023] [Revised: 12/17/2023] [Accepted: 02/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Goal setting is commonly used for promoting physical activity (PA) among insufficiently active individuals. Previous reviews have analyzed the effects of goal setting on PA, but the purpose of this systematic review was to examine the concurrent effects of goal setting on PA and psychological outcomes in insufficiently active individuals to support interventions aiming to produce sustained PA behavior change. METHODS In this review (PROSPERO: CRD42021243970), we identified 13 studies with 1208 insufficiently active adults that reported the effects of goal-setting interventions (range 3-24 wk) on both PA and psychological outcomes (eg, self-efficacy, motivation, and affect). We used meta-analysis and narrative synthesis to analyze these effects. RESULTS All goals used in the included studies were specific goals. Setting specific goals had a large, positive effect on PA (g [standard mean difference] = 1.11 [P < .001]; 95% confidence interval, 0.74-1.47), but only a small, positive effect on the combined psychological outcomes (g [standard mean difference] = 0.25 [P < .001]; 95% CI, 0.10-0.40). Moderator analyses revealed that interventions that did not reward participants had a significantly greater effect on PA than interventions that did provide rewards (g = 1.30 vs 0.60, respectively, P ≤ .003). No other significant moderators were found. CONCLUSION Our review offers initial insight into the long-term effects of specific goals on PA and psychological outcomes in insufficiently active adults. Further research that examines the PA and psychological effects of goal-setting interventions and investigates a wider range of goal types could develop a stronger evidence base to inform intervention for insufficiently active individuals.
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Affiliation(s)
- Katie R Garstang
- Sport, Health and Performance Enhancement (SHAPE) Research Group,Department of Sport Science,School of Science & Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Patricia C Jackman
- School of Sport and Exercise Science, University of Lincoln, Lincoln, United Kingdom
| | - Laura C Healy
- Sport, Health and Performance Enhancement (SHAPE) Research Group,Department of Sport Science,School of Science & Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Simon B Cooper
- Sport, Health and Performance Enhancement (SHAPE) Research Group,Department of Sport Science,School of Science & Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Daniele Magistro
- Sport, Health and Performance Enhancement (SHAPE) Research Group,Department of Sport Science,School of Science & Technology, Nottingham Trent University, Nottingham, United Kingdom
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Blacket CT, Fuller JT, Bennett H, Crozier AJ, Dziano JK, Arnold JB. Just Run: Development of a theory-based motivational online intervention for promoting ongoing running participation. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 71:102581. [PMID: 38061406 DOI: 10.1016/j.psychsport.2023.102581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 11/23/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023]
Abstract
Running is a popular form of physical activity yet discontinuation is common. Interventions targeting physical activity adoption have shown modest effects, often with little translation into long-term participation, which may limit the health benefits available to the wider community. This paper details the development of a new online running intervention (Just Run) aimed at improving continuation of running activity in new runners through a motivational and psychological lens, including aspects of design, content, refinement, and usability testing. A six-step intervention mapping process was used to develop a theory-based online intervention using a mix of research designs. Key stakeholders including runners, coaches and relevant experts in physical activity and behavior change provided valuable insight, feedback and refinement of the education to be delivered. The final Just Run intervention included ten modules delivered online over twelve weeks to promote ongoing running participation through videos, testimonials, and activities. Key themes identified through the literature and stakeholder engagement process related to goal setting, self-efficacy, intrinsic motivation, social support and overcoming barriers to running participation. Usability testing confirmed the quality and suitability of the education to the target population. Just Run has been developed with a range of stakeholders to address an area of unmet need in the adoption and promotion of running. Just Run is a robust online intervention that has been designed and pre-tested with positive feedback and unique insights from key stakeholders. Further investigation is required to support its implementation to the wider community.
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Affiliation(s)
- Chloe T Blacket
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Australia.
| | - Joel T Fuller
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Hunter Bennett
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Australia
| | - Alyson J Crozier
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Australia
| | - Jenelle K Dziano
- Centre for Heart Rhythm Disorders, University of Adelaide, South Australia, Australia
| | - John B Arnold
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Australia
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Hawkins RM, Swann C, Jackman PC. Exploring How Active and Insufficiently Active Individuals Respond to Specific and Non-Specific Physical Activity Goals. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:60-68. [PMID: 36693248 DOI: 10.1080/02701367.2022.2147894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/09/2022] [Indexed: 06/17/2023]
Abstract
Purpose: This study aimed to extend understanding of goal setting in physical activity (PA) by exploring qualitatively active and insufficiently active individuals' experiences of pursuing specific and non-specific goals. Methods: Twelve active (Mage = 25.00 years) and nine insufficiently active (Mage = 24.33 years) adults were interviewed after participating in three 6-minute walking tests, during which they pursued specific and non-specific (open and DYB) goals and completed a no-goal control condition. Content analysis was used to examine each subgroup independently, before a between-group comparison to explore similarities and differences in experiences was undertaken. Results: Several strategies were employed to enhance trustworthiness. Our analysis was organised into seven categories: (1) perception of challenge; (2) perceived control; (3) performance satisfaction; (4) motivational intensity; (5) enjoyment; (6) self-efficacy; and (7) strategies for pursuing goals. Our findings suggest that active participants responded more positively to specific goals, with differences in the cognitions experienced before, during, and after the goal conditions. Conversely, insufficiently active participants responded more positively to non-specific goals, with differences in the cognitions experienced before, during, and after the goal conditions and more negatively to specific goals. Conclusion: Findings extend understanding of specific and non-specific goals in PA and underline the need to consider goal specificity in the prescription of PA for certain population groups most in need of intervention.
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9
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van Grootel JWM, Bor P, Veenhof C, Valkenet K. Development of a goal-directed movement intervention (GOAL) using a movement sensor for hospitalized patients: An intervention mapping approach. Clin Rehabil 2024; 38:251-262. [PMID: 37644843 PMCID: PMC10725127 DOI: 10.1177/02692155231198173] [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: 05/03/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE To describe the development of a goal-directed movement intervention in two medical wards, including recommendations for implementation and evaluation. DESIGN Implementation Research. SETTING Pulmonology and nephrology/gastroenterology wards of the University Medical Centre Utrecht, The Netherlands. PARTICIPANTS Seven focus groups were executed including 28 nurses, 7 physical therapists and 15 medical specialists. Patients' perceptions were repeatedly assessed during the iterative steps of the intervention development. INTERVENTION Interventions were targeted to each ward's specific character, following an Intervention Mapping approach using literature and research meetings. Main measures: Intervention components were linked to Behavior Change Techniques and implementation strategies will be selected using the Expert Recommendation Implementing Change tool. Evaluation outcomes like number of patients using the movement intervention will be measured, based on the taxonomy of Proctor. RESULTS The developed intervention consists of: insight in patients movement behavior (monitoring & feedback), goal setting (goals & planning) and adjustments to the environment (associations & antecedents). The following implementation strategies are recommended: to conduct educational meetings, prepare & identify champions and audit & provide feedback. To measure service and client outcomes, the mean level of physical activity per ward can be evaluated and the Net Promoter Score can be used. CONCLUSION(S) This study shows the development of a goal-directed movement intervention aligned with the needs of healthcare professionals. This resulted in an intervention consisting of feedback & monitoring of movement behavior, goal setting and adjustments in the environment. Using a step-by-step iterative implementation model to guide development and implementation is recommended.
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Affiliation(s)
- JWM van Grootel
- HU University of Applied Sciences Utrecht, Research Center of Healthy and Sustainable Living, Research Group Innovation of Movement Care, Utrecht, The Netherlands
- University Medical Centre Utrecht, Department of Rehabilitation Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - P Bor
- University Medical Centre Utrecht, Department of Rehabilitation Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - C Veenhof
- HU University of Applied Sciences Utrecht, Research Center of Healthy and Sustainable Living, Research Group Innovation of Movement Care, Utrecht, The Netherlands
- University Medical Centre Utrecht, Department of Rehabilitation Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - K Valkenet
- HU University of Applied Sciences Utrecht, Research Center of Healthy and Sustainable Living, Research Group Innovation of Movement Care, Utrecht, The Netherlands
- University Medical Centre Utrecht, Department of Rehabilitation Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
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Mozafarinia M, Mate KKV, Brouillette MJ, Fellows LK, Knäuper B, Mayo NE. An umbrella review of the literature on the effectiveness of goal setting interventions in improving health outcomes in chronic conditions. Disabil Rehabil 2024; 46:618-628. [PMID: 36705274 DOI: 10.1080/09638288.2023.2170475] [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: 03/22/2022] [Accepted: 01/15/2023] [Indexed: 01/28/2023]
Abstract
PURPOSE To identify the contexts in which goal setting has been used in chronic disease management interventions and to estimate the magnitude of its effect on improvement of health outcomes. METHODS The strength of evidence and extent of potential bias in the published systematic reviews of goal setting interventions in chronic conditions were summarized using AMSTAR2 quality appraisal tool, number of participants, 95% prediction intervals, and between-study heterogeneity. Components of goal setting interventions were also extracted. RESULTS Nine publications and 35 meta-analysis models were identified, investigating 25 health outcomes. Of the 35 meta-analyses, none found strong evidence and three provided some suggestive evidence on symptom reduction and perceived well-being. There was weak evidence for effects on eight health outcomes (HbA1c, self-efficacy, depression, anxiety, distress, medication adherence, health-related quality of life and physical activity), with the rest classified as non-significant. Half of the meta-analyses had high level of heterogeneity. CONCLUSION Goal setting by itself affects outcomes of chronic diseases only to a small degree. This is not unexpected finding as changing outcomes in chronic diseases requires a complex and individualized approach. Implementing goal setting in a standardized way in the management of chronic conditions would seem to be a way forward.IMPLICATIONS FOR REHABILITATIONThe link between goal setting and health outcomes seems to be weak.Some levels of positive behavioural change could be of benefits to patients as seen by improved self-efficacy, patients' satisfaction and overall quality of life.Systematic and consistent application of personalized goal-oriented interventions considering patient's readiness to change could better predict improved outcomes.Incorporation of various goal setting components while actively engaging patient and/or their care givers in the process could appraise how goal setting could help with challenges in faced by people living with chronic conditions in different areas.
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Affiliation(s)
- Maryam Mozafarinia
- Division of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Center for Outcome Research & Evaluation, McGill University Health Centre Research Institute, Montreal, Canada
| | - Kedar K V Mate
- Center for Outcome Research & Evaluation, McGill University Health Centre Research Institute, Montreal, Canada
- Department of Family Medicine, Chronic Viral Illness Service, McGill University, Montreal, Canada
| | - Marie-Josee Brouillette
- Center for Outcome Research & Evaluation, McGill University Health Centre Research Institute, Montreal, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
| | - Lesley K Fellows
- Department of Neurology and Neurosurgery and Chronic Viral Illness service, Montreal Neurological Institute, Montreal, Canada
| | - Bärbel Knäuper
- Department of Psychology, McGill University, Montreal, Canada
| | - Nancy E Mayo
- Division of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Center for Outcome Research & Evaluation, McGill University Health Centre Research Institute, Montreal, Canada
- Department of Medicine and School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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Marcos TA, Crutzen R, Leitner V, Smeddinck JD, Strumegger EM, Wurhofer D, Kulnik ST. Making it transparent: A worked example of articulating programme theory for a digital health application using Intervention Mapping. Digit Health 2024; 10:20552076241260974. [PMID: 38894945 PMCID: PMC11185015 DOI: 10.1177/20552076241260974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Objective Digital health interventions for behaviour change are usually complex interventions, and intervention developers should 'articulate programme theory', that is, they should offer detailed descriptions of individual intervention components and their proposed mechanisms of action. However, such detailed descriptions often remain lacking. The objective of this work was to provide a conceptual case study with an applied example of 'articulating programme theory' for a newly developed digital health intervention. Methods Intervention Mapping methodology was applied to arrive at a detailed description of programme theory for a newly developed digital health intervention that aims to support cardiac rehabilitation patients in establishing heart-healthy physical activity habits. Based on a Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) logic model of the problem, a logic model of change was developed. The proposed mechanisms of action were visualised in an acyclic behaviour change diagram. Results Programme theory for this digital health intervention includes 4 sub-behaviours of the main target behaviour (i.e. habitual heart-healthy physical activity), 8 personal determinants and 12 change objectives (i.e. changes needed at the determinant level to achieve the sub-behaviours). These are linked to 12 distinct features of the digital health intervention and 12 underlying behaviour change methods. Conclusions This case study offers a worked example of articulating programme theory for a digital health intervention using Intervention Mapping. Intervention developers and researchers may draw on this example to replicate the method, or to reflect on most suitable approaches for their own behaviour change interventions.
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Affiliation(s)
- Tamika A. Marcos
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Rik Crutzen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Veronika Leitner
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Jan D. Smeddinck
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | | | - Daniela Wurhofer
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Stefan T. Kulnik
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
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Franco-Arellano B, Brown JM, Daggett Q, Lockhart C, Kapralos B, LeSage A, Arcand J. Updating the Foodbot Factory serious game with new interactive engaging features and enhanced educational content. Appl Physiol Nutr Metab 2024; 49:52-63. [PMID: 37905542 DOI: 10.1139/apnm-2023-0214] [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] [Indexed: 11/02/2023]
Abstract
Serious games (i.e., digital games designed for educational purposes) can foster positive learning attitudes and are increasingly used as educational tools. Foodbot Factory is a serious game application (app) that helps children learn about healthy eating based on Canada's Food Guide principles and has demonstrated to increase nutrition knowledge among this group. This paper describes the process followed to expand Foodbot Factory's educational content and integrate immersive technologies and innovative features into the app. The revision process, which was guided by the Obesity-Related Behavioral Intervention Trials model, included the following phases: first, an interdisciplinary team of nutrition scientists, education experts, and computer scientists analyzed data from the original pilot study, recently published literature, and feedback from stakeholders to define areas to improve Foodbot Factory. The five original Foodbot Factory modules were evaluated by the team during weekly meetings, where the educational content, interactive features, and other elements that required updates (e.g., aesthetics and accessibility) were identified. Second, prototypes were created and refined until a final version of Foodbot Factory was approved. Nineteen children tested the updated Foodbot Factory and found it "easy to use" (89%) and "fun" (95%). The new version of Foodbot Factory contains 19 learning objectives, including 13 original and six new objectives. Interactive engagement features in the updated Foodbot Factory included augmented reality incorporated into two learning modules; new mini-games were created, including a memory game; an overhaul of the aesthetics; (e.g., new food images); and accessibility features were included to support users with cognitive and vision disabilities.
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Affiliation(s)
| | | | - Quinn Daggett
- Faculty of Business and Information Technology, Ontario Tech University, Oshawa, ON, Canada
| | - Courtney Lockhart
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Bill Kapralos
- Faculty of Business and Information Technology, Ontario Tech University, Oshawa, ON, Canada
| | - Ann LeSage
- Faculty of Education, Ontario Tech University, Oshawa, ON, Canada
| | - JoAnne Arcand
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
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13
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Gayton J, Monga A. Goal setting in physiotherapy-led adult musculoskeletal care: A scoping review. Musculoskeletal Care 2023; 21:1315-1340. [PMID: 37641529 DOI: 10.1002/msc.1803] [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: 07/25/2023] [Accepted: 07/29/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Goal setting is a key part of rehabilitation across various fields of physiotherapy. It is less clear what evidence exists to underpin its effectiveness and to practically guide its use within musculoskeletal physiotherapy. OBJECTIVES This scoping review provides an overview of current research regarding goal setting in adult physiotherapy-led musculoskeletal care with three aims: 1) to identify and analyse any gaps in the literature, 2) to identify relevant features of goal setting theory and 3) to make recommendations for future research. The principal research question was what does the literature tell us about the role of goal setting for adults over the age of 18 with musculoskeletal pain accessing outpatient physiotherapy services? INCLUSION CRITERIA The population, concept and context framework was used to define the inclusion criteria. Key definitions were adults over the age of 18 with musculoskeletal conditions, goal setting, and physiotherapy-led interventions. METHODS This scoping review followed the guidance set out by the Joanna Briggs Institute Manual for Evidence Synthesis. Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, MEDLINE, American Psychological Association PsycInfo and the Cochrane Database of Systematic Reviews, Protocols and Trials were searched using pre-defined search criteria. Data were extracted from screened full-text articles and presented in basic statistical and narrative form. RESULTS 41 articles were included in the review. Several broad themes and research methods were identified. The nature of the studies suggested that the clinical application of goal setting is complex and the depth of understanding is limited. Most studies suggested that goal setting is feasible and has a positive impact on outcomes. A common finding was a lack of clear definitions regarding goal setting terminology and approaches. Study samples were generally defined by biomedical categories, suggesting a pathoanatomical approach to researching a cognitive construct. Theoretical underpinning was lacking in many studies. No frameworks guiding goal setting in physiotherapy-led musculoskeletal rehabilitation have been identified. CONCLUSIONS Goal setting is a popular tool within musculoskeletal outpatient physiotherapy. Further research is required to clarify its efficacy and provide guidance on its role and application in clinical practice.
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Affiliation(s)
- Jonathan Gayton
- Advanced Physiotherapy Practitioner, Musculoskeletal Service, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Aastha Monga
- School of Allied Health Professions, Keele University, Keele, UK
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14
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Yang T, Xiao H, Fan X, Zeng W. Exploring the effects of physical exercise on inferiority feeling in children and adolescents with disabilities: a test of chain mediated effects of self-depletion and self-efficacy. Front Psychol 2023; 14:1212371. [PMID: 37790224 PMCID: PMC10542406 DOI: 10.3389/fpsyg.2023.1212371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/16/2023] [Indexed: 10/05/2023] Open
Abstract
Objective The purpose of this study was to investigate the effects of physical exercise on inferiority feeling of children and adolescents with disabilities and its mechanism of action, as well as the mediating role of self depletion and self-efficacy. Methods The following scales were administered to 546 children and adolescents with disabilities (mean age 15.6 years): The Feelings of Inadequacy Scale, (FIS), the Self-Regulation Fatigue Scale (S-RFS), the General Self-Efficacy Scale (GSES), and the Physical Exercise Rating Scale. Results (1) Physical exercise can directly and negatively predict inferiority feeling, self-depletion, and can directly and positively predict self-efficacy; self-depletion can directly and negatively predict self-efficacy. Similarly, self-depletion positively predicts inferiority feeling; physical exercise and self-efficacy can also directly and negatively predict inferiority feeling. (2) The indirect effect of the path with self-depletion as the mediating variable was - 0.05, the indirect effect of the path with self-efficacy as the mediating variable was - 0.09, and the indirect effect of the path with self-depletion and self-efficacy as the mediating variables was - 0.04. (3) The sum of all indirect effects was - 0.18, and the three indirect effects accounted for 15.6%, 28.1%, and 12.5% of the total effect, with mediating effect was 56.2%. Conclusion Physical exercise can indirectly predict inferiority feeling in children and adolescents with disabilities through the independent mediation of self-depletion and self-efficacy, as well as through the chain mediation of both. This study supports that moderate physical exercise has a positive effect on the mental health of children and adolescents with disabilities, and that reducing self-depletion and improving self-efficacy are important ways to prevent inferiority feeling among children and adolescents with disabilities. It reveals the relationship between physical exercise and inferiority feeling and its mechanism of action, and further improves the research on the effect of physical exercise on inferiority feeling of children and adolescents with disabilities.
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Affiliation(s)
- Tongnian Yang
- School of Physical Education and Health, Jiangxi Science and Technology Normal University, Jiangxi, China
| | - Hui Xiao
- School of Physical Education and Health, Jiangxi Science and Technology Normal University, Jiangxi, China
| | - Xiaoyan Fan
- School of Physical Education and Health, Jiangxi Science and Technology Normal University, Jiangxi, China
| | - Wenping Zeng
- Nanchang Qiyin School (School for the Deaf and Dumb), Jiangxi, China
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15
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Bilic A, Burns RD, Bai Y, Brusseau TA, Lucero JE, King Jensen JL. Preliminary Efficacy of a Multi-Behavioral Zoom-Based Peer Health Coaching Intervention in Young Adults: A Stepped Wedge Randomized Controlled Trial. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:698-705. [PMID: 37433189 DOI: 10.1089/cyber.2022.0365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
The purpose of this study was to test the preliminary efficacy of a Zoom-based peer coaching intervention on health and risk behaviors in young adults. A convenience sample of young adults was recruited from one U.S. university (N = 89; 73.0 percent female). Participants were randomized to one of two coaching session sequences within the framework of a stepped wedge randomized controlled trial. One experimental sequence received a control condition and a single coaching session, and the second sequence received two sessions. The intervention was a 1-hour program delivered by peer health coaches in a one-on-one setting on Zoom. The program consisted of a behavior image screen, a consultation, and goal planning. Behavioral assessments were completed after each condition. Mixed-effects models were employed to test for behavior differences after coaching sessions compared with the control condition (no coaching session) adjusting for baseline scores. Participants reported significantly higher levels of vigorous physical activity (b = 750 metabolic equivalent of task minutes, p < 0.001), a lower frequency of e-cigarette use (b = -2.1 days; p < 0.001), and a lower risk of e-cigarette susceptibility after two sessions (relative risk = 0.04, p = 0.05), and higher odds of using stress reduction techniques after one session (odds ratio = 1.4, p = 0.04). A nonsignificant trend was observed for longer weekday sleep (b = 0.4 h/night, p = 0.11) after two coaching sessions. The Zoom-based peer health coaching intervention may be an efficient way to improve vigorous physical activity, lower e-cigarette use and susceptibility, and facilitate the use of stress reduction techniques in young adults. The results observed from this preliminary study warrants further investigation using powered effectiveness trials.
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Affiliation(s)
- Anna Bilic
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Ryan D Burns
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Yang Bai
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Timothy A Brusseau
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Julie E Lucero
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
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16
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Levental O, Yaffe Y, Lev Arey D. Goals and Success in Sport: The Perspectives of Parents and Adolescent Girls in Kayaking. Behav Sci (Basel) 2023; 13:580. [PMID: 37504027 PMCID: PMC10376742 DOI: 10.3390/bs13070580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/09/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
Setting objectives and evaluating success are intrinsically linked to motivation in sports and behavior during training and competition. According to social cognitive theory, the perception of success is divided into "task" and "ego", which indicate an inner orientation versus an external perspective when analyzing an athlete's achievements. These impressions can be influenced by various factors such as maturity level, gender, and the type of activity in which they participate. The current study compares perceptions of success among parents and adolescent girls competing in kayaking in Israel. To this end, a qualitative study was conducted with 20 in-depth interviews emphasizing goal setting and individual perceptions of success. The research findings reveal that contrary to previous studies, there is a perceptual gap between the two groups, with parents measuring success primarily in terms of enjoyment and self-fulfillment, and girls referring to perceived success in the context of achievements. It was also found that there is a discrepancy between setting goals and defining success, following experience and interactions within the training. The article discusses the reasons behind these gaps and the potential ramifications for sports activity and participation.
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Affiliation(s)
- Orr Levental
- Department of Physical Education, Tel Hai Academic College, Qiryat Shemona 1220800, Israel
| | - Yosi Yaffe
- Department of Education, Tel Hai Academic College, Qiryat Shemona 1220800, Israel
| | - Dalit Lev Arey
- School of Psychology, The Academic College of Tel Aviv Yaffo, Tel Aviv-Yafo 6818211, Israel
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17
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Gerend MA, Zetrenne S, Sutin AR, Naar S, Maner JK. Weight Discrimination and Health Risk Behavior in Racial, Ethnic, and Sexual Minority Adults. Ann Behav Med 2023; 57:571-581. [PMID: 37061832 DOI: 10.1093/abm/kaad003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND People with obesity face significant discrimination due to their weight. Exposure to such discrimination is associated with poor health outcomes. Little is known about pathways that explain that association, and even less is known about those pathways in racial, ethnic, and sexual minorities. Health risk behaviors may serve as one such pathway. PURPOSE We examined associations between weight discrimination and health risk behaviors and assessed whether associations are moderated by gender, race, ethnicity, or sexual orientation. METHODS Quota sampling was used to oversample Black (36%), Latino (36%), and sexual minority (29%) adults (n = 2,632) who completed an online survey. Using regression analysis, health risk behaviors (maladaptive eating behaviors, physical inactivity, sitting, smoking, alcohol use, and sleep disturbance) were predicted from previous experience with weight discrimination while controlling for demographic characteristics, BMI, and depressive symptoms. Additional analyses tested for interactions between weight discrimination and key demographic variables (i.e., gender, race, ethnicity, and sexual minority status). RESULTS Weight discrimination was associated with greater emotional eating, binge eating, unhealthy weight control behaviors, cigarette smoking, problematic alcohol use, and sleep disturbance. Gender moderated the association between weight discrimination and binge eating, alcohol use, and physical activity, with stronger effects observed in men than women. Exploratory analyses provided limited evidence for differential effects of weight discrimination across specific combinations of intersecting identities. CONCLUSIONS Weight discrimination was associated with engagement in unhealthy behaviors and relationships were largely similar across diverse demographic groups. Health risk behaviors may represent a key pathway through which weight discrimination harms health.
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Affiliation(s)
- Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | | | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Sylvie Naar
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Jon K Maner
- Department of Psychology, College of Arts and Sciences, Florida State University, Tallahassee, FL, USA
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18
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Jeftic I, Furzer BJ, Dimmock JA, Wright K, Boyd C, Budden T, Rosenberg M, Kramer B, Buist B, Fitzpatrick I, Sabiston C, de Jonge M, Jackson B. Structured exercise programs for higher education students experiencing mental health challenges: background, significance, and implementation. Front Public Health 2023; 11:1104918. [PMID: 37181716 PMCID: PMC10167056 DOI: 10.3389/fpubh.2023.1104918] [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: 11/22/2022] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Abstract
The incidence of mental illness is greatest among young adults, and those enrolled in higher education may be particularly vulnerable compared to the general young adult population. Many higher education institutions employ student support staff tasked with implementing strategies to improve student wellbeing and mental illness. However, these strategies tend to be focused on clinical therapies and pharmacological interventions with limited lifestyle approaches. Exercise is an effective method for addressing mental illness and promoting wellbeing, yet widespread provision of structured exercise services to support treatment options for students with mental health challenges has not been fully realized. In an effort to guide exercise strategies for student mental health, we synthesize considerations for developing and delivering exercise programs in higher education settings. We draw directly from the evidence base on existing exercise programs in higher education; and the broader behavior change, exercise adherence, health psychology, implementation science, and exercise prescription literatures. Our broad considerations cover issues regarding program engagement and behavior change, exercise 'dose' and prescription, integration with other on-campus services, and robust research and evaluation. These considerations may provide impetus for widespread program development and implementation, as well as informing research focused on protecting and improving student mental health.
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Affiliation(s)
- Ivan Jeftic
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Bonnie J. Furzer
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - James A. Dimmock
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Kemi Wright
- Department of Exercise Physiology, School of Health Sciences, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Conor Boyd
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Timothy Budden
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Michael Rosenberg
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ben Kramer
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Brett Buist
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ian Fitzpatrick
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Catherine Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Melissa de Jonge
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
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19
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Kringle EA, Tucker D, Wu Y, Lv N, Kannampallil T, Barve A, Dosala S, Wittels N, Dai R, Ma J. Associations between daily step count trajectories and clinical outcomes among adults with comorbid obesity and depression. Ment Health Phys Act 2023; 24:100512. [PMID: 37206660 PMCID: PMC10191421 DOI: 10.1016/j.mhpa.2023.100512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Purpose To examine the relationship between features of daily measured step count trajectories and clinical outcomes among people with comorbid obesity and depression in the ENGAGE-2 Trial. Methods This post hoc analysis used data from the ENGAGE-2 trial where adults (n=106) with comorbid obesity (BMI ≥30.0 or 27.0 if Asian) and depressive symptoms (Patient Health Questionnaire-9 score ≥10) were randomized (2:1) to receive the experimental intervention or usual care. Daily step count trajectories over the first 60 days (Fitbit Alta HR) were characterized using functional principal component analyses. 7-day and 30-day trajectories were also explored. Functional principal component scores that described features of step count trajectories were entered into linear mixed models to predict weight (kg), depression (Symptom Checklist-20), and anxiety (Generalized Anxiety Disorder Questionnaire-7) at 2-months (2M) and 6-months (6M). Results Features of 60-day step count trajectories were interpreted as overall sustained high, continuous decline, and disrupted decline. Overall sustained high step count was associated with low anxiety (2M, β=-0.78, p<.05; 6M, β=-0.80, p<.05) and low depressive symptoms (6M, β=-0.15, p<.05). Continuous decline in step count was associated with high weight (2M, β=0.58, p<.05). Disrupted decline was not associated with clinical outcomes at 2M or 6M. Features of 30-day step count trajectories were also associated with weight (2M, 6M), depression (6M), and anxiety (2M, 6M); Features of 7-day step count trajectories were not associated with weight, depression, or anxiety at 2M or 6M. Conclusions Features of step count trajectories identified using functional principal component analysis were associated with depression, anxiety, and weight outcomes among adults with comorbid obesity and depression. Functional principal component analysis may be a useful analytic method that leverages daily measured physical activity levels to allow for precise tailoring of future behavioral interventions.
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Affiliation(s)
| | - Danielle Tucker
- Department of Mathematics, Statistics, and Computer Science, University of Illinois at Chicago
| | - Yichao Wu
- Department of Mathematics, Statistics, and Computer Science, University of Illinois at Chicago
| | - Nan Lv
- Department of Medicine, University of Illinois at Chicago
| | - Thomas Kannampallil
- Department of Anesthesiology, School of Medicine, Washington University in St. Louis
| | - Amruta Barve
- Department of Medicine, University of Illinois at Chicago
| | | | - Nancy Wittels
- Department of Medicine, University of Illinois at Chicago
| | - Ruixuan Dai
- Department of Computer Science and Engineering, McKelvey School of Engineering, Washington University in St. Louis
| | - Jun Ma
- Department of Medicine, University of Illinois at Chicago
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20
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Dang Y, Guo S, Song H, Li Y. Setting goal difficulty in monetary incentives to physicians: evidence from an online health knowledge-sharing platform. INFORMATION TECHNOLOGY & PEOPLE 2023. [DOI: 10.1108/itp-11-2021-0901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
PurposePrior studies on the impact of incentives on physicians’ online participation mainly focused on different incentives while ignoring the difficulty of setting monetary incentives efficiently. Based on goal-setting theory, the current research examines the relationship between incentives with goals of varying difficulty and professional health knowledge sharing (PHKS) in online health knowledge-sharing platforms (OHKSPs).Design/methodology/approachFour field experiments with different monetary incentives were conducted by one of China’s largest OHKSPs, with whom the researchers cooperated in data collection. Monthly panel data on 10,584 physicians were collected from September 2018 to December 2019. There were 9,376 physicians in the treatment group and 1,208 in the control group. The authors used a difference-in-difference (DID) model to explore the research question based on the same control group and the Chow test with seemingly unrelated estimation (sureg) to compare regression coefficients between four groups. Several robustness checks were performed to validate the main results, including a relative time model, multiple falsification tests and a DID estimation using the propensity score matching method.FindingsThe results show that the monetary incentive significantly positively affected the volume of physicians’ PHKS directly with negative spillover to the duration of physicians’ PHKS. Moreover, the positive effect of incentives with higher difficulty on the volume of physicians’ PHKS was significantly smaller than that of incentives with low difficulty. Finally, professional title had a positive moderating effect on the volume of goal difficulty setting and did not significantly moderate the effect on the duration of physicians’ PHKS.Research limitations/implicationsSome limitations of this study are: firstly, because the field experiments were enterprise benefit oriented, the treatment and control groups were not balanced. Secondly, the experiments for different incentive measures were relatively similar, making it challenging to validate a causal effect. Finally, more consideration should be given to the strategy for setting hierarchical incentives in future research.Originality/valueThe research indicates that monetary incentives have a bilateral effect on PHKS, i.e. a positive direct effect on the volume of physicians’ contributions and a negative spillover effect on the duration of physicians’ PHKS. The professional titles of physicians also moderate such bilateral switches of PHKS. Furthermore, when a physician’s energy is limited, the goal difficulty setting of the incentive mechanism tends to be low. The more difficult the incentives are, the more inefficient the effects on physicians’ PHKS will be.
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21
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Barger MK, Howe-Heyman A. Systematic Reviews to Inform Practice, March/April 2023. J Midwifery Womens Health 2023; 68:294-299. [PMID: 36855030 DOI: 10.1111/jmwh.13479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 03/02/2023]
Affiliation(s)
- Mary K Barger
- Midwifery researcher and consultant, San Diego, California
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22
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Mavragani A, Zwanenburg SP, Paton C. Supporting Autonomous Motivation for Physical Activity With Chatbots During the COVID-19 Pandemic: Factorial Experiment. JMIR Form Res 2023; 7:e38500. [PMID: 36512402 PMCID: PMC9879319 DOI: 10.2196/38500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/14/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although physical activity can mitigate disease trajectories and improve and sustain mental health, many people have become less physically active during the COVID-19 pandemic. Personal information technology, such as activity trackers and chatbots, can technically converse with people and possibly enhance their autonomous motivation to engage in physical activity. The literature on behavior change techniques (BCTs) and self-determination theory (SDT) contains promising insights that can be leveraged in the design of these technologies; however, it remains unclear how this can be achieved. OBJECTIVE This study aimed to evaluate the feasibility of a chatbot system that improves the user's autonomous motivation for walking based on BCTs and SDT. First, we aimed to develop and evaluate various versions of a chatbot system based on promising BCTs. Second, we aimed to evaluate whether the use of the system improves the autonomous motivation for walking and the associated factors of need satisfaction. Third, we explored the support for the theoretical mechanism and effectiveness of various BCT implementations. METHODS We developed a chatbot system using the mobile apps Telegram (Telegram Messenger Inc) and Google Fit (Google LLC). We implemented 12 versions of this system, which differed in 3 BCTs: goal setting, experimenting, and action planning. We then conducted a feasibility study with 102 participants who used this system over the course of 3 weeks, by conversing with a chatbot and completing questionnaires, capturing their perceived app support, need satisfaction, physical activity levels, and motivation. RESULTS The use of the chatbot systems was satisfactory, and on average, its users reported increases in autonomous motivation for walking. The dropout rate was low. Although approximately half of the participants indicated that they would have preferred to interact with a human instead of the chatbot, 46.1% (47/102) of the participants stated that the chatbot helped them become more active, and 42.2% (43/102) of the participants decided to continue using the chatbot for an additional week. Furthermore, the majority thought that a more advanced chatbot could be very helpful. The motivation was associated with the satisfaction of the needs of competence and autonomy, and need satisfaction, in turn, was associated with the perceived system support, providing support for SDT underpinnings. However, no substantial differences were found across different BCT implementations. CONCLUSIONS The results provide evidence that chatbot systems are a feasible means to increase autonomous motivation for physical activity. We found support for SDT as a basis for the design, laying a foundation for larger studies to confirm the effectiveness of the selected BCTs within chatbot systems, explore a wider range of BCTs, and help the development of guidelines for the design of interactive technology that helps users achieve long-term health benefits.
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Affiliation(s)
| | | | - Chris Paton
- Department of Information Science, University of Otago, Dunedin, New Zealand.,Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom
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23
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Hébert-Losier K, Boswell-Smith C, Hanzlíková I. Effect of an overhead goal on landing error scoring system and jump height measures. Phys Ther Sport 2023; 59:115-121. [PMID: 36528004 DOI: 10.1016/j.ptsp.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Compare overall Landing Error Scoring System (LESS) scores, risk categorisation, specific LESS errors, and double-leg jump-landing jump heights between overhead goal and no goal conditions. DESIGN Randomised cross-over. SETTING Laboratory. PARTICIPANTS 76 (51% male). MAIN OUTCOME MEASURES Participants landed from a 30-cm box to 50% of their body height and immediately jumped vertically for maximum height. Participants completed three trials under two random-ordered conditions: with and without overhead goal. Group-level mean LESS scores, risk categorisation (5-error threshold), specific landing errors, and jump heights were compared between conditions. RESULTS Mean LESS scores were greater (0.3 errors, p < 0.001) with the overhead goal, but this small difference was not clinically meaningful. Similarly, although the number of high-risk participants was greater with the overhead goal (p = 0.039), the 9.2% difference was trivial. Participants jumped 2.7 cm higher with the overhead goal (p < 0.001) without affecting the occurrence of any specific LESS errors. DISCUSSION Performing the LESS with an overhead goal enhances sport specificity and elicits greater vertical jump performances with minimal change in landing errors and injury-risk categorisation. Adding an overhead goal to LESS might enhance its suitability for injury risk screening, although the predictive value of LESS with an overhead goal needs confirmation.
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Affiliation(s)
- Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, 52 Miro Street, 3116, Tauranga, New Zealand. https://twitter.com/KimHebertLosier
| | - Caleb Boswell-Smith
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, 52 Miro Street, 3116, Tauranga, New Zealand
| | - Ivana Hanzlíková
- Department of Physiotherapy, Faculty of Physical Culture, Palacký University Olomouc, Třída Míru 177, Olomouc, 771 11, Czech Republic. https://twitter.com/HanzlikovaIvana
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24
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Sinaise MK, Tran A, Johnson HM, Vedder LS, Hoppe KK, Lauver D. Concepts from behavioral theories can guide clinicians in coaching for behavior change. PATIENT EDUCATION AND COUNSELING 2023; 106:188-193. [PMID: 36335082 PMCID: PMC10153998 DOI: 10.1016/j.pec.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 05/04/2023]
Abstract
OBJECTIVES Many patients do not engage in health behaviors that can control common, chronic illnesses. Clinicians have opportunities to promote health behaviors yet may lack skills for coaching effectively about health behaviors. Our aims are to: present definitions of coaching, propose concepts for coaching about behavior change from two theories, share theory-guided research on behavior change relevant to ambulatory care settings, and delineate how concepts from these theories can guide coaching. METHODS In our discussion, we explain how two behavioral theories are complementary and applicable to coaching, present empirical support for these theories, and describe applications of these concepts for practice. CONCLUSIONS AND PRACTICE IMPLICATIONS Self-determination theory can guide clinicians in how to interact with patients to meet patients' psychological needs, to promote health behaviors, and subsequent health status. Self-regulation theory can guide coaches in what concepts to address for behavior change. These complementary theories have been supported in rigorous research with adult populations in ambulatory care settings.
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Affiliation(s)
- Megan Knutson Sinaise
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 1010 Mound Street, Madison, WI 53715, USA
| | - Abigail Tran
- Project Coordinator, System Cancer Service Line, Advocate-Aurora Health, 2900 W. Oklahoma Ave., Milwaukee, WI 53215, USA
| | - Heather M Johnson
- Clinical Affiliate Associate Professor, Christine E. Lynn Women's Health & Wellness Institute, Boca Raton Regional Hospital; Baptist Health South Florida, Florida Atlantic University, 690 Meadows Road, Boca Raton, FL 33486
| | - Lisa Sullivan Vedder
- Clinical Adjunct Associate Professor, Department of Family Medicine Advocate-Aurora University of Wisconsin Group, Aurora Sinai Medical Center, 945 N 12th Street, Milwaukee, WI 53233, USA
| | - Kara K Hoppe
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 1010 Mound Street, Madison, WI 53715, USA
| | - Diane Lauver
- School of Nursing & School of Medicine and Public Health University of Wisconsin, Madison, USA.
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Mastrogiovanni C, Rosenbaum S, Delbaere K, Tiedemann A, Teasdale S, McGavin A, Briggs N, McKeon G. A mental health-informed, online health promotion programme targeting physical activity and healthy eating for adults aged 60+ years: study protocol for the MovingTogether randomised controlled trial. Trials 2022; 23:1052. [PMID: 36575463 PMCID: PMC9793388 DOI: 10.1186/s13063-022-06978-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/02/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and associated social distancing regulations have led to an increased risk of social isolation and physical inactivity, particularly among older adults. The benefits of physical activity for reducing fall risk and improving mood and mental functioning have been well documented. The aim of this trial is to investigate the effect of the MovingTogether programme on psychological distress (primary outcome) and physical activity, social capital, cognition, concern about falling, loneliness, physical functioning, quality of life and physical activity enjoyment (secondary outcomes). METHODS A randomised controlled trial with a waitlist control will be conducted, recruiting 80 adults aged 60+ years with access to Facebook and a computer or tablet and not currently meeting the aerobic physical activity guidelines. Randomisation will be completed using REDCap. The intervention group (n = 40) will join a private Facebook group where allied health facilitators will provide targeted healthy lifestyle education throughout the 10-week programme with weekly telehealth group calls. Intervention participants will also be provided access to tailored strength and aerobic exercise guidance and an evidence-based eHealth balance exercise programme. Psychological distress and secondary outcomes will be assessed at baseline, 11 weeks (post-intervention) and 16 weeks (1-month follow-up). Linear mixed models will be applied for each outcome measure as per an intention-to-treat approach to determine the between-group differences. Secondary analyses are planned in people with greater adherence and those with higher psychological distress. DISCUSSION COVID-19 has highlighted the need for scalable, effective and novel methods to improve and protect the health of older adults. The integration of an evidence-based fall prevention programme with a mental health-informed online health promotion programme may help to improve mental and physical health outcomes among older adults. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001322820p. Registered on 29 September 2021.
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Affiliation(s)
- Chiara Mastrogiovanni
- grid.1005.40000 0004 4902 0432Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia
| | - Simon Rosenbaum
- grid.1005.40000 0004 4902 0432Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia ,grid.1005.40000 0004 4902 0432School of Health Sciences, University of New South Wales, Sydney, NSW 2052 Australia
| | - Kim Delbaere
- grid.1005.40000 0004 4902 0432Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW 2031 Australia ,grid.1005.40000 0004 4902 0432School of Population Health, University of New South Wales, Sydney, NSW 2052 Australia
| | - Anne Tiedemann
- grid.511617.5Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW 2050 Australia
| | - Scott Teasdale
- grid.1005.40000 0004 4902 0432Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia ,Mindgardens Neuroscience Network, Sydney, NSW 2052 Australia
| | - Annaliese McGavin
- grid.1005.40000 0004 4902 0432School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| | - Nancy Briggs
- grid.1005.40000 0004 4902 0432Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW 2052 Australia
| | - Grace McKeon
- grid.1005.40000 0004 4902 0432Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia ,grid.1005.40000 0004 4902 0432School of Population Health, University of New South Wales, Sydney, NSW 2052 Australia
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Gormley L, Belton CA, Lunn PD, Robertson DA. Interventions to increase physical activity: An analysis of candidate behavioural mechanisms. Prev Med Rep 2022; 28:101880. [PMID: 35813395 PMCID: PMC9260609 DOI: 10.1016/j.pmedr.2022.101880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 11/24/2022] Open
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Brandenbarg P, Hoekstra F, Krops LA, Seves BL, Hettinga FJ, Hoekstra T, Dekker R, van der Woude LHV. Physical activity behaviour up to 1 year post-rehabilitation among adults with physical disabilities and/or chronic diseases: results of the prospective cohort study ReSpAct. BMJ Open 2022; 12:e056832. [PMID: 35705356 PMCID: PMC9204426 DOI: 10.1136/bmjopen-2021-056832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Little is known of physical activity behaviour among adults with a disability and/or chronic disease during and up to 1 year post-rehabilitation. We aimed to explore (1) dose characteristics of physical activity behaviour among adults with physical disabilities and/or chronic diseases during that period, and (2) the effects of personal characteristics and diagnosis on the development of physical activity over time. METHODS Adults with physical disabilities and/or chronic diseases (N=1256), enrolled in the Rehabilitation, Sports and Active lifestyle study, were followed with questionnaires: 3-6 weeks before (T0) and 14 (T1), 33 (T2) and 52 (T3) weeks after discharge from rehabilitation. Physical activity was assessed with the adapted version of the Short Questionnaire to ASsess Health enhancing physical activity. Dose characteristics of physical activity were descriptively analysed. Multilevel regression models were performed to assess physical activity over time and the effect of personal and diagnosis characteristics on physical activity over time. RESULTS Median total physical activity ranged from 1545 (IQR: 853-2453) at T0 to 1710 (IQR: 960-2730) at T3 min/week. Household (495-600 min/week) and light-intensity (900-998 min/week) activities accrued the most minutes. Analyses showed a significant increase in total physical activity moderate-intensity to vigorous-intensity physical activity and work/commuting physical activity for all time points (T1-T3) compared with baseline (T0). Diagnosis, age, sex and body mass index had a significant effect on baseline total physical activity. CONCLUSION Physical activity is highly diverse among adults with physical disabilities and/or chronic diseases. Understanding this diversity in physical activity can help improve physical activity promotion activities.
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Affiliation(s)
- Pim Brandenbarg
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Femke Hoekstra
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Leonie A Krops
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bregje L Seves
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Florentina J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Trynke Hoekstra
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rienk Dekker
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lucas H V van der Woude
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Peng S, Othman AT, Yuan F, Liang J. The Effectiveness of Planning Interventions for Improving Physical Activity in the General Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7337. [PMID: 35742582 PMCID: PMC9223740 DOI: 10.3390/ijerph19127337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 01/27/2023]
Abstract
Planning interventions such as action planning (AP) and coping planning (CP) have been recognized as influential strategies in promoting physical activity (PA), but mixed results of existing evidence have been observed. This study aims to perform a systematical meta-analysis to evaluate the efficacy of planning interventions for improving PA in the general population. Eight databases, including Medline, Embase, PsycINFO, Cochrane Library, Web of Science, ProQuest, CNKI, and Wanfang Data, were searched to locate relevant randomized controlled trials (RCTs) from their inception to 31 December 2021. In total, 41 trials with 5439 samples were included in this systematic review, and 35 trials were used in our meta-analysis. The results showed that PA was better promoted in the planned intervention group compared to the control group (SMD = 0.35, 95% CI = 0.25-0.44, I2 = 61.4%). Based on the subgroup analyses, we found that planning strategies were more effective among patients, males, when adopting AP intervention, when using the face-to-face sessions delivery mode, and when reinforcements were conducted during the follow-up. The findings of this study indicate that planning interventions significantly improved PA behavior, and, in some contexts, the effects performed better. Future research needs to be conducted to explore the underlying mechanisms of planning interventions and validate their effects more extensively.
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Affiliation(s)
- Sanying Peng
- Physical Education Department, Hohai University, Nanjing 210024, China
- School of Educational Studies, Universiti Sains Malaysia, Penang 11800, Malaysia;
| | | | - Fang Yuan
- College of International Languages and Cultures, Hohai University, Nanjing 210024, China;
| | - Jinghong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China;
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Hong YR, Yadav S, Suk R, Lee AM, Newsome FA, Johnson-Mann CN, Cardel MI, Ross KM. Assessment of Physical Activity and Healthy Eating Behaviors Among US Adults Receiving Bariatric Surgery. JAMA Netw Open 2022; 5:e2217380. [PMID: 35708688 PMCID: PMC9204540 DOI: 10.1001/jamanetworkopen.2022.17380] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
IMPORTANCE Bariatric surgery effectively treats severe obesity and metabolic diseases. However, individual outcomes vary depending on sustainable lifestyle change. Little is known about lifestyle patterns after bariatric surgery among the US population. OBJECTIVE To compare the level of physical activity and eating behavior among postbariatric surgery patients, individuals eligible for surgery, and those with normal weight. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study using nationally representative survey data from National Health and Nutrition Examination Survey 2015-2018. Respondents included for analysis were age 18 years or older, and categorized by individuals with normal weight, individuals who received bariatric surgery, and individuals clinically eligible for bariatric surgery. Analyses were performed from February to October 2021. MAIN OUTCOMES AND MEASURES Self-reported measures were used to assess physical activity (moderate-to-vigorous physical activity [MVPA], sedentary activity, and whether PA guidelines were met) and eating behaviors (total energy intake and Healthy Eating Index [HEI]-2015 diet quality scores). RESULTS Of 4659 study participants (mean [SD] age, 46.1 [18.6] years; 2638 [weighted percentage, 58.8%] women; 1114 [weighted percentage, 12.7%] Black, 1570 [weighted percentage, 68.6%] White), 132 (3.7%) reported that they had undergone any bariatric surgery. Median (IQR) time since surgery was 7 (3-10) years. After propensity-score weighting, individuals who underwent bariatric surgery reported more time spent in MVPA than those eligible for surgery (147.9 min/wk vs 97.4 min/wk). Among respondents with normal weight, 45.6% (95% CI, 40.8% to 52.4%) reported meeting PA guidelines, almost 2 times higher than those in the bariatric surgery (23.1%; 95% CI, 13.8% to 32.4%) or in the surgery-eligible group (20.3%; 95% CI, 15.6% to 25.1%). Propensity-score weighted overall HEI was higher for individuals with normal weight (54.4; 95% CI, 53.0 to 55.9) than those who underwent bariatric surgery (50.0; 95% CI, 47.2 to 52.9) or were eligible for the surgery (48.0; 95% CI, 46.0 to 50.0). Across all HEI components, mean scores were similar between the bariatric surgery and surgery-eligible groups. Total energy intake was the lowest among those who underwent bariatric surgery (1746 kcal/d; 95% CI, 1554 to 1937 kcal/d), followed by those with normal weight (1943 kcal/d; 95% CI, 1873 to 2013 kcal/d) and those eligible for bariatric surgery (2040 kcal/d; 1953 to 2128 kcal/d). CONCLUSIONS AND RELEVANCE In this cross-sectional study, individuals who underwent bariatric surgery had beneficial lifestyle patterns compared with those eligible for surgery; however, these improvements seemed suboptimal based on the current guidelines. Efforts are needed to incorporate benefits of physical activity and a healthy, balanced diet in postbariatric care.
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Affiliation(s)
- Young-Rock Hong
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions University of Florida, Gainesville
- University of Florida Health Cancer Center, Gainesville
| | - Sandhya Yadav
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions University of Florida, Gainesville
| | - Ryan Suk
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston School of Public Health, Houston
| | - Alexandra M. Lee
- Department of Kinesiology, Pennsylvania State University, University Park
| | - Faith A. Newsome
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville
| | | | - Michelle I. Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville
- WW International, Inc, New York, New York
| | - Kathryn M. Ross
- Department of Clinical and Health Psychology, College of Public Health and Health Professions University of Florida, Gainesville
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Swann C, Jackman PC, Lawrence A, Hawkins RM, Goddard SG, Williamson O, Schweickle MJ, Vella SA, Rosenbaum S, Ekkekakis P. The (over)use of SMART goals for physical activity promotion: A narrative review and critique. Health Psychol Rev 2022; 17:211-226. [DOI: 10.1080/17437199.2021.2023608] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Christian Swann
- Faculty of Health, Southern Cross University, Coffs Harbour, Australia
| | | | - Alex Lawrence
- Faculty of Health, Southern Cross University, Coffs Harbour, Australia
| | - Rebecca M. Hawkins
- School of Sport and Exercise Science, University of Lincoln, Lincoln, UK
| | - Scott G. Goddard
- Faculty of Health, Southern Cross University, Coffs Harbour, Australia
| | - Ollie Williamson
- Faculty of Health, Southern Cross University, Coffs Harbour, Australia
- School of Sport and Exercise Science, University of Lincoln, Lincoln, UK
| | - Matthew J. Schweickle
- Global Alliance for Mental Health and Sport, School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Stewart A. Vella
- Global Alliance for Mental Health and Sport, School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Simon Rosenbaum
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
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McVay MA, Cooper KB, Donahue ML, Carrera Seoane M, Shah NR, Webb F, Perri M, Jake‐Schoffman DE. Engaging primary care patients with existing online tools for weight loss: A pilot trial. Obes Sci Pract 2022; 8:569-584. [PMID: 36238223 PMCID: PMC9535672 DOI: 10.1002/osp4.592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/29/2021] [Accepted: 01/18/2022] [Indexed: 11/11/2022] Open
Abstract
Objective Free online tools show potential for promoting weight loss at a low cost, but there is limited evidence about how to effectively engage patients with them. To address this, a low‐dose, flexible intervention was developed that aims to enhance weight‐related discussions with primary care providers (PCPs) and engage patients with an organic (i.e., not researcher‐created) weight loss‐focused social media community and online self‐monitoring tool. Feasibility and acceptability of the intervention was evaluated in a single‐arm, 12‐week pilot. Methods PCPs were recruited at two clinics, then PCP's patients with upcoming appointments were identified and recruited. Patients received an interactive online kickoff before their scheduled primary care appointment, then 8 follow‐up messages over 12 weeks via email or their electronic health record patient portal. Patients completed assessments at baseline, post‐appointment, and week 12. Primary care providers and patients completed semi‐structured interviews. Results All PCPs approached enrolled (n = 6); patient recruitment was on track to meet the study goal prior to COVID‐19 restrictions, and n = 27 patients enrolled. Patient satisfaction with the pre‐appointment kickoff was high. Twenty‐four patients reported discussing weight‐related topics at their primary care appointment and all were satisfied with the discussion. Twenty‐two patients completed 12‐week assessments. Of these, 15 reported engaging with the self‐monitoring tool and 9 with the social media community. Patient interviews revealed reasons for low social media community engagement, including perceived lack of fit. On average, patients with available data (n = 21) lost 2.4 ± 4.1% of baseline weight, and 28.6% of these patients lost ≥3% of baseline weight. Primary care providers reported high intervention satisfaction. Conclusions The intervention and trial design show potential, although additional strategies are needed to promote tool engagement.
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Affiliation(s)
- Megan A. McVay
- Department of Health Education & Behavior University of Florida Gainesville FL
| | - Kellie B Cooper
- Department of Health Education & Behavior University of Florida Gainesville FL
| | | | | | - Nipa R. Shah
- Department of Community Health and Family Medicine University of Florida College of Medicine Jacksonville FL
| | - Fern Webb
- Department of Surgery University of Florida Jacksonville FL
| | - Michael Perri
- College of Public Health and Health Professions University of Florida Gainesville
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Gorny AW, Chee WCD, Müller-Riemenschneider F. Active Use and Engagement in an mHealth Initiative Among Young Men With Obesity: Mixed Methods Study. JMIR Form Res 2022; 6:e33798. [PMID: 35076399 PMCID: PMC8826145 DOI: 10.2196/33798] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/15/2021] [Accepted: 12/10/2021] [Indexed: 12/23/2022] Open
Abstract
Background The effectiveness of mobile health (mHealth) approaches that employ wearable technology to promote physical activity have been the subject of concern due to the declining active use observed in trial settings. Objective To better contextualize active use, this study aimed to identify the barriers and enablers to engagement in a tracker-based mHealth initiative among young men who had recently completed a 19-week residential weight loss program. Methods A mixed methods study was conducted among 167 young men who had voluntarily enrolled in the national steps challenge (NSC), an mHealth physical activity promotion initiative, following a residential weight loss intervention. A subsample of 29 enrollees with a body mass index of 29.6 (SD 3.1) participated in semistructured interviews and additional follow-up assessments. Quantitative systems data on daily step count rates were used to describe active use. Qualitative data were coded and analyzed to elicit barriers and enablers to microlevel engagement in relation to the NSC, focusing on tracker and smartphone use. We further elicited barriers and enablers to macrolevel engagement by exploring attitudes and behaviors toward the NSC. Using triangulation, we examined how qualitative engagement in the NSC could account for quantitative findings on active use. Using integration of findings, we discussed how the mHealth intervention might have changed physical activity behavior. Results Among the 167 original enrollees, active use declined from 72 (47%) in week 1 to 27 (17%) in week 21. Mean daily step counts peaked in week 1 at 10,576 steps per day and were variable throughout the NSC. Barriers to engagement had occurred in the form of technical issues leading to abandonment, device switching, and offline tracking. Passive attitudes toward step counting and disinterest in the rewards had also prevented deeper engagement. Enablers of engagement included self-monitoring and coaching features, while system targets and the implicit prospect of reward had fostered new physical activity behaviors. Conclusions Our study showed that as the NSC is implemented in this population, more emphasis should be placed on technical support and personalized activity targets to promote lasting behavior change.
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Affiliation(s)
- Alexander Wilhelm Gorny
- Centre of Excellence for Soldier Performance, Singapore Armed Forces, Singapore, Singapore.,Headquarters Medical Corps, Singapore Armed Forces, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Wei Chian Douglas Chee
- Centre of Excellence for Soldier Performance, Singapore Armed Forces, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Digital Health Center, Berlin Institute of Health, Berlin, Germany
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Riseth L, Lund Nilsen TI, Hatlen Nøst T, Steinsbekk A. Fitness center use and subsequent achievement of exercise goals. A prospective study on long-term fitness center members. BMC Sports Sci Med Rehabil 2022; 14:9. [PMID: 35027081 PMCID: PMC8756662 DOI: 10.1186/s13102-022-00400-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/10/2022] [Indexed: 11/24/2022] Open
Abstract
Background Knowledge on the relationship between fitness center use and long-term members’ subsequent goal achievement is limited. Therefore, the aim was to investigate the prospective association between the use of fitness centers during 18 months and subsequent self-reported goal achievement among long-term members.
Methods This was a registry- and survey-based longitudinal study of 2851 people who had been members at a Norwegian fitness center chain for more than two years. Fitness center use from December 2016 to June 2018 was obtained from registry data. Subsequent goal achievement was measured in a survey in June 2018, assessed by a 1–100 visual analogue scale, and a score between 0 and 50 was defined as low goal achievement. Results Visiting the fitness center frequently and regularly, and having frequent group activity bookings were associated with higher subsequent self-reported goal achievement. Participants with fewest visits (1–57 days) during 18 months were more likely to report low goal achievement than participants with most visits (118–543 days) (OR = 8.5; 95% CI 6.3–11.4). Fitness trainer bookings was not clearly associated with subsequent goal achievement. Conclusions Frequent and regular long-term fitness center use were associated with higher subsequent self-reported goal achievement.
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Affiliation(s)
- Liv Riseth
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Post box 8905, 7491, Trondheim, Norway. .,3T-Fitness Center, Vestre Rosten 80, 7075, Tiller, Norway.
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Post box 8905, 7491, Trondheim, Norway.,Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torunn Hatlen Nøst
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Post box 8905, 7491, Trondheim, Norway.,Digital Health Care Unit, Norwegian Center for E-Health Research, Tromsø, Norway
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Gano-Overway L, Sackett SC. Let’s Get Smart and Set Goals to ASPIRE. JOURNAL OF SPORT PSYCHOLOGY IN ACTION 2021. [DOI: 10.1080/21520704.2021.2007192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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McCarthy M, Zhang L, Monacelli G, Ward T. Using Methods From Computational Decision-making to Predict Nonadherence to Fitness Goals: Protocol for an Observational Study. JMIR Res Protoc 2021; 10:e29758. [PMID: 34842557 PMCID: PMC8665389 DOI: 10.2196/29758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/24/2021] [Accepted: 10/03/2021] [Indexed: 11/21/2022] Open
Abstract
Background Can methods from computational models of decision-making be used to build a predictive model to identify individuals most likely to be nonadherent to personal fitness goals? Such a model may have significant value in the global battle against obesity. Despite growing awareness of the impact of physical inactivity on human health, sedentary behavior is increasingly linked to premature death in the developed world. The annual impact of sedentary behavior is significant, causing an estimated 2 million deaths. From a global perspective, sedentary behavior is one of the 10 leading causes of mortality and morbidity. Annually, considerable funding and countless public health initiatives are applied to promote physical fitness, with little impact on sustained behavioral change. Predictive models developed from multimodal methodologies combining data from decision-making tasks with contextual insights and objective physical activity data could be used to identify those most likely to abandon their fitness goals. This has the potential to enable development of more targeted support to ensure that those who embark on fitness programs are successful. Objective The aim of this study is to determine whether it is possible to use decision-making tasks such as the Iowa Gambling Task to help determine those most likely to abandon their fitness goals. Predictive models built using methods from computational models of decision-making, combining objective data from a fitness tracker with personality traits and modeling from decision-making games delivered via a mobile app, will be used to ascertain whether a predictive algorithm can identify digital personae most likely to be nonadherent to self-determined exercise goals. If it is possible to phenotype these individuals, it may be possible to tailor initiatives to support these individuals to continue exercising. Methods This is a siteless study design based on a bring your own device model. A total of 200 healthy adults who are novice exercisers and own a Fitbit (Fitbit Inc) physical activity tracker will be recruited via social media for this study. Participants will provide consent via the study app, which they will download from the Google Play store (Alphabet Inc) or Apple App Store (Apple Inc). They will also provide consent to share their Fitbit data. Necessary demographic information concerning age and sex will be collected as part of the recruitment process. Over 12 months, the scheduled study assessments will be pushed to the subjects to complete. The Iowa Gambling Task will be administered via a web app shared via a URL. Results Ethics approval was received from Dublin City University in December 2020. At manuscript submission, study recruitment was pending. The expected results will be published in 2022. Conclusions It is hoped that the study results will support the development of a predictive model and the study design will inform future research approaches. Trial Registration ClinicalTrials.gov NCT04783298; https://clinicaltrials.gov/ct2/show/NCT04783298
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Affiliation(s)
- Marie McCarthy
- Insight Centre For Data Analytics, Dublin City University, Dublin, Ireland
| | - Lili Zhang
- Insight Centre For Data Analytics, Dublin City University, Dublin, Ireland
| | - Greta Monacelli
- Insight Centre For Data Analytics, Dublin City University, Dublin, Ireland
| | - Tomas Ward
- Insight Centre For Data Analytics, Dublin City University, Dublin, Ireland
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Huang S, Magny-Normilus C, McMahon E, Whittemore R. Systematic Review of Lifestyle Interventions for Gestational Diabetes Mellitus in Pregnancy and the Postpartum Period. J Obstet Gynecol Neonatal Nurs 2021; 51:115-125. [PMID: 34843670 DOI: 10.1016/j.jogn.2021.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To examine the characteristics and effectiveness of lifestyle interventions for gestational diabetes mellitus (GDM) in pregnancy and the postpartum period to prevent Type 2 diabetes. DATA SOURCES We conducted searches in seven databases, including Ovid MEDLINE, CINAHL, Ovid Embase, Cochrane Central, Web of Science, Ovid PsycInfo, and ProQuest Dissertations and Theses for articles published from inception to January 2021. STUDY SELECTION We included articles on controlled intervention studies in which researchers evaluated a lifestyle intervention provided during pregnancy and the postpartum period for women with or at risk for GDM that were published in English. DATA EXTRACTION Twelve articles that were reports of seven studies met the inclusion criteria. In some cases, more than one article was selected from the same study. For example, articles reported different outcomes from the same study. We extracted data with the use of a data collection form and compared and synthesized data on study design, purpose, sample, intervention characteristics, recruitment and retention, and outcomes. DATA SYNTHESIS All seven studies focused on weight management and/or healthy lifestyle behaviors (diet and physical activity). Outcomes included glucose regulation, weight, lifestyle behaviors, and knowledge. The interventions varied in duration/dosage, strategies, and modes of delivery. In four studies, researchers reported interventions that had significant effects on improving glucose regulation and/or weight change. Some characteristics from the four effective interventions included goal setting, individualized care, and good retention rates. In the other three studies, limitations included low rates of participant retention, lack of personalized interventions, and limited population diversity or lack of culturally sensitive care. CONCLUSION Lifestyle interventions provided during and after pregnancy to reduce the risk associated with GDM have the potential to improve outcomes. Health care counseling to promote healthy lifestyle behaviors related to the prevention of Type 2 diabetes is needed at different stages of maternity care for women with GDM. Additional high-quality studies are needed to address the limitations of current studies.
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Kuwahara K, Yamamoto S, Honda T, Nakagawa T, Ishikawa H, Hayashi T, Mizoue T. Improving and maintaining healthy lifestyles are associated with a lower risk of diabetes: A large cohort study. J Diabetes Investig 2021; 13:714-724. [PMID: 34786886 PMCID: PMC9017641 DOI: 10.1111/jdi.13713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 12/29/2022] Open
Abstract
AIMS It is well known that healthy lifestyles measured at one time-point are inversely associated with diabetes risk. The impact of transitions in combined lifestyles in real settings remains unknown. MATERIALS AND METHODS The trajectory patterns of combined lifestyles over three years were identified using group-based trajectory modeling in 26,647 adults in Japan. Two types of indices (not having the unhealthy lifestyle [easy goal] and having healthiest lifestyles [challenging goal]) were developed using five lifestyle factors: smoking, alcohol consumption, exercise, sleep duration, and body weight control. This index was calculated using the yearly total score (0-5; higher score indicated healthier lifestyles). Diabetes was defined by high plasma glucose level, high hemoglobin A1c level, and self-report. RESULTS Five trajectory patterns were identified for each index and it was shown that healthier patterns are associated with a lower risk of type 2 diabetes during 6.6 years of average follow-up. For example, with a challenging-goal, compared with a persistently very unhealthy pattern, the adjusted hazard ratios (95% confidence intervals) were 0.65 (0.59, 0.73), 0.50 (0.39, 0.64), 0.43 (0.38, 0.48), and 0.33 (0.27, 0.41) for 'persistently unhealthy', 'improved from unhealthy to moderately healthy', 'persistently moderately healthy', and 'persistently mostly healthy' patterns, respectively. CONCLUSIONS Our data reinforce the importance of improving and maintaining health-related lifestyles to prevent diabetes.
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Affiliation(s)
- Keisuke Kuwahara
- National Center for Global Health and Medicine, Tokyo, Japan.,Teikyo University Graduate School of Public Health, Tokyo, Japan
| | | | | | | | - Hirono Ishikawa
- Teikyo University Graduate School of Public Health, Tokyo, Japan
| | | | - Tetsuya Mizoue
- National Center for Global Health and Medicine, Tokyo, Japan
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Patel MS, Bachireddy C, Small DS, Harrison JD, Harrington TO, Oon AL, Rareshide CAL, Snider CK, Volpp KG. Effect of Goal-Setting Approaches Within a Gamification Intervention to Increase Physical Activity Among Economically Disadvantaged Adults at Elevated Risk for Major Adverse Cardiovascular Events: The ENGAGE Randomized Clinical Trial. JAMA Cardiol 2021; 6:1387-1396. [PMID: 34468691 DOI: 10.1001/jamacardio.2021.3176] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Health promotion efforts commonly communicate goals for healthy behavior, but the best way to design goal setting among high-risk patients has not been well examined. Objective To test the effectiveness of different ways to set and implement goals within a behaviorally designed gamification intervention to increase physical activity. Design, Setting, and Participants Evaluation of the Novel Use of Gamification With Alternative Goal-setting Experiences was conducted from January 15, 2019, to June 1, 2020. The 24-week randomized clinical trial included a remotely monitored 8-week introductory intervention period, 8-week maintenance intervention period, and 8-week follow-up period. A total of 500 adults from lower-income neighborhoods in and around Philadelphia, Pennsylvania, who had either an atherosclerotic cardiovascular disease (ASCVD) condition or a 10-year ASCVD risk score greater than or equal to 7.5% were enrolled. Participants were paid for enrolling in and completing the trial. Interventions All participants used a wearable device to track daily steps, established a baseline level, and were then randomly assigned to an attention control or 1 of 4 gamification interventions that varied only on how daily step goals were set (self-chosen or assigned) and implemented (immediately or gradually). Main Outcome Measures The primary outcome was change in mean daily steps from baseline to the 8-week maintenance intervention period. Other outcomes included changes in minutes of moderate to vigorous physical activity. All randomly assigned participants were included in the intention-to-treat analysis. Results Of the 500 participants, 331 individuals (66.2%) were Black, 114 were White (22.8%), and 348 were women (69.6%). Mean (SD) age was 58.5 (10.8) years and body mass index was 33.2 (7.8). A total of 215 participants (43.0%) had an ASCVD condition. Compared with the control arm, participants with self-chosen and immediate goals had significant increases in the number of daily steps during the maintenance intervention period (1384; 95% CI, 805-1963; P < .001) that were sustained during the 8-week follow-up (1391; 95% CI, 785-1998; P < .001). This group also had significant increases in daily minutes of moderate to vigorous physical activity during the maintenance intervention (4.1; 95% CI, 1.8-6.4; P < .001) that were sustained during follow-up (3.5; 95% CI, 1.1-5.8; P = .004). No other gamification arms had consistent increases in physical activity compared with the control arm. No major adverse events were reported. Conclusions and Relevance In this trial among economically disadvantaged adults at elevated risk for major adverse cardiovascular events, a gamification intervention led to increases in physical activity that were sustained during 8 weeks of follow-up when goals were self-chosen and implemented immediately. Trial Registration ClinicalTrials.gov Identifier: NCT03749473.
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Affiliation(s)
- Mitesh S Patel
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.,The Wharton School, University of Pennsylvania, Philadelphia.,Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia.,Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.,Crescenz Veterans Affairs Medical Center, Philadelphia.,Now with Ascension Health, St Louis, Missouri
| | - Chethan Bachireddy
- Virginia Department of Medical Assistance Services, Richmond.,Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond
| | - Dylan S Small
- The Wharton School, University of Pennsylvania, Philadelphia.,Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia.,Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.,Crescenz Veterans Affairs Medical Center, Philadelphia
| | | | | | - Ai Leen Oon
- Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia
| | | | | | - Kevin G Volpp
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.,The Wharton School, University of Pennsylvania, Philadelphia.,Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia.,Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.,Crescenz Veterans Affairs Medical Center, Philadelphia
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Johnson N, Bradley A, Klawitter L, Johnson J, Johnson L, Tomkinson GR, Hackney KJ, Stastny S, Ehlers DK, McGrath R. The Impact of a Telehealth Intervention on Activity Profiles in Older Adults during the COVID-19 Pandemic: A Pilot Study. Geriatrics (Basel) 2021; 6:geriatrics6030068. [PMID: 34209416 PMCID: PMC8293040 DOI: 10.3390/geriatrics6030068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/17/2021] [Accepted: 06/28/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Physical inactivity during the COVID-19 pandemic is a public health concern for older adults. Telehealth presents a safe platform for conducting health-related interventions that may have additional benefits such as widespread reach. Our pilot study sought to examine how a telehealth intervention changed activity profiles in older adults during the COVID-19 pandemic. Methods: There were n = 13 adults aged 70.6 ± 4.5 years that participated in a 6 week telehealth intervention during the COVID-19 pandemic. The didactic intervention contents were shared online, and participants worked with trained interviewers over the telephone to discuss physical activity. At baseline and post-intervention, the Multimedia Activity Recall for Children and Adults examined activity profiles, while accelerometry estimated time spent sedentary and in physical activity. Results: Relative to the baseline measures, there was an 88 min/day (95% confidence interval (CI): 39, 137) increase in computer time and 36 min/day (CI: 10, 62) reduction in time spent in active transport at post-intervention. Moderate-to-vigorous physical activity participation also increased by an estimated 2 min/day (CI: −21, 26) and 12 min/week (CI: −154, 180), but this trend was not statistically significant. Conclusion: We recommend that support be provided to older adults transitioning to telehealth, especially as migration to telehealth progresses.
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Affiliation(s)
- Nathaniel Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Adam Bradley
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Lukus Klawitter
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Jane Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Lance Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Grant R. Tomkinson
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND 58202, USA;
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, SA 5501, Australia
| | - Kyle J. Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Sherri Stastny
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Diane K. Ehlers
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
- Fargo VA Healthcare System, Fargo, ND 58102, USA
- Correspondence: ; Tel.: +1-701-231-7474; Fax: +1-701-231-8872
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Diamond R, Waite F. Physical activity in a pandemic: A new treatment target for psychological therapy. Psychol Psychother 2021; 94:357-364. [PMID: 32588499 PMCID: PMC7361852 DOI: 10.1111/papt.12294] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/28/2019] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic and its management are placing significant new strains on people's well-being, particularly those with pre-existing mental health conditions. Physical activity has been shown to improve mental as well as physical health. Increasing activity levels should be prioritized as a treatment target, especially when the barriers to exercise are greater than ever. Promoting physical activity has not traditionally been the remit of psychologists. Yet psychological theory and therapeutic techniques can be readily applied to address physical inactivity. We present theoretical perspectives and therapy techniques relating to (1) beliefs about physical activity, (2) motivation to be physically active, and (3) the sense of reward achieved through being physically active. We outline strategies to initiate and maintain physical activity during the COVID-19 pandemic, thereby benefitting mental and physical health. COVID-19 is demanding rapid and substantial change across the whole health care system. Psychological therapists can respond creatively by addressing physical activity, a treatable clinical target which delivers both mental and physical health benefits. PRACTITIONER POINTS: Physical activity is essential for our mental and physical health. Yet COVID-19 presents novel barriers to physical activity. Psychological theory and techniques to address beliefs, motivation, and reward can be applied to increase physical activity during COVID-19. Physical activity is an important clinical target to sustain and improve mental health, especially in the current pandemic.
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Affiliation(s)
- Rowan Diamond
- Department of PsychiatryUniversity of OxfordUK,Oxford Cognitive Therapy CentreUK,Oxford Health NHS Foundation TrustUK
| | - Felicity Waite
- Department of PsychiatryUniversity of OxfordUK,Oxford Health NHS Foundation TrustUK
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Karahanoğlu A, Gouveia R, Reenalda J, Ludden G. How Are Sports-Trackers Used by Runners? Running-Related Data, Personal Goals, and Self-Tracking in Running. SENSORS 2021; 21:s21113687. [PMID: 34073181 PMCID: PMC8198506 DOI: 10.3390/s21113687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/13/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this research is to explore the roles that sports trackers and running-related data play in runners’ personal goal achievement. A two-week diary study and semi-structured interviews were conducted with 22 runners to explore how runners engage with their running-related data to set and achieve their running goals. We found that participants pursued and transitioned between different running goals as their needs, abilities, and surrounding environment changed. We also found multiple motivations that shaped the use of sports trackers. We identified two main categories in runners’ motivations for using trackers and data to achieve their goals. These categories were (i) documenting and tracking in running, and (ii) supporting goal-oriented reflections and actions, with various reasons for use while preparing for and during running. This study provides insights into the psychological effects of running-related data and signals practical implications for runners and developers of tracking technology.
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Affiliation(s)
- Armağan Karahanoğlu
- Faculty of Engineering Technology, University of Twente, 7522 NB Enschede, The Netherlands; (R.G.); (G.L.)
- Correspondence:
| | - Rúben Gouveia
- Faculty of Engineering Technology, University of Twente, 7522 NB Enschede, The Netherlands; (R.G.); (G.L.)
| | - Jasper Reenalda
- Faculty of Electrical Engineering Mathematics and Computer Science, University of Twente, 7522 NB Enschede, The Netherlands;
- Roessingh Research and Development, 7522 AH Enschede, The Netherlands
| | - Geke Ludden
- Faculty of Engineering Technology, University of Twente, 7522 NB Enschede, The Netherlands; (R.G.); (G.L.)
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Khosravi M. COVID-19 quarantine: Two-way interaction between physical activity and mental health. Eur J Transl Myol 2021; 30:9509. [PMID: 33520149 PMCID: PMC7844403 DOI: 10.4081/ejtm.2020.9509] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
Recent studies have revealed that physical activity significantly reduces the risk of coronavirus disease 2019 (COVID-19) infection by strengthening the immune system. Also, regular physical activity can reduce the risks of developing physical and mental health problems such as diabetes, hypertension, coronary heart disease, stress, anxiety, depression, etc. However, the two-way interaction between physical activity and psychological symptoms has not been well addressed yet. This paper is intended to examine various dimensions of this interaction and its effects on mental health at the time of COVID-19 quarantine.
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Affiliation(s)
- Mohsen Khosravi
- Department of Psychiatry and Clinical Psychology, Zahedan University of Medical Sciences, Zahedan, Iran
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43
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Chevance G, Baretta D, Golaszewski N, Takemoto M, Shrestha S, Jain S, Rivera DE, Klasnja P, Hekler E. Goal setting and achievement for walking: A series of N-of-1 digital interventions. Health Psychol 2021; 40:30-39. [PMID: 33252961 PMCID: PMC7928044 DOI: 10.1037/hea0001044] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Despite evidence that goal setting is valuable for physical activity promotion, recent studies highlighted a potential oversimplification in the application of this behavior change technique. While more difficult performance goals might trigger higher physical activity levels, higher performance goals might concurrently be more difficult to achieve, which could reduce long-term motivation. This study examined (a) the association between performance goal difficulty and physical activity and (b) the association between performance goal difficulty and goal achievement. METHOD This study used data from an e-Health intervention among inactive overweight adults (n = 20). The study duration included a 2-week baseline period and an intervention phase of 80 days. During the intervention, participants received a daily step goal experimentally manipulated by taking participants' baseline physical activity median (i.e., number of steps) multiplied by a pseudorandom factor ranging from 1 to 2.6. A continuous measure of goal achievement was inferred for each day by dividing the daily number of steps by the goal prescribed that day. Linear and generalized additive models were fit for each participant. RESULTS The results confirm that, for a majority of the participants involved in the study, performance goal difficulty was positively and significantly associated with physical activity (n = 14), but, concurrently, negatively and significantly associated with goal achievement (n = 19). These associations were mainly linear. CONCLUSION At the daily level, setting a higher physical activity goal leads to engaging in higher physical activity levels, but concurrently lower goal achievement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Guillaume Chevance
- Center for Wireless and Population Health Systems, the Qualcomm Institute, and the Department of Family Medicine and Public Health, University of California, San Diego
- Exercise and Physical Activity Resource Center, University of California, San Diego
| | - Dario Baretta
- Center for Wireless and Population Health Systems, the Qualcomm Institute, and the Department of Family Medicine and Public Health, University of California, San Diego
| | - Natalie Golaszewski
- Center for Wireless and Population Health Systems, the Qualcomm Institute, and the Department of Family Medicine and Public Health, University of California, San Diego
| | | | - Sama Shrestha
- Biostatistics Research Center, Department of Family Medicine and Public Health, University of California, San Diego
| | - Sonia Jain
- Center for Wireless and Population Health Systems, the Qualcomm Institute, and the Department of Family Medicine and Public Health, University of California, San Diego
- Biostatistics Research Center, Department of Family Medicine and Public Health, University of California, San Diego
| | - Daniel E. Rivera
- School for Engineering of Matter, Transport, and Energy, Arizona State University
| | | | - Eric Hekler
- Center for Wireless and Population Health Systems, the Qualcomm Institute, and the Department of Family Medicine and Public Health, University of California, San Diego
- Exercise and Physical Activity Resource Center, University of California, San Diego
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Kwasnicka D, Ntoumanis N, Sniehotta FF. Setting performance and learning goals is useful for active and inactive individuals, if goals are personalized and flexible: commentary on Swann et al. (2020). Health Psychol Rev 2020; 15:51-55. [PMID: 32608326 DOI: 10.1080/17437199.2020.1762107] [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: 01/03/2023]
Abstract
This commentary expands on the recent critical review by Swann et al. (2020) which aimed to update the applications of Goal-Setting Theory (Locke & Latham, 2019) in physical activity promotion. Drawing from other work on goal striving and behaviour change, we make four key points to further elaborate on Swann et al.'s review. First, goals are more likely to be enacted if they are specific, personally relevant and pursued for autonomous motives; performance goals can be useful for inactive individuals if set appropriately and self-endorsed. Second, goal striving needs to be flexible and adjustable, and to consider goal priorities and time factors relevant to goal engagement and disengagement. Goal-Setting Theory would therefore benefit from being expanded to add the factors of goal priority, context, and time. Third, research on goal setting in physical activity could benefit from embracing idiographic designs and interventions. Fourth, other theoretical approaches to goal striving should be considered when discussing goal setting in physical activity promotion.
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Affiliation(s)
- Dominika Kwasnicka
- SWPS University of Social Sciences and Humanities, Wrocław, Poland.,NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Nikos Ntoumanis
- Physical Activity and Well-Being Research Group, School of Psychology, Curtin University, Perth, Australia
| | - Falko F Sniehotta
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.,NIHR Policy Research Unit Behavioural Science, Newcastle University, Newcastle upon Tyne, United Kingdom
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The influence of idiosyncratic deals on employee proactive career behavior and creativity. ACTA PSYCHOLOGICA SINICA 2020. [DOI: 10.3724/sp.j.1041.2020.00081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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