Counseling middle-aged women about physical activity using the stages of change

Healthy lifestyle behaviors among teachers working in public primary schools and affecting factors

Healthy lifestyle behaviors have been recognized as a key strategy to achieve a policy of health for all. The aim of this study was to determine the levels of health promotion lifestyle behavior among teachers working in public primary schools. The present study also investigated the effects of selected socio-demographic characteristics on these behaviors. The research was designed using the survey model, one of the quantitative research methods. The sample of the research consisted of public primary school teachers (n = 372). Research data were collected using the Health-Promotion Lifestyle Profile-II (HPLP-II) scale. As a result of the research, it was put forward that there were statistically significant differences in levels of health promotion lifestyle behaviors based on taking courses on health promotion, and following programs and articles about healthy living (p < 0.05). It was revealed that primary teachers' taking courses on health promotion, and following programs and articles affected their healthy lifestyle behaviors. Public primary school teachers' health promotion lifestyle behaviors were found to be moderate. It was found that the primary teachers obtained the highest mean score for the spiritual growth subscale of the health promotion lifestyle behaviors scale; however, the primary school teachers had the lowest mean score for the physical activity subscale, which indicates that they need support in improving their healthy lifestyle. Male teachers had higher mean scores in the physical activity subscale, whereas females had higher mean scores in all other subscales. Training programs to protect and improve the health of teachers should be organized.

Rationale and Design of the Women's Health And Daily Experiences Project: Protocol for an Ecological Momentary Assessment Study to Identify Real-Time Predictors of Midlife Women's Physical Activity

BACKGROUND

Midlife women are at an elevated risk for cardiovascular disease (CVD) and associated mortality. Those who have additional risk conditions such as obesity or hypertension report specific barriers to engaging in cardioprotective behaviors such as physical activity (PA). Considerable effort has been devoted to understanding PA determinants and designing interventions for midlife women, although with suboptimal success, as increasing PA could meaningfully attenuate CVD risk. An updated approach to understanding PA among midlife women could improve upon existing resources by focusing on novel psychosocial influences on PA in this population (ie, body satisfaction, social interactions, social comparisons, mood state) and within-person relations between these influences and PA in the natural environment.

OBJECTIVE

The overarching goal of Project WHADE (Women's Health And Daily Experiences) is to use an ecological momentary assessment (EMA) approach to capture ecologically valid relations between midlife women's psychosocial experiences and PA as they engage in their normal daily activities. The primary aim of the study is to identify within-person psychosocial predictors of variability in PA (ie, experiences associated with higher vs lower PA for a given individual).

METHODS

Midlife women (aged 40-60 years) with one or more additional risk markers for CVD (eg, hypertension) will be recruited from primary care clinics and the general community (target n=100). Eligible women will complete an initial survey and a face-to-face baseline session before engaging in a 10-day EMA protocol. Psychosocial experiences will be assessed using a brief self-report via a smartphone 5 times per day, and PA will be assessed throughout waking hours using a research-grade monitor. Participants will return for a brief exit interview at the end of 10 days. Multilevel models that address the nested structure of EMA data will be used to evaluate the study aims.

RESULTS

Recruitment and enrollment are ongoing, and a total of 75 women have completed the protocol to date. Data collection is expected to be completed in Fall 2020.

CONCLUSIONS

Project WHADE is designed to identify naturally occurring psychosocial experiences that predict short-term variability in midlife women's PA. As such, the results of this study should advance the current understanding of PA among midlife women by providing further insight into within-person psychosocial influences on PA in this group. In the future, this information could help inform the design of interventions for this population.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/19044.

Changes in diet, exercise and stress behaviours using the stages of change model in cardiac rehabilitation patients

The behavioural changes initiated during Phase III cardiac rehabilitation programmes were recorded using Prochaska and Diclemente's “stages of change” model. This study aimed to ascertain if changes were initiated, maintained or further developed during Phase III programmes and 6 months after the programmes with a view to ascertaining the usefulness of this tool in providing stage matched individualised care. The risk factors examined were: exercise, diet and stress. The stages were recorded quantitatively and were numerically designated a value of 1–5. The results were analysed using SPSS. The sample number was one hundred and eighty seven patients.

Significant improvements were made by the end of the programme (6 or 8 weeks) indicating that most patients had modified their behaviour during the programme. There was no significant additional improvement in the risk factors 6 months later. These results are a further indication of the need for support post Phase III programmes. Patients entered Phase III rehabilitation at different stages in their risk behaviours and with regard to exercise this stage at commencement influences the final stage achieved. “Stages of change” is a useful simple method of recording behavioural change and this type of routine monitoring of a patient could be used effectively as part of the individual care plan during the programme.

Empowering self-care ability - a follow-up study of clinical-based perimenopausal women personal health counselling

AIMS AND OBJECTIVES

This study aimed to evaluate the longitudinal effects of a personal counselling intervention for perimenopausal women in northern Taiwan.

BACKGROUND

Women face a variety of physical changes during menopause. Counselling intervention could enrich individual health education for menopausal women.

DESIGN

Quasi-experimental design.

METHODS

The study used one-on-one personal health counselling with a 'menopausal health passport' for perimenopausal women. The Perceived Perimenopausal Disturbances scale, the Practice of Health Behavior scale and the Perceived Uncertainty scale were used to measure the intervention effects. Results were estimated by a Generalized Estimating Equation procedure at one and a half months, three months and six months post intervention. In addition, data regarding perceived health changes were collected qualitatively through interviews in the experimental group at the sixth month.

RESULTS

A total of 34 women were included in the experimental group, while 33 were in the control group. Interaction effect results showed that personal health counselling significantly increased the practice of health behaviours at one and a half months and extended to three months post intervention. Additionally, content categories, including 'relief of symptoms', 'establishment of health behaviors', 'interaction with others' and 'consideration from others' were identified in quantitative analysis.

CONCLUSIONS

The results suggest that perimenopausal personal health counselling can effectively improve healthy behaviours. This study can also serve as a future reference for effective perimenopausal counselling.

RELEVANCE TO CLINICAL PRACTICE

It is crucial to set up personal health counselling for perimenopausal women in clinics and develop information technology systems to support menopausal women in the technological era.

Using targeted messaging to increase physical activity in older adults: a review

Physical activity has many benefits for older adults; however, motivating older adults to engage in and maintain optimal levels of physical activity can be challenging for health care providers. A comprehensive literature review was performed to determine whether any evidence-based methods of delivery or particular content for targeted messaging exist that result in actual improvements in physical activity of older adults. Findings of the review demonstrate that messaging directed toward older adults to be physically active resulted in improvements in physical activity up to 1 year. Across studies many different modes of message delivery were shown to be effective. Message content, whether tailored or not, resulted in significant increases in physical activity. There is evidence to support the use of environmentally mediated messaging (i.e., local walking paths) for stronger results. Targeting the client's stage of change, having an activity partner if preferred, and scheduling physical activity also contribute to improved effects.

Registered nurses' beliefs of the benefits of exercise, their exercise behaviour and their patient teaching regarding exercise

Recommendations by experts have been in place for > 10 years encouraging every adult to participate in ≥ 30 min of daily moderate-intensity physical activity. Despite extensive research supporting the value of physical activity, only about one-third of all adults meet physical activity recommendations. Using Pender's Health Promotion Theory as the framework, this study was focused on the relationships between nurses' beliefs regarding the benefits of exercise, their exercise behaviour and their recommendation of exercise for health promotion or as part of a treatment plan. Results showed positive correlations between exercise benefits, physical activity and recommendation of exercise to patients. Nurses who believe in health promotion and embrace healthy behaviours are more likely to be positive role models and teach healthy behaviours to their patients. Recommendations for practice and future research are included.

Most people with rheumatoid arthritis undertake leisure-time physical activity and exercise in the Netherlands: an observational study

QUESTION

What type of physical activity or exercise is undertaken by people with rheumatoid arthritis? What type of physical activity or exercise do they prefer? What is their attitude towards physical activity or exercise? What are the perceived barriers to undertaking physical activity or exercise?

DESIGN

Survey of a random sample of people with rheumatoid arthritis.

PARTICIPANTS

Four hundred people with rheumatoid arthritis in the Netherlands.

RESULTS

Of the 252 people who returned the questionnaire (63% response) 201 (80%) people participated in some type of physical activity or exercise. Significantly more inactive people were male, less educated, and older than the active people. Of the active people, 45 (22%) participated exclusively in supervised activities, 72 (36%) in unsupervised activities, and 84 people (42%) combined supervised and unsupervised activities. Cycling and walking were the two unsupervised activities people performed most often. Supervised group exercise and unsupervised individual physical activity were reported as the favourite activities. Further, more people preferred being physically active under expert supervision than without supervision and preferred water-based over land-based activities. The most frequently-mentioned barriers were lack of energy, presence of pain, lack of motivation, lack of information, and fear of joint damage.

CONCLUSION

The majority of people with rheumatoid arthritis participated in some physical activity or exercise, mostly under supervision. Preferences for types of activity varied, underpinning the need for a variety of options for people with rheumatoid arthritis.

A tailored program for the promotion of physical exercise among Korean adults with chronic diseases

This study evaluated the effect of a tailored stage-matched intervention designed to increase exercise among Korean adults with chronic diseases. A physician and a nurse collaborated to deliver the intervention to 21 patients; the control group (CG) consisted of 20 patients. A nonequivalent CG pretest-posttest design was used. On follow-up, commitment to a plan for exercise was significantly greater in the intervention group (IG) than in the CG. Furthermore, the proportion of the IG in the active stage was significantly increased compared to that of the CG. The results suggest the potential of a stage-matched intervention program for increasing commitment to physical activity and for promoting progress through stages of exercise among patients with chronic diseases in a physician-based Korean clinic.