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Grant SJ, Liu S, Rhodes RE. A web-based physical activity intervention targeting affect regulation: a randomized feasibility trial. Psychol Health 2024:1-23. [PMID: 38946146 DOI: 10.1080/08870446.2024.2372658] [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: 10/12/2023] [Accepted: 06/20/2024] [Indexed: 07/02/2024]
Abstract
Early career professionals (ECPs) are a critical target for physical activity (PA) promotion. Affect contributes to an established PA intention-behaviour gap and is pertinent among ECPs. OBJECTIVE The purpose of this study was to examine the feasibility and acceptability of a web-based intervention and explore the effects on secondary outcomes (moderate-to-vigorous PA (MVPA), emotion regulation, multi-process action control constructs). METHODS Adults aged 25-44 who were employed at least part-time in a desk-based job and not meeting PA guidelines (<150 min MVPA) were recruited and randomized into a 6-week online intervention integrating acceptance and commitment principles and affect regulation strategies, or a control group. RESULTS Forty adults were recruited and randomized to the web-based intervention (n = 21) and waitlist control (n = 19). The recruitment rate was 29%, retention was 75%, engagement was 68%, and satisfaction was high in both quantitative and qualitative assessment. Participants allocated to the intervention improved MVPA (ηp2=0.30), emotion regulation (ηp2 =0.49), behavioural regulation (ηp2=0.53), affective attitude (ηp2=0.23), identity (ηp2=0.24), and constructs of mindfulness (ηp2=0.44), and valued living (ηp2=0.20). CONCLUSIONS Primary outcomes concerning feasibility were adequate and secondary outcomes improved, suggesting a full-scale randomized controlled trial is feasible with minor modifications. A large-scale study is warranted to establish intervention effectiveness.
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Affiliation(s)
- Stina J Grant
- Behavioural Medicine Lab, @bmedlab, University of Victoria, Victoria, BC, Canada
| | - Sam Liu
- Digital Health Lab, University of Victoria, Victoria, BC, Canada
| | - Ryan E Rhodes
- Behavioural Medicine Lab, @bmedlab, University of Victoria, Victoria, BC, Canada
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Espin A, Irazusta J, Aiestaran M, Latorre Erezuma U, García-García J, Arrinda I, Acedo K, Rodriguez-Larrad A. Videoconference-Supervised Group Exercise Reduces Low Back Pain in Eldercare Workers: Results from the ReViEEW Randomised Controlled Trial. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10182-2. [PMID: 38632115 DOI: 10.1007/s10926-024-10182-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To assess the effects of a group exercise intervention conducted by real-time videoconference on the low back pain of eldercare workers. METHODS We randomly assigned 130 eldercare workers to an experimental group (EG: n = 65) or control group (CG: n = 65). Participants from both groups took part in routine prevention programs carried out in their workplace, and participants from the EG received an additional 12-week resistance-exercise intervention supervised by real-time videoconference. Assessments were conducted before and after the intervention, and the primary outcome was average low back pain intensity during the last 7 days, measured by the 0-10 numerical rating scale. Secondary outcomes included additional measures of low back, neck, shoulder and hand/wrist pain, as well as psycho-affective parameters, medication consumption and muscle performance. Both intention-to-treat and per-protocol analyses were applied with a group-by-time ANCOVA including baseline measurements as covariates. RESULTS 125 participants completed post-intervention assessments (EG: n = 63, CG: n = 62). The intention-to-treat analysis showed an effect favouring the EG on average low back pain intensity (p = 0.034). Improvements in additional low back and hand/wrist pain outcomes were also observed, as well as on upper limb muscle performance (p < 0.05). The per-protocol analysis demonstrated additional benefits in depression, quality of life, hypnotic/anxiolytic medication consumption and lower limb and trunk muscle performance in participants with ≥ 50% adherence (p < 0.05). CONCLUSIONS The intervention was effective for reducing the low back and hand/wrist pain of eldercare workers and increasing upper limb muscle performance. The per-protocol analysis showed additional benefits in psycho-affective parameters, medication consumption and muscle performance. TRIAL REGISTRATION ClinicalTrials.gov, NCT05050526. Registered 20 September 2021-Prospectively registered, https://www. CLINICALTRIALS gov/study/NCT05050526.
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Affiliation(s)
- Ander Espin
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain.
- Biobizkaia Health Research Institute, Barakaldo, Spain.
| | - Jon Irazusta
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
| | - Maialen Aiestaran
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Unai Latorre Erezuma
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
| | - Julia García-García
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
| | | | | | - Ana Rodriguez-Larrad
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
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Locke S, Osborne J. Determining the Right Levels of Health Coaching and Heart Rate Variability Biofeedback in a Workplace Behavior Change Intervention: Multiphase Optimization Strategy Preparation Study. JMIR Form Res 2024; 8:e47181. [PMID: 38354036 PMCID: PMC10902773 DOI: 10.2196/47181] [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: 03/10/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Work-related stress is associated with poor job performance and negative health outcomes. Changing health behaviors through corporate wellness programs can improve physical and mental health and help employees manage stress. This project sought to pilot the potential addition of brief coaching and biofeedback to an 8-week web-based self-help program to improve employee stress using the multiphase optimization strategy. OBJECTIVE This study aims to determine which candidate components will be tested in a later optimization phase and at what dose they will be tested, examine the feasibility and acceptability of delivering the different components, investigate whether the outcomes can be feasibly measured, and review evidence to build a conceptual model before the optimization phase. METHODS The study was positioned within the preparation phase of the multiphase optimization strategy. It is a 2×2×2×2 design with 4 components: 2 types of health coaching and 2 types of biofeedback. All components were tested by turning them on or off. A total of 16 adult office workers (mean age 40, SD 14.3 years; n=15 women) completed an 8-week self-paced web-based stress management and health behavior change program and were randomly assigned to 1 of the 16 conditions, created from a combination of the 4 candidate components. Assessments included web analytics, surveys, and interviews regarding program recommendations, likes, and dislikes. RESULTS Findings from the interviews provided suggestions to improve the intervention (eg, separating wellness from stress content) and trial conduct (eg, streamlining the onboarding process). On average, participants logged into the wellness program 83 times (range 36-291), with 75% (12/16) participant retention and 67% (8/12) survey completion. There were no reported problems with coaching or obtaining data from interviews or apps. The interview findings suggested potential mediators to include and assess in a future conceptual model. CONCLUSIONS The results provided areas to improve the intervention content and trial methods. Instead of progressing to the next scheduled large-scale optimization phase, our plan to iterate through a second preparation phase after making changes to the protocol, apps, and corporate coaching partner.
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Affiliation(s)
- Sean Locke
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
| | - Jenna Osborne
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
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Harrison LT, Marenus MW, Chen W. Reducing Anxiety and Enhancing Mindfulness in College Students during COVID-19 through WeActive and WeMindful Interventions. Healthcare (Basel) 2024; 12:374. [PMID: 38338259 PMCID: PMC10855634 DOI: 10.3390/healthcare12030374] [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: 12/30/2023] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVE The purpose of this study was to examine the immediate and short-term, sustained effects of two virtual interventions, WeActive, an aerobic and resistance training program, and WeMindful, a mindful exercise, in reducing anxiety and improving mindfulness among college students during the COVID-19 pandemic. METHODS Participants were 60 students from a large Midwestern university who were randomly assigned to either the WeActive group (n = 36) or the WeMindful group (n = 24). The WeActive group participated in two virtual 30 min aerobic and resistance training sessions per week (WeActive) and the WeMindful group participated in two virtual 30 min mindful exercise sessions per week for eight weeks. All participants completed the Generalized Anxiety Disorder scale and the Five Facet Mindfulness Questionnaire through Qualtrics at three time points: one week prior to (pre-test), one week after (post-test), and six weeks after (follow-up) the intervention. RESULTS A repeated-measures ANOVA revealed a significant main effect of time on anxiety (F = 7.51, η2 = 0.036, p = 0.001) in both groups. WeActive significantly decreased anxiety scores between the pre-test and follow-up (t = 2.7, p = 0.027) and post-test and follow-up (t = 3.1, p = 0.007), and WeMindful significantly decreased anxiety scores between the post-test and follow-up (t = 0.641, p = 0.028). For mindfulness, there was a significant main effect of time in both groups (F = 3.91, η2 = 0.009, p = 0.025), where only WeMindful significantly increased mindfulness from the pre-test to follow-up (t = -2.7, p = 0.025). CONCLUSIONS Anxiety decreased significantly in both the WeActive and WeMindful groups and mindfulness increased significantly in the WeMindful group. Furthermore, the decrease in anxiety was sustained in a short-term period following the end of the intervention.
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Affiliation(s)
| | | | - Weiyun Chen
- School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA; (L.T.H.); (M.W.M.)
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Jeong S, Cha C, Nam S, Song J. The effects of mobile technology-based support on young women with depressive symptoms: A block randomized controlled trial. Medicine (Baltimore) 2024; 103:e36748. [PMID: 38181292 PMCID: PMC10766295 DOI: 10.1097/md.0000000000036748] [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: 07/04/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND The current body of knowledge highlights the potential role of mobile technology as a medium to deliver support for psychological and physical health. This study evaluated the influence of mobile technology support on depressive symptoms and physical activity in female university students. METHODS A block randomized controlled trial design with a single site was used. Ninety-nine participants were block-randomized into 3 arms: Experimental Group 1 (emotional and informational support group), Experimental Group 2 (informational support group), and the control group. Interventions were delivered via mobile technology for 2 weeks. Data on depressive symptoms and physical activity were collected from 84 participants at baseline and on Days 8 and 15. Data analyses included descriptive statistics, t tests, one-way analysis of variance, and repeated-measures analysis of variance. RESULTS This study showed no interaction effect of time and group on depressive symptom scores and physical activity, considering the emotional and informational support from mobile technology. However, Experimental Group 1 exhibited a significant reduction in depressive symptoms during the first week of the study compared to Experimental Group 2 and the control group. While physical activity in Experimental Group 2 and control group increased only during the first week of the study and subsequently decreased, Experimental Group 1 showed an initial increase during the first week that was sustained into the second week. CONCLUSIONS Since informational and emotional support showed a strong effect over a short period of time, mobile technology offering emotional support could be used to provide crisis interventions for depression among young women when a short-term impact is required.
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Affiliation(s)
- Sookyung Jeong
- Department of Nursing, College of Medicine, Wonkwang University, Iksan City, South Korea
| | - Chiyoung Cha
- College of Nursing, Ewha Womans University, Seoul City, South Korea
| | - Sujin Nam
- The University of Honkong, Pokfulam, Hong Kong
| | - Jiyoon Song
- College of Nursing, Ewha Womans University, Seoul City, South Korea
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Thomson L, Keshavarz M, Sénéchal M, Bouchard DR. Online exercise program for men living with obesity: Experiences, barriers, and enablers. Contemp Clin Trials Commun 2023; 36:101226. [PMID: 38034839 PMCID: PMC10681938 DOI: 10.1016/j.conctc.2023.101226] [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: 12/21/2022] [Revised: 10/18/2023] [Accepted: 11/04/2023] [Indexed: 12/02/2023] Open
Abstract
The prevalence of obesity is increasing among men, and this population remains under-represented in lifestyle and weight management interventions. The current study aims to explore the experiences of men living with obesity (body fat ≥25 %) toward a 12-week supervised online exercise platform. Ten men were interviewed for this qualitative study. Semi-structured, open-ended phone interviews were conducted, and the transcripts were thematically coded using the qualitative data analysis Nvivo QSR software package. The research findings are illustrated using quotes from participants. The results were organized into two main themes: those that removed barriers to exercise and those that improved the enablers of exercise. Eliminating barriers included not purchasing specialized equipment or travelling to a gym facility. The enablers to their success with the program included the structured format of the circuit program and having supervised sessions. By removing barriers and enhancing enablers, the 12-week online exercise circuit program increased compliance to and success of the exercise program for men living with obesity. Future research should explore the long-term effects of an online program for men living with obesity and its appeal beyond COVID-19.
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Affiliation(s)
- Lisa Thomson
- University of New Brunswick, Department of Sociology Fredericton NB, Canada
| | - Mohammad Keshavarz
- University of New Brunswick, Faculty of Kinesiology Fredericton NB, Canada
- Cardiometabolic Exercise and Lifestyles Laboratory, Fredericton NB, Canada
| | - Martin Sénéchal
- University of New Brunswick, Faculty of Kinesiology Fredericton NB, Canada
- Cardiometabolic Exercise and Lifestyles Laboratory, Fredericton NB, Canada
| | - Danielle R. Bouchard
- University of New Brunswick, Faculty of Kinesiology Fredericton NB, Canada
- Cardiometabolic Exercise and Lifestyles Laboratory, Fredericton NB, Canada
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Kariuki JK, Sereika S, Erickson K, Burke LE, Kriska A, Cheng J, Milton H, Hirshfield S, Ogutu D, Gibbs B. Feasibility and preliminary efficacy of a novel web-based physical activity intervention in adults with overweight/obesity: A pilot randomized controlled trial. Contemp Clin Trials 2023; 133:107318. [PMID: 37625586 PMCID: PMC10591946 DOI: 10.1016/j.cct.2023.107318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/13/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Only 14% of adults with obesity attain federal guidelines for physical activity (PA), but few interventions address obesity-specific barriers to PA. We designed the web-based Physical Activity for The Heart (PATH) intervention to address this gap. PURPOSE Test the feasibility and preliminary efficacy of PATH for promoting PA and reducing cardiovascular disease (CVD) risk in adults with overweight/obesity. METHODS In a 12-week pilot RCT, participants were randomized to PATH (n = 41) or wait-list control (n = 41) groups. Treatment group received access to PATH and met twice/month with a remote coach. The control group received a self-help PA guide and newsletters on general health. Moderate-to-vigorous PA (MVPA) was assessed via Actigraph-GT3X, steps via Fitbit Charge 2™, weight via smart scale, blood pressure (BP) via Omron BP device, and lipids/HbAIC via dry blood spot. Linear mixed modeling examined between- and within-group differences in PA and CVD risk. RESULTS The sample (N = 82) was on average 55.9 ± 8.2 years old; mean BMI 35.5 ± 6.2 kg/m2; 57.3% white and 80.5% female. Recruitment lasted 6-months, and 12-week retention was 96.3%. Treatment group accessed PATH ≥twice/week (92.1%), spent ≥10 min/visit (89.5%) and thought the site was culturally appropriate (79%). At 12 wks, the PATH group had greater mean changes in weekly MVPA (+58.9 vs. +0.9 min, p = .024) and daily steps (+1246.4 vs. -64.2 steps, p = .002) compared to the control group. Also, the PATH group improved in weight, BMI, body fat, waist circumference, and BP (p < .05). CONCLUSION The PATH intervention is feasible/acceptable and demonstrated preliminary efficacy for promoting PA among adults with overweight/obesity.
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Affiliation(s)
| | | | | | | | | | - Jessica Cheng
- Harvard University T. H. Chan School of Public Health, MA, USA
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Kariuki JK, Bizhanova Z, Conroy MB, Burke LE, Cheng J, Beatrice B, Sereika SM. The Association between Neighborhood Walkability and Physical Activity in a Behavioral Weight Loss Trial Testing the Addition of Remotely Delivered Feedback Messages to Self-Monitoring. Behav Med 2023:1-10. [PMID: 37489802 PMCID: PMC10808266 DOI: 10.1080/08964289.2023.2238102] [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] [Received: 12/15/2022] [Revised: 06/30/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023]
Abstract
Adding feedback messages (FB) to self-monitoring (SM) may reinforce behavior change. However, socio-environmental conditions (e.g., limited access to parks or low walkability) may limit one's ability to respond to FB focused on physical activity (PA). In this analysis, we hypothesized that high neighborhood walkability will positively modify the treatment effect of FB on PA, and residents of high walkability neighborhoods will achieve higher PA levels at 12 months than those in low walkability neighborhoods. The study is a secondary analysis of a 12-month behavioral weight-loss trial. Adults with overweight/obesity were randomized to SM + FB (n = 251) or SM alone (n = 251). SM + FB group received smartphone pop-up messages thrice/week tailored to their PA SM data. The assessment included neighborhood walkability via Walk Score (low [<50] vs. high [≥50]), moderate to vigorous PA (MVPA) and step count via Fitbit Charge 2™, and weight via smart scale. We report adjusted linear regression coefficients (b) with standard errors (SE). The analysis included participants who were primarily white, female, and with obesity. In adjusted models, neighborhood walkability did not moderate the effect of treatment assignment on log-transformed (ln) MVPA or steps count over 12 months. The SM + FB group had greater lnMVPA than the SM group, but lnMVPA and steps were similar between walkability groups. There were no significant interactions for group and time or group, time, and walkability. These findings suggest that adding FB to SM had a small but significant positive impact on PA over 12 months, but neighborhood walkability did not moderate the treatment effect of FB on PA.
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Affiliation(s)
| | | | | | | | - Jessica Cheng
- Harvard University T.H. Chan School of Public Health, MA, USA
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Alsaleh E. Is a combination of individual consultations, text message reminders and interaction with a Facebook page more effective than educational sessions for encouraging university students to increase their physical activity levels? Front Public Health 2023; 11:1098953. [PMID: 37448659 PMCID: PMC10338000 DOI: 10.3389/fpubh.2023.1098953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/03/2023] [Indexed: 07/15/2023] Open
Abstract
Background Physical activity (PA) has been consistently reported as a crucial component of disease prevention and improvement of people's health. Nevertheless, data has evidenced a decline in physical activity levels among adults in Jordan. Although previous behavioral change interventions have documented efficacy in increasing physical activity among adults, the PA levels is low among adults. A new motivational intervention that focuses on changing behavior toward performing the recommended level of physical activity is on need. Objective This two-arm single-center randomized controlled trial aimed to measure the efficacy of a multi-component behavioral intervention (including goal setting, self-monitoring, and feed-back) for increasing physical activity levels and self-efficacy for exercise and decreasing body mass index and blood pressure among students at a Jordanian University. Setting Philadelphia University in Jordan. Methods A behavioral intervention based on individualized consultations, text messages reminders and interaction with a Facebook page was compared with educational sessions in terms of efficacy for increasing physical activity levels among students at Philadelphia University. Results The intervention and control groups were comparable at baseline. At 6 months a significant increase was seen in the moderate physical activity and walking levels of the intervention group compared with the control group. The mean change (SD) in total METs of moderate physical activity and walking was 503 (325.20) METs/week in the intervention group and 6 (271.20) METs/week in the control group. The mean change (SD) in steps/day was 3,000 (1,217) steps/day in the intervention group and 876 (1120.23) steps/day in the control group. The difference between mean change of the two groups was very significant at 2,124 (-820 to -563). Self-efficacy for exercise scale significantly increased among the intervention group compared with the control group. In addition, body mass index (BMI) declined from the baseline (Mean: 28.23, SD: 4.82) to 6 months (Mean: 25.36, SD: 5.23) for the intervention group. Conclusion Behavioral intervention through multicomponent strategies, alongside the implementation of an advanced communication strategy via phone and social media, is effective for motivating adult students to increase their physical activity levels. Clinical trial registration ISRCTN54100536.
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Affiliation(s)
- Eman Alsaleh
- School of Nursing, Philadelphia University, Amman, Jordan
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Espin A, Irazusta J, Segovia Celaya I, Mosquera Lajas Á, González-Templado V, Rodriguez-Larrad A. Effects of a videoconference-based therapeutic exercise intervention on the musculoskeletal pain of eldercare workers: protocol for the ReViEEW randomized controlled trial. BMC Musculoskelet Disord 2023; 24:463. [PMID: 37280584 DOI: 10.1186/s12891-023-06584-7] [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] [Received: 04/25/2023] [Accepted: 05/31/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Prevalence of musculoskeletal pain is high among eldercare workers, and therapeutic exercise has shown to be effective for its management. Although telerehabilitation is an increasingly used alternative for delivering therapeutic exercise, no studies have assessed synchronous group telerehabilitation interventions for the management of musculoskeletal disorders. Thus, the aim of this article is to describe the protocol of a randomized controlled trial that will assess the effects of a videoconference-based group therapeutic exercise intervention on the musculoskeletal pain of eldercare workers. METHODS This multicenter trial will randomly assign 130 eldercare workers to either a control or experimental group. Participants in the control group will not receive any intervention, and participants in the experimental group will take part in a 12-week remote supervised videoconference-based intervention, consisting of 2 weekly 45-min group sessions. Each session will include 4 sets of 6 progressive resistance exercises for the lower limbs, upper limbs and trunk, performed with bodyweight and elastic bands at moderate-high intensity. Following the 12 weeks, participants in the experimental group will be provided with material for autonomously carry on the therapeutic exercises and advised to continue performing 2 weekly sessions on their own until a 48-week follow-up. Assessments will be performed at baseline, 12 and 48 weeks. Primary outcome will be average pain intensity in the low back during the last 7 days, measured by the 0-10 Numerical Rating Scale. Secondary outcomes will include additional measures of musculoskeletal pain, psycho-affective state, work-related variables, and physical fitness. DISCUSSION This will be the first trial, to our knowledge, assessing whether a remote delivery of a group therapeutic exercise intervention via videoconference is effective for reducing the musculoskeletal pain, improving the psycho-affective state and physical fitness, and enhancing the work-related parameters in eldercare workers. If successful, this study will provide innovative tools for implementing effective, scalable and affordable interventions to tackle musculoskeletal disorders in the workplace. It will also highlight the utility of telehealth, and address the importance of therapeutic exercise to manage musculoskeletal pain in a critical population for the future of the aging societies as it is the eldercare workers. TRIAL REGISTRATION The study protocol was prospectively registered at ClinicalTrials.gov (registration number: NCT05050526) on September 20, 2021.
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Affiliation(s)
- Ander Espin
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain.
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.
| | - Jon Irazusta
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | | | | | | | - Ana Rodriguez-Larrad
- Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
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Ruiz-Cortés M, Múzquiz-Barberá P, Herrero R, Vara MD, Escrivá-Martínez T, Carcelén R, Rodilla E, Baños RM, Lisón JF. How the Presence of a Doctor Known to Patients Impacts a Web-Based Intervention to Promote Physical Activity and Healthy Eating Behaviour in Individuals with an Overweight/Obesity–Hypertension Phenotype: A Randomised Clinical Trial. Nutrients 2023; 15:nu15071624. [PMID: 37049465 PMCID: PMC10097159 DOI: 10.3390/nu15071624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
(1) Background: The ‘Living Better’ web-based programme has shown short- and long-term benefits for body composition and psychological variables in obese patients with hypertension by promoting a healthier lifestyle. To further explore the potential of this programme, in this work we aimed to explore the possible effect of the patient’s ‘own doctor’ appearing in the video content of the Living Better intervention. (2) Methods: A total of 132 patients were randomly assigned either to the experimental (EG, n = 70) or control (CG, n = 62) group (with a doctor the patient knew as ‘their own’ or an ‘unknown doctor’, respectively). The body mass index (BMI), motivation towards physical activity (PA), PA levels, motivation to change one’s eating habits, adherence to the Mediterranean diet, and eating behaviour were all assessed and compared at baseline and post-intervention (12 weeks). (3) Results: The results of this study confirmed the positive effects of the Living Better programme on BMI and external eating style, with significant improvements in these variables in both groups. In addition, in the EG there was higher intrinsic motivation to change eating behaviour (mean difference of 0.9, 95% CI [0.1, 1.6], p = 0.032) and lower amotivation (mean difference of −0.6, 95% CI [−1.2, −0.1], p = 0.027) compared to the CG. (4) Conclusions: This study suggests that the presence of the patients’ own doctor in the audiovisual content of the Living Better intervention did not have significant additional benefits in terms of BMI or external eating style. However, their presence did improve intrinsic motivation and amotivation related to eating habits.
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Affiliation(s)
- Marta Ruiz-Cortés
- Department of Biomedical Sciences, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, 46115 Valencia, Spain
| | - Pedro Múzquiz-Barberá
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, 46115 Valencia, Spain
| | - Rocío Herrero
- Department of Psychology and Sociology, Universidad de Zaragoza, 50009 Teruel, Spain
- Centre of Physiopathology of Obesity and Nutrition (CIBERobn), CB06/03/0052, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Dolores Vara
- Centre of Physiopathology of Obesity and Nutrition (CIBERobn), CB06/03/0052, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Polibienestar Research Institute, Universitat de València, 46022 Valencia, Spain
| | - Tamara Escrivá-Martínez
- Centre of Physiopathology of Obesity and Nutrition (CIBERobn), CB06/03/0052, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Polibienestar Research Institute, Universitat de València, 46022 Valencia, Spain
| | - Raquel Carcelén
- Department of Medicine and Surgery, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, 46115 Valencia, Spain
| | - Enrique Rodilla
- Department of Medicine and Surgery, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, 46115 Valencia, Spain
- Hypertension and Vascular Risk Unit, Hospital Universitario de Sagunto, 46115 Valencia, Spain
| | - Rosa María Baños
- Centre of Physiopathology of Obesity and Nutrition (CIBERobn), CB06/03/0052, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Polibienestar Research Institute, Universitat de València, 46022 Valencia, Spain
| | - Juan Francisco Lisón
- Department of Biomedical Sciences, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, 46115 Valencia, Spain
- Centre of Physiopathology of Obesity and Nutrition (CIBERobn), CB06/03/0052, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-961369000 (ext. 64540)
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12
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Weber M, Schmitt KU, Frei A, Puhan MA, Raab AM. Needs assessment in community-dwelling older adults toward digital interventions to promote physical activity: Cross-sectional survey study. Digit Health 2023; 9:20552076231203785. [PMID: 37799500 PMCID: PMC10548814 DOI: 10.1177/20552076231203785] [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] [Accepted: 09/09/2023] [Indexed: 10/07/2023] Open
Abstract
Background Tackling physical inactivity represents a key global public health challenge. Strategies to increase physical activity (PA) are therefore warranted. Despite the rising availability of digital interventions (DIs), which offer tremendous potential for PA promotion, there has been inadequate attention to the special needs of older adults. Objective The aim was to investigate community-dwelling older adults' needs, requirements, and preferences toward DIs to promote PA. Methods The target population of this cross-sectional study was community-dwelling older adults (≥60 years old) within German-speaking Switzerland. Potential respondents were informed about the study and sent a link to a self-developed and self-administered online survey by our cooperating institutions. Results Overall, 922 respondents who completed the online survey were included in the final analysis. The mean age of the sample was 72 years (SD 6.4, range 60-98). The preferred delivery mode of DIs to promote PA was a website (428/922, 46.4%) and 80.3% (740/922) preferred video-based structures. Most respondents expressed the need for personal access, personal goals, personal messages, and a personal contact in case of problems or questions (585/817, 71.6%; 546/811, 67.3%; 536/822, 65.2%; 536/822, 65.2%). Memory training, psychological wellbeing, and nutrition were mainly rated as relevant additional content of DIs to promote PA (690/849, 81.2%; 661/845, 78.2%, 619/849, 72.9%). Conclusion Community-dwelling older adults may be willing to use DIs to promote PA in the long term, but this study identified particular needs and requirements in terms of design, technological realization, delivery mode, support, and individualization/personalization among the sample. Our results can inform future developments of DIs to promote PA specifically tailored to older adults. However, caution is warranted in interpreting the findings due to the sample's high PA and education levels.
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Affiliation(s)
- Manuel Weber
- Academic-Practice-Partnership between Bern University of Applied Sciences and University Hospital of Bern, School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Kai-Uwe Schmitt
- Academic-Practice-Partnership between Bern University of Applied Sciences and University Hospital of Bern, School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Anja M Raab
- Academic-Practice-Partnership between Bern University of Applied Sciences and University Hospital of Bern, School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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13
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Haggag O, Grundy J, Abdelrazek M, Haggag S. A large scale analysis of mHealth app user reviews. EMPIRICAL SOFTWARE ENGINEERING 2022; 27:196. [PMID: 36246486 PMCID: PMC9553639 DOI: 10.1007/s10664-022-10222-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 06/16/2023]
Abstract
The global mHealth app market is rapidly expanding, especially since the COVID-19 pandemic. However, many of these mHealth apps have serious issues, as reported in their user reviews. Better understanding their key user concerns would help app developers improve their apps' quality and uptake. While app reviews have been used to study user feedback in many prior studies, many are limited in scope, size and/or analysis. In this paper, we introduce a very large-scale study and analysis of mHealth app reviews. We extracted and translated over 5 million user reviews for 278 mHealth apps. These reviews were then classified into 14 different aspects/categories of issues reported. Several mHealth app subcategories were examined to reveal differences in significant areas of user concerns, and to investigate the impact of different aspects of mhealth apps on their ratings. Based on our findings, women's health apps had the highest satisfaction ratings. Fitness activity tracking apps received the lowest and most unfavourable ratings from users. Over half of users who reported troubles leading them to uninstall mHealth apps gave a 1-star rating. Half of users gave the account and logging aspect only one star due to faults and issues encountered while registering or logging in. Over a third of users who expressed privacy concerns gave the app a 1-star rating. However, only 6% of users gave apps a one-star rating due to UI/UX concerns. 20% of users reported issues with handling of user requests and internationalisation concerns. We validated our findings by manually analysing a sample of 1,000 user reviews from each investigated aspect/category. We developed a list of recommendations for mHealth apps developers based on our user review analysis.
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Affiliation(s)
- Omar Haggag
- Faculty of Information Technology, Monash University, Melbourne, Australia
| | - John Grundy
- Faculty of Information Technology, Monash University, Melbourne, Australia
| | - Mohamed Abdelrazek
- School of Information Technology, Deakin University, Melbourne, Australia
| | - Sherif Haggag
- School of Computer Science, The University of Adelaide, Adelaide, Australia
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14
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Pekmezi D, Motl R. Targeting Physical Inactivity Using Behavioral Theory in Chronic, Disabling Diseases. Exerc Sport Sci Rev 2022; 50:156-161. [PMID: 35522244 DOI: 10.1249/jes.0000000000000291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Physical inactivity and comorbidities (e.g., hypertension) result in poor prognoses among persons with chronic, disabling conditions including multiple sclerosis, Parkinson disease, and stroke. Theory can guide the design of behavior change interventions that can be delivered remotely for broad scale implementation. We hypothesize that theory-based behavior change interventions can increase physical activity and reduce comorbidities and associated consequences among persons with chronic, disabling conditions.
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Affiliation(s)
- Dori Pekmezi
- University of Alabama at Birmingham, Birmingham, AL
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15
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Wilke J, Mohr L, Yuki G, Bhundoo AK, Jiménez-Pavón D, Laiño F, Murphy N, Novak B, Nuccio S, Ortega-Gómez S, Pillay JD, Richter F, Rum L, Sanchez-Ramírez C, Url D, Vogt L, Hespanhol L. Train at home, but not alone: a randomised controlled multicentre trial assessing the effects of live-streamed tele-exercise during COVID-19-related lockdowns. Br J Sports Med 2022; 56:667-675. [PMID: 35168957 PMCID: PMC8861875 DOI: 10.1136/bjsports-2021-104994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Public life restrictions associated with the COVID-19 pandemic caused reductions in physical activity (PA) and decreases in mental and somatic health. Considering the interplay between these factors, we investigated the effects of digital home exercise (DHE) during government-enforced lockdowns. METHODS A multicentre randomised controlled trial was performed allocating healthy individuals from nine countries (N=763; 523 female) to a DHE or an inactive control group. During the 4-week main intervention, DHE members engaged in live-streamed multicomponent home exercise. Subsequently, both groups had access to prerecorded workouts for an additional 4 weeks. Outcomes, assessed weekly, included PA level (Nordic Physical Activity Questionnaire-Short), anxiety (Generalized Anxiety Disorder Scale-7), mental well-being (WHO-5 Questionnaire), sleep quality (Medical Outcome Study Sleep Scale), pain/disability (Chronic Pain Grade Scale) and exercise motivation (Self-Concordance Scale). Mixed models were used for analysis. RESULTS Live-streamed DHE consistently increased moderate PA (eg, week 1: 1.65 times more minutes per week, 95% CI 1.40 to 1.94) and vigorous PA (eg, week 1: 1.31 times more minutes per week, 95% CI 1.08 to 1.61), although the effects decreased over time. In addition, exercise motivation, sleep quality and anxiety were slightly improved for DHE in the 4-week live streaming period. The same applied to mental well-being (mean difference at week 4: +0.99, 95% CI 0.13 to 1.86), but an inverted trend was observed after live streaming was substituted by prerecorded exercise. CONCLUSIONS Live-streamed DHE represents an efficacious method to enhance PA and selected markers of health during pandemic-related public life restrictions. However, research on implementation is warranted to reduce dropout rates. TRIAL REGISTRATION NUMBER DRKS00021273.
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Affiliation(s)
- Jan Wilke
- Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Lisa Mohr
- Department of Sports Medicine and Exercise Physiology, Goethe University, Frankfurt am Main, Germany
| | - Gustavo Yuki
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil
| | - Adelle Kemlall Bhundoo
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences and Biomedical Research Innovation Institute of Cádiz, University of Cádiz, CIBERFES, Cádiz, Spain, Cadiz, Spain
- ImFine Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid; Exercise is Medicine, Madrid, Spain
| | - Fernando Laiño
- Fundación Instituto Superior de Ciencias de la Salud, Buenos Aires, Argentina
| | - Niamh Murphy
- Department of Sport and Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - Bernhard Novak
- Institute of Human Movement Science, Sport and Health, Karl-Franzens-Universitat Graz, Graz, Austria
| | - Stefano Nuccio
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Sonia Ortega-Gómez
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences and Biomedical Research Innovation Institute of Cádiz, University of Cádiz, CIBERFES, Cádiz, Spain, Cadiz, Spain
- ImFine Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid; Exercise is Medicine, Madrid, Spain
| | - Julian David Pillay
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
| | - Falk Richter
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Lorenzo Rum
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Celso Sanchez-Ramírez
- Sciences of Physical Activity, Sports and Health School, Universidad de Santiago de Chile, Santiago de Chile, Chile
| | - David Url
- Institute of Human Movement Science, Sport and Health, Karl-Franzens-Universitat Graz, Graz, Austria
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University, Frankfurt am Main, Germany
| | - Luiz Hespanhol
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil
- Department of Public and Occupational Health and the Amsterdam Public Health research institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
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16
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Enhancing Physical Activity and Psychological Well-Being in College Students during COVID-19 through WeActive and WeMindful Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074144. [PMID: 35409827 PMCID: PMC8998224 DOI: 10.3390/ijerph19074144] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 01/16/2023]
Abstract
This study aimed to examine the immediate and short-term effects of aerobic and resistance training (WeActive) and mindful exercise (WeMindful) virtual interventions in improving physical activity (PA) and resilience among college students. Participants were 55 students who were randomly assigned to either the WeActive group (n = 31) or the WeMindful group (n = 24). Both groups attended two virtual 30 min aerobic and resistance training sessions (WeActive) or mindful exercise sessions (WeMindful) per week for eight weeks. All participants completed the International Physical Activity Questionnaire and the Connor–Davidson Resilience Scale (CD-RISC-10) via Qualtrics one week prior to (pre-test) and after the intervention (post-test) and 6 weeks after the intervention (follow up). There was a significant main effect of time for resilience (F = 3.4.15, p = 0.024), where both the WeActive group and the WeMindful group significantly increased the resilience scores from pre-test to follow up (t = −2.74, p = 0.02; t = −2.54, p = 0.04), respectively. For moderate physical activity (MPA), there was a significant interaction effect of time with group (F = 4.81, p = 0.01, η2 = 0.038), where the WeActive group significantly increased MPA over time from pre-test to follow-up test as compared to the WeMindful group (t = −2.6, p = 0.033). Only the WeActive intervention was effective in increasing MPA. Both interventions were effective in increasing resilience from pre-test to 6 week follow up.
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17
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Lockdowns and Physical Activities: Sports in the Time of COVID. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042175. [PMID: 35206369 PMCID: PMC8872075 DOI: 10.3390/ijerph19042175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/04/2022] [Accepted: 02/10/2022] [Indexed: 12/23/2022]
Abstract
As aging causes challenges in several countries globally, more and more people are suffering from bad health conditions. Nowadays, COVID-19 causes many problems—and one of the root causes of these problems is the isolation of people from each other. The aim of our article is to investigate the effects of COVID-19 on people’s physical activity. Physical activity is strongly correlated with health status and health preservation is very important to minimize the negative effects of the pandemic. In order to investigate this topic, we prepared an extended literature review, citing the most important sources of COVID-related health-preservation issues. Our results showed that the negative economic effects of the coronavirus pandemic have caused a decrease in physical activities in several cases. A reduction in possible physical activities has a potential negative effect on the life expectancies of elderly people. In order to underline the importance of physical activities, we prepared an extended literature review, aiming to summarize the available knowledge related to COVID-19. As a conclusion we recommend to strengthen, maintain, and develop available sporting possibilities for people. The most important of these recommendations is the development of physical activities that are available for free.
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18
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Schroé H, Crombez G, De Bourdeaudhuij I, Van Dyck D. Investigating When, Which, and Why Users Stop Using a Digital Health Intervention to Promote an Active Lifestyle: Secondary Analysis With A Focus on Health Action Process Approach–Based Psychological Determinants. JMIR Mhealth Uhealth 2022; 10:e30583. [PMID: 35099400 PMCID: PMC8845016 DOI: 10.2196/30583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/01/2021] [Accepted: 12/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background Digital health interventions have gained momentum to change health behaviors such as physical activity (PA) and sedentary behavior (SB). Although these interventions show promising results in terms of behavior change, they still suffer from high attrition rates, resulting in a lower potential and accessibility. To reduce attrition rates in the future, there is a need to investigate the reasons why individuals stop using the interventions. Certain demographic variables have already been related to attrition; however, the role of psychological determinants of behavior change as predictors of attrition has not yet been fully explored. Objective The aim of this study was to examine when, which, and why users stopped using a digital health intervention. In particular, we aimed to investigate whether psychological determinants of behavior change were predictors for attrition. Methods The sample consisted of 473 healthy adults who participated in the intervention MyPlan 2.0 to promote PA or reduce SB. The intervention was developed using the health action process approach (HAPA) model, which describes psychological determinants that guide individuals in changing their behavior. If participants stopped with the intervention, a questionnaire with 8 question concerning attrition was sent by email. To analyze when users stopped using the intervention, descriptive statistics were used per part of the intervention (including pre- and posttest measurements and the 5 website sessions). To analyze which users stopped using the intervention, demographic variables, behavioral status, and HAPA-based psychological determinants at pretest measurement were investigated as potential predictors of attrition using logistic regression models. To analyze why users stopped using the intervention, descriptive statistics of scores to the attrition-related questionnaire were used. Results The study demonstrated that 47.9% (227/473) of participants stopped using the intervention, and drop out occurred mainly in the beginning of the intervention. The results seem to indicate that gender and participant scores on the psychological determinants action planning, coping planning, and self-monitoring were predictors of first session, third session, or whole intervention completion. The most endorsed reasons to stop using the intervention were the time-consuming nature of questionnaires (55%), not having time (50%), dissatisfaction with the content of the intervention (41%), technical problems (39%), already meeting the guidelines for PA/SB (31%), and, to a lesser extent, the experience of medical/emotional problems (16%). Conclusions This study provides some directions for future studies. To decrease attrition, it will be important to personalize interventions on different levels, questionnaires (either for research purposes or tailoring) should be kept to a minimum especially in the beginning of interventions by, for example, using objective monitoring devices, and technical aspects of digital health interventions should be thoroughly tested in advance. Trial Registration ClinicalTrials.gov NCT03274271; https://clinicaltrials.gov/ct2/show/NCT03274271 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-019-3456-7
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Affiliation(s)
- Helene Schroé
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
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19
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Feasibility and Effectiveness of the Web-Based WeActive and WeMindful Interventions on Physical Activity and Psychological Well-Being. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8400241. [PMID: 34660800 PMCID: PMC8519690 DOI: 10.1155/2021/8400241] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/14/2021] [Accepted: 09/22/2021] [Indexed: 01/04/2023]
Abstract
This study is aimed at examining the feasibility and effectiveness of aerobic and resistance training (WeActive) and mindful exercise (WeMindful) interventions in improving physical activity (PA), psychological well-being (PWB), and subjective vitality among college students. Participants in this study were 77 college students who were randomly assigned to either the WeActive group (n = 43) or the WeMindful group (n = 28). The WeActive group attended two 30-minute aerobic and resistance training sessions per week, and the WeMindful group attended two 30-minute yoga and mindful exercise sessions per week for eight weeks. All participants completed the International Physical Activity Questionnaire, the World Health Organization-Five Well-Being Index, and the Subjective Vitality Scale before and after the intervention, as well as the Assessing Feasibility and Acceptability Questionnaire at the end of the intervention. The primary study outcome measures were PA, PWB, and subjective vitality. A repeated-measures ANCOVA indicated a significant main effect of time for total PA (F = 7.89, p = 0.006, η 2 = 0.049), vigorous PA (F = 5.36, p = 0.024, η 2 = 0.022), and walking (F = 7.34, p = 0.009, η 2 = 0.042) in both intervention groups. There was a significant interaction effect of time and group for PWB (F = 11.26, p = 0.001, η 2 = 0.022), where the WeActive group experienced a decrease in PWB scores while participants in the WeMindful group experienced an increase in PWB scores over time. There was a main effect of group for subjective vitality (F = 8.91, p = 0.007, η 2 = 0.088), indicating that the WeMindful group experienced a greater increase in subjective vitality than the WeActive group. Further, the participants in both groups indicated that the synchronized and asynchronized Zoom-based WeActive and WeMindful interventions were acceptable, appropriate, and feasible for participants. This study demonstrated that mindful exercise is effective in increasing PA, PWB, and subjective vitality while aerobic and resistance training may only be effective in increasing PA.
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20
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Scarpa MP, Prilletensky I, McMahon A, Myers ND, Prilleltensky O, Lee S, Pfeiffer KA, Bateman AG, Brincks AM. Is Fun For Wellness Engaging? Evaluation of User Experience of an Online Intervention to Promote Well-Being and Physical Activity. FRONTIERS IN COMPUTER SCIENCE 2021. [DOI: 10.3389/fcomp.2021.690389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Online well-being interventions demonstrate great promise in terms of both engagement and outcomes. Fun For Wellness (FFW) is a novel online intervention grounded in self-efficacy theory and intended to improve multidimensional well-being and physical activity through multi-modal methods. These strategies include capability-enhancing opportunities, learning experiences such as games, video vignettes, and self-assessments. RCT studies have suggested that FFW is efficacious in improving subjective and domain-specific well-being, and effective in improving mental health, physical health, physical activity, and self-efficacy in United States. adults who are overweight and in the general population. The present study uses qualitative and quantitative user experience data collected during two RCT trials to understand and evaluate engagement with FFW, its drivers, and its outcomes. Results suggest that FFW is enjoyable, moderately engaging, and easy to use; and contributes to positive outcomes including skill development and enhanced confidence, for both overweight individuals and the general adult population. Drivers of engagement appear to include rewards, gamification, scenario-based learning, visual tracking for self-monitoring, ease of use and simple communications, and the entertaining, interactive nature of program activities. Findings indicate that there are opportunities to streamline and simplify the experience. These results can help improve FFW and contribute to the science of engagement with online interventions designed to improve well-being.
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21
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Woessner MN, Tacey A, Levinger-Limor A, Parker AG, Levinger P, Levinger I. The Evolution of Technology and Physical Inactivity: The Good, the Bad, and the Way Forward. Front Public Health 2021; 9:655491. [PMID: 34123989 PMCID: PMC8193221 DOI: 10.3389/fpubh.2021.655491] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/05/2021] [Indexed: 12/29/2022] Open
Abstract
Since the beginning of time people explored and developed new technologies to make their activities of daily living less labour intense, more efficient and, consequently, more sedentary. In addition, technological advances in medicine throughout history have led to a substantial increase in life expectancy. However, the combination of increased sedentary behaviour and increased life-expectancy resulted in a sharp increase in overweight and obesity related chronic conditions and illness. Although people may live longer, they are doing so with poorer physical function and a reduced quality of life. In this review we explore how technological advances have influenced people's sedentary behaviour and, through the lens of the affective-reflective theory (ART), we propose a means by which technology could be repurposed to encourage greater engagement in physical activity.
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Affiliation(s)
- Mary N Woessner
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia
| | - Alexander Tacey
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
| | | | - Alexandra G Parker
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Pazit Levinger
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia.,National Ageing Research Institute, Melbourne, VIC, Australia.,Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, VIC, Australia
| | - Itamar Levinger
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
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22
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Kariuki JK, Gibbs BB, Erickson KI, Kriska A, Sereika S, Ogutu D, Milton H, Wagner L, Rao N, Peralta R, Bobb J, Bermudez A, Hirshfield S, Goetze T, Burke LE. The feasibility and acceptability of a web-based physical activity for the heart (PATH) intervention designed to reduce the risk of heart disease among inactive African Americans: Protocol for a pilot randomized controlled trial. Contemp Clin Trials 2021; 104:106380. [PMID: 33798731 PMCID: PMC8180502 DOI: 10.1016/j.cct.2021.106380] [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: 12/24/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Many studies have used the internet to promote physical activity (PA) in several settings, including the home environment, but few have been tailored for African Americans (AAs). To address this research gap, we conducted focus groups with AAs to inform the development of a web-based intervention, Physical Activity for The Heart (PATH), that leverages openly accessible platforms, such as YouTube, to promote PA in any setting. PURPOSE To describe the rationale and design of a pilot randomized clinical trial (RCT), that examines the feasibility and acceptability of the PATH intervention among 30 AA adults aged 40--70 years without history of cardiovascular disease. METHODS A 12-week, single-site, wait-listed RCT with subjects randomized 1:1 to either: 1) treatment group - participants receive the PATH intervention, including the online portal and twice a month phone calls from a PA coach, or 2) attention control group - participants receive a self-help PA handout and twice a month general health newsletter. All participants self-monitor step count using actigraphy. The primary outcomes of this 12-week, pilot RCT are recruitment, retention, and adherence to self-monitoring (Actigraph wear time) and the intervention protocol (PATH utilization). The secondary outcomes include changes in PA (step count, moderate-to-vigorous PA, exercise self-efficacy), and cardiometabolic risk (HbA1C, HDL, LDL, total cholesterol, type 2 diabetes risk score, percent body fat, weight, and waist circumference) from baseline to 12 weeks. CONCLUSIONS This study will provide PATH intervention feasibility and acceptability data among inactive AA adults and will inform a future, full-scale RCT testing efficacy.
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Affiliation(s)
| | | | | | | | | | - David Ogutu
- Ritiko Cloud-based Home-care Software, MA, USA
| | | | | | - Neel Rao
- University of Pittsburgh, PA, USA
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23
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Gans KM, Dulin A, Palomo V, Benitez T, Dunsiger S, Dionne L, Champion G, Edgar R, Marcus B. A Tailored Web- and Text-Based Intervention to Increase Physical Activity for Latino Men: Protocol for a Randomized Controlled Feasibility Trial. JMIR Res Protoc 2021; 10:e23690. [PMID: 33512327 PMCID: PMC7880809 DOI: 10.2196/23690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 12/03/2022] Open
Abstract
Background Latino men in the United States report low physical activity (PA) levels and related health conditions (eg, diabetes and obesity). Engaging in regular PA can reduce the risk of chronic diseases and yield many health benefits; however, there is a paucity of interventions developed exclusively for Latino men. Objective To address the need for culturally relevant PA interventions, this study aims to develop and evaluate Hombres Saludables, a 6-month theory-based, tailored web- and text message-based PA intervention in Spanish for Latino men. This protocol paper describes the study design, intervention, and evaluation methods for Hombres Saludables. Methods Latino men aged 18-65 years were randomized to either the individually tailored PA internet intervention arm or the nutrition and wellness internet control arm. The PA intervention included 2 check-in phone calls; automated SMS text messages; a pedometer; a 6-month gym membership; access to a private Facebook group; and an interactive website with PA tracking, goal setting, and individually tailored PA content. The primary outcomes were feasibility, acceptability, and efficacy (minutes per week of total moderate-to-vigorous PA assessed via the ActiGraph GT3X+ accelerometer worn at the waist and 7-day physical activity recall at baseline and 6 months). Secondary outcomes examined potential moderators (eg, demographics, acculturation, and environmental variables) and mediators (eg, self-efficacy and cognitive and behavioral processes of change) of treatment effects at 6 months post randomization. Results This study was funded in September 2016. Initial institutional review board approval was received in February 2017, and focus groups and intervention development were conducted from April 2017 to January 2018. Recruitment for the clinical trial was carried out from February 2018 to July 2019. Baseline data collection was carried out from February 2018 to October 2019, with a total of 43 participants randomized. Follow-up data were collected through April 2020. Data cleaning and analysis are ongoing. Conclusions We developed and tested protocols for a highly accessible, culturally and linguistically relevant, theory-driven PA intervention for Latino men. Hombres Saludables used an innovative, interactive, web- and text message–based intervention for improving PA among Latino men, an underserved population at risk of low PA and related chronic disease. If the intervention demonstrates feasibility, acceptability, and preliminary efficacy, we will refine and evaluate it in a larger randomized control trial. Trial Registration Clinicaltrials.gov: NCT03196570; https://clinicaltrials.gov/ct2/show/NCT03196570 International Registered Report Identifier (IRRID) DERR1-10.2196/23690
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Affiliation(s)
- Kim M Gans
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States.,Department of Behavioral And Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Akilah Dulin
- Department of Behavioral And Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Vanessa Palomo
- Cardiovascular Center for Research and Innovation, Tufts University Medical Center, Boston, MA, United States
| | - Tanya Benitez
- Department of Behavioral And Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Shira Dunsiger
- Department of Behavioral And Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Laura Dionne
- Department of Behavioral And Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Gregory Champion
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
| | - Rachelle Edgar
- Department of Behavioral And Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Bess Marcus
- Department of Behavioral And Social Sciences, Brown University School of Public Health, Providence, RI, United States
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Enciso J, Variya D, Sunthonlap J, Sarmiento T, Lee KM, Velasco J, Pebdani RN, de Leon RD, Dy C, Keslacy S, Won DS. Electromyography-Driven Exergaming in Wheelchairs on a Mobile Platform: Bench and Pilot Testing of the WOW-Mobile Fitness System. JMIR Rehabil Assist Technol 2021; 8:e16054. [PMID: 33464221 PMCID: PMC7854037 DOI: 10.2196/16054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/09/2019] [Accepted: 03/05/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Implementing exercises in the form of video games, otherwise known as exergaming, has gained recent attention as a way to combat health issues resulting from sedentary lifestyles. However, these exergaming apps have not been developed for exercises that can be performed in wheelchairs, and they tend to rely on whole-body movements. OBJECTIVE This study aims to develop a mobile phone app that implements electromyography (EMG)-driven exergaming, to test the feasibility of using this app to enable people in wheelchairs to perform exergames independently and flexibly in their own home, and to assess the perceived usefulness and usability of this mobile health system. METHODS We developed an Android mobile phone app (Workout on Wheels, WOW-Mobile) that senses upper limb muscle activity (EMG) from wireless body-worn sensors to drive 3 different video games that implement upper limb exercises designed for people in wheelchairs. Cloud server recordings of EMG enabled long-term monitoring and feedback as well as multiplayer gaming. Bench testing of data transmission and power consumption were tested. Pilot testing was conducted on 4 individuals with spinal cord injury. Each had a WOW-Mobile system at home for 8 weeks. We measured the minutes for which the app was used and the exergames were played, and we integrated EMG as a measure of energy expended. We also conducted a perceived usefulness and usability questionnaire. RESULTS Bench test results revealed that the app meets performance specifications to enable real-time gaming, cloud storage of data, and live cloud server transmission for multiplayer gaming. The EMG sampling rate of 64 samples per second, in combination with zero-loss data communication with the cloud server within a 10-m range, provided seamless control over the app exergames and allowed for offline data analysis. Each participant successfully used the WOW-Mobile system at home for 8 weeks, using the app for an average of 146 (range 89-267) minutes per week with the system, actively exergaming for an average of 53% of that time (39%-59%). Energy expenditure, as measured by integrated EMG, was found to be directly proportional to the time spent on the app (Pearson correlation coefficient, r=0.57-0.86, depending on the game). Of the 4 participants, 2 did not exercise regularly before the study; these 2 participants increased from reportedly exercising close to 0 minutes per week to exergaming 58 and 158 minutes on average using the WOW-Mobile fitness system. The perceived usefulness of WOW-Mobile in motivating participants to exercise averaged 4.5 on a 5-point Likert scale and averaged 5 for the 3 participants with thoracic level injuries. The mean overall ease of use score was 4.25 out of 5. CONCLUSIONS Mobile app exergames driven by EMG have promising potential for encouraging and facilitating fitness for individuals in wheelchairs who have maintained arm and hand mobility.
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Affiliation(s)
- James Enciso
- Department of Electrical and Computer Engineering, California State University, Los Angeles, Los Angeles, CA, United States
| | | | | | - Terrence Sarmiento
- Department of Electrical and Computer Engineering, California State University, Los Angeles, Los Angeles, CA, United States
| | - Ka Mun Lee
- Department of Electrical and Computer Engineering, California State University, Los Angeles, Los Angeles, CA, United States
| | - James Velasco
- Department of Electrical and Computer Engineering, California State University, Los Angeles, Los Angeles, CA, United States
| | | | - Ray D de Leon
- School of Kinesiology and Nutritional Science, California State University, Los Angeles, Los Angeles, CA, United States
| | - Christine Dy
- School of Kinesiology and Nutritional Science, California State University, Los Angeles, Los Angeles, CA, United States
| | - Stefan Keslacy
- School of Kinesiology and Nutritional Science, California State University, Los Angeles, Los Angeles, CA, United States
| | - Deborah Soonmee Won
- Department of Electrical and Computer Engineering, California State University, Los Angeles, Los Angeles, CA, United States
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Whitsel LP, Bantham A, Jarrin R, Sanders L, Stoutenberg M. Physical activity assessment, prescription and referral in US healthcare: How do we make this a standard of clinical practice? Prog Cardiovasc Dis 2020; 64:88-95. [PMID: 33383058 DOI: 10.1016/j.pcad.2020.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
Numerous guidelines and recommendations reinforce the important role of healthcare providers promoting physical activity (PA) through assessment, prescription, and referral. This paper summarizes what is required to accomplish these actions as a standard of care. The sections describe the importance of measurement development and standardization, the integration of PA into the care continuum, suggested roles and responsibilities for the healthcare team, the role of technology and telehealth in promoting PA, connecting patients to different PA modalities and settings, a summary of the overall regulatory and policy plan to accomplish integration of PA into delivery of care, and areas for future research. Integrating PA assessment, prescription, and referral into delivery of care requires a multi-stakeholder, coordinated effort with government agencies, payers, non-governmental organizations, professional societies, the United States Congress, state legislatures, healthcare systems, and the healthcare industry.
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Abstract
This narrative review of web-delivered weight management, diet quality, and physical activity interventions for cancer survivors relies on a systematic search of PubMed, Psych Info, and EBSCOhost which identified 19 unique web-delivered lifestyle interventions for cancer survivors. The sample sizes for these studies ranged from 11–492. Intervention duration ranged from 1–12 months; however, most interventions were 6–12 weeks in length. Ten studies were randomized controlled trials (RCTs), two were two-arm quasi RCTs, and seven employed a single-arm pre/post-test design. Many (N= 15) of the interventions were well-grounded in behavioral theory, which may have led to favorable behavior change. Most studies (15-of-19) targeted and reported increases in physical activity, while only a few targeted and reported improvements in diet quality (36.9% and 15.8%, respectively) and weight management (26.3% and 10.5%, respectively). A notable limitation was that most studies were conducted among populations that were primarily White and female. Future directions for Internet-based lifestyle interventions for cancer survivors include increasing: (a) focus on multiple behavior change, (b) representation of male and minority populations to improve generalizability of findings, (c) extended intervention duration and follow-up to evaluate long-term efficacy of web-based lifestyle interventions, and (d) sample size to allow for adequate statistical power.
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Taylor AH, Taylor RS, Ingram WM, Anokye N, Dean S, Jolly K, Mutrie N, Lambert J, Yardley L, Greaves C, King J, McAdam C, Steele M, Price L, Streeter A, Charles N, Terry R, Webb D, Campbell J, Hughes L, Ainsworth B, Jones B, Jane B, Erwin J, Little P, Woolf A, Cavanagh C. Adding web-based behavioural support to exercise referral schemes for inactive adults with chronic health conditions: the e-coachER RCT. Health Technol Assess 2020; 24:1-106. [PMID: 33243368 DOI: 10.3310/hta24630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND There is modest evidence that exercise referral schemes increase physical activity in inactive individuals with chronic health conditions. There is a need to identify additional ways to improve the effects of exercise referral schemes on long-term physical activity. OBJECTIVES To determine if adding the e-coachER intervention to exercise referral schemes is more clinically effective and cost-effective in increasing physical activity after 1 year than usual exercise referral schemes. DESIGN A pragmatic, multicentre, two-arm randomised controlled trial, with a mixed-methods process evaluation and health economic analysis. Participants were allocated in a 1 : 1 ratio to either exercise referral schemes plus e-coachER (intervention) or exercise referral schemes alone (control). SETTING Patients were referred to exercise referral schemes in Plymouth, Birmingham and Glasgow. PARTICIPANTS There were 450 participants aged 16-74 years, with a body mass index of 30-40 kg/m2, with hypertension, prediabetes, type 2 diabetes, lower limb osteoarthritis or a current/recent history of treatment for depression, who were also inactive, contactable via e-mail and internet users. INTERVENTION e-coachER was designed to augment exercise referral schemes. Participants received a pedometer and fridge magnet with physical activity recording sheets, and a user guide to access the web-based support in the form of seven 'steps to health'. e-coachER aimed to build the use of behavioural skills (e.g. self-monitoring) while strengthening favourable beliefs in the importance of physical activity, competence, autonomy in physical activity choices and relatedness. All participants were referred to a standard exercise referral scheme. PRIMARY OUTCOME MEASURE Minutes of moderate and vigorous physical activity in ≥ 10-minute bouts measured by an accelerometer over 1 week at 12 months, worn ≥ 16 hours per day for ≥ 4 days including ≥ 1 weekend day. SECONDARY OUTCOMES Other accelerometer-derived physical activity measures, self-reported physical activity, exercise referral scheme attendance and EuroQol-5 Dimensions, five-level version, and Hospital Anxiety and Depression Scale scores were collected at 4 and 12 months post randomisation. RESULTS Participants had a mean body mass index of 32.6 (standard deviation) 4.4 kg/m2, were referred primarily for weight loss and were mostly confident self-rated information technology users. Primary outcome analysis involving those with usable data showed a weak indicative effect in favour of the intervention group (n = 108) compared with the control group (n = 124); 11.8 weekly minutes of moderate and vigorous physical activity (95% confidence interval -2.1 to 26.0 minutes; p = 0.10). Sixty-four per cent of intervention participants logged on at least once; they gave generally positive feedback on the web-based support. The intervention had no effect on other physical activity outcomes, exercise referral scheme attendance (78% in the control group vs. 75% in the intervention group) or EuroQol-5 Dimensions, five-level version, or Hospital Anxiety and Depression Scale scores, but did enhance a number of process outcomes (i.e. confidence, importance and competence) compared with the control group at 4 months, but not at 12 months. At 12 months, the intervention group incurred an additional mean cost of £439 (95% confidence interval -£182 to £1060) compared with the control group, but generated more quality-adjusted life-years (mean 0.026, 95% confidence interval 0.013 to 0.040), with an incremental cost-effectiveness ratio of an additional £16,885 per quality-adjusted life-year. LIMITATIONS A significant proportion (46%) of participants were not included in the primary analysis because of study withdrawal and insufficient device wear-time, so the results must be interpreted with caution. The regression model fit for the primary outcome was poor because of the considerable proportion of participants [142/243 (58%)] who recorded no instances of ≥ 10-minute bouts of moderate and vigorous physical activity at 12 months post randomisation. FUTURE WORK The design and rigorous evaluation of cost-effective and scalable ways to increase exercise referral scheme uptake and maintenance of moderate and vigorous physical activity are needed among patients with chronic conditions. CONCLUSIONS Adding e-coachER to usual exercise referral schemes had only a weak indicative effect on long-term rigorously defined, objectively assessed moderate and vigorous physical activity. The provision of the e-coachER support package led to an additional cost and has a 63% probability of being cost-effective based on the UK threshold of £30,000 per quality-adjusted life-year. The intervention did improve some process outcomes as specified in our logic model. TRIAL REGISTRATION Current Controlled Trials ISRCTN15644451. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 63. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Adrian H Taylor
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Rod S Taylor
- University of Exeter Medical School, University of Exeter, Exeter, UK.,Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Wendy M Ingram
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Nana Anokye
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Sarah Dean
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Jeffrey Lambert
- University of Exeter Medical School, University of Exeter, Exeter, UK.,Department for Health, University of Bath, Bath, UK
| | - Lucy Yardley
- School of Social and Community Medicine, University of Bristol, Bristol, UK.,Centre for Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Colin Greaves
- University of Exeter Medical School, University of Exeter, Exeter, UK.,School of Sport, Exercise and Rehabilitation, University of Birmingham, Birmingham, UK
| | - Jennie King
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Chloe McAdam
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Mary Steele
- Centre for Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Lisa Price
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Adam Streeter
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | | | - Rohini Terry
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Douglas Webb
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK.,Bristol Medical School, University of Bristol, Bristol, UK
| | - John Campbell
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Lucy Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Ben Ainsworth
- Centre for Applications of Health Psychology, University of Southampton, Southampton, UK.,Department of Psychology, University of Bath, Bath, UK
| | - Ben Jones
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Ben Jane
- School of Sport, Health and Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Jo Erwin
- Bone and Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Paul Little
- Centre for Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Anthony Woolf
- Bone and Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
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Rubin DS, Rich Severin, Arena R, Bond S. Leveraging technology to move more and sit less. Prog Cardiovasc Dis 2020; 64:55-63. [PMID: 33129794 DOI: 10.1016/j.pcad.2020.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
One of the major changes in the updated physical activity (PA) guidelines is the recommendation for adults to simply move more and sit less throughout the day. This recommendation comes during a time of proliferation and advancement of personal health technologies that allow adults greater access to interventions to increase PA. Wearable activity monitors provide direct feedback of activity levels allowing users to reach PA targets throughout the day. Gamification of these and other devices can engage users and sustain their motivation to increase PA, along with the formation of social networks through social media platforms. This review will discuss and present an overview of current technologies that can be leveraged to increase PA in adults. Specific attention will be paid to wearable activity monitors, gamification and social network platforms that can help adults increase and sustain their PA levels to improve their overall health.
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Affiliation(s)
- Daniel S Rubin
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Rich Severin
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, USA
| | - Ross Arena
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, USA
| | - Samantha Bond
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Biomedical & Health Information Science, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, USA
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Wurst R, Maliezefski A, Ramsenthaler C, Brame J, Fuchs R. Effects of Incentives on Adherence to a Web-Based Intervention Promoting Physical Activity: Naturalistic Study. J Med Internet Res 2020; 22:e18338. [PMID: 32729835 PMCID: PMC7426800 DOI: 10.2196/18338] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/02/2020] [Accepted: 05/13/2020] [Indexed: 11/18/2022] Open
Abstract
Background Despite many advantages of web-based health behavior interventions such as wide accessibility or low costs, these interventions are often accompanied by high attrition rates, particularly in usage under real-life conditions. It would therefore be helpful to implement strategies such as the use of financial incentives to motivate program participation and increase adherence. Objective This naturalistic study examined real-life usage data of a 12-week web-based physical activity (PA) intervention (Fitness Coach) among insurants who participated in an additional incentive program (incentive group) and those who did not (nonincentive group). Users in the incentive group had the perspective of receiving €30 (about US $33) cash back at the end of the intervention. Methods Registration and real-life usage data as part of routine data management and evaluation of the Fitness Coach were analyzed between September 2016 and June 2018. Depending on the duration of use and the weekly recording of tasks, 4 adherence groups (low, occasional, strong, and complete adherence) were defined. Demographic characteristics were collected by a self-reported questionnaire at registration. We analyzed baseline predictors and moderators of complete adherence such as participation in the program, age, gender, and BMI using binary logistic regressions. Results A total of 18,613 eligible persons registered for the intervention. Of these, 15,482 users chose to participate in the incentive program (incentive group): mean age 42.4 (SD 14.4) years, mean BMI 24.5 (SD 4.0) kg/m2, median (IQR) BMI 23.8 (21.7-26.4) kg/m2; 65.12% (10,082/15,482) female; and 3131 users decided not to use the incentive program (nonincentive group): mean age 40.7 (SD 13.4) years, mean BMI 26.2 (SD 5.0) kg/m2, median BMI 25.3 (IQR 22.6-28.7) kg/m2; 72.18% (2260/3131) female. At the end of the intervention, participants in the incentive program group showed 4.8 times higher complete adherence rates than those in the nonincentive program group (39.2% vs 8.1%), also yielding significantly higher odds to complete the intervention (odds ratio [OR] 12.638) for the incentive program group. Gender significantly moderated the effect with men in the incentive group showing higher odds to be completely adherent than women overall and men in the nonincentive group (OR 1.761). Furthermore, older age and male gender were significant predictors of complete adherence for all participants, whereas BMI did not predict intervention completion. Conclusions This is the first naturalistic study in the field of web-based PA interventions that shows the potential of even small financial incentives to increase program adherence. Male users, in particular, seem to be strongly motivated by incentives to complete the intervention. Based on these findings, health care providers can use differentiated incentive systems to increase regular participation in web-based PA interventions.
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Affiliation(s)
- Ramona Wurst
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | | | | | - Judith Brame
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Reinhard Fuchs
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
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Navarro J, Cebolla A, Llorens R, Borrego A, Baños RM. Manipulating Self-Avatar Body Dimensions in Virtual Worlds to Complement an Internet-Delivered Intervention to Increase Physical Activity in Overweight Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114045. [PMID: 32517117 PMCID: PMC7312466 DOI: 10.3390/ijerph17114045] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 01/13/2023]
Abstract
Virtual reality has been found to be a useful tool for positively influencing relevant psychological variables in order to increase physical activity (PA), especially in the overweight population. This study investigates the use of avatars and their physical variations to extend the effectiveness of existing interventions to promote PA. The main objective is to analyze the influence of the avatars' body dimensions on the efficacy of an Internet intervention to increase PA levels and improve other relevant variables (motivation toward PA, enjoyment, anxiety, self-efficacy, and PA goals). A total of 42 overweight women received a brief online intervention, and they were randomly assigned to one of three conditions: the "Ideal avatar" (IAC: participants are represented by avatars with ideal body dimensions); the "Real avatar" (RAC: participants are represented by avatars with participants' current body dimensions); and the "Non avatar" (NAC: participants are not represented by avatars). Results showed that the online intervention was effective in increasing PA practice and self-efficacy expectations. However, manipulating the body dimensions of avatars did not improve this intervention, although ideal avatars helped to reduce the anxiety experienced during PA in this population.
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Affiliation(s)
- Jessica Navarro
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, 46010 Valencia, Spain; (A.C.); (R.M.B.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-96-386-44-12
| | - Ausiàs Cebolla
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, 46010 Valencia, Spain; (A.C.); (R.M.B.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute, 28029 Madrid, Spain
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto de investigación e Innovación en Bioingenieria, Universitat Politécnica de Valencia, 46022 Valencia, Spain; (R.L.); (A.B.)
- NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, 46007 Valencia, Spain
| | - Adrián Borrego
- Neurorehabilitation and Brain Research Group, Instituto de investigación e Innovación en Bioingenieria, Universitat Politécnica de Valencia, 46022 Valencia, Spain; (R.L.); (A.B.)
| | - Rosa M. Baños
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, 46010 Valencia, Spain; (A.C.); (R.M.B.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute, 28029 Madrid, Spain
- Polibienestar Institute, 46022 Valencia, Spain
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Ballin M, Hult A, Björk S, Dinsmore J, Nordström P, Nordström A. Digital exercise interventions for improving measures of central obesity: a systematic review. Int J Public Health 2020; 65:593-605. [PMID: 32410008 PMCID: PMC7224590 DOI: 10.1007/s00038-020-01385-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/22/2020] [Accepted: 05/02/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES We aimed to systematically review the potential benefits of digital exercise interventions for improving measures of central obesity including visceral adipose tissue (VAT) and anthropometric surrogates for VAT in overweight or centrally obese adults aged 18 or over. METHODS A systematic literature search was conducted in three databases up until March 2020 (PROSPERO registration nr CRD42019126764). RESULTS N = 5 studies including 438 participants (age 48-80) with body mass index ≥ 25 kg/m2 met the eligibility criteria and were included. The duration of the interventions ranged from 8 to 24 weeks. No study measured the primary outcome VAT, although in N = 4 studies, waist circumference (WC) decreased by between 1.3 and 5.6 cm in the intervention groups. CONCLUSIONS This systematic review shows that there is no evidence for the effects of digital exercise on VAT, although digital exercise may decrease WC. These findings highlight the need for additional randomized controlled trials to confirm the findings with respect to WC, and to further investigate the effects of digital exercise on VAT. Together, this may have important implications for reducing the burden of physical inactivity and obesity.
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Affiliation(s)
- Marcel Ballin
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden.
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
| | - Andreas Hult
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, Umeå, Sweden
| | - Sabine Björk
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | - John Dinsmore
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Ballin M, Hult A, Björk S, Lundberg E, Nordström P, Nordström A. Web-based exercise versus supervised exercise for decreasing visceral adipose tissue in older adults with central obesity: a randomized controlled trial. BMC Geriatr 2020; 20:173. [PMID: 32398024 PMCID: PMC7216357 DOI: 10.1186/s12877-020-01577-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Visceral adipose tissue (VAT) is a strong risk factor for cardiovascular disease and increases with age. While supervised exercise (SE) may be an effective approach, web-based exercise (WE) have other advantages such as being more readily accessible. Therefore, we evaluated the effects of WE on VAT, body composition and cardiometabolic risk markers in centrally obese older adults and compared the effects of WE to SE. We also explored the feasibility of WE. METHODS In a randomized controlled trial conducted in Umeå, Sweden during January 2018 - November 2018, N = 77, 70-year-old men and women with central obesity (> 1 kg VAT for women, > 2 kg for men) were randomized to an intervention group (n = 38) and a wait-list control group (n = 39). The intervention group received 10 weeks of SE while the wait-list control group lived as usual. Following a 10-week wash-out-period, the wait-list control group received 10 weeks of WE. The primary outcome was changes in VAT. Secondary outcomes included changes in fat mass (FM), lean body mass (LBM), blood lipids, fasting blood glucose. Additionally, we explored the feasibility of WE defined as adherence and participant experiences. RESULTS WE had no significant effect on VAT (P = 0.5), although it decreased FM by 450 g (95% confidence interval [CI], 37 to 836, P < 0.05). The adherence to WE was 85% and 87-97% of the participants rated aspects of the WE intervention > 4 on a scale of 1-5. Comparing SE to WE, there was no significant difference in decrease of VAT (Cohen's δ effect size [ES], 0.5, 95% CI, - 24 to 223, P = 0.11), although SE decreased FM by 619 g (ES, 0.5, 95% CI, 22 to 1215, P < 0.05) compared to WE. CONCLUSIONS Ten weeks of vigorous WE is insufficient to decrease VAT in centrally obese older adults, but sufficient to decrease FM while preserving LBM. The high adherence and positive experiences of the WE intervention implies that it could serve as an alternative exercise strategy for older adults with central obesity, with increased availability for a larger population. TRIAL REGISTRATION ClinicalTrials.gov (NCT03450655), retrospectively registered February 28, 2018.
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Affiliation(s)
- Marcel Ballin
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden. .,Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
| | - Andreas Hult
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, Umeå, Sweden
| | - Sabine Björk
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
| | - Emmy Lundberg
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Pischke CR, Voelcker-Rehage C, Peters M, Ratz T, Pohlabeln H, Meyer J, von Holdt K, Lippke S. Implementation and Effects of Information Technology-Based and Print-Based Interventions to Promote Physical Activity Among Community-Dwelling Older Adults: Protocol for a Randomized Crossover Trial. JMIR Res Protoc 2020; 9:e15168. [PMID: 32338622 PMCID: PMC7215507 DOI: 10.2196/15168] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/13/2019] [Accepted: 01/27/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Despite the known health benefits of physical activity (PA), less than half and less than one-third of older adults in Germany reach the PA recommendations for endurance training and strength training, respectively, of the World Health Organization. The aim of this study is to investigate the implementation and effectiveness over the course of 9 months of two interventions (information technology [IT]-based vs print-based) for PA promotion among initially inactive older adults in a randomized, crossover trial. This study is part of a large research consortium (2015-2021) investigating different aspects of PA promotion. The IT-based intervention was previously developed and refined, while the print-based intervention was newly developed during this funding phase. OBJECTIVE We aim to compare the effectiveness and examine the preferences of study participants regarding both delivery modes. METHODS Our target sample size was 390 initially inactive community-dwelling older adults aged ≥60 years at baseline (3-month follow-up [T1]: expected n=300; 9-month follow-up [T2]: expected n=240) who were randomized to one of two interventions for self-monitoring PA: IT-based (50%) or print-based (50%) intervention. In addition, 30% of the IT-based intervention group received a PA tracker. At T1, participants in both groups could choose whether they prefered to keep their assigned intervention or cross over to the other group for the following 6 months (T2). Participants' intervention preferences at baseline were collected retrospectively to run a post hoc matched-mismatched analysis. During the initial 3-month intervention period, both intervention groups were offered weekly group sessions that were continued monthly between T1 and T2. A self-administered questionnaire and 3D accelerometers were employed to assess changes in PA between baseline, T1, and T2. Adherence to PA recommendations, attendance at group sessions, and acceptance of the interventions were also tracked. RESULTS The funding period started in February 2018 and ends in January 2021. We obtained institutional review board approval for the study from the Medical Association in Bremen on July 3, 2018. Data collection was completed on January 31, 2020, and data cleaning and analysis started in February 2020. We expect to publish the first results by the end of the funding period. CONCLUSIONS Strategies to promote active aging are of particular relevance in Germany, as 29% of the population is projected to be ≥65 years old by 2030. Regular PA is a key contributor to healthy aging. This study will provide insights into the acceptance and effectiveness of IT-based vs print-based interventions to promote PA in initially inactive individuals aged ≥60 years. Results obtained in this study will improve the existing evidence base on the effectiveness of community-based PA interventions in Germany and will inform efforts to anchor evidence-based PA interventions in community structures and organizations via an allocation of permanent health insurance funds. TRIAL REGISTRATION German Registry of Clinical Trials DRKS00016073; https://tinyurl.com/y983586m. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15168.
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Affiliation(s)
- Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Manuela Peters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Tiara Ratz
- Jacobs University Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Jochen Meyer
- OFFIS - Institute for Information Technology, Oldenburg, Germany
| | - Kai von Holdt
- OFFIS - Institute for Information Technology, Oldenburg, Germany
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Engagement with a Web-Based Health Promotion Intervention among Vocational School Students: A Secondary User and Usage Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072180. [PMID: 32218251 PMCID: PMC7177298 DOI: 10.3390/ijerph17072180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 12/27/2022]
Abstract
Engagement with web-based interventions is both generally low and typically declining. Visits and revisits remain a challenge. Based on log data of a web-based cluster randomized controlled trial conducted in vocational schools, the present secondary analysis aimed to identify influencing factors on initially logging in to a health promotion platform among young adults and to examine the engagement over the course of an eight-week intervention. Data of 336 students (62.2% female, age span 18–25) from two intervention arms (web-based intervention and web-based intervention with an additional initial face-to-face contact) was included. Binary logistic regression and log-data visualization were performed. An additional initial face-to-face contact (odds ratio (OR) = 2.971, p = 0.005), female sex (OR = 2.237, p = 0.046) and the health-related skill “dealing with health information” (OR = 2.179, p = 0.030) significantly increased the likelihood of initially logging in. Other variables showed no influence. 16.6% of all potential users logged in at least once, of which 57.4% revisited the platform. Most logins were tracked at the beginning of the intervention and repeated engagement was low. To increase the engagement with web-based interventions, health-related skills should be fostered. In addition, a strategy could be to interlink comparable interventions in vocational schools more regularly with everyday teaching through multi-component interventions.
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Faries MD, Lopez ML, Faries E, Keenan K, Green SD. Evaluation of Walk Across Texas! - a web-based community physical activity program. BMC Public Health 2019; 19:1588. [PMID: 31779598 PMCID: PMC6883669 DOI: 10.1186/s12889-019-7918-3] [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: 07/10/2019] [Accepted: 11/08/2019] [Indexed: 11/15/2022] Open
Abstract
Background In response to the chronic disease burden, web- and community-based programs have the potential to address targeted behaviors, such as physical activity (PA), using a novel approach with large audiences. The purpose of this study was to preliminarily evaluate an established team centered, web-based community PA program in Texas. Methods Walk Across Texas! (WAT!) is an eight-week community program delivered through a web-based platform to help people of various ages and abilities establish the habit of regular PA. Teams are challenged to walk a minimum of 832 miles. Changes in self-reported PA (miles/week; days/week) and leisure-time sitting (hours/day) were examined from 11,116 adult participants who participated in the program in 2016. Further analysis determined changes in physical activity (miles/week) between groups of pre-program assessment self-reported physical activity levels (0, 1–2, 3–4, or 5–7 days/week). Statistical analysis included paired-sample t-tests, repeated measures ANOVA and participant descriptors for PA change. Results Overall, mean changes in PA in all variables were statistically significant (p < .001), with the largest, clinically significant changes in submitted miles/week (mean increase of 4.89 ± 20.92). Self-reported PA increased 0.63 ± 2.89 days/week, while leisure-time sitting decreased less than 1 h per day (0.87 ± 1.86 h/day). All sub-groups (inactive, low active, active, high active at pre-program assessment) increased in self-reported miles per week, on average. Both the inactive and low-active groups experienced a statistically significant increase in mileage from week 1 to week 8 (5.48 miles/week or 12,330 steps /week, and 3.91 miles/week or 8797 steps /week, respectively). Conclusions The results provide initial support for the effectiveness of WAT! to initially increase and maintain moderate levels of PA of participants over 8-weeks, even in inactive or low-active participants. Descriptor variables were unable to differentiate between those who increased PA and those who did not. However; the results provide a canvas for future research questions regarding PA enhancement within a team-centered, web-based approach.
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Affiliation(s)
- Mark D Faries
- Family & Community Health, Texas A&M AgriLife Extension Service, College Station, TX, USA. .,School of Public Health, Texas A&M Health Science Center, College Station, TX, USA.
| | - Michael L Lopez
- Family & Community Health, Texas A&M AgriLife Extension Service, College Station, TX, USA
| | | | - Kristen Keenan
- School of Public Health, Texas A&M Health Science Center, College Station, TX, USA
| | - Stephen D Green
- Family & Community Health, Texas A&M AgriLife Extension Service, College Station, TX, USA
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Feng NC, Ryan E, Kidane M, Tusch ES, McFeeley BM, Carlsson R, Mohammed AH, Håkansson K, Daffner KR. Feasibility of an at-home, web-based, interactive exercise program for older adults. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2019; 5:825-833. [PMID: 31799367 PMCID: PMC6883315 DOI: 10.1016/j.trci.2019.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction Increased physical exercise is linked to enhanced brain health and reduced dementia risk. Exercise intervention studies usually are conducted at facilities in groups under trainer supervision. To improve scalability, accessibility, and engagement, programs may need to be structured such that individuals can execute and adjust routines in their own homes. Methods One hundred eighty-three healthy older adults from two sites (the United States and Sweden) were screened. One hundred fifty-six subjects (mean age 73.2), randomly assigned to one of four interventions (PACE-Yourself physical exercise program, mindfulness meditation, or Cogmed® adaptive or nonadaptive computerized working memory training) began the study. All interventions were structurally similar: occurring in subjects' homes using interactive, web-based software, over five weeks, ∼175 minutes/week. In the PACE-Yourself program, video segments presented aerobic exercises at different pace and intensity (P&I). The program paused frequently, allowing subjects to indicate whether P&I was “too easy,” “too hard,” or “somewhat hard.” P&I of the subsequent exercise set was adjusted, allowing subjects to exercise at a perceived exertion level of “somewhat hard.” Program completion was defined as finishing ≥60% of sessions. Results A high percentage of participants in all groups completed the program, although the number (86%) was slightly lower in the PACE-Yourself group than the other three. Excluding dropouts, the PACE-Yourself group had a lower adherence rate of 93%, compared with the other three (∼98%). Over the five weeks, PACE-Yourself participants increased exercising at the highest intensity level, consistent with augmented aerobic activity over time. The number of exercise sessions completed predicted the postintervention versus preintervention increase in self-reported level of physical activity. Discussion This study supports the feasibility of a home-based, subject-controlled, exercise program in which P&I is regulated via real-time participant feedback, which may promote self-efficacy. Further study is needed to determine if similar results are found over longer periods and in more diverse populations. Physical exercise is linked to enhanced brain health and reduced dementia risk. PACE-Yourself is an interactive, web-based exercise program. Its novel design allows participants to regulate exercise pace and intensity. Older adults in the program had high completion and adherence rates. PACE-Yourself may facilitate scalability and accessibility of exercise programs.
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Affiliation(s)
- Nicole C Feng
- Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Eliza Ryan
- Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Mhretab Kidane
- Department of Computer Science and Media Technology, Linnaeus University, Växjö, Sweden
| | - Erich S Tusch
- Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Brittany M McFeeley
- Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Roger Carlsson
- Department of Psychology, Linnaeus University, Växjö, Sweden
| | - Abdul H Mohammed
- Department of Psychology, Linnaeus University, Växjö, Sweden.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Krister Håkansson
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Kirk R Daffner
- Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
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The Effectiveness of Physical Activity Interventions for Low-Income and Ethnic Minority Children and Youths: A Meta-Analysis. J Phys Act Health 2019; 16:799-808. [DOI: 10.1123/jpah.2018-0648] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/06/2019] [Accepted: 04/23/2019] [Indexed: 11/18/2022]
Abstract
Background: Children and youths from low-income families and certain ethnic minority groups show high levels of risk and vulnerability to physical inactivity. The aim of this review was to examine the effectiveness of interventions to increase physical activity (PA) in children and youths from low-income and ethnic minority (LIEM) families. Methods: Eight databases were systematically searched for PA interventions for LIEM children and youths. Twenty-six studies were included in the analyses. Effect sizes (ESs) were calculated using a random-effects model. The ESs were computed using Hedges g with 95% confidence interval. Results: There were small to medium effects of interventions on PA in LIEM children and youth (Q = 1499.193, df = 30, P < .05; I2 = 97.999). Analyses on the moderator variables showed that ES for participants aged 9–12 years (ES = 0.542, P = .01); intervention length less than 13 weeks (ES = 0.561, P = .01); specialists as the intervention agent (ES = 0.680, P < .05); interventions without technology (ES = 0.363, P = .02); and interventions with a behavioral modification component (ES = 0.336, P = .03) were significantly different from zero. Conclusion: PA intervention can be an effective strategy to increase PA for LIEM children and youths.
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McGuire AM, Seib C, Porter-Steele J, Anderson DJ. The Association Between Web-Based or Face-to-Face Lifestyle Interventions on the Perceived Benefits and Barriers to Exercise in Midlife Women: Three-Arm Equivalency Study. J Med Internet Res 2019; 21:e10963. [PMID: 31436162 PMCID: PMC6724500 DOI: 10.2196/10963] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 11/19/2018] [Accepted: 03/30/2019] [Indexed: 01/14/2023] Open
Abstract
Background Noncommunicable diseases pose a significant threat to women’s health globally, with most diseases being attributed to modifiable risk factors such as physical inactivity. Women perceive a range of benefits and barriers to exercise; however, there is little evidence about the effect of different lifestyle intervention delivery modes on perceptions of exercise. Objective This study aimed to compare the effect of a multiple health behavior change (MHBC) intervention called the Women’s Wellness Program. This intervention was delivered in 3 different modes on perceived exercise benefits, perceived exercise barriers, and actual physical activity and exercise in midlife women. Methods Women aged 45 to 65 years were recruited via the study website. They were assigned in blocks to 3 different treatment groups (A: Web-based independent; B: face-to-face with nurse consultations; and C: Web-based with virtual nurse consultations). All participants received the 12-week intervention that utilizes principles from social-cognitive theory to provide a structured guide to promote healthy lifestyle behaviors with an emphasis on regular exercise and healthy eating. Data were collected using a self-report Web-based questionnaire at baseline (T1) and postintervention (T2) including perceived exercise benefits and barriers and exercise and physical activity. A data analysis examined both within- and between-group changes over time. Results Participants in this study (N=225) had a mean age of 50.9 years (SD 5.9) and most were married or living with a partner (83.3%, 185/225). Attrition was 30.2% with 157 participants completing the final questionnaire. Women in all intervention groups reported a significant increase in positive perceptions of exercise (P<.05); a significant increase in exercise and overall physical activity (P<.01) with moderate-to-large effect sizes noted for overall physical activity (d=0.5 to d=0.87). Participants receiving support from registered nurses in the face-to-face and Web-based groups had a greater magnitude of change in benefit perceptions and physical activity than those in the Web-based independent group. There was no significant change in exercise barrier perceptions within or between groups over time. Conclusions The results of this study suggest that the (MHBC) intervention is effective in increasing exercise benefit perceptions, overall physical activity, and exercise in midlife women. Although Web-based programs are cost-effective and flexible and can be delivered remotely, providing a range of options including face-to-face group delivery and personalized electronic health coaching from registered nurses has the potential to enhance participant engagement and motivation.
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Affiliation(s)
- Amanda Mary McGuire
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Charrlotte Seib
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Janine Porter-Steele
- Menzies Health Institute Queensland, Griffith University, Southport, Australia.,Wesley Hospital, Brisbane, Australia
| | - Debra Jane Anderson
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
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Fischer X, Kreppke JN, Zahner L, Gerber M, Faude O, Donath L. Telephone-Based Coaching and Prompting for Physical Activity: Short- and Long-Term Findings of a Randomized Controlled Trial (Movingcall). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2626. [PMID: 31340528 PMCID: PMC6678542 DOI: 10.3390/ijerph16142626] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/18/2019] [Accepted: 07/20/2019] [Indexed: 12/15/2022]
Abstract
This study analyzed the short- and long-term efficacy of telephone coaching and short message service (SMS) prompting for physical activity (PA) promotion. Two-hundred-and-eighty-eight adults (age: 42 ± 11 years) were assigned randomly to three intervention arms: The intervention groups received 12 bi-weekly telephone calls with (coaching and SMS group) or without (coaching group) additional SMS prompts (n = 48 SMS). The control group received a single written PA recommendation. Self-reported and objective moderate-to-vigorous physical activity (MVPA) levels were assessed by a structured interview and by accelerometer at baseline, after the intervention (6 months), as well as after a no-contact follow-up (12 months). At post-test, self-reported MVPA increased by 173 min/week (95% CI 95 to 252) in the coaching group and by 165 min/week (95% CI 84 to 246) in the coaching and SMS group compared to control. These group differences remained similar in the follow-up test. For the objectively assessed MVPA, the coaching group increased by 32 min/week (95% CI 0.1 to 63) and the coaching and SMS group by 34 min/week (95% CI 1.6 to 66) compared to the control group. In the follow-up test, the objective MVPA levels of the intervention groups no longer differed from baseline, but group differences persisted as the control group decreased below baseline. Additional SMS prompts did not result in a further increase in PA. Telephone coaching can be considered an effective tool for PA promotion.
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Affiliation(s)
- Xenia Fischer
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Jan-Niklas Kreppke
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, 50933 Köln, Germany
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Huang SJ, Hung WC, Shyu ML, Chang KC, Chen CK. Web-based intervention to promote physical activity in Taiwanese children. J Pediatr Nurs 2019; 45:e35-e43. [PMID: 30700375 DOI: 10.1016/j.pedn.2018.12.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/30/2018] [Accepted: 12/31/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE This study investigated the effectiveness of a theory-based, technology-integrated website in promoting the physical activity of schoolchildren. DESIGN AND METHODS A website designed using a self-management strategy and supplemented with a geographical information system (GIS) mapping function was used to increase children's physical activity levels. A total of 524 students from six elementary schools in Taipei City completed surveys at three times during 2010 and were assigned to one of three groups: (1) a self-management group, using a website employing a goal-setting strategy and a storytelling schema based on a classical Chinese novel; (2) a knowledge-only group that was given only access to the website; or (3) a control group that was only given lectures and not allowed to access the website. RESULTS After adjustment for the effects of the pretest, the self-management and knowledge-only groups were found to be more physically active and have higher self-efficacy than the control group. Moreover, the self-management group had higher scores for these two variables than the knowledge-only group. Furthermore, the intervention was more effectives for male students than female students. CONCLUSION Overall, the self-management website proved to be effective in promoting schoolchildren's physical activity. The positive correlation of self-efficacy with the ability to handle the difficulties inherent in physical activity continued for 3 months after the intervention was completed.
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Affiliation(s)
- Sheu-Jen Huang
- Department of Health Promotion & Health Education, National Taiwan Normal University, Taipei, Taiwan.
| | - Wen-Chi Hung
- Department of Oral Hygiene & Healthcare, Cardinal Tien Junior College of Healthcare and Management, New Taipei City, Taiwan
| | - Meei-Ling Shyu
- School of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Kuo-Chen Chang
- Department of Geography, National Taiwan Normal University, Taipei, Taiwan.
| | - Chun-Kai Chen
- Disaster Prevention Technology Research Center, Sino Technology Company, Taipei City, Taiwan
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A Systematic Review of Electronic and Mobile Health (e- and mHealth) Physical Activity Interventions for African American and Hispanic Women. J Phys Act Health 2019; 16:230-239. [PMID: 30782040 DOI: 10.1123/jpah.2018-0103] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The purpose of this systematic review was to evaluate the existing scientific literature on e- and mHealth interventions promoting physical activity (PA) among African American (AA) and Hispanic women. METHODS Using Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, 5 electronic databases and gray literature sources were searched in August 2017. Inclusion criteria are published in English language peer-reviewed journals between 2000 and 2017, use of an e- or mHealth delivery strategy to promote PA, primary focus on AA or Hispanic women, and reported PA outcome data. RESULTS Ten articles met inclusion criteria for review, 6 studies focused on AA women and 4 studies on Hispanic women. The majority (n = 8) were pilot studies; only 2 studies were full-scale randomized controlled trials and both focused on Hispanic women. Six studies (60%) used websites as the primary method of intervention delivery, 3 studies (30%) used text messaging, and 1 study (10%) used the social networking website Facebook. In total, 70% of the studies (n = 7) reported significant within- or between-group differences for at least 1 PA outcome. CONCLUSIONS Findings provide preliminary support for e- and mHealth PA interventions among AA and Hispanic women. However, future large-scale, rigorously designed, randomized controlled trials are needed to further explore their effectiveness among AA and Hispanic women.
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Sharaievska I, Battista RA, Zwetsloot J. Use of Physical Activity Monitoring Devices by Families in Rural Communities: Qualitative Approach. JMIR Pediatr Parent 2019; 2:e10658. [PMID: 31518327 PMCID: PMC6715065 DOI: 10.2196/10658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 09/30/2018] [Accepted: 12/10/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Several studies support the impact of information communication technology-based interventions to promote physical activity among youth. However, little is known on how technology can be used by the entire family to encourage healthy behavior. Previous studies showed that children and youth rely and are dependent upon the decisions and values of their caregivers when it comes to having a healthy lifestyle. Thus, the exploration of behavior and attitudes of the entire family is needed. OBJECTIVE The study aimed to explore (1) perceptions of how the use of physical activity tracking devices (Fitbit Zip) by families in rural communities influence their patterns of participation in physical activity, (2) how attitudes toward physical activity change as a result of using physical activity tracking devices as a family, and (3) what factors influence participation in physical activity among families in rural communities. METHODS A total of 11 families with 1 to 3 children of different ages (7-13 years) took part in semistructured group interviews following 2 weeks of using physical activity tracking devices (Fitbit Zip) as a family. The participants were asked to discuss their experience using the Fitbit Zip as a family, the motivation to be physically active, the changes in their pattern of participation in those activities, the level of engagement by different family members, and the factors that affected their participation. All interviews were voice-recorded with the participants' permission and later transcribed verbatim using pseudonyms. To analyze the data, the principal investigator (IS) used open, axial, and selective coding techniques. RESULTS A total of 3 themes and several subthemes appeared from the data. The families in rural communities reported no or minimal changes in physical activities as a result of using physical activity tracking devices (Fitbit Zip) because of a lack of interest or an already active lifestyle. However, the attitude toward physical activity was altered. The family members reported an increased awareness of their activity level, introduced more conversations about active and healthy lifestyles, and changed their view of physical activity to a more positive one. The participants described the changes they were able to make and the constraining factors that stopped them from making further changes in their lifestyle. CONCLUSIONS Technology might serve as a facilitator to participation in physical activity among families. Technology can motivate the change in attitude toward active recreation. As long-term changes in lifestyle require internal motivation, the change in the attitude might have a more long-lasting impact than the change in the immediate behavior. More longitudinal studies are needed to further explore long-term change in both behavior and attitude toward physical activity. Additional exploration of constraints to participation in physical activity among families is also an important area of exploration.
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Affiliation(s)
- Iryna Sharaievska
- Department of Recreation Management and Physical Education, Appalachian State University, Boone, NC, United States
| | - Rebecca A Battista
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, United States
| | - Jennifer Zwetsloot
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, United States
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Fischer X, Donath L, Zwygart K, Gerber M, Faude O, Zahner L. Coaching and Prompting for Remote Physical Activity Promotion: Study Protocol of a Three-Arm Randomized Controlled Trial (Movingcall). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E331. [PMID: 30691013 PMCID: PMC6388245 DOI: 10.3390/ijerph16030331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 11/16/2022]
Abstract
Background. Physical inactivity is currently seen as one of the biggest global public health issue. Remote physical activity (PA) promotion programs are expected to be effective if they are individually tailored and include behavior change techniques, personal coaching, and regular prompting. However, it is still not fully understood which intervention components are most effective. This paper describes the rationale and design of a study on an individually tailored remote PA promotion program comparing the efficacy of coaching and prompting with a single written advice. Methods. In total, 288 adults (age 20 to 65 years) were randomly assigned to three different intervention arms of a 6-month-long PA promotion program. A minimal intervention group received a single written PA recommendation. The two remaining groups either received telephone coaching sessions (n = 12 calls) with or without additional short message service (SMS) prompting (n = 48 SMSs for each participant). Data assessment took place at baseline, at the end of the intervention, and after a six-month follow-up-period. The primary outcome of the study was self-reported PA. Objectively assessed PA, psychosocial determinants of PA, well-being, body mass index (BMI), and adherence were assessed as secondary outcomes. Conclusion. Findings of this three-arm study will provide insight into the short and long-term effects of coaching and prompting for PA promotion.
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Affiliation(s)
- Xenia Fischer
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, 50933 Köln, Germany.
| | - Kimberly Zwygart
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
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Ghanvatkar S, Kankanhalli A, Rajan V. User Models for Personalized Physical Activity Interventions: Scoping Review. JMIR Mhealth Uhealth 2019; 7:e11098. [PMID: 30664474 PMCID: PMC6352015 DOI: 10.2196/11098] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 10/01/2018] [Accepted: 10/26/2018] [Indexed: 02/06/2023] Open
Abstract
Background Fitness devices have spurred the development of apps that aim to motivate users, through interventions, to increase their physical activity (PA). Personalization in the interventions is essential as the target users are diverse with respect to their activity levels, requirements, preferences, and behavior. Objective This review aimed to (1) identify different kinds of personalization in interventions for promoting PA among any type of user group, (2) identify user models used for providing personalization, and (3) identify gaps in the current literature and suggest future research directions. Methods A scoping review was undertaken by searching the databases PsycINFO, PubMed, Scopus, and Web of Science. The main inclusion criteria were (1) studies that aimed to promote PA; (2) studies that had personalization, with the intention of promoting PA through technology-based interventions; and (3) studies that described user models for personalization. Results The literature search resulted in 49 eligible studies. Of these, 67% (33/49) studies focused solely on increasing PA, whereas the remaining studies had other objectives, such as maintaining healthy lifestyle (8 studies), weight loss management (6 studies), and rehabilitation (2 studies). The reviewed studies provide personalization in 6 categories: goal recommendation, activity recommendation, fitness partner recommendation, educational content, motivational content, and intervention timing. With respect to the mode of generation, interventions were found to be semiautomated or automatic. Of these, the automatic interventions were either knowledge-based or data-driven or both. User models in the studies were constructed with parameters from 5 categories: PA profile, demographics, medical data, behavior change technique (BCT) parameters, and contextual information. Only 27 of the eligible studies evaluated the interventions for improvement in PA, and 16 of these concluded that the interventions to increase PA are more effective when they are personalized. Conclusions This review investigates personalization in the form of recommendations or feedback for increasing PA. On the basis of the review and gaps identified, research directions for improving the efficacy of personalized interventions are proposed. First, data-driven prediction techniques can facilitate effective personalization. Second, use of BCTs in automated interventions, and in combination with PA guidelines, are yet to be explored, and preliminary studies in this direction are promising. Third, systems with automated interventions also need to be suitably adapted to serve specific needs of patients with clinical conditions. Fourth, previous user models focus on single metric evaluations of PA instead of a potentially more effective, holistic, and multidimensional view. Fifth, with the widespread adoption of activity monitoring devices and mobile phones, personalized and dynamic user models can be created using available user data, including users’ social profile. Finally, the long-term effects of such interventions as well as the technology medium used for the interventions need to be evaluated rigorously.
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Affiliation(s)
- Suparna Ghanvatkar
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
| | - Atreyi Kankanhalli
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
| | - Vaibhav Rajan
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
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Kariuki JK, Gibbs BB, Davis KK, Mecca LP, Hayman LL, Burke LE. Recommendations for a Culturally Salient Web-based Physical Activity Program for African Americans. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2019; 4:8-15. [PMID: 30778397 PMCID: PMC6377171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Barriers to physical activity (PA) among African Americans (AAs) have been extensively studied, yet there is limited research on innovative PA interventions designed to address them. In recent years, many studies have used the internet to promote PA, but very few have included AAs. In this study, we sought the input of AA focus groups to inform the development of a web-based Physical Activity for The Heart (PATH) program for inactive AAs. METHODS A qualitative design involving 4 focus groups stratified by sex and age was employed to explore AAs' needs and preferences for resources to be included in the PATH program. We employed an inductive approach to content analysis to analyze data using ATLAS.ti 7.5. RESULTS Sixteen women and ten men (age 30-65 years) participated in the focus groups. Participants were obese (mean BMI 32.2 ± 5.4 kg/m2) with below average confidence rating (mean 46.4 ± 19.1%) on the Barriers Self-Efficacy Scale. Three main themes emerged from the data: 1) need to see similar others engaging in PA (workout videos featuring models with relatable body size, age, ethnicity), 2) flexible PA regimen (doable at any time/setting), and 3) age and sex differences in preferences for PA resources (religion, music, intensity). CONCLUSION These data suggest that specific intervention components, i.e., PA models who match participants' profiles, flexibility and tailoring to age/gender groups, could improve uptake of web-based PA programs designed for inactive AAs. Therefore, a precision health approach needs to be employed when designing interventions to promote PA among inactive AAs.
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Affiliation(s)
| | | | | | | | - Laura L. Hayman
- University of Massachusetts, College of Nursing and Health Sciences, Boston, MA
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Le D, Holt CL. CervixCheck: A Spiritually-Based Text Messaging Intervention to Promote Cervical Cancer Awareness and Pap Test Screening Intention among African-American Women. JOURNAL OF HEALTH COMMUNICATION 2018; 23:842-853. [PMID: 30300091 PMCID: PMC9159894 DOI: 10.1080/10810730.2018.1528317] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND/PURPOSE On a national level, African-American women have a 34% higher incidence of cervical cancer and are twice as likely to die of the disease when compared to White women. In response to the need to improve cervical cancer prevention and Pap test screening knowledge and utilization, we developed and pilot tested a 16-day SMS text message-based intervention. The CervixCheck study was designed to develop, pilot test, and evaluate the feasibility, acceptability, and initial efficacy of a spiritually-based SMS text messaging intervention aimed at increasing cervical cancer awareness and Pap test screening intention in church-attending African-American women ages 21-65. Methods/Approach: The Theory of Planned Behavior guided the development of the CervixCheck intervention. This intervention utilized a non-experimental one-group pretest-posttest design. In this article, we present findings from the pilot testing phase. Of the 52 participants at baseline, 46 completed the post-program survey. RESULTS/FINDINGS The current study provides evidence for the early feasibility, high acceptability, and some initial efficacy of the CervixCheck intervention. There was a significant pre-post increase observed for knowledge about cervical cancer and the Pap test (p = .001) and subjective norms (p = .006). Findings post-intervention also revealed that 83% of participants reported being either "satisfied" or "very satisfied" with the CervixCheck intervention and 85% found the SMS text messages either "useful" or "very useful". CONCLUSIONS/SIGNIFICANCE A spiritually-based SMS text messaging intervention could be a culturally-appropriate and cost-effective method of promoting cervical cancer early detection information to church-attending African-American women.
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Affiliation(s)
- Daisy Le
- a Department of Behavioral and Community Health (DL, CH) , University of Maryland, School of Public Health , College Park , MD , USA
| | - Cheryl L Holt
- a Department of Behavioral and Community Health (DL, CH) , University of Maryland, School of Public Health , College Park , MD , USA
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Ingram W, Webb D, Taylor RS, Anokye N, Yardley L, Jolly K, Mutrie N, Campbell JL, Dean SG, Greaves C, Steele M, Lambert JD, McAdam C, Jane B, King J, Jones RB, Little P, Woolf A, Erwin J, Charles N, Terry RH, Taylor AH. Multicentred randomised controlled trial of an augmented exercise referral scheme using web-based behavioural support in individuals with metabolic, musculoskeletal and mental health conditions: protocol for the e-coachER trial. BMJ Open 2018; 8:e022382. [PMID: 30244214 PMCID: PMC6157530 DOI: 10.1136/bmjopen-2018-022382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/16/2018] [Accepted: 05/21/2018] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Physical activity is recommended for improving health among people with common chronic conditions such as obesity, diabetes, hypertension, osteoarthritis and low mood. One approach to promote physical activity is via primary care exercise referral schemes (ERS). However, there is limited support for the effectiveness of ERS for increasing long-term physical activity and additional interventions are needed to help patients overcome barriers to ERS uptake and adherence.This study aims to determine whether augmenting usual ERS with web-based behavioural support, based on the LifeGuide platform, will increase long-term physical activity for patients with chronic physical and mental health conditions, and is cost-effective. METHODS AND ANALYSIS A multicentre parallel two-group randomised controlled trial with 1:1 individual allocation to usual ERS alone (control) or usual ERS plus web-based behavioural support (intervention) with parallel economic and mixed methods process evaluations. Participants are low active adults with obesity, diabetes, hypertension, osteoarthritis or a history of depression, referred to an ERS from primary care in the UK.The primary outcome measure is the number of minutes of moderate-to-vigorous physical activity (MVPA) in ≥10 min bouts measured by accelerometer over 1 week at 12 months.We plan to recruit 413 participants, with 88% power at a two-sided alpha of 5%, assuming 20% attrition, to demonstrate a between-group difference of 36-39 min of MVPA per week at 12 months. An improvement of this magnitude represents an important change in physical activity, particularly for inactive participants with chronic conditions. ETHICS AND DISSEMINATION Approved by North West Preston NHS Research Ethics Committee (15/NW/0347). Dissemination will include publication of findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals.Results will be disseminated to ERS services, primary healthcare providers and trial participants. TRIAL REGISTRATION NUMBER ISRCTN15644451; Pre-results.
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Affiliation(s)
- Wendy Ingram
- Faculty of Medicine and Dentistry, Peninsula Medical School, University of Plymouth, Plymouth, UK
| | - Douglas Webb
- Faculty of Medicine and Dentistry, Peninsula Medical School, University of Plymouth, Plymouth, UK
| | | | - Nana Anokye
- Department of Clinical Sciences, Brunel University, London, UK
| | - Lucy Yardley
- Faculty of Medicine, Southampton University, Southampton, UK
- Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - Kate Jolly
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | | | | | - Colin Greaves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Mary Steele
- Faculty of Medicine, Southampton University, Southampton, UK
| | | | - Chloe McAdam
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Ben Jane
- Faculty of Sport and Health, University of St Mark and St John, Plymouth, UK
| | | | - Ray B Jones
- Faculty of Medicine and Dentistry, Peninsula Medical School, University of Plymouth, Plymouth, UK
| | - Paul Little
- Faculty of Medicine, Southampton University, Southampton, UK
| | - Anthony Woolf
- Department of Rheumatology, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Jo Erwin
- Department of Rheumatology, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | | | | | - Adrian H Taylor
- Faculty of Medicine and Dentistry, Peninsula Medical School, University of Plymouth, Plymouth, UK
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Favorable Outcomes Using an eHealth Approach to Promote Physical Activity and Nutrition Among Young African American Women. J Cardiovasc Nurs 2018; 33:62-71. [PMID: 28481823 DOI: 10.1097/jcn.0000000000000409] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Internet and mobile devices are widely used and provide alternative approaches for promoting healthy lifestyles, yet less information is available describing outcomes of these approaches when used with young African American (AA) women at risk for developing hypertension. OBJECTIVE In this study, we evaluated a Web-based, culturally relevant lifestyle change intervention targeting AA women (referred to as the eHealth study). METHODS African American women, aged 18 to 45 years, with untreated prehypertension and Internet access were eligible for a 12-week study that incorporated social cognitive theory strategies. Participants were randomized to (1) lifestyle physical activity (PA) or (2) Dietary Approaches to Stop Hypertension (DASH) online education modules. RESULTS The 14 DASH and 12 PA participant attributes were similar at baseline. The DASH participants had a significant change in total DASH score (P = .001) and large effect sizes for DASH components (vegetables, 0.84; nonfat dairy, 0.71; fruit, 0.62). The PA participants had a favorable change (+39%) in pedometer steps (P = .055). With respect to weight change, a large effect size was observed for PA (0.84) and smaller for DASH participants (0.18). Seventy-one percent of DASH and 48% of PA participants completed program activities, corresponding to a moderate difference in program engagement between groups (d = 0.58). CONCLUSION Our eHealth platform provides an alternative approach for reaching young AA women and was successful with respect to improving PA and dietary behaviors. Furthermore, the eHealth approach has the potential as a powerful program for changing health behaviors for other at-risk populations.
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Lambert JD, Greaves CJ, Farrand P, Price L, Haase AM, Taylor AH. Web-Based Intervention Using Behavioral Activation and Physical Activity for Adults With Depression (The eMotion Study): Pilot Randomized Controlled Trial. J Med Internet Res 2018; 20:e10112. [PMID: 30012547 PMCID: PMC6066639 DOI: 10.2196/10112] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 01/08/2023] Open
Abstract
Background Physical activity is a potentially effective treatment for depression and depressive relapse. However, promoting physical activity in people with depression is challenging. Interventions informed by theory and evidence are therefore needed to support people with depression to become more physically active. eMotion is a Web-based intervention combining behavioral activation and physical activity promotion for people in the community with symptoms of depression. Objective The objectives were to assess the feasibility and acceptability of delivering eMotion to people in the community with symptoms of depression and to explore outcomes. Methods Participants with elevated depressive symptoms were recruited from the community through various methods (eg, social media) and randomized to eMotion or a waiting list control group for 8 weeks. eMotion is an administratively supported weekly modular program that helps people use key behavior change techniques (eg, graded tasks, action planning, and self-monitoring) to re-engage in routine, pleasurable, and necessary activities, with a focus on physical activities. Feasibility data were collected that included the following: recruitment and trial retention rates; fidelity of intervention delivery, receipt, and enactment; and acceptability of the intervention and data collection procedures. Data were collected for the primary (depression) and secondary outcomes (eg, anxiety, physical activity, fidelity, and client satisfaction) at baseline and 2 months postrandomization using self-reported Web-based questionnaires and accelerometers. Delivery fidelity (logins, modules accessed, time spent) was tracked using Web usage statistics. Exploratory analyses were conducted on the primary and secondary outcomes. Results Of the 183 people who contacted the research team, 62 were recruited and randomized. The mean baseline score was 14.6 (SD 3.2) on the 8-item Patient Health Questionnaire depression scale (PHQ-8). Of those randomized, 52 participants provided accelerometer-recorded physical activity data at baseline that showed a median of 35.8 (interquartile range [IQR] 0.0-98.6) minutes of moderate-to-vigorous physical activity (MVPA) recorded in at least 10-minute bouts per week, with only 13% (7/52) people achieving guideline levels (150 minutes of MVPA per week). In total, 81% (50/62) of participants provided follow-up data for the primary outcome (PHQ-8), but only 39% (24/62) provided follow-up accelerometer data. Within the intervention group, the median number of logins, modules accessed, and total minutes spent on eMotion was 3 (IQR 2.0-8.0), 3 (IQR 2.0-5.0), and 41.3 (IQR 18.9-90.4), respectively. Acceptability was mixed. Exploratory data analysis showed that PHQ-8 levels were lower for the intervention group than for the control group at 2 months postrandomization (adjusted mean difference −3.6, 95% CI −6.1 to −1.1). Conclusions It was feasible to deliver eMotion in UK communities to inactive populations. eMotion has the potential to be effective and is ready for testing in a full-scale trial. Further work is needed to improve engagement with both the intervention and data collection procedures. Trial Registration ClinicalTrials.gov NCT03084055; https://clinicaltrials.gov/ct2/show/NCT03084055 (Archived by WebCite at http://www.webcitation.org/6zoyM8UXa)
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Affiliation(s)
- Jeffrey D Lambert
- Institute for Health Research, Primary Care, University of Exeter Medical School, Exeter, United Kingdom
| | - Colin J Greaves
- School for Sport, Exercise and Rehabilitation, University of Birmingham, Birmingham, United Kingdom
| | - Paul Farrand
- Clinical Education, Development and Research, Psychology, University of Exeter, Exeter, United Kingdom
| | - Lisa Price
- Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Anne M Haase
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Adrian H Taylor
- Faculty of Medicine & Dentistry, University of Plymouth, Plymouth, United Kingdom
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Nutzung und User Experience einer gamifizierten Webanwendung zur Förderung der körperlichen Aktivität im betrieblichen Setting. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2018. [DOI: 10.1007/s11553-018-0649-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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