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Shimokihara S, Tabira T, Maruta M, Makizako H, Han G, Ikeda Y, Kamasaki T, Akasaki Y, Hidaka Y, Kumura Y, Kukizaki W, Nakahara R, Matsunaga S, Medina L, Kubozono T, Ohishi M. Smartphone Proficiency in Community-Dwelling Older Adults is Associated With Higher-Level Competence and Physical Function: A Population-Based Age-Specific Cross-Sectional Study. J Appl Gerontol 2024:7334648241261885. [PMID: 38901835 DOI: 10.1177/07334648241261885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024] Open
Abstract
With the rapid development of information and communication technology, smartphone ownership has increased among older adults. While previous research has examined the impact of smartphone use on the health of older adults, this study focuses on the less-explored relationship between smartphone use, proficiency, and health-related outcomes including higher-level competence. The study was a cross-sectional survey of 208 community-dwelling older adults who used smartphones daily. Smartphone use, including years of use and applications, was assessed and categorized by age group. Health-related outcomes were measured, including cognitive and psychological function, higher-level competence, basic daily abilities, and physical function. The results indicated that smartphone proficiency decreased with age, with older adults primarily using basic smartphone applications. Notably, higher smartphone proficiency was positively associated with higher-level competence and physical functions. The study underscores the importance of considering smartphone proficiency when assessing older adults' life skills and physical performance in our digital society.
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Affiliation(s)
- Suguru Shimokihara
- Department of Occupational Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
- Research Fellowship for Young Scientists, Japan Society for the Promotion of Science, Tokyo, Japan
- Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Michio Maruta
- Faculty of Medicine, Kagoshima University, Kagoshima, Japan
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Gwanghee Han
- Faculty of Medicine, Kagoshima University, Kagoshima, Japan
- Department of Occupational Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Yuriko Ikeda
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Taishiro Kamasaki
- Department of Rehabilitation Sciences, Faculty of Rehabilitation Sciences, Nishikyushu University, Saga, Japan
| | - Yoshihiko Akasaki
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuma Hidaka
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Yusuke Kumura
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Wataru Kukizaki
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Rena Nakahara
- Master's Program of Health Sciences, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Shuto Matsunaga
- Master's Program of Health Sciences, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Leiya Medina
- Master's Program of Health Sciences, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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Meguro T, Takayama F, Hammarlund H, Honjo M. Effects of a mobile health intervention on health-related outcomes in Japanese office workers: a pilot study. Int J Occup Med Environ Health 2024; 37:153-164. [PMID: 38375630 PMCID: PMC11142403 DOI: 10.13075/ijomeh.1896.02317] [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: 09/22/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES The purpose of the current study was to explore the effects of a mobile health (mHealth) intervention based on the Persuasive System Design (PSD) model on health-related outcomes among office workers. MATERIAL AND METHODS The authors conducted a trial that consisted of a 4-week baseline and an 8-week intervention period by reference to 23 office workers in a private research company. The mHealth application was developed to improve these workers' daily step count, decrease their sedentary time, and increase their sleep duration in accordance with the PSD model. The app features included at least 1 principal factor from each of the 4 main categories of the PSD model (primary task support, dialogue support, system credibility support, and social support). The objective health-related variables were measured using a smartwatch (Fitbit Luxe) that was synchronized with the application using the Fitbit Web Application Programming Interface. Subjects used the app, which included self-monitoring, personalized messages, education, and a competition system for users, during the intervention period. RESULTS Sedentary time exhibited a significant decrease (a median reduction of 14 min/day, p < 0.05) during the intervention period. No significant differences in daily step count and sleep duration were observed between the baseline and intervention periods. CONCLUSIONS This study suggests that the mHealth intervention based on the PSD model was useful for reducing sedentary time among office workers. Given that many previous studies on this topic have not been based on any theories, future studies should investigate the impact of structured selection behavior change theories on health-related outcomes among office workers. Int J Occup Med Environ Health. 2024;37(2):153-64.
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Affiliation(s)
- Takumi Meguro
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
| | | | | | - Masaru Honjo
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
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Tam HL, Wong EML, Cheung K. Educational Program with Text Messaging for Community-Dwelling Patients with Hypertension: A Pilot Randomized Controlled Trial. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:158-166. [PMID: 37295501 DOI: 10.1016/j.anr.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE Controlling blood pressure minimizes the risk of cardiovascular events among patients with hypertension. Despite regular follow-ups, the hypertension management for patients aged ≥45 years is limited as evidenced from a decreased control rate. This pilot study aimed to test a theory-guided educational program for community-dwelling patients with hypertension. METHODS Sixty-nine patients with hypertension aged ≥45 years and having high blood pressure (>130/80 mmHg) were recruited in this two-arm pilot randomized controlled trial. Participants in the intervention group underwent a program guided by the Health Promotion Model, whereas those in the control group received usual care. Data were collected at baseline, week 8, and week 12 and used to assess the blood pressure, pulse pressure, self-efficacy, and adherence to hypertension management. Data were analyzed using a generalized estimating equation based on the intention-to-treat principle. Process evaluation was conducted to assess the feasibility and acceptability of the educational program. RESULTS The results obtained using the generalized estimating equation revealed that the educational program led to reduction in the systolic blood pressure (β = -7.12, p = .086) and pulse pressure (β = -8.20, p = .007) and to improve self-efficacy (β = 2.61, p = .269) at week 12. The program had a small-to-moderate effect on the reduction of systolic blood pressure (effect size = -0.45) and pulse pressure (effect size = -0.66) and self-efficacy (effect size = 0.23). The participants were highly satisfied with the educational program. CONCLUSIONS The educational program was found to be feasible and acceptable and may be incorporated into current hypertension management practices at the community level. TRIAL REGISTRATION ClinicalTrials.gov with identifier: NCT04565548.
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Affiliation(s)
- Hon Lon Tam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | | | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Wu S, Li G, Du L, Chen S, Zhang X, He Q. The effectiveness of wearable activity trackers for increasing physical activity and reducing sedentary time in older adults: A systematic review and meta-analysis. Digit Health 2023; 9:20552076231176705. [PMID: 37252261 PMCID: PMC10214103 DOI: 10.1177/20552076231176705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
Background Traditional interventions such as education and counseling are successful in increasing physical activity (PA) participation, but are usually labor and resource intensive. Wearable activity trackers can objectively record PA and provide feedback to help users to achieve activity goals and are an increasingly popular tool among adults used to facilitate self-monitoring of PA. However, no reviews systematically explored the roles of wearable activity trackers in older populations. Methods We searched PubMed, Web of Science, Google Scholar, Embase, Cochrane Library, and Scopus from inception to September 10, 2022. Randomized controlled trials were included. Two reviewers independently conducted study selection, data extraction, risk of bias, and certainty of evidence assessment. A random-effects model was used to evaluate the effect size. Results A total of 45 studies with 7144 participants were included. A wearable activity tracker was effective in increasing daily steps (standard mean differences (SMD) = 0.59, 95% confidence interval (CI) (0.44, 0.75)), weekly moderate-to-vigorous PA (MVPA) (SMD = 0.54, 95% CI (0.36, 0.72)), and total daily PA (SMD = 0.21, 95% CI (0.01, 0.40)) and reducing sedentary time (SMD = -0.10, 95% CI (-0.19, -0.01)). Subgroup analysis showed that the effectiveness of wearable activity trackers for daily steps was not influenced by participants and intervention features. However, wearable activity trackers seemed more effective in promoting MVPA of participant's age <70 than participant's age ≥70. In addition, wearable activity trackers incorporated with traditional intervention components (e.g. telephone counseling, goal setting, and self-monitoring) could better promote MVPA than alone use. Short-term interventions potentially achieve better MVPA increase than long-term. Conclusion This review showed that wearable activity trackers are an effective tool to increase PA for the old population and also favor reducing sedentary time. When used together with other interventions, wearable activity trackers can achieve better MVPA increase, especially in the short term. However, how to more effectively improve the effectiveness of wearable activity trackers is an important direction of future research.
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Affiliation(s)
- Shuang Wu
- School of Physical Education, Shandong University, Jinan, China
| | - Guangkai Li
- School of Physical Education, Shandong University, Jinan, China
| | - Litao Du
- School of Physical Education, Shandong University, Jinan, China
| | - Si Chen
- School of Nursing and Rehabilitation,
Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China
| | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
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Johns T, Huot C, Jenkins JC. Telehealth in Geriatrics. Prim Care 2022; 49:659-676. [DOI: 10.1016/j.pop.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bai Y, Burns R, Gell N, Byun W. A randomized trial to promote physical activity in adult pre-hypertensive and hypertensive patients. J Sports Sci 2022; 40:1648-1657. [PMID: 35830497 DOI: 10.1080/02640414.2022.2099179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The purpose of the pilot study was to determine the effectiveness of wearable activity trackers alone or in combination with behaviour change strategies for promoting physical activity (PA) among individuals with pre-hypertension or hypertension. A sample of 44 adults (68% female and mean age 55) were randomized to receive either a Fitbit Charge HR 3 alone (FB) or the Fitbit in combination with behaviour change strategies (i.e., goal setting, behaviour goal review, adaptive feedback) delivered by a trained health coach (FB+) for 12 weeks. Moderate and vigorous PA (MVPA), steps, and sedentary time (ST) were assessed using ActiGraph wGT3X-BT. The FB+ group significantly increased PA [+1854 (2518) steps/day, p < .01] and MVPA [+26 (34) mins/day, p < .05], and decreased their ST [-63 (73) mins/day, p < .01]. The FB group significantly increased MVPA [+11 (16) mins/day, p < .05], and decreased their ST [-87 (117) mins/day, p < .01]. Participants in FB+ had a significantly greater increase in MVPA/day compared to FB only with a between-group effect size of 0.6 (p < .05). Using Fitbit for self-monitoring is effective in increasing PA and reducing ST among pre-hypertensive and hypertensive participants. Additional behaviour change support amplified the intervention effectiveness for promoting MVPA.
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Affiliation(s)
- Yang Bai
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA.,Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
| | - Ryan Burns
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Nancy Gell
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
| | - Wonwoo Byun
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
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Dehghan Ghahfarokhi A, Vosadi E, Barzegar H, Saatchian V. The Effect of Wearable and Smartphone Applications on Physical Activity, Quality of Life, and Cardiovascular Health Outcomes in Overweight/Obese Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Biol Res Nurs 2022; 24:503-518. [PMID: 35535558 DOI: 10.1177/10998004221099556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Advances in the device and smartphone technology have resulted in a convenient option for providing physical activity strategies; this is especially important during the coronavirus disease 2019 pandemic. OBJECTIVE The purpose of this meta-analysis is to evaluate the efficacy of wearable and smartphone-based interventions to promote physical activity and improve quality of life and cardiovascular health outcomes among overweight/obese adults. DATA SOURCES We searched relevant databases up to 18 November 2021 for conducting a systematic review and meta-analysis of randomized controlled trials lasting 4 or more weeks that investigated the impacts of wearables and smartphone applications on physical activity, quality of life and health outcomes. RESULTS Twenty-six studies including 2373 participants were included. There was a significant pooled standard mean differences (SMD) for the comparison between intervention versus control in steps per day (SMD: 0.54; p = 0.0003), moderate-to-vigorous physical activity (SMD: 0.47; p = 0.02), quality of life (SMD: 0.33; p = 0.0006), body weight (mean difference (MD), -1.61 kg; p = 0.009), and BMI (MD, -0.59 kg/m2; p = 0.04). There were no significant differences between the intervention and control groups for systolic and diastolic blood pressure and resting heart rate (all p > 0.05). CONCLUSION Our findings suggest that wearable and smartphone-based interventions are effective strategies in promoting physical activity and can provide a direct contact line to health professionals.
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Affiliation(s)
- Amin Dehghan Ghahfarokhi
- Sport Management Department, Faculty of Physical Education and Sport Sciences, 48425University of Tehran, Tehran, Iran
| | - Elham Vosadi
- Department of Physical Education and Sport Sciences, 68259Shahrood University of Technology, Shahrood, Iran
| | - Hamed Barzegar
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, 48425University of Tehran, Tehran, Iran
| | - Vahid Saatchian
- Department of Physical Education and Sport Sciences, 305467Imam Reza international University, Mashhad, Iran
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Lucerón-Lucas-Torres MI, Valera-Ortín J. Health technology tools used to increase physical activity and improve cardiovascular parameters in older adults: A review. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32:171-183. [PMID: 35078754 DOI: 10.1016/j.enfcle.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 05/29/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Ageing is a period of physical and psychological changes. Inactivity is one of the biggest problems among the older adult population increasing the risk of sarcopenia and chronic diseases. Physical activity is an effective intervention to improve health outcomes. In recent years, there has been an increase in the use of technology, with health technology tools (ICT) appearing as an intervention to increase physical activity and improve associated health problems. OBJECTIVE In this review, we evaluated the effectiveness of health technology to increase physical activity and to improve cardiovascular parameters in older adults. METHODOLOGY Studies with a great variety of health technology tools to increase physical activity levels, and that evaluated the effect of that increase on cardiovascular parameters were included by searching the main databases. RESULTS Eleven studies reporting the use of a variety of ICT tools were included in this review. Despite these differences, the effectiveness of health technology tool interventions has been demonstrated in increasing physical activity and reducing cardiovascular parameters. DISCUSSION The lack of adherence of older adults to health technology would be a disadvantage, but it has been shown that younger older adults are more familiar with health technology tools and the number using them is increasing. CONCLUSION Health technology tools show effectiveness in increasing physical activity in older adults and improving cardiovascular parameters.
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Affiliation(s)
| | - Jorge Valera-Ortín
- Facultad de Enfermería de Cuenca, Edificio Melchor Cano, Universidad de Castilla-La Mancha, Cuenca, Spain
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Lucerón-Lucas-Torres MI, Valera-Ortín J. TIC en actividad física y parámetros cardiovasculares en mayores: una revisión. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Mair JL, Hayes LD, Campbell AK, Buchan DS, Easton C, Sculthorpe N. A Personalized Smartphone-Delivered Just-in-time Adaptive Intervention (JitaBug) to Increase Physical Activity in Older Adults: Mixed Methods Feasibility Study. JMIR Form Res 2022; 6:e34662. [PMID: 35389348 PMCID: PMC9030994 DOI: 10.2196/34662] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/20/2022] [Accepted: 02/11/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Just-in-time adaptive interventions (JITAIs) provide real time in-the-moment behavior change support to people when they need it most. JITAIs could be a viable way to provide personalized physical activity (PA) support to older adults in the community. However, it is unclear how feasible it is to remotely deliver a PA intervention through a smartphone to older adults or how acceptable they would find a JITAI targeting PA in everyday life. OBJECTIVE The aims of this study are to describe the development of JitaBug, a personalized smartphone-delivered JITAI designed to support older adults to increase or maintain their PA level, assess the feasibility of conducting an effectiveness trial of the JitaBug intervention, and explore the acceptability of JitaBug among older adults in a free-living setting. METHODS The intervention was developed using the Behavior Change Wheel and consisted of a wearable activity tracker (Fitbit) and a companion smartphone app (JitaBug) that delivered goal-setting, planning, reminders, and JITAI messages to encourage achievement of personalized PA goals. Message delivery was tailored based on time of day, real time PA tracker data, and weather conditions. We tested the feasibility of remotely delivering the intervention with older adults in a 6-week trial. Data collection involved assessment of PA through accelerometery and activity tracker, self-reported mood and mental well-being through ecological momentary assessment, and contextual information on PA through voice memos. Feasibility outcomes included recruitment capability and adherence to the intervention, intervention delivery in the wild, appropriateness of data collection methodology, adverse events, and participant satisfaction. RESULTS Of the 46 recruited older adults (aged 56-72 years), 31 (67%) completed the intervention. The intervention was successfully delivered as intended; 87% (27/31) of the participants completed the intervention independently; 94% (2247/2390) of the PA messages were successfully delivered; 99% (2239/2261) of the Fitbit and 100% (2261/2261) of the weather data calls were successful. Valid and usable wrist-worn accelerometer data were obtained from 90% (28/31) of the participants at baseline and follow-up. On average, the participants recorded 50% (7.9/16, SD 7.3) of the voice memos, 38% (3.3/8, SD 4.2) of the mood assessments, and 50% (2.1/4, SD 1.6) of the well-being assessments through the app. Overall acceptability of the intervention was very good (23/30, 77% expressed satisfaction). Participant feedback suggested that more diverse and tailored PA messages, app use reminders, technical refinements, and an improved user interface could improve the intervention and make it more appealing. CONCLUSIONS This study suggests that a smartphone-delivered JITAI is an acceptable way to support PA in older adults in the community. Overall, the intervention is feasible; however, based on user feedback, the JitaBug app requires further technical refinements that may enhance use, engagement, and user satisfaction before moving to effectiveness trials.
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Affiliation(s)
- Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Lawrence D Hayes
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, United Kingdom
| | - Amy K Campbell
- School of Science, Technology and Health, York St John University, York, United Kingdom
| | - Duncan S Buchan
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, United Kingdom
| | - Chris Easton
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, United Kingdom
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, United Kingdom
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Wong SH, Tan ZYA, Cheng LJ, Lau ST. Wearable technology-delivered lifestyle intervention amongst adults with overweight and obese: A systematic review and meta-regression. Int J Nurs Stud 2021; 127:104163. [DOI: 10.1016/j.ijnurstu.2021.104163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 02/08/2023]
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Leskinen T, Suorsa K, Heinonen IHA, Löyttyniemi E, Pentti J, Vahtera J, Stenholm S. The Effect of Commercial Activity Tracker Based Physical Activity Intervention on Body Composition and Cardiometabolic Health Among Recent Retirees. FRONTIERS IN AGING 2021; 2:757080. [PMID: 35822058 PMCID: PMC9261302 DOI: 10.3389/fragi.2021.757080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022]
Abstract
The REACT is a commercial activity tracker based intervention, which primarily aimed to increase physical activity. This study examines the secondary outcomes of the physical activity intervention on body composition and cardiometabolic health indicators. Overall 231 recently retired Finnish men and women [65.2 (SD 1.1) years, 83% women] took part to the study. The participants were randomized into intervention (n = 117) and control (n = 114) groups. The intervention group members used a commercial activity tracker (Polar Loop 2, Polar, Kempele, Finland) with a daily activity goal and inactivity alerts every day for 12 months. Controls received no intervention. Secondary health outcomes included body weight, fat mass, fat free mass, waist circumference, blood pressure, indicators of glucose and lipid metabolisms, and high-sensitivity C-reactive protein, and they were measured at baseline and at 12-months end point. Hierarchical linear mixed models were used to examine the differences between the groups over time, and no differences in the mean changes of the body composition and cardiometabolic health indicators between the groups were found (group*time interaction >0.20 for all measures). Fat free mass, waist circumference, blood pressure, and low density lipoprotein levels decreased in both groups over the 12 months. These findings state that 1-year daily use of commercial activity tracker does not induce different cardiometabolic health effects when compared to the non-user controls among general population of recent retirees.
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Affiliation(s)
- Tuija Leskinen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- *Correspondence: Tuija Leskinen,
| | - Kristin Suorsa
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Ilkka HA Heinonen
- Turku PET Centre, and Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland
- Rydberg Laboratory of Applied Sciences, Department of Environmental- and Biosciences, University of Halmstad, Halmstad, Sweden
| | - Eliisa Löyttyniemi
- Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Liu JYW, Kwan RYC, Yin YH, Lee PH, Siu JYM, Bai X. Enhancing the Physical Activity Levels of Frail Older Adults with a Wearable Activity Tracker-Based Exercise Intervention: A Pilot Cluster Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10344. [PMID: 34639644 PMCID: PMC8507976 DOI: 10.3390/ijerph181910344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/22/2022]
Abstract
A wearable activity tracker (WAT) incorporated with behavioral change techniques (BCTs) increases physical activity in younger adults; however, its effectiveness with frail older adults is unknown. The feasibility and preliminary effects of a WAT-based exercise intervention to increase physical activity levels in frail older adults was investigated in this pilot study involving 40 community-dwelling frail older adults. The experimental group received a 14-week WAT-based group exercise intervention and a 3-month follow-up, while the control group only received similar physical training and all BCTs. The recruitment rate was 93%, and the average attendance rate was 85.2% and 82.2% in the WAT and control groups, respectively, establishing feasibility. Adherence to wearing the WAT was 94.2% and 92% during the intervention and follow-up periods, respectively. A significant interaction effect between time and group was found in all physical assessments, possibly lasting for 3 months post-intervention. However, no significant difference between groups was observed in any daily activity level by the ActiGraph measurement. The majority of the WAT group's ActiGraph measurements reverted to baseline levels at the 1-month follow-up. Thus, the WAT-based exercise program has potential for employment among community-dwelling frail older adults, but sustaining the effects after the intervention remains a major challenge.
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Affiliation(s)
- Justina Y. W. Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (R.Y.C.K.); (Y.-H.Y.)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Rick Y. C. Kwan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (R.Y.C.K.); (Y.-H.Y.)
| | - Yue-Heng Yin
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (R.Y.C.K.); (Y.-H.Y.)
| | - Paul H. Lee
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK;
| | - Judy Yuen-man Siu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Xue Bai
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China;
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14
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An Intentionally Designed Walking Program for Seniors Results in Enhanced Community Connection. J Aging Phys Act 2021; 30:44-53. [PMID: 34348232 DOI: 10.1123/japa.2020-0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 11/18/2022]
Abstract
Social connection is vital for older adults' physical and psychological well-being, yet nearly one third of them report feeling lonely. The purpose of this study was to evaluate the influence of a monthly walking program (walking once a month for 8 months) on older adults' community connection. Older adults (Mage = 78.06 ± 5.98 years) completed a focus group at the completion of the program (n = 15). Qualitative findings indicate that participation in the walking program led to enhanced social connection. Researchers developed six major themes: (1) frequent and engaging walking programs, (2) benefits of group activity, (3) enhanced social connections, (4) connection to the community, (5) knowledge about transit, and (6) personal well-being, and 10 subthemes. Implications from this study highlight the importance of designing a walking program with older adults' needs and desires in mind.
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15
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LESKINEN TUIJA, SUORSA KRISTIN, TUOMINEN MIIKA, PULAKKA ANNA, PENTTI JAANA, LÖYTTYNIEMI ELIISA, HEINONEN ILKKA, VAHTERA JUSSI, STENHOLM SARI. The Effect of Consumer-based Activity Tracker Intervention on Physical Activity among Recent Retirees-An RCT Study. Med Sci Sports Exerc 2021; 53:1756-1765. [PMID: 34261997 PMCID: PMC8284385 DOI: 10.1249/mss.0000000000002627] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The randomized controlled trial REACT (NCT03320746) examined the effect of a 12-month consumer-based activity tracker intervention on accelerometer-measured physical activity among recent retirees. METHODS Altogether 231 recently retired Finnish adults (age, 65.2 ± 1.1 yr, mean ± SD; 83% women) were randomized to intervention and control groups. Intervention participants were requested to wear a commercial wrist-worn activity tracker (Polar Loop 2; Polar, Kempele, Finland) for 12 months, to try to reach the daily activity goals shown on the tracker display, and to upload their activity data to a Web-based program every week. The control group received no intervention. Accelerometer-based outcome measurements of daily total, light physical activity (LPA), and moderate to vigorous (MVPA) physical activity were conducted at baseline and at 3-, 6-, and 12-month time points. Hierarchical linear mixed models were used to examine the differences between the groups over time. All analyses were performed by intention-to-treat principle and adjusted for wake wear time. RESULTS The use of a commercial activity tracker did not increase daily total activity, LPA, or MVPA over the 12-months period when compared with nonuser controls (group-time interaction, P = 0.39, 0.23, and 0.77, respectively). There was an increase in LPA over the first 6 months in both the intervention (26 min·d-1, 95% confidence interval [CI] = 13 to 39) and the control (14 min·d-1, 95% CI = 1 to 27) groups, but the difference between the groups was not significant (12 min·d-1, 95% CI = -6 to 30). In both groups, LPA decreased from 6 to 12 months. CONCLUSION The 12-month use of a commercial activity tracker does not appear to elicit significant changes in the daily total activity among a general population sample of recent retirees, thus highlighting the need to explore other alternatives to increase physical activity in this target group.
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Affiliation(s)
- TUIJA LESKINEN
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
| | - KRISTIN SUORSA
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
| | - MIIKA TUOMINEN
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
| | - ANNA PULAKKA
- Finnish Institute for Health and Welfare, Helsinki, FINLAND
| | - JAANA PENTTI
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, FINLAND
| | - ELIISA LÖYTTYNIEMI
- Department of Biostatistics, University of Turku and Turku University Hospital, Turku, FINLAND
| | - ILKKA HEINONEN
- Turku PET Centre, and Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, FINLAND
- Rydberg Laboratory of Applied Sciences, Department of Environmental and Biosciences, University of Halmstad, Halmstad, SWEDEN
| | - JUSSI VAHTERA
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
| | - SARI STENHOLM
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
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16
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St Fleur RG, St George SM, Leite R, Kobayashi M, Agosto Y, Jake-Schoffman DE. Use of Fitbit Devices in Physical Activity Intervention Studies Across the Life Course: Narrative Review. JMIR Mhealth Uhealth 2021; 9:e23411. [PMID: 34047705 PMCID: PMC8196365 DOI: 10.2196/23411] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/31/2021] [Accepted: 04/06/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Commercial off-the-shelf activity trackers (eg, Fitbit) allow users to self-monitor their daily physical activity (PA), including the number of steps, type of PA, amount of sleep, and other features. Fitbits have been used as both measurement and intervention tools. However, it is not clear how they are being incorporated into PA intervention studies, and their use in specific age groups across the life course is not well understood. OBJECTIVE This narrative review aims to characterize how PA intervention studies across the life course use Fitbit devices by synthesizing and summarizing information on device selection, intended use (intervention vs measurement tool), participant wear instructions, rates of adherence to device wear, strategies used to boost adherence, and the complementary use of other PA measures. This review provides intervention scientists with a synthesis of information that may inform future trials involving Fitbit devices. METHODS We conducted a search of the Fitabase Fitbit Research Library, a database of studies published between 2012 and 2018. Of the 682 studies available on the Fitabase research library, 60 interventions met the eligibility criteria and were included in this review. A supplemental search in PubMed resulted in the inclusion of 15 additional articles published between 2019 and 2020. A total of 75 articles were reviewed, which represented interventions conducted in childhood; adolescence; and early, middle, and older adulthood. RESULTS There was considerable heterogeneity in the use of Fitbit within and between developmental stages. Interventions for adults typically required longer wear periods, whereas studies on children and adolescents tended to have more limited device wear periods. Most studies used developmentally appropriate behavior change techniques and device wear instructions. Regardless of the developmental stage and intended Fitbit use (ie, measurement vs intervention tool), the most common strategies used to enhance wear time included sending participants reminders through texts or emails and asking participants to log their steps or synchronize their Fitbit data daily. The rates of adherence to the wear time criteria were reported using varying metrics. Most studies supplemented the use of Fitbit with additional objective or self-reported measures for PA. CONCLUSIONS Overall, the heterogeneity in Fitbit use across PA intervention studies reflects its relative novelty in the field of research. As the use of monitoring devices continues to expand in PA research, the lack of uniformity in study protocols and metrics of reported measures represents a major issue for comparability purposes. There is a need for increased transparency in the prospective registration of PA intervention studies. Researchers need to provide a clear rationale for the use of several PA measures and specify the source of their main PA outcome and how additional measures will be used in the context of Fitbit-based interventions.
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Affiliation(s)
- Ruth Gaelle St Fleur
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Sara Mijares St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Rafael Leite
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Marissa Kobayashi
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Yaray Agosto
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Danielle E Jake-Schoffman
- Department of Health, Education, and Behavior, University of Florida, Gainesville, FL, United States
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17
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Hartman SJ, Dillon LW, LaCroix AZ, Natarajan L, Sears DD, Owen N, Dunstan DW, Sallis JF, Schenk S, Allison M, Takemoto M, Herweck AM, Nguyen B, Rosenberg DE. Interrupting Sitting Time in Postmenopausal Women: Protocol for the Rise for Health Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e28684. [PMID: 33983131 PMCID: PMC8160808 DOI: 10.2196/28684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 11/17/2022] Open
Abstract
Background Many older adults spend the majority of their waking hours sitting, which increases their risk of chronic diseases. Given the challenges that many older adults face when engaging in moderate-to-vigorous physical activity, understanding the health benefits of decreasing sitting time and increasing the number of sit-to-stand transitions is needed to address this growing public health concern. Objective The aim of this 3-arm randomized controlled trial is to investigate how changes in sitting time and brief sit-to-stand transitions impact biomarkers of healthy aging and physical, emotional, and cognitive functioning compared with a healthy attention control arm. Methods Sedentary and postmenopausal women (N=405) will be recruited and randomly assigned to 1 of the 3 study conditions for 3 months: healthy living attention control (Healthy Living), reduce sitting time (Reduce Sitting), and increase sit-to-stand transitions (Increase Transitions). Assessments conducted at baseline and 3 months included fasting blood draw, blood pressure, anthropometric measurements, physical functioning, cognitive testing, and 7 days of a thigh-worn accelerometer (activPAL) and a hip-worn accelerometer (ActiGraph). Blood-based biomarkers of healthy aging included those associated with glycemic control (glycated hemoglobin, fasting plasma insulin and glucose, and homeostatic model assessment of insulin resistance). Results Recruitment began in May 2018. The intervention is ongoing, with data collection expected to continue through the end of 2022. Conclusions The Rise for Health study is designed to test whether 2 different approaches to interrupting sitting time can improve healthy aging in postmenopausal women. Results from this study may inform the development of sedentary behavior guidelines and interventions to reduce sitting time in older adults. Trial Registration ClinicalTrials.gov NCT03473145; https://clinicaltrials.gov/ct2/show/NCT03473145 International Registered Report Identifier (IRRID) DERR1-10.2196/28684
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Affiliation(s)
- Sheri J Hartman
- Hebert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States.,Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
| | - Lindsay W Dillon
- Hebert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Andrea Z LaCroix
- Hebert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Loki Natarajan
- Hebert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Dorothy D Sears
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States.,Department of Medicine, University of California, San Diego, La Jolla, CA, United States.,College of Health Solutions, Arizona State University, Phoenix, AZ, United States.,Department of Family Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Centre for Urban Transitions, Swinburne University, Melbourne, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - James F Sallis
- Hebert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Simon Schenk
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, United States
| | - Matthew Allison
- Department of Family Medicine, University of California, San Diego, La Jolla, CA, United States
| | | | - Alexandra M Herweck
- Hebert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Bao Nguyen
- School of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
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18
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Mankowski RT, Laitano O, Clanton TL, Brakenridge SC. Pathophysiology and Treatment Strategies of Acute Myopathy and Muscle Wasting after Sepsis. J Clin Med 2021; 10:1874. [PMID: 33926035 PMCID: PMC8123669 DOI: 10.3390/jcm10091874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 02/07/2023] Open
Abstract
Sepsis survivors experience a persistent myopathy characterized by skeletal muscle weakness, atrophy, and an inability to repair/regenerate damaged or dysfunctional myofibers. The origins and mechanisms of this persistent sepsis-induced myopathy are likely complex and multifactorial. Nevertheless, the pathobiology is thought to be triggered by the interaction between circulating pathogens and impaired muscle metabolic status. In addition, while in the hospital, septic patients often experience prolonged periods of physical inactivity due to bed rest, which may exacerbate the myopathy. Physical rehabilitation emerges as a potential tool to prevent the decline in physical function in septic patients. Currently, there is no consensus regarding effective rehabilitation strategies for sepsis-induced myopathy. The optimal timing to initiate the rehabilitation intervention currently lacks consensus as well. In this review, we summarize the evidence on the fundamental pathobiological mechanisms of sepsis-induced myopathy and discuss the recent evidence on in-hospital and post-discharge rehabilitation as well as other potential interventions that may prevent physical disability and death of sepsis survivors.
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Affiliation(s)
- Robert T. Mankowski
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL 32603, USA
| | - Orlando Laitano
- Department of Nutrition and Integrated Physiology, Florida State University, Tallahassee, FL 32306, USA;
| | - Thomas L. Clanton
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA;
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19
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Suorsa K, Leskinen T, Pulakka A, Pentti J, Löyttyniemi E, Heinonen I, Vahtera J, Stenholm S. The effect of a consumer-based activity tracker intervention on accelerometer-measured sedentary time among retirees: a randomized controlled REACT trial. J Gerontol A Biol Sci Med Sci 2021; 77:579-587. [PMID: 33839766 PMCID: PMC8893187 DOI: 10.1093/gerona/glab107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Indexed: 12/03/2022] Open
Abstract
Background Effective strategies to reverse the increasing trend of sedentary behavior after retirement are needed. The aim of this study was to examine the effect of 12-month activity tracker-based intervention on daily total and prolonged sedentary time (≥60 minutes) among recent retirees. Methods Randomization to intervention and control groups was performed to 231 retirees (mean age 65.2 [SD 1.1] years, 83% women). Intervention participants wore a consumer-based wrist-worn activity tracker (Polar Loop 2, Polar, Kempele, Finland), including daily activity goal, every day and night for 12 months. The activity tracker also gave vibrating reminders to break up uninterrupted inactivity periods after 55 minutes. A wrist-worn triaxial ActiGraph wGT3X-BT accelerometer was used to measure sedentary time at baseline and at 3-, 6-, and 12-month time points. Results The use of an activity tracker did not reduce daily total or prolonged sedentary time over 12 months (p values for time * group interaction 0.39 and 0.27, respectively). In the post hoc analysis focusing on short- and medium-term effects on prolonged sedentary time, no differences between the intervention and control groups over 3 months were found, but a tendency for a greater decrease in prolonged sedentary time in the intervention group over 6 months was seen (mean difference in changes between the groups 29 minutes, 95% CI −2 to 61). Conclusions The activity tracker with inactivity alerts did not elicit changes in sedentary time over 12 months among recent retirees. Alternative approaches may be needed to achieve long-term changes in sedentary time among retirees. Clinical Trials registration Number: NCT03320746
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Affiliation(s)
- Kristin Suorsa
- Department of Public Health, University of Turku and Turku University Hospital, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Tuija Leskinen
- Department of Public Health, University of Turku and Turku University Hospital, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Anna Pulakka
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Finland
| | - Eliisa Löyttyniemi
- Department of Biostatistics, University of Turku and Turku University Hospital, Finland
| | - Ilkka Heinonen
- Turku PET Centre, and department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland.,Rydberg Laboratory of Applied Sciences, department of Environmental- and Biosciences, University of Halmstad, Halmstad, Sweden
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
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20
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Project Step: A Randomized Controlled Trial Investigating the Effects of Frequent Feedback and Contingent Incentives on Physical Activity. J Phys Act Health 2021; 18:247-253. [PMID: 33601334 DOI: 10.1123/jpah.2020-0198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 11/02/2020] [Accepted: 11/15/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Financial incentives and feedback on behavior offer promise for promoting physical activity. However, evidence for the effect of each of these techniques is inadequate. The present study evaluated the effects of daily versus weekly feedback and incentives contingent on reaching a daily walking goal versus noncontingent incentives in a 2 × 2 trial. METHODS Participants (N = 57) had a body mass index >25 kg/m2 and were insufficiently active. Participants received a daily walking goal that adapted weekly. RESULTS Participants receiving daily feedback increased daily steps (P = .03) more than those receiving weekly feedback. Participants receiving contingent incentives did not significantly increase steps (P = .12) more than those receiving noncontingent incentives. A trend-level effect (P = .09) suggested that there may be an interaction such that the combination of daily feedback and contingent incentives is most effective. CONCLUSIONS Results indicate that feedback is an important component of remotely delivered PA interventions and that evaluating each component of low-intensity interventions may help to improve efficacy. Moreover, results indicate that possible synergistic effects of feedback and rewards should be investigated further to help optimize interventions.
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21
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Laranjo L, Ding D, Heleno B, Kocaballi B, Quiroz JC, Tong HL, Chahwan B, Neves AL, Gabarron E, Dao KP, Rodrigues D, Neves GC, Antunes ML, Coiera E, Bates DW. Do smartphone applications and activity trackers increase physical activity in adults? Systematic review, meta-analysis and metaregression. Br J Sports Med 2020; 55:422-432. [PMID: 33355160 DOI: 10.1136/bjsports-2020-102892] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine the effectiveness of physical activity interventions involving mobile applications (apps) or trackers with automated and continuous self-monitoring and feedback. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed and seven additional databases, from 2007 to 2020. STUDY SELECTION Randomised controlled trials in adults (18-65 years old) without chronic illness, testing a mobile app or an activity tracker, with any comparison, where the main outcome was a physical activity measure. Independent screening was conducted. DATA EXTRACTION AND SYNTHESIS We conducted random effects meta-analysis and all effect sizes were transformed into standardised difference in means (SDM). We conducted exploratory metaregression with continuous and discrete moderators identified as statistically significant in subgroup analyses. MAIN OUTCOME MEASURES Physical activity: daily step counts, min/week of moderate-to-vigorous physical activity, weekly days exercised, min/week of total physical activity, metabolic equivalents. RESULTS Thirty-five studies met inclusion criteria and 28 were included in the meta-analysis (n=7454 participants, 28% women). The meta-analysis showed a small-to-moderate positive effect on physical activity measures (SDM 0.350, 95% CI 0.236 to 0.465, I2=69%, T 2=0.051) corresponding to 1850 steps per day (95% CI 1247 to 2457). Interventions including text-messaging and personalisation features were significantly more effective in subgroup analyses and metaregression. CONCLUSION Interventions using apps or trackers seem to be effective in promoting physical activity. Longer studies are needed to assess the impact of different intervention components on long-term engagement and effectiveness.
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Affiliation(s)
- Liliana Laranjo
- Faculty of Medicine and Health, Westmead Applied Research Centre, The University of Sydney, Sydney, New South Wales, Australia .,Centre for Health Informatics - Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Ding Ding
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Bruno Heleno
- CEDOC, Chronic Diseases Research Centre, NOVA Medical School, Faculdade de Ciências Médicas, Lisbon, Portugal
| | - Baki Kocaballi
- Centre for Health Informatics - Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.,Faculty of Engineering and IT, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Juan C Quiroz
- Centre for Health Informatics - Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.,Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Huong Ly Tong
- Centre for Health Informatics - Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Bahia Chahwan
- Centre for Health Informatics - Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Ana Luisa Neves
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Elia Gabarron
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromso, Norway
| | - Kim Phuong Dao
- Centre for Health Informatics - Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - David Rodrigues
- Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | | | - Maria L Antunes
- Escola Superior Tecnologias da Saude, Instituto Politécnico de Lisboa, Lisboa, Portugal
| | - Enrico Coiera
- Centre for Health Informatics - Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - David W Bates
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA
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22
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Núñez de Arenas-Arroyo S, Cavero-Redondo I, Alvarez-Bueno C, Sequí-Domínguez I, Reina-Gutiérrez S, Martínez-Vizcaíno V. Effect of eHealth to increase physical activity in healthy adults over 55 years: A systematic review and meta-analysis. Scand J Med Sci Sports 2020; 31:776-789. [PMID: 33280182 DOI: 10.1111/sms.13903] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/21/2020] [Accepted: 11/30/2020] [Indexed: 12/21/2022]
Abstract
To estimate the effect of eHealth interventions on increasing physical activity (PA) in healthy adults over 55 years, a systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE, Cochrane, Web of Science, SPORTDiscus, and Scopus databases were searched, from inception to February 2020, for experimental studies reporting the effect of eHealth interventions on steps/day, daily moderate-to-vigorous physical activity (MVPA min/day), PA min/week, and MVPA min/week among adults over 55 years. The DerSimonian and Laird method was used to compute a pooled effect size (ES) estimate and the respective 95% confidence interval (95% CI). Eighteen studies were included in this meta-analysis with adults whose age ranged from 58 to 74.2 years. The interventions lasted between four and 52 weeks. The ES estimates of eHealth interventions on increasing PA were 0.59 (95% CI: 0.15-1.02) for steps/day, 0.49 (95% CI: 0.17-0.80) for daily MVPA, 0.13 (95% CI: 0.01-0.24) for total weekly PA and 0.31 (95% CI: 0.13-0.48) for weekly MVPA. Considering clinical improvements, the mean change difference estimates were an increase of 1616.28 steps/day (95% CI: 386.25-2846.31), 7.41 minutes of daily MVPA (95% CI: 3.24-11.57), 40.54 minutes of total weekly PA (95% CI: -8.71 to 89.79) and 56.35 minutes of weekly MVPA (95% CI: 17.43-95.27). In conclusion, eHealth interventions are effective in increasing PA levels among adults over 55 years, resulting in increased steps/day, MVPA min/day, PA min/week and MVPA min/week.
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Affiliation(s)
| | - Ivan Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla- La Mancha, Cuenca, Spain.,Universidad Politécnica y artística del Paraguay, Asunción, Paraguay
| | - Celia Alvarez-Bueno
- Health and Social Research Center, Universidad de Castilla- La Mancha, Cuenca, Spain.,Universidad Politécnica y artística del Paraguay, Asunción, Paraguay
| | - Irene Sequí-Domínguez
- Health and Social Research Center, Universidad de Castilla- La Mancha, Cuenca, Spain
| | - Sara Reina-Gutiérrez
- Health and Social Research Center, Universidad de Castilla- La Mancha, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla- La Mancha, Cuenca, Spain.,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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23
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Farris SG, Abrantes AM. Mental health benefits from lifestyle physical activity interventions: A systematic review. Bull Menninger Clin 2020; 84:337-372. [PMID: 33779237 DOI: 10.1521/bumc.2020.84.4.337] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Lifestyle physical activity (LPA) interventions are a promising alternative to structured exercise interventions for addressing mental health problems. The authors conducted a systematic review of the literature on LPA interventions in any population in order to determine (a) the extent to which mental health outcomes were examined and (b) whether benefits in mental health outcomes were observed. Mental health outcomes were defined as depression, anxiety, perceived stress, health-related quality of life, and psychological well-being. A total of 73 articles were identified as LPA intervention, of which 24.7% (n = 18) reported the effect of LPA intervention on mental health outcomes. The most commonly evaluated mental health outcome was depression, and to a lesser extent anxiety and perceived stress. Overall, findings point to promising effects of LPA interventions across common mental health problems. Key areas for future research are discussed in light of emergent limitations in existing published studies.
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Affiliation(s)
- Samantha G Farris
- Department of Psychology, Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.,Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, Rhode Island
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Anton SD, Cruz-Almeida Y, Singh A, Alpert J, Bensadon B, Cabrera M, Clark DJ, Ebner NC, Esser KA, Fillingim RB, Goicolea SM, Han SM, Kallas H, Johnson A, Leeuwenburgh C, Liu AC, Manini TM, Marsiske M, Moore F, Qiu P, Mankowski RT, Mardini M, McLaren C, Ranka S, Rashidi P, Saini S, Sibille KT, Someya S, Wohlgemuth S, Tucker C, Xiao R, Pahor M. Innovations in Geroscience to enhance mobility in older adults. Exp Gerontol 2020; 142:111123. [PMID: 33191210 PMCID: PMC7581361 DOI: 10.1016/j.exger.2020.111123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023]
Abstract
Aging is the primary risk factor for functional decline; thus, understanding and preventing disability among older adults has emerged as an important public health challenge of the 21st century. The science of gerontology - or geroscience - has the practical purpose of "adding life to the years." The overall goal of geroscience is to increase healthspan, which refers to extending the portion of the lifespan in which the individual experiences enjoyment, satisfaction, and wellness. An important facet of this goal is preserving mobility, defined as the ability to move independently. Despite this clear purpose, this has proven to be a challenging endeavor as mobility and function in later life are influenced by a complex interaction of factors across multiple domains. Moreover, findings over the past decade have highlighted the complexity of walking and how targeting multiple systems, including the brain and sensory organs, as well as the environment in which a person lives, can have a dramatic effect on an older person's mobility and function. For these reasons, behavioral interventions that incorporate complex walking tasks and other activities of daily living appear to be especially helpful for improving mobility function. Other pharmaceutical interventions, such as oxytocin, and complementary and alternative interventions, such as massage therapy, may enhance physical function both through direct effects on biological mechanisms related to mobility, as well as indirectly through modulation of cognitive and socioemotional processes. Thus, the purpose of the present review is to describe evolving interventional approaches to enhance mobility and maintain healthspan in the growing population of older adults in the United States and countries throughout the world. Such interventions are likely to be greatly assisted by technological advances and the widespread adoption of virtual communications during and after the COVID-19 era.
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Affiliation(s)
- Stephen D Anton
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Yenisel Cruz-Almeida
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Arashdeep Singh
- University of Florida, Department of Pharmacodynamics, College of Pharmacy, 1345 Center Drive, Gainesville, FL 32610, United States.
| | - Jordan Alpert
- University of Florida, College of Journalism and Communications, Gainesville, FL 32610, United States.
| | - Benjamin Bensadon
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Melanie Cabrera
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - David J Clark
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Natalie C Ebner
- University of Florida, Department of Psychology, 945 Center Drive, Gainesville, FL 32611, United States.
| | - Karyn A Esser
- University of Florida, Department of Physiology and Functional Genomics, 1345 Center Drive, Gainesville, FL, United States.
| | - Roger B Fillingim
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Soamy Montesino Goicolea
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Sung Min Han
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Henrique Kallas
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Alisa Johnson
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Christiaan Leeuwenburgh
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Andrew C Liu
- University of Florida, Department of Physiology and Functional Genomics, 1345 Center Drive, Gainesville, FL, United States.
| | - Todd M Manini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Michael Marsiske
- University of Florida, Department of Clinical & Health Psychology, 1225 Center Drive, Gainesville, FL 32610, United States.
| | - Frederick Moore
- University of Florida, Department of Surgery, Gainesville, FL 32610, United States.
| | - Peihua Qiu
- University of Florida, Department of Biostatistics, Gainesville, FL 32611, United States.
| | - Robert T Mankowski
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Mamoun Mardini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Christian McLaren
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Sanjay Ranka
- University of Florida, Department of Computer & Information Science & Engineering, Gainesville, FL 32611, United States.
| | - Parisa Rashidi
- University of Florida, Department of Biomedical Engineering. P.O. Box 116131. Gainesville, FL 32610, United States.
| | - Sunil Saini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Kimberly T Sibille
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Shinichi Someya
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Stephanie Wohlgemuth
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Carolyn Tucker
- University of Florida, Department of Psychology, 945 Center Drive, Gainesville, FL 32611, United States.
| | - Rui Xiao
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Marco Pahor
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
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Ringeval M, Wagner G, Denford J, Paré G, Kitsiou S. Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e23954. [PMID: 33044175 PMCID: PMC7589007 DOI: 10.2196/23954] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Unhealthy behaviors, such as physical inactivity, sedentary lifestyle, and unhealthful eating, remain highly prevalent, posing formidable challenges in efforts to improve cardiovascular health. While traditional interventions to promote healthy lifestyles are both costly and effective, wearable trackers, especially Fitbit devices, can provide a low-cost alternative that may effectively help large numbers of individuals become more physically fit and thereby maintain a good health status. OBJECTIVE The objectives of this meta-analysis are (1) to assess the effectiveness of interventions that incorporate a Fitbit device for healthy lifestyle outcomes (eg, steps, moderate-to-vigorous physical activity, and weight) and (2) to identify which additional intervention components or study characteristics are the most effective at improving healthy lifestyle outcomes. METHODS A systematic review was conducted, searching the following databases from 2007 to 2019: MEDLINE, EMBASE, CINAHL, and CENTRAL (Cochrane). Studies were included if (1) they were randomized controlled trials, (2) the intervention involved the use of a Fitbit device, and (3) the reported outcomes were related to healthy lifestyles. The main outcome measures were related to physical activity, sedentary behavior, and weight. All the studies were assessed for risk of bias using Cochrane criteria. A random-effects meta-analysis was conducted to estimate the treatment effect of interventions that included a Fitbit device compared with a control group. We also conducted subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) to further disentangle the effects of intervention components. RESULTS Our final sample comprised 41 articles reporting the results of 37 studies. For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference [MD] 950.54, 95% CI 475.89-1425.18; P<.001) and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001), a significant decrease in weight (MD -1.48, 95% CI -2.81 to -0.14; P=.03), and a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD -10.62, 95% CI -35.50 to 14.27; P=.40 and standardized MD -0.11, 95% CI -0.48 to 0.26; P=.56, respectively). In general, the included studies were at low risk for bias, except for performance bias. Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component. CONCLUSIONS The use of Fitbit devices in interventions has the potential to promote healthy lifestyles in terms of physical activity and weight. Fitbit devices may be useful to health professionals for patient monitoring and support. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42019145450; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145450.
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Affiliation(s)
- Mickael Ringeval
- École des Sciences de la Gestion, Université du Québec à Montréal, Montreal, QC, Canada
| | - Gerit Wagner
- Research Chair in Digital Health, HEC Montreal, Montreal, QC, Canada
| | - James Denford
- Department of Management, Faculty of Social Sciences and Humanities, Royal Military College of Canada, Kingston, ON, Canada
| | - Guy Paré
- Research Chair in Digital Health, HEC Montreal, Montreal, QC, Canada
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
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Chaudhry UAR, Wahlich C, Fortescue R, Cook DG, Knightly R, Harris T. The effects of step-count monitoring interventions on physical activity: systematic review and meta-analysis of community-based randomised controlled trials in adults. Int J Behav Nutr Phys Act 2020; 17:129. [PMID: 33036635 PMCID: PMC7545847 DOI: 10.1186/s12966-020-01020-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 09/07/2020] [Indexed: 12/17/2022] Open
Abstract
Background Step-count monitors (pedometers, body-worn trackers and smartphone applications) can increase walking, helping to tackle physical inactivity. We aimed to assess the effect of step-count monitors on physical activity (PA) in randomised controlled trials (RCTs) amongst community-dwelling adults; including longer-term effects, differences between step-count monitors, and between intervention components. Methods Systematic literature searches in seven databases identified RCTs in healthy adults, or those at risk of disease, published between January 2000–April 2020. Two reviewers independently selected studies, extracted data and assessed risk of bias. Outcome was mean differences (MD) with 95% confidence intervals (CI) in steps at follow-up between treatment and control groups. Our preferred outcome measure was from studies with follow-up steps adjusted for baseline steps (change studies); but we also included studies reporting follow-up differences only (end-point studies). Multivariate-meta-analysis used random-effect estimates at different time-points for change studies only. Meta-regression compared effects of different step-count monitors and intervention components amongst all studies at ≤4 months. Results Of 12,491 records identified, 70 RCTs (at generally low risk of bias) were included, with 57 trials (16,355 participants) included in meta-analyses: 32 provided change from baseline data; 25 provided end-point only. Multivariate meta-analysis of the 32 change studies demonstrated step-counts favoured intervention groups: MD of 1126 steps/day 95%CI [787, 1466] at ≤4 months, 1050 steps/day [602, 1498] at 6 months, 464 steps/day [301, 626] at 1 year, 121 steps/day [− 64, 306] at 2 years and 434 steps/day [191, 676] at 3–4 years. Meta-regression of the 57 trials at ≤4 months demonstrated in mutually-adjusted analyses that: end-point were similar to change studies (+ 257 steps/day [− 417, 931]); body-worn trackers/smartphone applications were less effective than pedometers (− 834 steps/day [− 1542, − 126]); and interventions providing additional counselling/incentives were not better than those without (− 812 steps/day [− 1503, − 122]). Conclusions Step-count monitoring leads to short and long-term step-count increases, with no evidence that either body-worn trackers/smartphone applications, or additional counselling/incentives offer further benefit over simpler pedometer-based interventions. Simple step-count monitoring interventions should be prioritised to address the public health physical inactivity challenge. Systematic review registration PROSPERO number CRD42017075810.
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Affiliation(s)
- Umar A R Chaudhry
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.
| | - Charlotte Wahlich
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Rebecca Fortescue
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Derek G Cook
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Rachel Knightly
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Tess Harris
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
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27
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Lewis ZH, Ottenbacher KJ, Fisher SR, Jennings K, Brown AF, Swartz MC, Martinez E, Lyons EJ. Effect of Electronic Activity Monitors and Pedometers on Health: Results from the TAME Health Pilot Randomized Pragmatic Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186800. [PMID: 32961834 PMCID: PMC7559399 DOI: 10.3390/ijerph17186800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 11/16/2022]
Abstract
Background: Brief counseling and self-monitoring with a pedometer are common practice within primary care for physical activity promotion. It is unknown how high-tech electronic activity monitors compare to pedometers within this setting. This study aimed to investigate the outcomes, through effect size estimation, of an electronic activity monitor-based intervention to increase physical activity and decrease cardiovascular disease risk. Method: The pilot randomized controlled trial was pre-registered online at clinicaltrials.gov (NCT02554435). Forty overweight, sedentary participants 55–74 years of age were randomized to wear a pedometer or an electronic activity monitor for 12 weeks. Physical activity was measured objectively for 7 days at baseline and follow-up by a SenseWear monitor and cardiovascular disease risk was estimated by the Framingham risk calculator. Results: Effect sizes for behavioral and health outcomes ranged from small to medium. While these effect sizes were favorable to the intervention group for physical activity (PA) (d = 0.78) and general health (d = 0.39), they were not favorable for measures. Conclusion: The results of this pilot trial show promise for this low-intensity intervention strategy, but large-scale trials are needed to test its efficacy.
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Affiliation(s)
- Zakkoyya H. Lewis
- College of Science, Department of Kinesiology and Health Promotion, California State Polytechnic University Pomona, 3801 West Temple Ave., Pomona, CA 91768, USA
- Correspondence:
| | - Kenneth J. Ottenbacher
- School of Health Professions, Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA;
| | - Steve R. Fisher
- School of Health Professions, Department of Physical Therapy, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA;
| | - Kristofer Jennings
- Department of Biostatistics, MD Anderson Cancer Center, 1400 Pressler St., Unit 1411, Houston, TX 77030-4008, USA;
| | - Arleen F. Brown
- School of Medicine, Division of General Internal Medicine and Health Services Research, University of California Los Angeles, 1100 Glendon, Ave., Los Angeles, CA 90095, USA;
| | - Maria C. Swartz
- Department of Pediatrics, Division of Pediatrics, MD Anderson Cancer Center, 7777 Knight Rd., Houston, TX 77054, USA;
| | - Eloisa Martinez
- Sealy Center on Aging, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA;
| | - Elizabeth J. Lyons
- School of Health Professions, Department of Nutrition and Metabolism, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA;
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Tang MSS, Moore K, McGavigan A, Clark RA, Ganesan AN. Effectiveness of Wearable Trackers on Physical Activity in Healthy Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth 2020; 8:e15576. [PMID: 32706685 PMCID: PMC7407266 DOI: 10.2196/15576] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/18/2019] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
Background Wearable trackers are an increasingly popular tool among healthy adults and are used to facilitate self-monitoring of physical activity. Objective We aimed to systematically review the effectiveness of wearable trackers for improving physical activity and weight reduction among healthy adults. Methods This review used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology and reporting criteria. English-language randomized controlled trials with more than 20 participants from MEDLINE, CINAHL, Cochrane Library, Web of Science, PubMed, and Scopus (2000-2017) were identified. Studies were eligible for inclusion if they reported an intervention group using wearable trackers, reporting steps per day, total moderate-to-vigorous physical activity, activity, physical activity, energy expenditure, and weight reduction. Results Twelve eligible studies with a total of 1693 participants met the inclusion criteria. The weighted average age was 40.7 years (95% CI 31.1-50.3), with 64.4% women. The mean intervention duration was 21.4 weeks (95% CI 6.1-36.7). The usage of wearable trackers was associated with increased physical activity (standardized mean difference 0.449, 95% CI 0.10-0.80; P=.01). In the subgroup analyses, however, wearable trackers demonstrated no clear benefit for physical activity or weight reduction. Conclusions These data suggest that the use of wearable trackers in healthy adults may be associated with modest short-term increases in physical activity. Further data are required to determine if a sustained benefit is associated with wearable tracker usage.
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Affiliation(s)
| | - Katherine Moore
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Andrew McGavigan
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.,Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia
| | - Robyn A Clark
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Anand N Ganesan
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.,Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
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Rodríguez-Monforte M, Fernández-Jané C, Martin-Arribas A, Costa-Tutusaus L, Sitjà-Rabert M, Ramírez-García I, Canet Vélez O, Kopp J, Vilaró J, Carrillo-Alvarez E. Interventions across the Retirement Transition for Improving Well-Being: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4341. [PMID: 32560506 PMCID: PMC7344699 DOI: 10.3390/ijerph17124341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 11/16/2022]
Abstract
(1) Background: The work-to-retirement transition involves a process of psychologically and behaviorally distancing oneself from the workforce that is often accompanied by other social changes, which can influence health and well-being. However, research on interventions targeting the work-to-retirement transition to improve health status is limited. Our objective was to summarize and describe interventions aiming to improve well-being across the retirement transition; (2) Methods: We conducted a scoping review following the methodological framework described by Arksey and O'Malley; the Joanna Briggs Institute guidelines as well as the PRISMA-ScR statements; we systematically searched articles and gray literature to identify interventions and policies that aimed to improve well-being across the retirement transition. (3) Results: 15 publications were included, which comprised both experimental designs (n = 10) and systematic reviews (n = 5). (4) Conclusions: More research on how to promote overall well-being during the work-to-retirement transition is needed. The results of this scoping review show that most reported interventions address one single lifestyle behavior, and that relevant social determinants of health have been barely considered in their design. Future investigations need to consider vulnerable groups and country-specific structural conditions. Adopting a patient and public involvement approach will contribute to developing interventions that address the significant needs of those in the transition to retirement.
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Affiliation(s)
- Miriam Rodríguez-Monforte
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Carles Fernández-Jané
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Anna Martin-Arribas
- GHenderS Research Group, Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (A.M.-A.); (I.R.-G.); (O.C.V.)
| | - Lluís Costa-Tutusaus
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Mercè Sitjà-Rabert
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Inés Ramírez-García
- GHenderS Research Group, Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (A.M.-A.); (I.R.-G.); (O.C.V.)
| | - Olga Canet Vélez
- GHenderS Research Group, Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (A.M.-A.); (I.R.-G.); (O.C.V.)
| | - Jenna Kopp
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Jordi Vilaró
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Elena Carrillo-Alvarez
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
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Wearable activity trackers and health awareness: Nursing implications. Int J Nurs Sci 2020; 7:179-183. [PMID: 32685614 PMCID: PMC7355185 DOI: 10.1016/j.ijnss.2020.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 03/01/2020] [Accepted: 03/19/2020] [Indexed: 11/12/2022] Open
Abstract
Purpose Wearable devices are commonly used to measure physical activity. However, it remains unclear the effect of wearing these devices on health awareness. Our aim was to provide evidence related to wearing physical activity trackers and health awareness. Methods A quantitative comparison study design was used comparing participants who wore physical activity tracking devices (n = 108) and those who did not (n = 112). A paper-based Physical Health Knowledge survey designed for the purpose of this research was used for data collection in 2018. Results A difference between participants who wore physical activity tracking devices and those that did not was identified in relation to activity levels and physical health awareness. Wearable devices are suggested as an opportunity for nurses to engage people in physical activity with the potential to improve their health awareness. Conclusions Nurses are well placed in the healthcare landscape to work with patients who own an activity tracker device concerning increasing activity self-monitoring. This information the patient has from the device can also form the basis of health discussions between nurses and the people in their care.
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31
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Hadgraft NT, Winkler E, Climie RE, Grace MS, Romero L, Owen N, Dunstan D, Healy G, Dempsey PC. Effects of sedentary behaviour interventions on biomarkers of cardiometabolic risk in adults: systematic review with meta-analyses. Br J Sports Med 2020; 55:144-154. [PMID: 32269058 PMCID: PMC7841485 DOI: 10.1136/bjsports-2019-101154] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2020] [Indexed: 01/28/2023]
Abstract
Context/purpose Observational and acute laboratory intervention research has shown that excessive sedentary time is associated adversely with cardiometabolic biomarkers. This systematic review with meta-analyses synthesises results from free living interventions targeting reductions in sedentary behaviour alone or combined with increases in physical activity. Methods Six electronic databases were searched up to August 2019 for sedentary behaviour interventions in adults lasting for ≥7 days publishing cardiometabolic biomarker outcomes covering body anthropometry, blood pressure, glucose and lipid metabolism, and inflammation (54 studies). The pooled effectiveness of intervention net of control on 15 biomarker outcomes was evaluated using random effects meta-analyses in the studies with control groups not providing other relevant interventions (33 studies; 6–25 interventions analysed). Results Interventions between 2 weeks and <6 months in non-clinical populations from North America, Europe and Australia comprised much of the evidence base. Pooled effects revealed small, significant (p<0.05) beneficial effects on weight (≈ −0.6 kg), waist circumference (≈ −0.7 cm), percentage body fat (≈ −0.3 %), systolic blood pressure (≈ −1.1 mm Hg), insulin (≈ −1.4 pM) and high-density lipoprotein cholesterol (≈ 0.04 mM). Pooled effects on the other biomarkers (p>0.05) were also small, and beneficial in direction except for fat-free mass (≈ 0.0 kg). Heterogeneity ranged widely (I2=0.0–72.9). Conclusions Our review of interventions targeting sedentary behaviour reductions alone, or combined with increases in physical activity, found evidence of effectiveness for improving some cardiometabolic risk biomarkers to a small degree. There was insufficient evidence to evaluate inflammation or vascular function. Key limitations to the underlying evidence base include a paucity of high-quality studies, interventions lasting for ≥12 months, sensitive biomarkers and clinical study populations (eg, type 2 diabetes). PROSPERO trial registration number CRD42016041742
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Affiliation(s)
- Nyssa T Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Elisabeth Winkler
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Rachel E Climie
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Megan S Grace
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | | | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - David Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Central Clinical School/Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Institute of Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.,Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia.,School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia
| | - Genevieve Healy
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Paddy C Dempsey
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia .,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
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Gray M, Adamo G, Pitini E, Jani A. Precision social prescriptions to promote active ageing in older people. J R Soc Med 2020; 113:143-147. [PMID: 32286116 PMCID: PMC7160795 DOI: 10.1177/0141076819865888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2024] Open
Affiliation(s)
- Muir Gray
- Department of Primary Care, University
of Oxford, Oxford OX2 6GG, UK
| | - Giovanna Adamo
- Dipartimento di Sanita Pubblica e
Malattie Infettive, Universita degli Studi di Roma La Sapienza, Roma 00185,
Italy
| | - Erica Pitini
- Dipartimento di Sanita Pubblica e
Malattie Infettive, Universita degli Studi di Roma La Sapienza, Roma 00185,
Italy
| | - Anant Jani
- Department of Primary Care, University
of Oxford, Oxford OX2 6GG, UK
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33
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Evaluating the Feasibility, Acceptability, and Effects of Deposit Contracts With and Without Daily Feedback to Promote Physical Activity. J Phys Act Health 2020; 17:29-36. [DOI: 10.1123/jpah.2018-0589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 07/24/2019] [Accepted: 09/07/2019] [Indexed: 11/18/2022]
Abstract
Background: Despite interest in financial incentive programs, evidence regarding the feasibility, acceptability, and effectiveness of deposit contracts (ie, use of participants’ own money as a financial reward) for increasing physical activity (PA) is limited. Furthermore, evidence regarding the use of feedback within incentive programs is limited. Purpose: To evaluate: (1) the feasibility and acceptability of deposit contracts for increasing objectively measured PA and (2) the effects of deposit contracts with or without ongoing feedback on PA. Methods: Participants (n = 24) were exposed to 3 conditions (1) self-monitoring, (2) incentive, and (3) incentive with feedback in an ABACABAC design, with the order of incentive conditions counterbalanced across participants. Results: Effect sizes suggest that individuals had a modest increase in PA during the incentive conditions compared with self-monitoring. Presentation order moderated results, such that individuals exposed to incentives with feedback first performed more poorly across both incentive conditions. In addition, individuals often cited the deposit contract as a reason for not enrolling, and those who did participate reported inadequate acceptability of the incentives and feedback. Conclusions: Results suggest that while deposit contracts may engender modest increases in PA, this type of incentive may not be feasible or acceptable for promoting PA.
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Yerrakalva D, Yerrakalva D, Hajna S, Griffin S. Effects of Mobile Health App Interventions on Sedentary Time, Physical Activity, and Fitness in Older Adults: Systematic Review and Meta-Analysis. J Med Internet Res 2019; 21:e14343. [PMID: 31778121 PMCID: PMC6908977 DOI: 10.2196/14343] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/01/2019] [Accepted: 09/24/2019] [Indexed: 12/31/2022] Open
Abstract
Background High sedentary time, low physical activity (PA), and low physical fitness place older adults at increased risk of chronic diseases, functional decline, and premature mortality. Mobile health (mHealth) apps, apps that run on mobile platforms, may help promote active living. Objective We aimed to quantify the effect of mHealth app interventions on sedentary time, PA, and fitness in older adults. Methods We systematically searched five electronic databases for trials investigating the effects of mHealth app interventions on sedentary time, PA, and fitness among community-dwelling older adults aged 55 years and older. We calculated pooled standardized mean differences (SMDs) in these outcomes between the intervention and control groups after the intervention period. We performed a Cochrane risk of bias assessment and Grading of Recommendations, Assessment, Development, and Evaluation certainty assessment. Results Overall, six trials (486 participants, 66.7% [324/486] women; age mean 68 [SD 6] years) were included (five of these trials were included in the meta-analysis). mHealth app interventions may be associated with decreases in sedentary time (SMD=−0.49; 95% CI −1.02 to 0.03), increases in PA (506 steps/day; 95% CI −80 to 1092), and increases in fitness (SMD=0.31; 95% CI −0.09 to 0.70) in trials of 3 months or shorter and with increases in PA (753 steps/day; 95% CI −147 to 1652) in trials of 6 months or longer. Risk of bias was low for all but one study. The quality of evidence was moderate for PA and sedentary time and low for fitness. Conclusions mHealth app interventions have the potential to promote changes in sedentary time and PA over the short term, but the results did not achieve statistical significance, possibly because studies were underpowered by small participant numbers. We highlight a need for larger trials with longer follow-up to clarify if apps deliver sustained clinically important effects.
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Affiliation(s)
- Dharani Yerrakalva
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.,Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Dhrupadh Yerrakalva
- Barking, Havering, and Redbridge University Hospitals Trust, London, United Kingdom
| | - Samantha Hajna
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Simon Griffin
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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Corr M, McMullen J, Morgan PJ, Barnes A, Murtagh EM. Supporting Our Lifelong Engagement: Mothers and Teens Exercising ( SOLE MATES); a feasibility trial. Women Health 2019; 60:618-635. [PMID: 31709910 DOI: 10.1080/03630242.2019.1688446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed to examine the feasibility of the Supporting Our Lifelong Engagement; Mothers and Teens Exercising (SOLE MATES) program. SOLE MATES, a single-arm six-week feasibility trial, comprised six face-to-face sessions. Participants were mothers (n = 27) with daughters (n = 31) aged 12-16 years. Data were collected in Ireland between January 2018 and March 2018. Feasibility benchmarks examined recruitment, data collection, acceptability, resources and participant responses. The primary outcome was daughters' step counts, measured via sealed pedometer for seven consecutive days at baseline and six weeks. Secondary outcomes included mothers' step counts, measures of communication, co-participation in activity, health-related quality of life and parenting practices. Feasibility benchmarks were reached or exceeded, except for retention. Eligibility rates were 93.4%, and baseline activity levels were low. Program content, measures and facilitators were acceptable, demonstrated through a mean score of 4.14 (SD 0.3) on a 5-point Likert Scale. Daily steps increased in mothers (2,875 increase, p = .009) and daughters (1,393 increase, p = .007). Positive feasibility metrics demonstrated the program's appeal. Participant responses for outcome measures also indicated program success. However, the relatively homogenous sample and relatively poor initial participation rate were study limitations. The intervention should be evaluated in a randomized controlled trial.
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Affiliation(s)
- Méabh Corr
- Department of Arts Education and Physical Education, Mary Immaculate College, University of Limerick , Limerick, Ireland
| | - Jaimie McMullen
- School of Sport and Exercise Science, University of Northern Colorado , Greeley, Colorado, USA
| | - Philip J Morgan
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle , Newcastle, Australia
| | - Alyce Barnes
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle , Newcastle, Australia
| | - Elaine M Murtagh
- Department of Arts Education and Physical Education, Mary Immaculate College, University of Limerick , Limerick, Ireland
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36
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Noz MP, Hartman YAW, Hopman MTE, Willems PHGM, Tack CJ, Joosten LAB, Netea MG, Thijssen DHJ, Riksen NP. Sixteen-Week Physical Activity Intervention in Subjects With Increased Cardiometabolic Risk Shifts Innate Immune Function Towards a Less Proinflammatory State. J Am Heart Assoc 2019; 8:e013764. [PMID: 31623506 PMCID: PMC6898840 DOI: 10.1161/jaha.119.013764] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Low‐grade inflammation, largely mediated by monocyte‐derived macrophages, contributes to atherosclerosis. Sedentary behavior is associated with atherosclerosis and cardiovascular diseases (CVD). We examined whether reducing sedentary behavior and improving walking time improves monocyte inflammatory phenotype in subjects with increased cardiovascular risk. Methods and Results Across 2 waves, 16 individuals with increased cardiovascular risk performed a 16‐week intervention study (age 64±6 years, body mass index 29.9±4.3 kg/m2), using a device with vibration feedback to promote physical activity. Before and after intervention, we objectively examined physical activity (ActivPAL), cytokine production capacity after ex vivo stimulation in peripheral blood mononuclear cells, metabolism of peripheral blood mononuclear cells, circulating cytokine concentrations, and monocyte immunophenotype. Overall, no significant increase in walking time was found (1.9±0.7 to 2.2±1.2 h/day, P=0.07). However, strong, inverse correlations were observed between the change in walking time and the change in production of interleukin (IL)‐1β, IL‐6, IL‐8, and IL‐10 after lipopolysaccharide stimulation (rs=−0.655, −0.844, −0.672, and −0.781, respectively, all P<0.05). After intervention optimization based on feedback from wave 1, participants in wave 2 (n=8) showed an increase in walking time (2.2±0.8 to 3.0±1.3 h/day, P=0.001) and attenuated cytokine production of IL‐6, IL‐8, and IL‐10 (all P<0.05). Glycolysis (P=0.08) and maximal OXPHOS (P=0.04) of peripheral blood mononuclear cells decreased after intervention. Lower IL‐6 concentrations (P=0.06) and monocyte percentages (P<0.05), but no changes in monocyte subsets were found. Conclusions Successfully improving walking time shifts innate immune function towards a less proinflammatory state, characterized by a lower capacity to produce inflammatory cytokines, in individuals with increased cardiovascular risk. Clinical Trial Registration Information URL: http://www.trialregister.nl. Unique identifier: NTR6387.
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Affiliation(s)
- Marlies P Noz
- Department of Internal Medicine Radboud Institute for Molecular Life Sciences (RIMLS) Radboud University Medical Center Nijmegen The Netherlands
| | - Yvonne A W Hartman
- Department of Physiology Radboud Institute for Health Sciences (RIHS) Radboud University Medical Center Nijmegen The Netherlands
| | - Maria T E Hopman
- Department of Physiology Radboud Institute for Health Sciences (RIHS) Radboud University Medical Center Nijmegen The Netherlands
| | - Peter H G M Willems
- Department of Biochemistry Radboud Institute for Molecular Life Sciences (RIMLS) Nijmegen The Netherlands
| | - Cees J Tack
- Department of Internal Medicine Radboud Institute for Molecular Life Sciences (RIMLS) Radboud University Medical Center Nijmegen The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine Radboud Institute for Molecular Life Sciences (RIMLS) Radboud University Medical Center Nijmegen The Netherlands
| | - Mihai G Netea
- Department of Internal Medicine Radboud Institute for Molecular Life Sciences (RIMLS) Radboud University Medical Center Nijmegen The Netherlands.,Department for Genomics & Immunoregulation, Life and Medical Sciences Institute (LIMES) University of Bonn Germany
| | - Dick H J Thijssen
- Department of Physiology Radboud Institute for Health Sciences (RIHS) Radboud University Medical Center Nijmegen The Netherlands.,Research Institute for Sport and Exercise Sciences Liverpool John Moores University Liverpool United Kingdom
| | - Niels P Riksen
- Department of Internal Medicine Radboud Institute for Molecular Life Sciences (RIMLS) Radboud University Medical Center Nijmegen The Netherlands
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37
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Compernolle S, DeSmet A, Poppe L, Crombez G, De Bourdeaudhuij I, Cardon G, van der Ploeg HP, Van Dyck D. Effectiveness of interventions using self-monitoring to reduce sedentary behavior in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2019; 16:63. [PMID: 31409357 PMCID: PMC6693254 DOI: 10.1186/s12966-019-0824-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/24/2019] [Indexed: 11/16/2022] Open
Abstract
Background Sedentary behavior occurs largely subconsciously, and thus specific behavior change techniques are needed to increase conscious awareness of sedentary behavior. Chief amongst these behavior change techniques is self-monitoring of sedentary behavior. The aim of this systematic review and meta-analysis was to evaluate the short-term effectiveness of existing interventions using self-monitoring to reduce sedentary behavior in adults. Methods Four electronic databases (PubMed, Embase, Web of Science, and The Cochrane Library) and grey literature (Google Scholar and the International Clinical Trials Registry Platform) were searched to identify appropriate intervention studies. Only (cluster-)randomized controlled trials that 1) assessed the short-term effectiveness of an intervention aimed at the reduction of sedentary behavior, 2) used self-monitoring as a behavior change technique, and 3) were conducted in a sample of adults with an average age ≥ 18 years, were eligible for inclusion. Relevant data were extracted, and Hedge’s g was used as the measure of effect sizes. Random effects models were performed to conduct the meta-analysis. Results Nineteen intervention studies with a total of 2800 participants met the inclusion criteria. Results of the meta-analyses showed that interventions using self-monitoring significantly reduced total sedentary time (Hedges g = 0,32; 95% CI = 0,14 − 0,50; p = 0,001) and occupational sedentary time (Hedge’s g = 0,56; 95% CI = 0,07 − 0,90; p = 0,02) on the short term. Subgroup analyses showed that significant intervention effects were only found if objective self-monitoring tools were used (g = 0,40; 95% CI = 0,19 − 0,60; p < 0,001), and if the intervention only targeted sedentary behavior (g = 0,45; 95% CI = 0,15-0,75; p = 0,004). No significant intervention effects were found on the number of breaks in sedentary behavior. Conclusions Despite the small sample sizes, and the large heterogeneity, results of the current meta-analysis suggested that interventions using self-monitoring as a behavior change technique have the potential to reduce sedentary behavior in adults. If future – preferably large-scale studies – can prove that the reductions in sedentary behavior are attributable to self-monitoring and can confirm the sustainability of this behavior change, multi-level interventions including self-monitoring may impact public health by reducing sedentary behavior. Electronic supplementary material The online version of this article (10.1186/s12966-019-0824-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.
| | - Ann DeSmet
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
| | - Louise Poppe
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health Amsterdam Public Health research institute Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
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Men on the Move: A Randomized Controlled Feasibility Trial of a Scalable, Choice-Based, Physical Activity and Active Transportation Intervention for Older Men. J Aging Phys Act 2019; 27:489-502. [PMID: 30507281 DOI: 10.1123/japa.2018-0137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We conducted Men on the Move, a 12-week randomized controlled feasibility trial of a scalable, choice-based, physical activity (PA) and active transportation intervention. Participants were community-dwelling men aged 60 years and older (n = 29 intervention [INT] and n = 29 waitlist control [CON]). Trained activity coaches delivered: (a) one-on-one participant consultations to develop personal action plans for PA and active transportation, (b) monthly group-based motivational meetings, (c) weekly telephone support, (d) complimentary recreation and transit passes, and (e) pedometers and diaries for self-monitoring. Men on the Move demonstrated high rates of recruitment, retention, and intervention adherence. INT chose a variety of group-based and individual PAs and destinations for their personal action plans. At 12 weeks, INT achieved more steps, moderate-vigorous PA, and energy expenditure than CON. INT was also more likely to take transit and meet national guideline levels of PA. At 24 weeks follow-up, INT benefits were sustained for moderate-vigorous PA and energy expenditure.
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Ashe MC, Edwards NY, Taylor A, Burnett L, Giangregorio L, Milne K, Clemson L, Fleig L. Return to Everyday Activity in the Community and Home: a feasibility study for a lifestyle intervention to sit less, move more, and be strong. Pilot Feasibility Stud 2019; 5:84. [PMID: 31297236 PMCID: PMC6599351 DOI: 10.1186/s40814-019-0467-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 06/13/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Many interventions designed to meet physical activity guideline recommendations focus on a single component (e.g., walking), to the detriment of other elements of a healthy lifestyle, such as reducing prolonged sitting and doing balance and strength exercises (i.e., bundled multiple behaviors). Adopting these multiple health behaviors within daily life routines may facilitate uptake and support longer-term behavior change. We tested feasibility for a three-part lifestyle intervention to support older women to sit less, move more, and complete balance and strength exercises. METHODS We used a convergent parallel mixed-methods, single-arm study design to test feasibility for a 6-week lifestyle intervention: Return to Everyday Activities in the Community and Home (REACH). We collected information at baseline, 3 and 6 weeks (final), and 6 months (follow-up) using questionnaires, semi-structured interviews, and performance-based measures. We describe three key elements: (1) implementation factors such as recruitment, retention, program delivery, and adherence; (2) participants' acceptability and experience with the program; and (3) health outcomes, including participants' global mobility, activity, and perceptions of their physical activity identity, and habit strength for (i) physical activity, (ii) breaking up sitting time, and (iii) balance and strength exercises. RESULTS We were able to recruit enough participants in the allotted time to conduct one cycle of the REACH group-based program. There were 10 community-dwelling women, median (p25, p75) age 61 (57.5, 71) years, who completed the study. The program was feasible to deliver, with high attendance (mean 5/6 sessions) and positive overall ratings (8/10). Participants rated session content and length high, and educational materials as highly acceptable and understandable. Although participants were active walkers at baseline, few were breaking up prolonged sitting or participating in any balance and strength exercises. At final and follow-up assessments, participants reported developing habits for all three health behaviors, without diminishing physical activity. CONCLUSION These results show acceptability of the program and its materials, and feasibility for bundling multiple health behaviors within the REACH program. It also provides confirmation to advance to testing feasibility of this three-part lifestyle intervention with older, less active, adults. TRIAL REGISTRATION ClinicalTrials.gov Identifier, NCT02786394; May 18, 2016.
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Affiliation(s)
- Maureen C. Ashe
- Department of Family Practice, Centre for Hip Health and Mobility, 7F–2635 Laurel Street, Vancouver, BC V5Z 1M9 Canada
- The University of British Columbia, Vancouver, Canada
- The University of Adelaide, Adelaide, Australia
| | - Nicola Y. Edwards
- Department of Family Practice, Centre for Hip Health and Mobility, 7F–2635 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | | | - Laura Burnett
- Department of Family Practice, Centre for Hip Health and Mobility, 7F–2635 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | - Lora Giangregorio
- University of Waterloo, Waterloo, Canada
- Schlegel Research Institute for Aging, Waterloo, Ontario Canada
| | - Kate Milne
- Cardea Health Consulting, Vancouver, Canada
| | | | - Lena Fleig
- MSB Medical School Berlin, Berlin, Germany
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40
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Shin G, Jarrahi MH, Fei Y, Karami A, Gafinowitz N, Byun A, Lu X. Wearable activity trackers, accuracy, adoption, acceptance and health impact: A systematic literature review. J Biomed Inform 2019; 93:103153. [DOI: 10.1016/j.jbi.2019.103153] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 03/17/2019] [Accepted: 03/18/2019] [Indexed: 11/24/2022]
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Brickwood KJ, Watson G, O'Brien J, Williams AD. Consumer-Based Wearable Activity Trackers Increase Physical Activity Participation: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2019. [PMID: 30977740 DOI: 10.2196/11819.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND The range of benefits associated with regular physical activity participation is irrefutable. Despite the well-known benefits, physical inactivity remains one of the major contributing factors to ill-health throughout industrialized countries. Traditional lifestyle interventions such as group education or telephone counseling are effective at increasing physical activity participation; however, physical activity levels tend to decline over time. Consumer-based wearable activity trackers that allow users to objectively monitor activity levels are now widely available and may offer an alternative method for assisting individuals to remain physically active. OBJECTIVE This review aimed to determine the effects of interventions utilizing consumer-based wearable activity trackers on physical activity participation and sedentary behavior when compared with interventions that do not utilize activity tracker feedback. METHODS A systematic review was performed searching the following databases for studies that included the use of a consumer-based wearable activity tracker to improve physical activity participation: Cochrane Controlled Register of Trials, MEDLINE, PubMed, Scopus, Web of Science, Cumulative Index of Nursing and Allied Health Literature, SPORTDiscus, and Health Technology Assessments. Controlled trials of adults comparing the use of a consumer-based wearable activity tracker with other nonactivity tracker-based interventions were included. The main outcome measures were physical activity participation and sedentary behavior. All studies were assessed for risk of bias, and the Grades of Recommendation, Assessment, Development, and Evaluation system was used to rank the quality of evidence. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement were followed. A random-effects meta-analysis was completed on the included outcome measures to estimate the treatment effect of interventions that included an activity tracker compared with a control group. RESULTS There was a significant increase in daily step count (standardized mean difference [SMD] 0.24; 95% CI 0.16 to 0.33; P<.001), moderate and vigorous physical activity (SMD 0.27; 95% CI 0.15 to 0.39; P<.001), and energy expenditure (SMD 0.28; 95% CI 0.03 to 0.54; P=.03) and a nonsignificant decrease in sedentary behavior (SMD -0.20; 95% CI -0.43 to 0.03; P=.08) following the intervention versus control comparator across all studies in the meta-analyses. In general, included studies were at low risk of bias, except for performance bias. Heterogeneity varied across the included meta-analyses ranging from low (I2=3%) for daily step count through to high (I2=67%) for sedentary behavior. CONCLUSIONS Utilizing a consumer-based wearable activity tracker as either the primary component of an intervention or as part of a broader physical activity intervention has the potential to increase physical activity participation. As the effects of physical activity interventions are often short term, the inclusion of a consumer-based wearable activity tracker may provide an effective tool to assist health professionals to provide ongoing monitoring and support.
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Affiliation(s)
- Katie-Jane Brickwood
- School of Health Science, College of Health and Medicine, University of Tasmania, Newnham, Australia
| | - Greig Watson
- School of Health Science, College of Health and Medicine, University of Tasmania, Newnham, Australia
| | - Jane O'Brien
- School of Health Science, College of Health and Medicine, University of Tasmania, Newnham, Australia
| | - Andrew D Williams
- School of Health Science, College of Health and Medicine, University of Tasmania, Newnham, Australia
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42
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Brickwood KJ, Watson G, O'Brien J, Williams AD. Consumer-Based Wearable Activity Trackers Increase Physical Activity Participation: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2019; 7:e11819. [PMID: 30977740 PMCID: PMC6484266 DOI: 10.2196/11819] [Citation(s) in RCA: 278] [Impact Index Per Article: 55.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/11/2018] [Accepted: 01/23/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The range of benefits associated with regular physical activity participation is irrefutable. Despite the well-known benefits, physical inactivity remains one of the major contributing factors to ill-health throughout industrialized countries. Traditional lifestyle interventions such as group education or telephone counseling are effective at increasing physical activity participation; however, physical activity levels tend to decline over time. Consumer-based wearable activity trackers that allow users to objectively monitor activity levels are now widely available and may offer an alternative method for assisting individuals to remain physically active. OBJECTIVE This review aimed to determine the effects of interventions utilizing consumer-based wearable activity trackers on physical activity participation and sedentary behavior when compared with interventions that do not utilize activity tracker feedback. METHODS A systematic review was performed searching the following databases for studies that included the use of a consumer-based wearable activity tracker to improve physical activity participation: Cochrane Controlled Register of Trials, MEDLINE, PubMed, Scopus, Web of Science, Cumulative Index of Nursing and Allied Health Literature, SPORTDiscus, and Health Technology Assessments. Controlled trials of adults comparing the use of a consumer-based wearable activity tracker with other nonactivity tracker-based interventions were included. The main outcome measures were physical activity participation and sedentary behavior. All studies were assessed for risk of bias, and the Grades of Recommendation, Assessment, Development, and Evaluation system was used to rank the quality of evidence. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement were followed. A random-effects meta-analysis was completed on the included outcome measures to estimate the treatment effect of interventions that included an activity tracker compared with a control group. RESULTS There was a significant increase in daily step count (standardized mean difference [SMD] 0.24; 95% CI 0.16 to 0.33; P<.001), moderate and vigorous physical activity (SMD 0.27; 95% CI 0.15 to 0.39; P<.001), and energy expenditure (SMD 0.28; 95% CI 0.03 to 0.54; P=.03) and a nonsignificant decrease in sedentary behavior (SMD -0.20; 95% CI -0.43 to 0.03; P=.08) following the intervention versus control comparator across all studies in the meta-analyses. In general, included studies were at low risk of bias, except for performance bias. Heterogeneity varied across the included meta-analyses ranging from low (I2=3%) for daily step count through to high (I2=67%) for sedentary behavior. CONCLUSIONS Utilizing a consumer-based wearable activity tracker as either the primary component of an intervention or as part of a broader physical activity intervention has the potential to increase physical activity participation. As the effects of physical activity interventions are often short term, the inclusion of a consumer-based wearable activity tracker may provide an effective tool to assist health professionals to provide ongoing monitoring and support.
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Affiliation(s)
- Katie-Jane Brickwood
- School of Health Science, College of Health and Medicine, University of Tasmania, Newnham, Australia
| | - Greig Watson
- School of Health Science, College of Health and Medicine, University of Tasmania, Newnham, Australia
| | - Jane O'Brien
- School of Health Science, College of Health and Medicine, University of Tasmania, Newnham, Australia
| | - Andrew D Williams
- School of Health Science, College of Health and Medicine, University of Tasmania, Newnham, Australia
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Takemoto M, Schechtman M, Villa N, Talavera G, Sears DD, Natarajan L, Owen N, Rosenberg DE, Dunstan D, Allison M, Kerr J. Arriba por la Vida Estudio (AVE): Study protocol for a standing intervention targeting postmenopausal Latinas. Contemp Clin Trials 2019; 79:66-72. [PMID: 30771560 DOI: 10.1016/j.cct.2019.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/16/2019] [Accepted: 02/12/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Postmenopausal Latinas are a growing population group in the US who are at high risk for cardiovascular disease. Epidemiological studies have shown that excessive sitting is related to cardiovascular disease risk. Older women sit for prolonged periods and most individuals do not meet physical activity guidelines. Reducing sitting through increased standing may improve cardiovascular risk. More research is needed on how to intervene to increase standing in older Latinas. OBJECTIVE To describe the protocol for a randomized controlled trial to increase standing in postmenopausal Latinas: the Arriba por la Vida Estudio (AVE). DESIGN/METHODS Postmenopausal Latinas will be randomized to one of two study arms: an increase standing intervention or a heart healthy attention-comparison condition. A total of 250 overweight postmenopausal Latinas will be recruited and followed for 12weeks. AVE is based on various models of behavior change including strategies such as self-monitoring, goal setting, and habit formation. Participants will receive three in-personhealth-counseling sessions (including one in-home visit) and five follow-up telephone calls using motivational interviewing techniques. Those in the attention-comparison condition will receive an equal number of contacts as the standing intervention with topics focused on healthy aging. The primary outcome is objectively-measured sitting time over three months measured via thigh-worn inclinometers and secondary outcomes include blood pressure, physical functioning and glucoregulatory and lipid biomarkers. CONCLUSIONS The findings from this study will provide valuable information about effective approaches to increase standing time in postmenopausal Latinas and its impact on cardiovascular disease risk. TRIAL REGISTRATION This study is registered at clincialtrials.gov Identifier: NCT02905929.
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Affiliation(s)
- Michelle Takemoto
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States of America.
| | - Megan Schechtman
- University of Michigan Medical School, 1500 E Medical Center Drive, Ann Arbor, MI 48109, United States of America
| | - Nicole Villa
- San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, United States of America
| | - Gregory Talavera
- San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, United States of America
| | - Dorothy D Sears
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States of America; College of Health Solutions, Arizona State University, 445 N. 5th Street, Phoenix, AZ, 85004, United States of America
| | - Loki Natarajan
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States of America
| | - Neville Owen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave Suite 1600, Seattle, WA 98101, United States of America
| | - David Dunstan
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia
| | - Matthew Allison
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States of America
| | - Jacqueline Kerr
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States of America
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Investigating the Use of an Electronic Activity Monitor System as a Component of Physical Activity and Weight-Loss Interventions in Nonclinical Populations: A Systematic Review. J Phys Act Health 2019; 16:294-302. [PMID: 30849927 DOI: 10.1123/jpah.2017-0660] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Electronic activity monitor systems (EAMSs) have been readily incorporated into physical activity (PA) and weight-loss interventions to facilitate self-monitoring PA behavior. A comprehensive review is required to better understand their utility as intervention modalities in nonclinical populations. METHODS Medscape, MEDLINE, PsycINFO, and Cochrane databases were searched in February 2017, with a search update in April 2017. Citation screening, risk of bias assessment, and an intensity evaluation were conducted in duplicate by 2 investigators. RESULTS The search returned 409 unique citations. Of which, 22 citations met the inclusion criteria. Seven studies found significant between-group differences: 3 in weight loss, 3 in PA levels, and 1 in both weight loss and PA levels. Effective interventions lasted 6 weeks to 12 months. Positive health outcomes were demonstrated when users interacted with multiple features of the EAMS and had access to other services, such as personal coaching or environmental reinforcement. CONCLUSIONS When control and intervention groups have access to the same components, such as counseling or group interaction, the addition of an EAMS for self-monitoring within the intervention group may not confer more favorable results. Risk of performance bias and low sample sizes should be addressed in future trials to generate more reliable findings.
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Stockwell S, Schofield P, Fisher A, Firth J, Jackson SE, Stubbs B, Smith L. Digital behavior change interventions to promote physical activity and/or reduce sedentary behavior in older adults: A systematic review and meta-analysis. Exp Gerontol 2019; 120:68-87. [PMID: 30836130 DOI: 10.1016/j.exger.2019.02.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/19/2019] [Accepted: 02/27/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Physical activity and sedentary behavior are modifiable risk factors for non-communicable disease and healthy ageing, however the majority of older adults remain insufficiently active. Digital behavior change interventions (DBCI) have the potential to reach many older adults to promote physical activity and reduce sedentary time. This study aims to assess the efficacy of DBCI interventions in older adults (≥50 years) on physical activity and sedentary behavior. METHODS A systematic review of major databases from inception to 03/2018 was undertaken. Randomized controlled trials (RCT) or pre-post interventions assessing effects of DBCI on physical activity and/or sedentary behavior in older adults (≥50 years) were included. Random effects meta-analyses were carried out. RESULTS Twenty-two studies were included, including 1757 older adults (mean age = 67 years, %male = 41), 68% showed moderate-high risk of bias. Meta-analyses suggested that DBCI increased total physical activity among RCT studies (n = 8) (SMD = 0.28; 95%CI 0.01, 0.56; p = 0.04) and pre-post studies (n = 6) (SMD = 0.25; 95%CI 0.09, 0.41; p = 0.002), increased moderate-to-vigorous physical activity (SMD = 0.47; 95%CI 0.32, 0.62, p < 0.001; MD = 52 min/week) and reduced sedentary time (SMD = -0.45; 95%CI -0.69, -0.19; p < 0.001; MD = 58 min/day). Reductions in systolic blood pressure (-11 bpm; p = 0.04) and improvements in physical functioning (p = 0.03) were also observed. CONCLUSIONS DBCI may increase physical activity and physical functioning, and reduce sedentary time and systolic blood pressure in older adults, however more high-quality studies are required.
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Affiliation(s)
- Stephanie Stockwell
- Positive Ageing Research Institute, Anglia Ruskin University, Chelmsford, UK; The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Compass House Annex, Newmarket Road, Cambridge CB5 8DZ, UK.
| | - Patricia Schofield
- Positive Ageing Research Institute, Anglia Ruskin University, Chelmsford, UK
| | - Abi Fisher
- Department of Behavioral Science & Health, University College London, Torrington Place, London WC1E 7HB, UK
| | - Joseph Firth
- NICM Health Research Institute University of Western Sydney, Australia; Division of Psychology and Mental Health, University of Manchester, UK
| | - Sarah E Jackson
- Department of Behavioral Science & Health, University College London, Torrington Place, London WC1E 7HB, UK
| | - Brendon Stubbs
- Positive Ageing Research Institute, Anglia Ruskin University, Chelmsford, UK; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Compass House Annex, Newmarket Road, Cambridge CB5 8DZ, UK
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Lee SH, Ha Y, Jung M, Yang S, Kang WS. The Effects of a Mobile Wellness Intervention with Fitbit Use and Goal Setting for Workers. Telemed J E Health 2019; 25:1115-1122. [PMID: 30648920 DOI: 10.1089/tmj.2018.0185] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background and Introduction: There is strong evidence that worksite wellness programs can significantly improve the health profile of participating workers. To date, little is known about research on the effects of mobile wellness interventions in worksite settings. Furthermore, no studies have been conducted to evaluate mobile wellness interventions with activity trackers and tailoring strategies for physically inactive workers in manufacturing companies. This study aimed to examine the effects of a mobile wellness intervention with Fitbit and goal setting using brief counseling and text messaging among workers. Materials and Methods: A total of 79 (n = 79) workers from large manufacturing companies were allocated into an experimental group (n = 41) and a control group (n = 38). All participants were asked to wear an activity tracker (Fitbit Charger HR) during all waking hours for 5 weekdays. Participants in the experimental group received Fitbit, daily motivational text messaging, and biweekly counseling with a specifically designed workbook for 12 weeks, whereas Fitbit was only provided to the control group. Results: At the 12-week measurement, there were significant differences between the experimental group and control group on wellness (p < 0.001), physical activity behavior (p < 0.001), daily walking steps (p < 0.001), and physical activity self-efficacy (p < 0.001). Discussion and Conclusions: Although Fitbit facilitates an individual's activities by providing information about daily steps, the tracker itself, without additional goal-setting techniques, may be insufficient to encourage behavior change. These findings indicate that the mobile wellness intervention with Fitbit and goal setting using brief counseling and tailored text messaging is more effective for physically inactive workers.
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Affiliation(s)
- Sang-Ho Lee
- Convergence Research Center for Wellness, Daegu Gyeonbuk Institute of Science and Technology (DGIST), Daegu, South Korea
| | - Yeongmi Ha
- College of Nursing and Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea
| | - Mira Jung
- Department of Nursing, Hanyeong College, Yeosu, South Korea
| | - Seungkyoung Yang
- Department of Nursing, Kyungnam University, Changwon, South Korea
| | - Won-Seok Kang
- Convergence Research Center for Wellness, Daegu Gyeonbuk Institute of Science and Technology (DGIST), Daegu, South Korea
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Zavala-Crichton JP, Yáñez-Sepúlveda RA, Hernández-García NY, Barraza-Gómez FO, Mahecha-Matsudo SM. [Effects of the government's healthy living program on metabolic markers and physical capacity in Chilean women]. ACTA ACUST UNITED AC 2018; 20:618-622. [PMID: 33111896 DOI: 10.15446/rsap.v20n5.67041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 07/14/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the effects of the government's healthy living plan on metabolic markers and physical capacity in sedentary women from Villa Alemana, Chile. MATERIALS AND METHODS 63 women who participated in the study (41.2±11.2 years) underwent 12 months of multi- and interdisciplinary intervention (doctor, nutritionist, psychologist and physical education teacher) of 180 minutes of physical activity per week. Mean and standard deviation were used for statistical analysis, while the t-test of related samples was used to determine the effects of the program. The level of significance was estimated with a value of p<0.05. RESULTS There was a decrease in total cholesterol (p=0.003) and LDL cholesterol (p=0.048), improvement in the 6-minute test (p=0.000) and number of squats in thirty seconds (p=0.000) with a positive effect on delta recovery heart rate (p=0.001). CONCLUSIONS The government's strategy resulted in a decrease of cardiovascular risk due to improved metabolic markers and women's physical capacity.
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Affiliation(s)
- Juan P Zavala-Crichton
- JZ: Profesor de Educación Física. M. Sc. Nutrición Humana. Facultad de Educación y Ciencias Sociales, Universidad Andres Bello. Viña del Mar, Chile.
| | - Rodrigo A Yáñez-Sepúlveda
- RY: Profesor de Educación Física. M. Sc. Medicina y Ciencias del Deporte. Grupo IRyS, Escuela de Educación Física. Pontificia Universidad Católica de Valparaíso. Viña del Mar, Chile.
| | - Nayaded Y Hernández-García
- NH: Profesora de Educación Física. M. Sc. Gestión deportiva. Facultad de Educación y Ciencias Sociales, Universidad Andres Bello. Viña del Mar, Chile.
| | - Fernando O Barraza-Gómez
- FB: Profesor de Educación Física. M. Sc. Medicina y Ciencias del Deporte. Carrera de Pedagogía en Educación Física. Universidad Viña del Mar, Viña del Mar, Chile.
| | - Sandra M Mahecha-Matsudo
- SM: MD. Ph. D.; Post Doctorado en Ciencias del envejecimiento. Esp. Medicina Deportiva. Facultad de Ciencias, Universidad Mayor. Santiago, Chile.
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Can a Lifestyle Intervention Increase Active Transportation in Women Aged 55-70 years? Secondary Outcomes From a Pilot Randomized Controlled Trial. J Phys Act Health 2018; 15:411-416. [PMID: 29570005 DOI: 10.1123/jpah.2016-0348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical activity confers many health benefits to older adults, and adopting activity into daily life routines may lead to better uptake. The purpose of this study was to test the effect of a lifestyle intervention to increase daily physical activity in older women through utilitarian walking and use of public transportation. METHODS In total, 25 inactive women with mean age (SD) of 64.1 (4.6) years participated in this pilot randomized controlled trial [intervention (n = 13) and control (n = 12)]. Seven-day travel diaries (trips per week) and the International Physical Activity Questionnaire (minutes per week) were collected at baseline, 3, and 6 months. RESULTS At 3 months, intervention participants reported 9 walking trips per week and 643.5 minutes per week of active transportation, whereas control participants reported 4 walking trips per week and 49.5 minutes per week of active transportation. Adjusting for baseline values, there were significant group differences favoring Everyday Activity Supports You for walking trips per week [4.6 (0.5 to 9.4); P = .04] and active transportation minutes per week [692.2 (36.1 to 1323.5); P = .05]. At 6 months, significant group differences were observed in walking trips per week [6.1 (1.9 to 11.4); P = .03] favoring the intervention (9 vs 2 trips per week). CONCLUSION Given these promising findings, the next step is to test Everyday Activity Supports You model's effectiveness to promote physical activity in older women within a larger study.
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Rosenberg DE, Lee AK, Anderson M, Renz A, Matson TE, Kerr J, Arterburn D, McClure JB. Reducing Sedentary Time for Obese Older Adults: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e23. [PMID: 29434012 PMCID: PMC5826980 DOI: 10.2196/resprot.8883] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/05/2017] [Accepted: 12/06/2017] [Indexed: 01/12/2023] Open
Abstract
Background Older adults have high rates of obesity and are prone to chronic health conditions. These conditions are in part due to high rates of sedentary time (ST). As such, reducing ST could be an innovative strategy for improving health outcomes among obese older adults. To test this theory, we developed a novel, technology-enhanced intervention to reduce sitting time (I-STAND) and pilot tested it to assess the feasibility, acceptability, and preliminary effects of the intervention on ST and biometric outcomes. Objective The current paper aims to describe the rationale, design, and methods of the I-STAND sitting reduction pilot trial. Methods Older adults with obesity (n=60) were recruited from a large health care system and randomized to receive I-STAND or a healthy living intervention. I-STAND combined personal coaching with a technology-enhanced intervention (Jawbone UP band) to cue breaks from sitting. Participants completed self-report and biometric assessments at baseline and 3 months. Additional qualitative results were collected from a subset of I-STAND participants (n=22) to further inform the feasibility and acceptability of the interventions. The primary outcome was total hours of daily sitting time measured by the activPAL device. Secondary outcomes included sit-to-stand transitions, bouts of sitting longer than 30 minutes, physical function, blood pressure, fasting glucose, cholesterol, and depressive symptoms. Results Study enrollment has ended and data processing is underway. Conclusions Data from randomized trials on sitting reduction are needed to inform novel approaches to health promotion among older adults with obesity. Our trial will help fill this gap. The methods used in our study can guide future research on using technology-based devices to assess or prompt sedentary behavior reduction, or those interested in behavioral interventions targeting obese older adults with novel approaches Trial Registration ClinicalTrials.gov: NCT02692560; https://clinicaltrials.gov/ct2/show/NCT02692560 (Archived by WebCite at http://www.webcitation.org/6wppLTWAl)
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Affiliation(s)
- Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Amy K Lee
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Melissa Anderson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Anne Renz
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Theresa E Matson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Jacqueline Kerr
- University of California San Diego, San Diego, CA, United States
| | - David Arterburn
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Jennifer B McClure
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
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Abstract
Physical activity outcomes are poor following total knee arthroplasty (TKA). The purpose was to evaluate feasibility of a physical activity feedback intervention for patients after TKA. Participants completing conventional TKA rehabilitation were randomized to a physical activity feedback (PAF; n = 22) or control (CTL; n = 23) group. The PAF intervention included real-time activity feedback, weekly action planning, and monthly group support meetings (12 weeks). The CTL group received attention control education. Feasibility was assessed using retention, adherence, dose goal attainment, and responsiveness with pre- and postintervention testing. The PAF group had 100% retention, 92% adherence (frequency of feedback use), and 65% dose goal attainment (frequency of meeting goals). The PAF group average daily step count increased from 5,754 (2,714) (pre) to 6,917 (3,445) steps/day (post). This study describes a feasible intervention to use as an adjunct to conventional rehabilitation for people with TKA.
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