1
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Tufford AR, Diou C, Lucassen DA, Ioakimidis I, O'Malley G, Alagialoglou L, Charmandari E, Doyle G, Filis K, Kassari P, Kechadi T, Kilintzis V, Kok E, Lekka I, Maglaveras N, Pagkalos I, Papapanagiotou V, Sarafis I, Shahid A, van ’t Veer P, Delopoulos A, Mars M. Toward Systems Models for Obesity Prevention: A Big Role for Big Data. Curr Dev Nutr 2022; 6:nzac123. [PMID: 36157849 PMCID: PMC9492244 DOI: 10.1093/cdn/nzac123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/24/2022] [Accepted: 07/28/2022] [Indexed: 11/14/2022] Open
Abstract
The relation among the various causal factors of obesity is not well understood, and there remains a lack of viable data to advance integrated, systems models of its etiology. The collection of big data has begun to allow the exploration of causal associations between behavior, built environment, and obesity-relevant health outcomes. Here, the traditional epidemiologic and emerging big data approaches used in obesity research are compared, describing the research questions, needs, and outcomes of 3 broad research domains: eating behavior, social food environments, and the built environment. Taking tangible steps at the intersection of these domains, the recent European Union project "BigO: Big data against childhood obesity" used a mobile health tool to link objective measurements of health, physical activity, and the built environment. BigO provided learning on the limitations of big data, such as privacy concerns, study sampling, and the balancing of epidemiologic domain expertise with the required technical expertise. Adopting big data approaches will facilitate the exploitation of data concerning obesity-relevant behaviors of a greater variety, which are also processed at speed, facilitated by mobile-based data collection and monitoring systems, citizen science, and artificial intelligence. These approaches will allow the field to expand from causal inference to more complex, systems-level predictive models, stimulating ambitious and effective policy interventions.
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Affiliation(s)
- Adele R Tufford
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Christos Diou
- Department of Informatics and Telematics, Harokopio University of Athens, Athens, Greece
| | - Desiree A Lucassen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Ioannis Ioakimidis
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
| | - Grace O'Malley
- W82GO Child and Adolescent Weight Management Service, Children's Health Ireland at Temple Street, Dublin, Ireland
- Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland University for Medicine and Health Sciences, Dublin, Ireland
| | - Leonidas Alagialoglou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children's Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Gerardine Doyle
- College of Business, University College Dublin, Dublin, Ireland
- Geary Institute for Public Policy, University College Dublin, Dublin, Ireland
| | | | - Penio Kassari
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children's Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Tahar Kechadi
- CeADAR: Ireland's Centre for Applied AI, University College Dublin, Dublin 4, Ireland
| | - Vassilis Kilintzis
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Esther Kok
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Irini Lekka
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nicos Maglaveras
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Vasileios Papapanagiotou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Sarafis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Arsalan Shahid
- CeADAR: Ireland's Centre for Applied AI, University College Dublin, Dublin 4, Ireland
| | - Pieter van ’t Veer
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Anastasios Delopoulos
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Monica Mars
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
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2
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Kim MJ, Hall CM. Application of EMGB to Study Impacts of Public Green Space on Active Transport Behavior: Evidence from South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127459. [PMID: 35742705 PMCID: PMC9245604 DOI: 10.3390/ijerph19127459] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 12/31/2022]
Abstract
Public green spaces (e.g., parks, green trails, greenways) and motivations to engage in active transport are essential for encouraging walking and cycling. However, how these key factors influence walker and cyclist behavior is potentially being increasingly influenced by the use of smart apps, as they become more ubiquitous in everyday practices. To fill this research gap, this work creates and tests a theoretically integrated study framework grounded in an extended model of goal-directed behavior, including public green space and motivation with perceived usefulness of smart apps. In order to accomplish the purpose of this study, we conducted an online survey of Korean walkers (n = 325) and cyclists (n = 326) between 10 and 25 July 2021 and applied partial least squares, structural equation, and multi-group analysis to validate the research model. Results revealed that active transport users' awareness of public green space positively influences attitude toward (γ = 0.163), as well as behavioral intention of (γ = 0.159), walking and cycling. Additionally, motivation (extrinsic and intrinsic) greatly influences attitude (γ = 0.539) and behavioral intention (γ = 0.535). Subjective norms (γ = 0.137) and positive (γ = 0.466) and negative anticipated emotions (γ = 0.225) have a significant impact on the desire that leads to behavioral intention. High and low perceived smart app usefulness also significantly moderates between public green space and attitude (t-value = 25.705), public green space and behavioral intention (t-value = 25.726), motivation and attitude (t-value = -25.561), and motivation and behavioral intention (t-value = -15.812). Consequently, the findings are useful to academics and practitioners by providing new knowledge and insights.
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Affiliation(s)
- Myung Ja Kim
- The College of Hotel & Tourism Management, Kyung Hee University, Seoul 02447, Korea
- Correspondence: (M.J.K.); (C.H.M.); Tel.: +82-10-9035-2696 (M.J.K.); Fax: +82-2-961-0549 (M.J.K.)
| | - C. Michael Hall
- The College of Hotel & Tourism Management, Kyung Hee University, Seoul 02447, Korea
- Department of Management, Marketing and Entrepreneurship, University of Canterbury, Christchurch 8140, New Zealand
- Geography Research Unit, University of Oulu, 90014 Oulu, Finland
- Ekonomihögskolan, Linnéuniversitet, Universitetskajen, Landgången 6, 39182 Kalmar, Sweden
- Department of Service Management and Service Studies, Campus Helsingborg, Lund University, 25108 Helsingborg, Sweden
- Centre for Research and Innovation in Tourism, Taylor’s University, Subang Jaya 47500, Malaysia
- Correspondence: (M.J.K.); (C.H.M.); Tel.: +82-10-9035-2696 (M.J.K.); Fax: +82-2-961-0549 (M.J.K.)
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3
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Herreros-Irarrázabal D, Guzmán-Habinger J, Mahecha Matsudo S, Kovalskys I, Gómez G, Rigotti A, Cortés LY, Yépez García MC, Pareja RG, Herrera-Cuenca M, Farías-Valenzuela C, Marques A, Leme ACB, Fisberg M, Drenowatz C, Ferrari G. Association between Active Transportation and Public Transport with an Objectively Measured Meeting of Moderate-to-Vigorous Physical Activity and Daily Steps Guidelines in Adults by Sex from Eight Latin American Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11553. [PMID: 34770064 PMCID: PMC8583702 DOI: 10.3390/ijerph182111553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 01/23/2023]
Abstract
This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18-65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8-30.0) and 12.9 min/day in women (IQR: 4.3-25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58-2.54; women: OR: 1.57; 95%CI: 1.25-1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31-3.91; women: OR: 1.82; 95%CI: 1.45-2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15-2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.
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Affiliation(s)
- Diego Herreros-Irarrázabal
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile; (D.H.-I.); (J.G.-H.); (S.M.M.)
| | - Juan Guzmán-Habinger
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile; (D.H.-I.); (J.G.-H.); (S.M.M.)
| | - Sandra Mahecha Matsudo
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile; (D.H.-I.); (J.G.-H.); (S.M.M.)
- Centro de Investigación en Medicina Deporte Ejercicio y Salud—Clínica MEDS, Santiago 7550000, Chile
| | - Irina Kovalskys
- Nutrition Career, Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires C1107AAZ, Argentina;
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José 11501-2060, Costa Rica;
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, Santiago 8330024, Chile;
| | - Lilia Yadira Cortés
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas 1053, Venezuela;
| | - Claudio Farías-Valenzuela
- Instituto del Deporte, Universidad de las Américas, Santiago 9170022, Chile;
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Education, University of Granada, 18071 Granada, Spain
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisbon, Portugal;
- ISAMB, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Ana Carolina B. Leme
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil; (A.C.B.L.); (M.F.)
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil; (A.C.B.L.); (M.F.)
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria;
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile
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Peruzzi M, Sanasi E, Pingitore A, Marullo AG, Carnevale R, Sciarretta S, Sciarra L, Frati G, Cavarretta E. An overview of cycling as active transportation and as benefit for health. Minerva Cardioangiol 2021; 68:81-97. [PMID: 32429627 DOI: 10.23736/s0026-4725.20.05182-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Active transportation is defined as travelling on foot, by bicycle or other non-motorized means, sometimes in combination with other forms of public transportation, in contrast with the use of motor vehicles. The prevalence of sedentary lifestyle and physical inactivity is a growing epidemic in most developed countries that spread over the last three decades; active transportation may be a promising approach to increase physical activity and reduce the risk of non-communicable diseases improving cardiorespiratory fitness and cardiometabolic health. The health benefits of physical activity in reducing mortality and morbidity have been proved by several publications. Cardiorespiratory fitness can be improved by regular physical activity with an amelioration of insulin sensitivity, blood lipid profile, body composition, inflammation, and blood pressure. Active transportation as a daily physical activity is less expensive compared to motor vehicle use. The advantages are remarkable in terms of contrasting obesity and sedentary lifestyle, decrease motor traffic congestion and mitigate climate change. Massive investments in policies and interventions aimed to increase active transportation are not generally promoted and there are differences in the prevalence of active transportation in the daily routine among different areas. As in the literature several studies as randomized trials or observational studies have been published, with different end-points, in order to investigate if active commuting may be the right answer to improve cardiorespiratory fitness and cardiometabolic health, we aimed to review the available evidences of cycling as an active transportation and to consider its benefits on health.
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Affiliation(s)
| | - Elena Sanasi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | | | - Antonino G Marullo
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Roberto Carnevale
- Mediterranea Cardiocentro, Naples, Italy.,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Sebastiano Sciarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Department of Angio-Cardio-Neurology, IRCCS NeuroMed, Pozzilli, Isernia, Italy
| | - Luigi Sciarra
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Department of Angio-Cardio-Neurology, IRCCS NeuroMed, Pozzilli, Isernia, Italy
| | - Elena Cavarretta
- Mediterranea Cardiocentro, Naples, Italy - .,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
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5
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Makai A, Füge K, Breitenbach Z, Betlehem J, Ács P, Lampek K, Figler M. The effect of a community-based e-health program to promote the role of physical activity among healthy adults in Hungary. BMC Public Health 2020; 20:1059. [PMID: 32799879 PMCID: PMC7429904 DOI: 10.1186/s12889-020-08750-1] [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: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 12/15/2022] Open
Abstract
Background Physically active lifestyle can prolong the years spent without chronic diseases and is strongly associated with good mental and physical health. The goal of the study was to examine the physical activity patterns of the healthy adults and the effectiveness of a community-based e-health program. Methods The study sample comprised of 633 participants. Analyses were based on the E-Harmony health program that was conducted in Hungary in 2014–2015. The longitudinal study measured the physical activity patterns of the healthy adult population, and a 12-month community-based internet and media program was evaluated for the target group to improve the physical activity level and related knowledge. We examined the effectiveness of the program by the International Physical Activity Questionnaire – Hungarian validated long version adjusting for socio-demographic parameters, also across multivariate linear regression analysis using SPSS 24.0 software. Confidence interval of 95% was used and the level of significance was p < 0.05. Results The total physical activity of the study sample was 5129.9 (SD = 4488.1) MET min/week. Male participants scored higher in total activity but the results showed no statistical significance. Our participants were sitting 2211.6 (SD = 1592.8) min /week on average (daily average was 315.9 (SD = 227.6) minutes); the results showed no statistically significant difference by gender. We found weak but significant relationship between the active lifestyle and anthropometric data, especially according to leisure time activities and sedentary behaviour (p < 0.001). Based on the multivariate linear regression models the socio-demographic parameters significantly affected the physical activity level of participants. After the 12-month community-based e-health program, 10.34% changes occurred in the total physical activity level (p < 0.001). Conclusions To our knowledge, ours was the first community-based e-health program in Hungary to improve the physical activity level of the healthy adult population. Based on our results this web-based e-health program can be an adequate tool to promote healthy lifestyle. The study could provide appropriate information for the further health interventions and policy making. Further research is necessary to determine the special risk groups and to develop an applicable e-health program for such specific subgroups.
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Affiliation(s)
- Alexandra Makai
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621, Hungary.
| | - Kata Füge
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621, Hungary
| | - Zita Breitenbach
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621, Hungary
| | - József Betlehem
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621, Hungary
| | - Pongrác Ács
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621, Hungary
| | - Kinga Lampek
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621, Hungary
| | - Mária Figler
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621, Hungary
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Lindqvist AK, Rutberg S, Söderström E, Ek A, Alexandrou C, Maddison R, Löf M. User Perception of a Smartphone App to Promote Physical Activity Through Active Transportation: Inductive Qualitative Content Analysis Within the Smart City Active Mobile Phone Intervention (SCAMPI) Study. JMIR Mhealth Uhealth 2020; 8:e19380. [PMID: 32755889 PMCID: PMC7439138 DOI: 10.2196/19380] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/08/2020] [Accepted: 06/21/2020] [Indexed: 01/15/2023] Open
Abstract
Background Physical inactivity is globally recognized as a major risk factor for morbidity, particularly the incidence of noncommunicable diseases. Increasing physical activity (PA) is therefore a public health priority. Engaging in active transportation (AT) is a viable approach for promoting daily PA levels. Mobile health interventions enable the promotion of AT to a larger population. The Smart City Active Mobile Phone Intervention (SCAMPI) study was a randomized controlled trial designed to evaluate the ability of a behavior change program delivered via a smartphone app to motivate participants to increase their PA by engaging in AT. Objective This qualitative study aims to examine the acceptance and user experience of the app promoting AT that was used in the SCAMPI trial (the TRavelVU Plus app). Methods A total of 17 residents of Stockholm County (13 women; age range 25-61 years) who completed the 3-month app-based behavioral change program (delivered through the TRavelVU Plus app) in the SCAMPI randomized controlled trial during 2018 agreed to participate in a semistructured telephone-based interview. These participants were well representative of the whole intervention group (n=127) in terms of baseline characteristics such as age, sex, and area of residence. The interviews were audiorecorded, transcribed verbatim, and analyzed using an inductive qualitative content analysis. Results The content analysis revealed 2 themes and 4 subcategories. The first theme, “main motivators: monitoring and messages,” highlighted that monitoring AT and being able to set weekly goals using the app were the primary motivators reported by study participants. The second theme, “acceptable but modifiable,” reflects that the app was well accepted and effectively encouraged many participants to use more AT. Nevertheless, there were functions in the app that require modification. For example, while the semiautomated travel tracking feature was appreciated, participants found it time-consuming and unreliable at times. Conclusions This study contributes novel insight into adults’ experiences of using a mobile app to promote the use of AT. The results showed that the app was well accepted and that self-monitoring and goal setting were the main motivators to engage in more AT. The semiautomated tracking of AT was appreciated; however, it was also reported to be energy- and time-consuming when it failed to work. Thus, this feature should be improved going forward. Trial Registration ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837 International Registered Report Identifier (IRRID) RR2-10.1186/s12889-018-5658-4
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Affiliation(s)
- Anna-Karin Lindqvist
- Division of Health, Medicine and Rehabilitation, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Stina Rutberg
- Division of Health, Medicine and Rehabilitation, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Emmie Söderström
- Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anna Ek
- Department of Clinical Science Intervention and Technology, Karolinska Institutet, Huddinge, Sweden
| | - Christina Alexandrou
- Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Science Intervention and Technology, Karolinska Institutet, Huddinge, Sweden
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Marie Löf
- Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
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Ek A, Alexandrou C, Söderström E, Bergman P, Delisle Nyström C, Direito A, Eriksson U, Henriksson P, Maddison R, Trolle Lagerros Y, Bendtsen M, Löf M. Effectiveness of a 3-Month Mobile Phone-Based Behavior Change Program on Active Transportation and Physical Activity in Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e18531. [PMID: 32510462 PMCID: PMC7308910 DOI: 10.2196/18531] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking. OBJECTIVE The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA). METHODS For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months. RESULTS No effect on MVPA was observed after 3 months (P=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; P=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was >5 minute MVPA per day. CONCLUSIONS No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA. TRIAL REGISTRATION ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12889-018-5658-4.
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Affiliation(s)
- Anna Ek
- Department of Clinical Science Intervention and Technology, Karolinska Institutet, Huddinge, Sweden
| | | | - Emmie Söderström
- Department of Health, Medicine and Caring Sciences, Linköping, Sweden
| | - Patrick Bergman
- eHealth Institute, Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | | | - Artur Direito
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping, Sweden
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Ylva Trolle Lagerros
- Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
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8
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Reich B, Niederseer D, Loidl M, Fernandez La Puente de Battre MD, Rossi VA, Zagel B, Caselli S, Schmied C, Niebauer J. Effects of active commuting on cardiovascular risk factors: GISMO-a randomized controlled feasibility study. Scand J Med Sci Sports 2020; 30 Suppl 1:15-23. [PMID: 32335963 PMCID: PMC7496369 DOI: 10.1111/sms.13697] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 12/19/2022]
Abstract
A sedentary lifestyle is a major modifiable risk factor for many chronic diseases. Lifestyle modification in order to increase exercise capacity is key in the prevention and rehabilitation of chronic diseases. This could be achieved by active commute. The aim of this study was to assess the effects of daily active commuting on physical activity (PA) and exercise capacity. Seventy‐three healthy hospital employees (age: 46 ± 9 years, 38% male), with a predominantly passive way of commuting, were randomly assigned to two parallel groups, a control group (CG, N = 22) or an intervention group (IG, N = 51), which was further split into public transportation/active commuting (IG‐PT, N = 25) and cycling (IG‐C, N = 26). Both intervention groups were asked to reach 150 min/wk of moderate‐ to vigorous‐intensity exercise during their commute for 1 year. CG maintained a passive commuting mode. All participants underwent assessment of anthropometry, risk factor stratification, and exercise capacity by a medical doctor at the Institute of Sports Medicine, Prevention and Rehabilitation. Weekly physical activity, using the International Physical Activity Questionnaire and commuting behavior, using an online diary, were used to assess physical activity. At the end of the study, the change in exercise capacity did significantly differ between IG and CG (P = .003, ES = 0.82). Actively covered distances through commuting significantly differed between groups (walking P = .026; cycling P < .001). Therefore, active commuting improves exercise capacity and can be recommended to the working population to increase exercise capacity.
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Affiliation(s)
- Bernhard Reich
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Valentina Alice Rossi
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Bernhard Zagel
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| | - Stefano Caselli
- Cardiovascular Center Zürich, Hirslanden Klinik im Park, Zürich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
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9
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Bendtsen M, Bendtsen P, Henriksson H, Henriksson P, Müssener U, Thomas K, Löf M. The Mobile Health Multiple Lifestyle Behavior Interventions Across the Lifespan (MoBILE) Research Program: Protocol for Development, Evaluation, and Implementation. JMIR Res Protoc 2020; 9:e14894. [PMID: 32310147 PMCID: PMC7199135 DOI: 10.2196/14894] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 12/06/2019] [Accepted: 01/14/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Clustering of multiple lifestyle risk behaviors has been associated with a greater risk of noncommunicable diseases and mortality than one lifestyle risk behavior or no lifestyle risk behaviors. The National Board of Health and Welfare in Sweden reported in 2018 that it is important to provide additional support to individuals with multiple lifestyle risk behaviors, as risks from these behaviors are multiplicative rather than additive. However, the same report emphasized that there is a lack of knowledge regarding interventions that support changes to unhealthy lifestyle behaviors. OBJECTIVE The MoBILE (Mobile health Multiple lifestyle Behavior Interventions across the LifEspan) research program has brought together two Swedish research groups supported by international collaborators. Through this collaboration, we aim to design and evaluate a number of novel and tailored mobile health (mHealth) multiple lifestyle behavior interventions across the life span of different health care populations. In addition, the MoBILE research program will extend ongoing research to include mHealth interventions for migrant pregnant women and children. METHODS Each project within the MoBILE program will focus on a specific group: pregnant women, preschool children, high school and university students, and adults in primary and clinical care. All the projects will follow the same 4 phases: requirements, development, evaluation, and implementation. During the requirements phase, implementers and end users will aid the design of content and functionality of the interventions. In the development phase, findings from the first phase will be synthesized with expert domain knowledge and theoretical constructs to create interventions tailored to the target groups. The third phase, evaluation, will comprise randomized controlled trials conducted to estimate the effects of the interventions on multiple lifestyle risk behaviors (eg, alcohol, nutrition, physical activity, and smoking). The final phase will investigate how the interventions, if found effective, can be disseminated into different health care contexts. RESULTS The research program commenced in 2019, and the first results will be available in 2020. Projects involving pregnant women, preschool children, and high school and university students will be completed in the first 3 years, with the remaining projects being planned for the program's final 3 years. CONCLUSIONS The development of evidence-based digital tools is complex, as they should be guided by theoretical frameworks, and requires large interdisciplinary teams with competence in technology, behavioral science, and lifestyle-specific areas. Individual researchers or smaller research groups developing their own tools is not the way forward, as it means reinventing the wheel over and over again. The MoBILE research program therefore aims to join forces and learn from the past 10 years of mHealth research to maximize scientific outcomes, as well as the use of financial resources to expand the growing body of evidence for mHealth lifestyle behavior interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/14894.
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Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Preben Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Medical Specialist, Motala, Sweden
| | - Hanna Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ulrika Müssener
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kristin Thomas
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
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10
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Seyyedi N, Rahimi B, Eslamlou HRF, Afshar HL, Spreco A, Timpka T. Smartphone-Based Maternal Education for the Complementary Feeding of Undernourished Children Under 3 Years of Age in Food-Secure Communities: Randomised Controlled Trial in Urmia, Iran. Nutrients 2020; 12:nu12020587. [PMID: 32102310 PMCID: PMC7071370 DOI: 10.3390/nu12020587] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 12/25/2022] Open
Abstract
The mothers’ nutritional literacy is an important determinant of child malnourishment. We assessed the effect of a smartphone-based maternal nutritional education programme for the complementary feeding of undernourished children under 3 years of age in a food-secure middle-income community. The study used a randomised controlled trial design with one intervention arm and one control arm (n = 110; 1:1 ratio) and was performed at one well-child clinic in Urmia, Iran. An educational smartphone application was delivered to the intervention group for a 6-month period while the control group received treatment-as-usual (TAU) with regular check-ups of the child’s development at the well-child centre and the provision of standard nutritional information. The primary outcome measure was change in the indicator of acute undernourishment (i.e., wasting) which is the weight-for-height z-score (WHZ). Children in the smartphone group showed greater wasting status improvement (WHZ +0.65 (95% Confidence Interval (CI) ± 0.16)) than children in the TAU group (WHZ +0.31 (95% CI ± 0.21); p = 0.011) and greater reduction (89.6% vs. 51.5%; p = 0.016) of wasting caseness (i.e., WHZ < −2; yes/no). We conclude that smartphone-based maternal nutritional education in complementary feeding is more effective than TAU for reducing undernourishment among children under 3 years of age in food-secure communities.
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Affiliation(s)
- Navisa Seyyedi
- Student Research Committee, Urmia University of Medical Sciences, Urmia 571478334, Iran;
- Department of Health Information Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia 571478334, Iran;
| | - Bahlol Rahimi
- Department of Health Information Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia 571478334, Iran;
- Correspondence: (B.R); (T.T.)
| | | | - Hadi Lotfnezhad Afshar
- Department of Health Information Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia 571478334, Iran;
| | - Armin Spreco
- Department of Health, Medicine, and Caring Sciences, Linköping University, 581 83 Linköping, Sweden;
- Centre for Health Services Development, Region Östergötland, 581 85 Linköping, Sweden
| | - Toomas Timpka
- Department of Health, Medicine, and Caring Sciences, Linköping University, 581 83 Linköping, Sweden;
- Centre for Health Services Development, Region Östergötland, 581 85 Linköping, Sweden
- Correspondence: (B.R); (T.T.)
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