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Lara D, Alaniz-Cantú EI, Siddalingaiaha S, Oliveira I, Chávez-Iñiguez A, DeJesus E, Fuller D, Marquez DX, Vásquez E, Li D, McIntosh S, Ossip DJ, Cupertino AP, Cartujano-Barrera F. Actívatexto: Feasibility and Acceptability of a Mobile Intervention That Promotes Smoking Cessation and Physical Activity among Latinos. CANCER RESEARCH COMMUNICATIONS 2024; 4:1016-1023. [PMID: 38592449 PMCID: PMC11000686 DOI: 10.1158/2767-9764.crc-23-0519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/16/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
The purpose of this study was to assess the feasibility and acceptability of a mobile intervention that promotes smoking cessation and physical activity among Latinos living in the United States. Twenty Latino adults who smoked and did not meet recommended levels of physical activity were recruited using community-based recruitment strategies. Participants received Actívatexto, a theory-based, culturally accommodated, 12-week text messaging intervention (available in English and Spanish) that promotes smoking cessation and physical activity. Actívatexto integrates four components: (i) a text messaging program, (ii) a wearable device, (iii) an online dashboard where the research team manages participants' incoming and outgoing data from both the text messaging program and wearable device, and (iv) nicotine replacement therapies (NRT). We assessed self-reported 7-day point prevalence smoking abstinence at month 3, weekly minutes of moderate to vigorous physical activity (MVPA), pharmacotherapy adherence, and satisfaction. At baseline, participants' mean age was 47.3 years old (SD 16.0), 55% of participants were female, and 60% indicated that Spanish was their language of preference. Seventy-five percent of participants smoked 1-10 cigarettes daily and 35% smoked their first cigarette within 5 minutes after waking up. At month 3, 14 participants (70%) self-reported 7-day point prevalence smoking abstinence (90% follow-up rate). Fitbit-assessed mean minutes of MVPA per week increased from 113 (SD 127; range: 0-399) at week 1 to 177 (SD 163; range: 0-513) at month 3 (P = 0.15). Sixteen participants (88.9%, 16/18) reported NRT use in the past 90 days. Most participants reported being extremely satisfied or satisfied with the intervention (88.9%, 16/18). SIGNIFICANCE Actívatexto resulted in a noteworthy cessation rate at month 3 (70%), increased mean weekly minutes of MVPA, produced high use of NRT, and was well received by participants. Additional testing in a randomized clinical trial is warranted to assess the efficacy of the intervention.
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Affiliation(s)
- Daimarelys Lara
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Edgar I. Alaniz-Cantú
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Simran Siddalingaiaha
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Igor Oliveira
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Arlette Chávez-Iñiguez
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Elisa DeJesus
- Language Services, Ibero American Action League, Rochester, New York
| | - Daniel Fuller
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
| | - David X. Marquez
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, Illinois
| | - Elizabeth Vásquez
- Department of Epidemiology and Biostatistics, SUNY University at Albany, Albany, New York
| | - Dongmei Li
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, New York
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
- Department of Surgery, University of Rochester Medical Center, Rochester, New York
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Formagini T, Teruel Camargo J, Perales-Puchalt J, Drees BM, Fracachan Cabrera M, Ramírez M. A culturally and linguistically adapted text-message Diabetes Prevention Program for Latinos: Feasibility, acceptability, and preliminary effectiveness. Transl Behav Med 2024; 14:138-147. [PMID: 37715986 DOI: 10.1093/tbm/ibad053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023] Open
Abstract
Despite the general positive outcomes of the Diabetes Prevention Program (DPP), the program's reach, adherence, and effectiveness among Latinos are still suboptimal. Text-message DPP can potentially overcome barriers and improve DPP outcomes for this group. We aimed to assess the feasibility, acceptability, and preliminarily effectiveness of a culturally and linguistically adapted text-message DPP for Latinos. We enrolled 26 eligible Spanish-speaking Latino adults at risk of developing type 2 diabetes (A1c = 5.7%-6.4%, body mass index ≥25) in a 6-month culturally and linguistically adapted text-message DPP. Participants received (i) two to three daily automated text-messages about healthy eating, physical activity, problem-solving skills, lifestyle change motivation, and logistics, (ii) on-demand keyword-driven messages, and (iii) on-demand chat messages with a DPP coach. Outcomes included feasibility (e.g. adherence), acceptability (e.g. satisfaction), and preliminary effectiveness (e.g. weight loss). Twenty-four participants completed the program and follow-up assessments. Participants' mean body weight changed from 191.2 to 186.7 pounds (P = .004); 45.8% of participants lost ≥3%, and 29.2% lost ≥5% of body weight. Body mass index and waist circumference were also reduced [0.9 kg/m2 (P = .003) and 1.1 cm (P = .03), pre-post]. Self-reported physical activity frequency was increased (P = .003). No statistically significant changes in diet quality were found. Most participants were satisfied with the program and perceived it to help prevent diabetes. Our pilot study of an innovative text-message DPP for Latinos demonstrated the program was acceptable, feasible, and potentially effective. Using text-message for DPP can reduce barriers to in-person participation by increasing the program's reach without compromising fidelity and effectiveness.
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Affiliation(s)
- Taynara Formagini
- Department of Family Medicine, University of California San Diego, San Diego, CA, USA
- School of Social Work, University of Central Florida, Orlando, FL, USA
| | - Juliana Teruel Camargo
- Minority Health and Health Disparities Population Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jaime Perales-Puchalt
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Kansas City, KS, USA
| | - Betty M Drees
- University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
- The Graduate School of the Stowers Institute for Medical Research, Kansas City, MO, USA
| | - Monica Fracachan Cabrera
- Juntos Center for Advancing Latino Health, Department of Population Health, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Mariana Ramírez
- Juntos Center for Advancing Latino Health, Department of Population Health, University of Kansas School of Medicine, Kansas City, KS, USA
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Saarikko J, Axelin A, Huvinen E, Rahmani AM, Azimi I, Pasanen M, Niela-Vilén H. Supporting lifestyle change in obese pregnant mothers through the wearable internet-of-things (SLIM) -intervention for overweight pregnant women: Study protocol for a quasi-experimental trial. PLoS One 2023; 18:e0279696. [PMID: 36656819 PMCID: PMC9851496 DOI: 10.1371/journal.pone.0279696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To assess, in terms of self-efficacy in weight management, the effectiveness of the SLIM lifestyle intervention among overweight or obese women during pregnancy and after delivery, and further to exploit machine learning and event mining approaches to build personalized models. Additionally, the aim is to evaluate the implementation of the SLIM intervention. METHODS This prospective trial, which is a non-randomized, quasi-experimental, pre-post intervention, includes an embedded mixed-method process evaluation. The SLIM Intervention is delivered by public health nurses (n = 9) working in maternity clinics. The public health nurses recruited overweight women (n = 54) at their first antenatal visit using convenience sampling. The core components of the intervention i.e. health technology, motivational interviewing, feedback, and goal setting, are utilized in antenatal visits in maternity clinics starting from gestational week 15 or less and continuing to 12 weeks after delivery. Mixed effect models are used to evaluate change over time in self-efficacy, weight management and weight change. Simple mediation models are used to assess calories consumed and moderate to vigorous physical activity (MVPA) as mediators between self-efficacy and weight change. Signal processing and machine learning techniques are exploited to extract events from the data collected via the Oura ring and smartphone-based questionnaires. DISCUSSION The SLIM intervention was developed in collaboration with overweight women and public health nurses working in maternity clinics. This study evaluates the effectiveness of the intervention among overweight women in increasing self-efficacy and achieving a healthy weight; thus, impacting the healthy lifestyle and long-term health of the whole family. The long-term objective is to contribute to women's health by supporting weight-management through behavior change via interventions conducted in maternity clinics. TRIAL REGISTRATION The trial was registered at the Clinicaltrials.gov register platform (ID NCT04826861) on 17 March 2021.
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Affiliation(s)
- Johanna Saarikko
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
- Department of Obstetrics and Gynaecology, Turku University Hospital and Faculty of Medicine, University of Turku, Turku, Finland
| | - Emilia Huvinen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Amir M. Rahmani
- School of Nursing, University of California Irvine, Irvine, California, United States of America
- Department of Computer Science, University of California Irvine, Irvine, California, United States of America
- * E-mail:
| | - Iman Azimi
- Department of Future Technologies, University of Turku, Turku, Finland
| | - Miko Pasanen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Hannakaisa Niela-Vilén
- Department of Nursing Science, University of Turku, Turku, Finland
- Department of Obstetrics and Gynaecology, Turku University Hospital and Faculty of Medicine, University of Turku, Turku, Finland
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Billek-Sawhney B, Criss MG, Galantino ML, Sawhney R. Wellness Aging Model Related to Inactivity, Illness, and Injury (WAMI-3): A Tool to Encourage Prevention in Practice. J Geriatr Phys Ther 2022; 45:168-177. [DOI: 10.1519/jpt.0000000000000356] [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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Maddock JE, Suess C, Bratman GN, Smock C, Kellstedt D, Gustat J, Perry CK, Kaczynski AT. Development and validation of self-efficacy and intention measures for spending time in nature. BMC Psychol 2022; 10:51. [PMID: 35241177 PMCID: PMC8895766 DOI: 10.1186/s40359-022-00764-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/22/2022] [Indexed: 12/17/2022] Open
Abstract
Purpose The purpose of this study was to develop and evaluate the reliability and validity of self-efficacy and intentions measures for time spent in nature (TSN). TSN is related to improvement in psychological well-being and health, yet most American adults spend very little time in such settings. Theory-based interventions have been effective in increasing physical activity, a related behavior, and may be one mechanism to increase TSN. Self-efficacy and intentions have been shown to be strong predictors of health behaviors and are used across several theories. However, scales to measure these factors have not yet been developed and are needed to facilitate effective interventions. Methods TSN self-efficacy and intentions scales were developed using a sequential nine-step procedure: identification of the domain and item generation; content validity; pre-testing of questions; sampling and survey administration; item reduction; extraction of factors; tests of dimensionality; tests of reliability; and tests of validity. The 14-member multidisciplinary, researcher and practitioner investigative team generated 50 unique items for self-efficacy and 24 unique items for intentions. After subjecting items to content validity and pre-testing, item sets were reduced to 21 assessing self-efficacy and nine assessing intentions. A nationwide sample of 2109 adult participants (49.7% female, Mean Age = 58.1; 59.8% White, 18.4% Hispanic, 13.3% Black) answered these items via an on-line survey. Results Using split-half measures, principal components analysis indicated a one-factor solution for both scales. The factor structure was upheld in confirmatory factor analyses and had high internal consistency (α = .93 self-efficacy; .91 intentions). The scales were moderately correlated with each other (r = .56, p < .001) and were strongly related to TSN with large effect sizes (eta2 > .20). Conclusions The study resulted in reliable and valid self-efficacy (14 items) and intentions (8 items) scales that can be used to develop future theory-based interventions to increase TSN and thereby improve population health.
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Han NS, Won MH. Association between Social Support and Physical Activity in Patients with Coronary Artery Disease: Multiple Mediating Roles of Self-Efficacy and Autonomous Motivation. Healthcare (Basel) 2022; 10:healthcare10030425. [PMID: 35326905 PMCID: PMC8956098 DOI: 10.3390/healthcare10030425] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
Physical inactivity in patients with coronary artery disease is linked to recurrent cardiac events. Given that social support may be an enduring major factor for physical activity, the mechanism underlying the multiple mediating effects of self-efficacy and autonomous motivation on the relationship between social support and physical activity in patients with coronary artery disease has hardly been examined. Therefore, this study aimed to clarify the multiple mediating roles of social support and physical activity on the relationship between self-efficacy and autonomous motivation in patients with coronary artery disease. This descriptive cross-sectional study included 190 inpatients who were diagnosed with coronary artery disease and admitted to a cardiology ward university hospital in Korea. Parallel multiple mediated models were tested using the SPSS PROCESS macro. The direct effects of social support on physical activity and the indirect effects of self-efficacy and autonomous motivation on social support and physical activity were statistically significant. Thus, positive social support from health-care providers has an important role to play in promoting physical activity by increasing self-efficacy and autonomous motivation for physical activity in patients with coronary artery disease.
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Affiliation(s)
- Nam-Sin Han
- Department of Nursing, Wonkwang University Hospital, Iksan 54538, Korea;
| | - Mi-Hwa Won
- Department of Nursing, Wonkwang University, Iksan 54538, Korea
- Correspondence: ; Tel.: +82-63-850-6045
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Walker TJ, Craig DW, Szeszulski J, Fernandez ME. Examining the Validity and Reliability of Measures for Individual-Level Constructs related to Implementation of School-Based Physical Activity Approaches. JOURNAL OF HEALTHY EATING AND ACTIVE LIVING 2021; 1:117-126. [PMID: 36313519 PMCID: PMC9615476 DOI: 10.51250/jheal.v1i3.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Valid and reliable measures are important to understanding the implementation of physical activity approaches in schools. The study purpose is to examine the psychometric properties of measures of individual-level constructs (knowledge, attitudes, outcome expectations, self-efficacy, innovativeness, and support) in the context of implementing school-based physical activity approaches. We collected data from a sample of elementary school employees (administrators, classroom teachers, physical educators, and support staff) from an urban school district in southeast Texas. Confirmatory factor analysis (CFA) models were used to examine structural validity. We also examined correlations between constructs to assess discriminant and convergent validity. Last, we used a CFA-based approach to examine scale reliability. The analytic sample consisted of 205 employees. CFA results for each individual measure revealed good-fitting models for most measures (χ2(df)>0.05, RMSEA<0.08, CFI>0.90, TLI>0.90, SRMR≤0.07). A combined model that included all the measures also indicated good fit across indices: χ2(306)=485, p<0.001; RMSEA=0.05, CFI=0.93, TLI=0.92, SRMR=0.07. All correlations between constructs were <0.70, and all but one construct (innovativeness) demonstrated moderate correlations with support for classroom-based physical activity approaches (>0.30). In addition, reliability point estimates were all >0.70. The measures tested in this study were found to have good reliability, as well as good structural, discriminant, and convergent validity. These measures are useful in efforts to better understand how individual-level constructs relate to implementation behaviors for physical activity approaches in schools.
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Affiliation(s)
- Timothy J Walker
- University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research
| | - Derek W Craig
- University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research
| | - Jacob Szeszulski
- University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research
| | - Maria E Fernandez
- University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research
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Impact of Flexible Work Arrangements, Self-Efficacy, and Barriers on Daily Physical Activity Among University Staff. J Phys Act Health 2021; 18:594-602. [PMID: 33811186 DOI: 10.1123/jpah.2020-0099] [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: 02/17/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little is known about the link between flexible work arrangements and health behaviors, such as physical activity. This study aimed to explore how self-efficacy and daily barriers to physical activity influence daily levels of physical activity on workdays when university staff members used a flexible work arrangement (flextime or telework). METHODS Full-time university staff employees (N = 61, mean age = 41; 89% female) participated in this daily diary study. Participants completed an initial survey followed by daily surveys over the course of one workweek, resulting in 281 diary days. RESULTS The most frequently reported barriers to physical activity were as follows: lack of time, feeling tired, and not enough motivation. Multilevel models revealed that as the number of barriers increased, minutes of physical activity significantly decreased. Self-efficacy was not significantly related to daily physical activity. Participants reported fewer minutes of physical activity on flextime workdays compared to days when a flexible work arrangement was not used (ie, traditional workday). Daily use of a flexible work arrangement did not moderate the association between barriers and physical activity. CONCLUSIONS This study illustrated the influence of daily barriers and flextime workdays on physical activity levels, which can inform workplace health programs for university staff.
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Mendoza-Vasconez AS, Arredondo EM, Larsen B, Crespo N, Hurst S, Marcus BH. Lapse, Relapse, and Recovery in Physical Activity Interventions for Latinas: a Survival Analysis. Int J Behav Med 2021; 28:540-551. [PMID: 33415695 DOI: 10.1007/s12529-020-09943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Physical activity (PA) research extensively focuses on initiation of PA, yet lapse and relapse among PA intervention participants are less well understood, particularly among minority populations such as Latinas in the USA. This study aimed to (1) determine the probability of lapse during two PA interventions for Latinas; (2) assess demographic, psychosocial, and environmental predictors of the amount of time until first lapse; and (3) identify factors predictive of lapse recovery. METHODS Data from 176 Latina intervention participants were pooled. Survival functions and Kaplan-Meier curves were used to illustrate probability of lapse. Cox proportional hazard models assessed predictors of time to lapse. Logistic regressions identified predictors of lapse recovery. RESULTS The probability of lapse after 1 month of starting to exercise was 18%, escalating to 34% after 4 months. Predictors of earlier lapse included various psychosocial constructs (i.e., self-efficacy and various processes of change), but none of the measured environmental factors, and only one demographic factor (≥ 2 children under 18). Increased use of consciousness raising at 2 months was associated with lower likelihood of lapse recovery, yet use of behavioral processes of change at 6 months was associated with higher likelihood of recovery. CONCLUSIONS Lapsing may not be pre-determined by demographic and environmental characteristics. On the other hand, skills that can be learned through interventions, such as skills to improve self-efficacy, seem important in the delay or prevention of lapses. Results pertaining to lapse recovery are less clear.
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Affiliation(s)
- Andrea S Mendoza-Vasconez
- Stanford Prevention Research Center, Stanford University, 1265 Welch Rd, Palo Alto, CA, 94305, USA. .,School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA. .,Department of Family Medicine & Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA.
| | - Elva M Arredondo
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA
| | - Britta Larsen
- Department of Family Medicine & Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Noe Crespo
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA
| | - Samantha Hurst
- Department of Family Medicine & Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121, South Main Street, Providence, Rhode Island, 02903, USA
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Burkart S, Marcus BH, Pekow P, Rosal MC, Manson JE, Braun B, Chasan-Taber L. The impact of a randomized controlled trial of a lifestyle intervention on postpartum physical activity among at-risk hispanic women: Estudio PARTO. PLoS One 2020; 15:e0236408. [PMID: 32706812 PMCID: PMC7380594 DOI: 10.1371/journal.pone.0236408] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/04/2020] [Indexed: 01/19/2023] Open
Abstract
AIMS To assess the impact of a culturally modified, motivationally targeted, individually-tailored intervention on postpartum physical activity (PA) and PA self-efficacy among Hispanic women. METHODS Estudio PARTO was a randomized controlled trial conducted in Western Massachusetts from 2013-17. Hispanic women who screened positive for gestational diabetes mellitus were randomized to a Lifestyle Intervention (LI, n = 100) or to a comparison Health and Wellness (HW, n = 104) group during late pregnancy. Exercise goals in LI were to meet American College of Obstetrician & Gynecologists guidelines for postpartum PA. The Pregnancy Physical Activity Questionnaire (PPAQ) and the Self-Efficacy for Physical Activity Questionnaire were administered at 6 weeks, 6 months, and 1 year postpartum. RESULTS Compared to baseline levels, both groups had significant increases in moderate-to-vigorous PA at 6 months and one year postpartum (i.e., LI: mean change = 30.9 MET-hrs/wk, p = 0.05; HW: 27.6 MET-hrs/wk, p = 0.01), with only LI group experiencing significant increases in vigorous PA (mean change = 1.3 MET-hrs/wk, p = 0.03). Based on an intent-to-treat analysis using mixed effects models, we observed no differences in pattern of change in PA intensity and type over time between intervention groups (all p > 0.10). However, there was the suggestion of a greater decrease in sedentary activity in the LI group compared to the HW group (β = -3.56, p = 0.09). CONCLUSIONS In this randomized trial among high-risk Hispanic women, both groups benefitted from participation in a postpartum intervention.
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Affiliation(s)
- Sarah Burkart
- Department of Kinesiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, Massachusetts, United States of America
| | - Bess H. Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Penelope Pekow
- Department of Biostatistics and Epidemiology, School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
| | - Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Barry Braun
- Department of Health and Exercise Science, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - Lisa Chasan-Taber
- Department of Biostatistics and Epidemiology, School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
- * E-mail:
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Benitez TJ, Dunsiger SI, Pekmezi DJ, Larsen BA, Mendoza-Vasconez AS, Linke SE, Bock BC, Gans KM, Hartman SJ, Marcus BH. Design and rationale for a randomized trial of a theory- and technology- enhanced physical activity intervention for Latinas: The Seamos Activas II study. Contemp Clin Trials 2020; 96:106081. [PMID: 32687974 DOI: 10.1016/j.cct.2020.106081] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/23/2020] [Accepted: 07/06/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Latina women report disproportionately high rates of physical inactivity and related chronic health conditions. Physical activity (PA) efforts to date have shown modest success in this at-risk population; thus, more effective interventions are necessary to help Latinas reach national PA guidelines and reduce related health disparities. This paper describes the design, rationale, and baseline findings from the Seamos Activas II intervention. METHODS/DESIGN The ongoing RCT will test the efficacy of the Seamos Saludables PA print intervention vs. a theory-and technology-enhanced version (Seamos Activas II). The purpose of the study is to increase the percentage of Latinas meeting the national PA guidelines compared to the prior trial, improve biomarkers related to disease, and extend generalizability to a broader and more representative population of Latinas (i.e. Mexican/Mexican-Americans). Intervention refinements included further targeting key constructs of Social Cognitive Theory, and incorporating interactive text message-based self-monitoring strategies. The primary outcome is change in minutes per week of MVPA measured by ActiGraph GT3X+ accelerometers at 6- and 12-months. Secondary PA outcomes assessed by the 7-Day PA Recall will be used to corroborate findings. RESULTS Participants (N = 199) are Latinas 18-65 years (mean = 43.8) of predominantly Mexican origin (89%). At baseline, objectively measured MVPA was 39.51 min/week (SD = 71.20, median = 10) and self-reported MVPA was 12.47 min/week (SD = 22.54, median = 0).Participants reported generally low self-efficacy and higher cognitive vs. behavioral processes of change. CONCLUSION Addressing interactivity and accountability through text messaging, and more rigorously targeting theoretical constructs may be key to helping Latinas achieve nationally recommended PA levels and thereby reducing health disparities.
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Affiliation(s)
- Tanya J Benitez
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States of America
| | - Shira I Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States of America
| | - Dori J Pekmezi
- Department of Health Behavior, School of Public Health at University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Britta A Larsen
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA, United States of America
| | | | - Sarah E Linke
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Beth C Bock
- Department of Psychiatry & Human Behavior, Alpert Medical School, Brown University, Providence, RI, United States of America
| | - Kim M Gans
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States of America; Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, United States of America
| | - Sheri J Hartman
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States of America.
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Efficacy of a physical activity programme combining individualized aerobic exercise and coaching to improve physical fitness in neuromuscular diseases (I'M FINE): study protocol of a randomized controlled trial. BMC Neurol 2020; 20:184. [PMID: 32404133 PMCID: PMC7218829 DOI: 10.1186/s12883-020-01725-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/12/2020] [Indexed: 12/18/2022] Open
Abstract
Background In individuals with neuromuscular diseases (NMD), symptoms of muscle weakness, fatigue and pain may limit physical activity. Inactivity leads to reduced physical fitness, which further complicates daily life functioning. Due to inconclusive evidence regarding exercise in NMD, the optimal training approach and strategies to preserve an active lifestyle remain to be determined. The physical activity programme I’M FINE, consisting of individualized aerobic exercise to improve physical fitness and coaching to preserve an active lifestyle, was therefore developed. The primary objective of this study will be to evaluate the efficacy of the I’M FINE programme in terms of improved physical fitness in individuals with slowly progressive NMD, compared to usual care. Methods A multicentre, assessor-blinded, two armed, randomized controlled trial will be conducted in a sample of 90 individuals with slowly progressive NMD. Participants motivated to improve their reduced physical fitness will be randomized (ratio 1:1) to the I’M FINE intervention or usual care. The I’M FINE intervention consists of a six-month physical activity programme, including individualized home-based aerobic exercise to improve physical fitness (i.e. peak oxygen uptake), and motivational interviewing coaching (e.g. goal setting, self-management) to adopt and preserve an active lifestyle. Measurements will be performed at baseline, post-intervention, and at 12- and 18-months follow-up. The primary outcome is peak oxygen uptake (VO2 peak) directly post intervention. Main secondary outcomes are physical capacity, muscle strength, self-efficacy, daily activity, quality of life and markers of metabolic syndrome. The primary analysis compares change in VO2 peak post-intervention between the intervention and usual care group, with analysis of covariance. Discussion The I’M FINE study will provide evidence regarding the efficacy of a physical activity intervention on the physical fitness and active lifestyle over the short- and long-term in individuals with slowly progressive NMD. These outcomes could potentially improve the (inter)national guidelines for efficacy of aerobic exercise programmes and provide insight in achieving a more active lifestyle in NMD. Trial registration (5/11/2018): Netherlands Trial Register NTR7609 (retrospectively registered), https://www.trialregister.nl/trial/7344. However, the Ethics Review Committee of the Amsterdam Medical Center (AMC) approved the study protocol on 7/11/2017. No adjustments were made to the approved study protocol before the first participant enrolment and registration. Registration was done after the second participant enrolment and the information in the register corresponds one on one with the approved study protocol.
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Coll-Planas L, Blancafort Alias S, Tully M, Caserotti P, Giné-Garriga M, Blackburn N, Skjødt M, Wirth K, Deidda M, McIntosh E, Rothenbacher D, Gallardo Rodríguez R, Jerez-Roig J, Sansano-Nadal O, Santiago M, Wilson J, Guerra-Balic M, Martín-Borràs C, Gonzalez D, Lefebvre G, Denkinger M, Kee F, Salvà Casanovas A, Roqué i Figuls M. Exercise referral schemes enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity among community-dwelling older adults from four European countries: protocol for the process evaluation of the SITLESS randomised controlled trial. BMJ Open 2019; 9:e027073. [PMID: 31203243 PMCID: PMC6588992 DOI: 10.1136/bmjopen-2018-027073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION SITLESS is a randomised controlled trial determining whether exercise referral schemes can be enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity in the long term, in community-dwelling older citizens. The intervention is complex and requires a process evaluation to understand how implementation, causal mechanisms and context shape outcomes. The specific aims are to assess fidelity and reach of the implementation, understand the contextual aspects of each intervention site, evaluate the mechanisms of impact, and explore perceived effects. METHODS AND ANALYSIS Following the Medical Research Council guidance on complex interventions, a combination of qualitative and quantitative procedures is applied, including observational checklists and attendance registries, standardised scales (ie, Marcus's Self-Efficacy Questionnaire, Physical Activity Self-Regulation Scale and the Lubben Social Network Scale) at baseline, postintervention and follow-up assessments, semistructured questionnaires gathering contextual characteristics, and participant observations of the sessions. Semistructured interviews and focus groups with the participants and trainers are conducted at postintervention and during the follow-up to explore their experiences. Outcomes from the standardised scales are analysed as moderators within the impact evaluation. Descriptive results on context and perceived effects complement results on impact. The qualitative and quantitative findings will help to refine the logic model to finally support the interpretation of the results on the effectiveness of the intervention. ETHICS AND DISSEMINATION The study design was approved by the respective Ethical Committee of Ramon Llull University, Southern Denmark, Northern Ireland and Ulm University. Participation is voluntary, and all participants are asked to sign informed consent before starting the study. A dissemination plan operationalises how to achieve a social impact by reaching academic and non-academic stakeholders. A data management plan describes the specific data sets and regulates its deposition and curation. All publications will be open access. TRIAL REGISTRATION NUMBER NCT02629666; Pre-results.
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Affiliation(s)
- Laura Coll-Planas
- Fundació Salut i Envelliment (Foundation on Health and Ageing)- UAB, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Sergi Blancafort Alias
- Fundació Salut i Envelliment (Foundation on Health and Ageing)- UAB, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Mark Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
- UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, Queen’s University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, UK
| | - Paolo Caserotti
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA), Syddansk Universitet, Odense, Denmark
| | - Maria Giné-Garriga
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Nicole Blackburn
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
- UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, Queen’s University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, UK
| | - Mathias Skjødt
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA), Syddansk Universitet, Odense, Denmark
| | - Katharina Wirth
- Institute of Epidemiology and Medical Biometry, Universitat Ulm, Ulm, Germany
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University and Geriatric Center Ulm Alb-Donau, Universitat Ulm, Ulm, Germany
| | - Manuela Deidda
- Health Economics and Health Technology Assessment (HEHTA), University of Glasgow Institute of Health and Wellbeing, Glasgow, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment (HEHTA), University of Glasgow Institute of Health and Wellbeing, Glasgow, UK
| | | | - Rodrigo Gallardo Rodríguez
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, CEADE, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Javier Jerez-Roig
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), Universitat de Vic - Universitat Central de Catalunya, Catalunya, Spain
| | - Oriol Sansano-Nadal
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Marta Santiago
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Jason Wilson
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
- UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, Queen’s University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, UK
| | - Míriam Guerra-Balic
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Carme Martín-Borràs
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
- Department of Physical Therapy, Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Denise Gonzalez
- Sport Initiative et Loisir Bleu Association, Strasbourg, France
| | | | - Michael Denkinger
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University and Geriatric Center Ulm Alb-Donau, Universitat Ulm, Ulm, Germany
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, Queen’s University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, UK
| | - Antoni Salvà Casanovas
- Fundació Salut i Envelliment (Foundation on Health and Ageing)- UAB, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Marta Roqué i Figuls
- Fundació Salut i Envelliment (Foundation on Health and Ageing)- UAB, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
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