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Bäccman C, Bergkvist L, Wästlund E. Personalized Coaching via Texting for Behavior Change to Understand a Healthy Lifestyle Intervention in a Naturalistic Setting: Mixed Methods Study. JMIR Form Res 2023; 7:e47312. [PMID: 37966893 PMCID: PMC10687691 DOI: 10.2196/47312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 09/02/2023] [Accepted: 09/19/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Digital health interventions, such as personalized SMS coaching, are considered affordable and scalable methods to support healthy lifestyle changes. SMS, or texting, is a readily available service to most people in Sweden, and personalized SMS coaching has shown great promise in supporting behavior changes. OBJECTIVE This study aims to explore the effectiveness of highly personalized SMS coaching for behavior change according to the Capability, Opportunity, Motivation-Behavior (COM-B) model on a sample of physically inactive adults in a nonprofit fitness organization in Sweden. METHODS The study used a mixed methods design in which clients acted as their own controls. The participants were clients (n=28) and fitness consultants (n=12). Three types of data were collected: (1) quantitative data at baseline and after the SMS intervention and the waitlist from the clients, (2) qualitative data from semistructured interviews with the fitness consultants, and (3) pseudonymized texting conversations between the fitness consultants and clients. RESULTS Overall, the results showed that personalized SMS coaching was effective in supporting the clients' behavior changes. The quantitative analysis showed how the clients' capabilities (Cohen d=0.50), opportunities (Cohen d=0.43), and relationship with the fitness consultants (Cohen d=0.51) improved during the SMS intervention in comparison with baseline. Furthermore, the qualitative analysis revealed how personalized texts added value to existing work methods (eg, increasing continuity and flexibility) and how the relationship between the clients and fitness consultants changed during the intervention, which helped motivate the clients. CONCLUSIONS Personalized SMS coaching is an effective method for supporting healthy behavior changes. The human connection that emerged in this study needs to be further explored to fully understand the effectiveness of a digital health intervention.
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Affiliation(s)
- Charlotte Bäccman
- Service Research Center (CTF), Karlstad University, Karlstad, Sweden
| | - Linda Bergkvist
- Service Research Center (CTF), Karlstad University, Karlstad, Sweden
| | - Erik Wästlund
- Service Research Center (CTF), Karlstad University, Karlstad, Sweden
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Hooker L, Burgemeister F, Mills J. Investment in community-based rural health care innovation to address health inequities in Australia. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 40:100967. [PMID: 38033433 PMCID: PMC10681935 DOI: 10.1016/j.lanwpc.2023.100967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Leesa Hooker
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Bundoora, Australia
| | - Fiona Burgemeister
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Bundoora, Australia
| | - Jane Mills
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
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Li N, Ye Q, Deng Q, Wang Y, Hu J, Li X, Liu Q, Jiang M, Zhao X, Zhou J. Physical Activity Intervention for Leisure-Time Activity Levels Among Older Adults: A Cluster Randomized Trial. JAMA Netw Open 2023; 6:e2333195. [PMID: 37713199 PMCID: PMC10504609 DOI: 10.1001/jamanetworkopen.2023.33195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/02/2023] [Indexed: 09/16/2023] Open
Abstract
Importance Current randomized trial evidence of the effects of physical activity interventions in older adults is mainly from developed countries, with little reliable evidence from low- and middle-income countries, such as China, where race, culture, and lifestyles differ substantially from those in Western populations. Objective To evaluate the effects of a multilevel intervention for increasing leisure-time activity levels in Chinese older adults. Design, Setting, and Participants This cluster randomized trial was conducted from May 2021 to May 2023, including an 8-week intervention period and a follow-up period of 24 months. Eight villages in China were randomly assigned to the intervention (4 villages) or the control (4 villages) group. Potentially eligible participants were 60 years or older. A total of 511 older adults from the selected 8 villages were enrolled. Interventions The intervention group received an 8-week socioecological model-based intervention, comprising individual, interpersonal, and community-level components, whereas the control group did not. Main Outcome and Measure The primary outcome was the change in leisure-time activity at 8 weeks, measured by the Physical Activity Scale for the Elderly (PASE). Possible PASE scores for leisure-time activity range from 0 to 502, with higher scores indicating higher activity levels. Results A total of 511 older adults from 8 villages were recruited and randomly allocated to the intervention (240 participants, 4 villages) or control (271 participants, 4 villages) groups. The mean (SD) age was 70.95 (5.72) years, and 284 (55.6%) were female participants. Seven serious adverse events (unrelated deaths) were reported. Participants in the intervention group increased leisure-time activity more than those in the control group, with a mean difference in PASE scores of 13.74 points (95% CI, 8.58-18.91 points) between the groups at 8 weeks (P < .001). Significant differences in leisure-time activity were also found over 24 months (mean difference in scores at 4 weeks, 11.66 points; 95% CI, 6.41-16.90 points; P < .001; at 6 months, 12.35 points; 95% CI, 7.19-17.50 points; P < .001; at 12 months, 11.55 points; 95% CI, 6.32-16.78 points; P < .001; and at 24 months, 14.51 points; 95% CI, 9.28-19.75 points; P < .001). Conclusions and Relevance In this cluster randomized trial, the multilevel intervention was effective in promoting leisure-time activity over 24 months of follow-up in older adults from China. This finding suggests that implementation of such interventions could be an important step in addressing physical inactivity in older adults in low- and middle-income countries. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR2100045653.
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Affiliation(s)
- Nanyan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qin Ye
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qian Deng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yufei Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Julinling Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xianlan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qianqian Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Meili Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Gawlik A, Lüdemann J, Neuhausen A, Zepp C, Vitinius F, Kleinert J. A Systematic Review of Workplace Physical Activity Coaching. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:550-569. [PMID: 36849840 PMCID: PMC10495277 DOI: 10.1007/s10926-023-10093-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 06/18/2023]
Abstract
Aim Studies show that about 60 min of moderate physical activity (PA) per day compensate for sitting all day at work. However, the workplace offers an ideal setting for health-promoting interventions such as PA coaching as a person-centered intervention aimed at achieving lasting health behavior changes. Given a good evidence base of health coaching studies in general, this systematic review aims to provide an overview of workplace PA coaching interventions. Methods This review was conducted according to PRISMA guidelines. Studies published up to July 2021 were considered based on the following inclusion criteria: (1) longitudinal intervention studies, (2) analysis of PA at work, (3) sedentary employees, (4) PA coaching in the workplace as intervention, (5) increasing workplace PA. Results Of 4323 studies found, 14 studies with 17 interventions met inclusion criteria. All 17 interventions indicated an increase in at least one PA outcome. Twelve interventions indicated significant improvements in at least one workplace or total PA outcome. There is a high variation within the different coaching parameters, such as behavior change techniques and communication channels. The study quality showed a moderate to high risk of bias. Conclusions The majority of interventions provided evidence for the effectiveness of workplace PA coaching. Nevertheless, the results are inconclusive with regard to the variety of coaching parameters and thus no general statement can be made about the effectiveness of individual parameters. However, this variety of parameters also leads to a high degree of individualization of workplace PA coaching interventions to increase PA for different groups of employees and different types of workplaces.
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Affiliation(s)
- A Gawlik
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany.
| | - J Lüdemann
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - A Neuhausen
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - C Zepp
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - F Vitinius
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - J Kleinert
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
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Collins B, Gordon B, Wundersitz D, Hunter J, Hanson LC, O'Doherty AF, Hayes A, Kingsley M. Comparison of telehealth and supervised phase III cardiac rehabilitation in regional Australia: protocol for a non-inferiority trial. BMJ Open 2023; 13:e070872. [PMID: 37321816 PMCID: PMC10277106 DOI: 10.1136/bmjopen-2022-070872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Exercise-based cardiac rehabilitation programmes (ExCRP) promote recovery and secondary prevention for individuals with cardiovascular disease (CVD). Despite this, enrolment and adherence to ExCRP in rural locations is low. Telehealth programmes provide a convenient, home-based intervention, but concerns remain about compliance to exercise prescription. This paper presents the rationale and protocol design to determine if telehealth delivered ExCRP is not inferior to supervised ExCRP for improving cardiovascular function and exercise fidelity. METHOD AND ANALYSIS A non-inferiority, parallel (1:1), single-blinded randomised clinical trial will be conducted. Fifty patients with CVD will be recruited from a rural phase II ExCRP. Participants will be randomly assigned to telehealth or supervised ExCRP and prescribed three weekly exercise sessions for 6 weeks. Exercise sessions will include a 10 min warm up, up to 30 min of continuous aerobic exercise at a workload equivalent to the ventilatory anaerobic threshold and a 10 min cool down. The primary outcome will be change in cardiorespiratory fitness as measured by cardiopulmonary exercise test. Secondary outcome measures will include change in blood lipid profile, heart rate variability, pulse wave velocity, actigraphy measured sleep quality and training fidelity. Non-inferiority will be confirmed if intention-to-treat and per-protocol analyses conclude the same outcome following independent samples t-test with p<0.025. ETHICS AND DISSEMINATION Research ethics committees at La Trobe University, St John of God Health Care and Bendigo Health approved the study protocol and informed consent. Findings will be published in peer-reviewed journals and disseminated among stakeholders. TRIAL REGISTRATION NUMBER ACTRN12622000872730p; pre-results.
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Affiliation(s)
- Blake Collins
- Holswroth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Brett Gordon
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Daniel Wundersitz
- Holswroth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Jayden Hunter
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Lisa C Hanson
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Alasdair F O'Doherty
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, Tyne and Wear, UK
| | - Abbey Hayes
- St John of God Health Care, Bendigo, Victoria, Australia
| | - Michael Kingsley
- Holswroth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Exercise Sciences, The University of Auckland, Auckland, Newmarket, New Zealand
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Nightingale H, Mnatzaganian G, Hooker L, Barrett S, Kingsley M. The effect of motivational interviewing and/or cognitive behaviour therapy techniques on gestational weight gain - a systematic review and meta-analysis. BMC Public Health 2023; 23:626. [PMID: 37005572 PMCID: PMC10067184 DOI: 10.1186/s12889-023-15446-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/15/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Women with gestational weight gain (GWG) that is below or above recommendations are at risk of adverse perinatal outcomes. Motivational interviewing and/or cognitive behaviour therapy have demonstrated efficacy in initiating and sustaining behaviour change, including weight control. The objective of this review was to investigate the effect of antenatal interventions that include components of motivational interviewing and/or cognitive behaviour therapy on gestational weight gain. METHODS This review was designed and reported in accordance with guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Five electronic databases were systematically searched to March 2022. Randomised controlled trials evaluating interventions with identified components of motivational interviewing and/or cognitive behaviour therapies were included. Pooled proportions of appropriate GWG and GWG above or below guidelines, and standardised mean difference for total gestational weight gain, were calculated. Risk of bias in included studies was evaluated using the Risk of Bias 2 tool, and the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence. RESULTS Twenty-one studies (8030 participants) were included. Overall, MI and/or CBT interventions had a small effect on the total gestational weight gain (SMD: -0.18, 95% confidence interval: -0.27 to -0.09, p < 0.001) and improved the proportion of women achieving recommended gestational weight gain (29% versus 23% in the comparison, p < 0.001). The GRADE assessment indicated that overall quality of evidence is very uncertain, however sensitivity analyses to account for high risk of bias produced similar results to original meta-analyses. The magnitude of effect was greater in women with overweight or obesity when compared to women with BMI < 25 kg/m2. CONCLUSION Motivational interviewing and/or cognitive behaviour therapy techniques may be effective for promoting healthy gestational weight gain. Nevertheless, a high proportion of women do not achieve recommended gestational weight gain. Future interventions should consider factors, including clinician and consumer perspectives, in the design and delivery of psychosocial interventions that aim to support healthy gestational weight gain. TRIAL REGISTRATION The protocol for this review was registered with the PROSPERO International register of systematic reviews (registration number CRD42020156401).
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Affiliation(s)
- Helen Nightingale
- Rural Department of Nursing & Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
| | - George Mnatzaganian
- Rural Department of Community Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Leesa Hooker
- Rural Department of Nursing & Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
| | - Stephen Barrett
- Research and Innovation, Bendigo Health, Bendigo, Australia
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Michael Kingsley
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
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Kopylova OV, Ershova AI, Yaltonsky VM, Sirota NA, Drapkina OM. Motivational counseling in the prevention of the development and progression of cardiovascular diseases. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2023. [DOI: 10.15829/1728-8800-2022-3455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Despite significant progress in the development of novel methods for the prevention and treatment of cardiovascular diseases, their prevalence remains high, which is largely due to low adherence of patients to drug and non-drug preventive interventions. Motivational counseling (MC) is a unique technology that makes it possible to activate the patient’s desire to change their behavior towards a healthy one. The review presents an analysis of the literature on MC technology and the possibilities of its application in cardiology practice. Research data show the effectiveness of MC in improving the nutrition profile, physical activity, weight loss, smoking cessation, control of glycated hemoglobin in patients with diabetes, improving outcomes in patients with heart failure, increasing adherence to therapy, etc. Conducting MC using telemedicine technologies seems promising. The training of specialists is of paramount importance, since the effectiveness of this type of counseling largely depends on the accuracy of the consultant’s adherence to the essence and technologies of MC.
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Affiliation(s)
- O. V. Kopylova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. I. Ershova
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. M. Yaltonsky
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
| | - N. A. Sirota
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Pipingas A, Murphy KJ, Davis CR, Itsiopoulos C, Kingsley M, Scholey A, Macpherson H, Segal L, Breckon J, Minihane AM, Meyer D, Ogden E, Dyer KA, Eversteyn E, Hardman RJ, Poorun K, Justice K, Hana M, Buckley JD, White D, Davison K, Clark JS, Bracci EL, Kennedy G. A Mediterranean Diet and Walking Intervention to Reduce Cognitive Decline and Dementia Risk in Independently Living Older Australians: The MedWalk Randomized Controlled Trial Experimental Protocol, Including COVID-19 Related Modifications and Baseline Characteristics. J Alzheimers Dis 2023; 96:409-427. [PMID: 37781806 PMCID: PMC10657681 DOI: 10.3233/jad-230641] [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: 08/10/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Several clinical trials have examined diet and physical activity lifestyle changes as mitigation strategies for risk factors linked to cognitive decline and dementias such as Alzheimer's disease. However, the ability to modify these behaviors longer term, to impact cognitive health has remained elusive. OBJECTIVE The MedWalk trial's primary aim is to investigate whether longer-term adherence to a Mediterranean-style diet and regular walking, delivered through motivational interviewing and cognitive-behavioral therapy (MI-CBT), can reduce age-associated cognitive decline and other dementia risk factors in older, independently living individuals without cognitive impairment. METHODS MedWalk, a one-year cluster-randomized controlled trial across two Australian states, recruited 60-90-year-old people from independent living retirement villages and the wider community. Participants were assigned to either the MedWalk intervention or a control group (maintaining their usual diet and physical activity). The primary outcome is 12-month change in visual memory and learning assessed from errors on the Paired Associates Learning Task of the Cambridge Neuropsychological Test Automated Battery. Secondary outcomes include cognition, mood, cardiovascular function, biomarkers related to nutrient status and cognitive decline, MI-CBT effectiveness, Mediterranean diet adherence, physical activity, quality of life, cost-effectiveness, and health economic evaluation.Progress and Discussion:Although COVID-19 impacts over two years necessitated a reduced timeline and sample size, MedWalk retains sufficient power to address its aims and hypotheses. Baseline testing has been completed with 157 participants, who will be followed over 12 months. If successful, MedWalk will inform interventions that could substantially reduce dementia incidence and ameliorate cognitive decline in the community. TRIAL REGISTRATION Registered on the Australia New Zealand Clinical Trials Registry ANZCTR 12620000978965 (https://www.anzctr.org.au).
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Affiliation(s)
- Andrew Pipingas
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Karen J. Murphy
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Courtney R. Davis
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | | | - Michael Kingsley
- Department of Exercise Sciences, The University of Auckland, Newmarket, New Zealand
- Holsworth Research Initiative, La Trobe University, Bendigo, VIC, Australia
| | - Andrew Scholey
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- Nutrition Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, VIC, Australia
| | - Helen Macpherson
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
| | - Leonie Segal
- Economics and Social Policy Group, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Jeff Breckon
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | | | - Denny Meyer
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Edward Ogden
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Kathryn A. Dyer
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Emily Eversteyn
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Roy J. Hardman
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Kaylass Poorun
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Keri Justice
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Maher Hana
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jonathan D. Buckley
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - David White
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Kade Davison
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Jessie S. Clark
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Ella L. Bracci
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Greg Kennedy
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - on behalf of MedWalk collaborative team
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
- Department of Exercise Sciences, The University of Auckland, Newmarket, New Zealand
- Holsworth Research Initiative, La Trobe University, Bendigo, VIC, Australia
- Nutrition Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, VIC, Australia
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
- Economics and Social Policy Group, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
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Barrett S, Begg S, O'Halloran P, Breckon J, Rodda K, Barrett G, Kingsley M. Factors influencing adults who participate in a physical activity coaching intervention: a theoretically informed qualitative study. BMJ Open 2022; 12:e057855. [PMID: 35926990 PMCID: PMC9358940 DOI: 10.1136/bmjopen-2021-057855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Behaviour change interventions targeting changes in physical activity (PA) can benefit by examining the underlying mechanisms that promote change. This study explored the use of the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the Theoretical Domains Framework (TDF) to code and contextualise the experiences of participants who completed a PA coaching intervention underpinned by motivational interviewing and cognitive-behavioural therapy. DESIGN Semistructured interviews were conducted with a purposive sample of participants. SETTING Interviews were conducted in a tertiary hospital in regional Victoria, Australia. PARTICIPANTS Eighteen participants who completed a PA coaching intervention were interviewed. The participants were recruited into the coaching intervention because they were insufficiently physically active at the time of recruitment. RESULTS Thirteen (72%) participants were women and the average age of participants was 54 (±5) years. Four participant themes mapped directly onto five components of the COM-B model, and ten of the TDF domains. Increases in PA were influenced by changes in motivation and psychological capability. The autonomy-supportive PA coaching intervention helped to evoke participants' own reasons (and motives) for change and influenced PA behaviours. Participants reflected on their own social and/or professional strengths, and used these skills to set appropriate PA goals and action plans. The structure of the PA coaching intervention provided clarity on session determinants and a framework from which to set an appropriate agenda. Relational components (eg, non-judgemental listening, collaboration) were continually highlighted as influential for change, and should be considered in future behaviour change intervention design. CONCLUSIONS We demonstrate the beneficial effect of using theory-informed behaviour change techniques, and delivering them in a style that promotes autonomy and relatedness. The views of participants should be a key consideration in the design and implementation of PA coaching interventions TRIAL REGISTRATION NUMBER: ACTRN12619000036112. Post-results analysis.
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Affiliation(s)
- Stephen Barrett
- Health Promotion Department, Bendigo Health Care Group, Bendigo, Victoria, Australia
- Holsworth Research Initiative, La Trobe University, Melbourne, Victoria, Australia
| | - Stephen Begg
- Holsworth Research Initiative, La Trobe University, Melbourne, Victoria, Australia
| | - Paul O'Halloran
- Holsworth Research Initiative, La Trobe University, Melbourne, Victoria, Australia
| | - Jeff Breckon
- Research and Innovation, Teesside University, Middlesbrough, North Yorkshire, UK
| | - Kane Rodda
- Outpatient Rehabilitation Department, Bendigo Health Care Group, Bendigo, Victoria, Australia
| | - Gabrielle Barrett
- Health Promotion Department, Bendigo Health Care Group, Bendigo, Victoria, Australia
| | - Michael Kingsley
- Holsworth Research Initiative, La Trobe University, Melbourne, Victoria, Australia
- Department of Exercise Sciences, Newmarket, Auckland, New Zealand
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Barrett S, Begg S, O'Halloran P, Rodda K, Barrett G, Kingsley M. “Exercise Is My Medicine”: A Qualitative Study Exploring the Experiences of Non-admitted Patients Receiving Physical Activity Promotion From Hospital Surgeons. Front Public Health 2022; 10:915496. [PMID: 35719636 PMCID: PMC9204139 DOI: 10.3389/fpubh.2022.915496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/12/2022] [Indexed: 11/22/2022] Open
Abstract
Background Hospital clinicians are increasingly encouraged to use outpatient consultations as an avenue to deliver opportunistic health promotion. There is a dearth of evidence regarding the acceptance of health promotion initiatives from hospital patients themselves. Methods We explored the experiences of non-admitted patients who, during a routine consultation with a hospital surgeon received a recommendation to increase physical activity (PA) and a recommendation to engage in a PA telephone coaching program. Twenty-two semi-structured interviews were conducted with individuals who had received the recommendation and proceeded to enroll in a telephone coaching intervention to identify factors that influenced behavior change. Data were analyzed thematically. Results Participants' age ranged between 42 and 66 years, with the average age being 54 years. Of the participants, 15 (68%) were women and 7 (32%) were men. Three major themes were identified: (1) the hospital visit represented an opportunity for behavior change that is not to be missed; (2) surgeons were influential in promoting PA change contemplation; and (3) patients welcomed a communication style that promoted autonomy. Conclusions Almost all patients considered receiving the recommendation to engage with the telephone coaching as acceptable and helpful toward PA change. Although working in time-restricted consultations, surgeons delivered the recommendation in a patient-centered, autonomy-supportive way, which influenced behavior change. Hospitals should explore avenues to integrate health promotion into routine care, confident of the acceptability and appropriateness of health promotion practice to hospital patients.
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Affiliation(s)
- Stephen Barrett
- Health Promotion Department, Bendigo Health Care Group, Bendigo, VIC, Australia
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Stephen Begg
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Paul O'Halloran
- Centre for Sport and Social Impact, La Trobe University, Melbourne, VIC, Australia
| | - Kane Rodda
- Outpatient Rehabilitation Services, Bendigo Health Care Group, Bendigo, VIC, Australia
| | - Gabrielle Barrett
- Health Promotion Department, Bendigo Health Care Group, Bendigo, VIC, Australia
| | - Michael Kingsley
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
- *Correspondence: Michael Kingsley
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Gawlik A, Boss M, Kleinert J. Increasing workplace physical activity through motivational and volitional coaching – a randomized controlled trial with truck drivers. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2022. [DOI: 10.1108/ijwhm-04-2021-0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeAlthough the health hazards of truck drivers are well known, only few studies address the health status of this occupational group. The purpose of this empirical research paper is to evaluate the effects of motivational and volitional coaching on workplace physical activity (WPA) with the provision of a vehicle-integrated fitness device.Design/methodology/approachIntervention group 1 and intervention group 2 received motivational coaching to improve behavioral internalization. Intervention group 2 received additional volitional coaching to increase physical activity (PA)-related self-efficacy. The control group received only the vehicle-integrated fitness device to perform WPA, as did both intervention groups. Internalization and PA-related self-efficacy were collected four times. WPA was assessed weekly.FindingsAll 140 participating truck drivers were consistently physically active for an average of 85 min (SD = 85.2 min) during motivational coaching, 76 min (SD = 65.0 min) during volitional coaching and 71.0 min (SD = 63.5 min) during follow-up, with no differences found between groups. Variance analyses for repeated measures revealed no intervention effects on WPA, internalization and self-efficacy, and internalization and self-efficacy did not prove to be mediators of increased WPA.Originality/valueThe primary goal of increasing WPA of all participants was achieved, but the present form of coaching cannot be confirmed as a successful strategy. Nevertheless, the results are valuable and could be an impetus for further research on WPA promotion in truck drivers as the creation of an opportunity with the vehicle-integrated fitness device alone led to an increased WPA.
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Smart MH, Nabulsi NA, Gerber BS, Gupta I, Di Eugenio B, Ziebart B, Sharp LK. A Remote Health Coaching, Text-Based Walking Program in Ethnic Minority Primary Care Patients With Overweight and Obesity: Feasibility and Acceptability Pilot Study. JMIR Form Res 2022; 6:e31989. [PMID: 35044308 PMCID: PMC8811699 DOI: 10.2196/31989] [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: 08/23/2021] [Revised: 11/08/2021] [Accepted: 11/16/2021] [Indexed: 12/04/2022] Open
Abstract
Background Over half of US adults have at least one chronic disease, including obesity. Although physical activity is an important component of chronic disease self-management, few reach the recommended physical activity goals. Individuals who identify as racial and ethnic minorities are disproportionally affected by chronic diseases and physical inactivity. Interventions using consumer-based wearable devices have shown promise for increasing physical activity among patients with chronic diseases; however, populations with the most to gain, such as minorities, have been poorly represented to date. Objective This study aims to assess the feasibility, acceptability, and preliminary outcomes of an 8-week text-based coaching and Fitbit program aimed at increasing the number of steps in a predominantly overweight ethnic minority population. Methods Overweight patients (BMI >25 kg/m2) were recruited from an internal medicine clinic located in an inner-city academic medical center. Fitbit devices were provided. Using 2-way SMS text messaging, health coaches (HCs) guided patients to establish weekly step goals that were specific, measurable, attainable, realistic, and time-bound. SMS text messaging and Fitbit activities were managed using a custom-designed app. Program feasibility was assessed via the recruitment rate, retention rate (the proportion of eligible participants completing the 8-week program), and patient engagement (based on the number of weekly text message goals set with the HC across the 8-week period). Acceptability was assessed using a qualitative, summative evaluation. Exploratory statistical analysis included evaluating the average weekly steps in week 1 compared with week 8 using a paired t test (2-tailed) and modeling daily steps over time using a linear mixed model. Results Of the 33 patients initially screened; 30 (91%) patients were enrolled in the study. At baseline, the average BMI was 39.3 (SD 9.3) kg/m2, with 70% (23/33) of participants presenting as obese. A total of 30% (9/30) of participants self-rated their health as either fair or poor, and 73% (22/30) of participants set up ≥6 weekly goals across the 8-week program. In total, 93% (28/30) of participants completed a qualitative summative evaluation, and 10 themes emerged from the evaluation: patient motivation, convenient SMS text messaging experience, social support, supportive accountability, technology support, self-determined goals, achievable goals, feedback from Fitbit, challenges, and habit formation. There was no significant group change in the average weekly steps for week 1 compared with week 8 (mean difference 7.26, SD 6209.3; P=.99). However, 17% (5/30) of participants showed a significant increase in their daily steps. Conclusions Overall, the results demonstrate the feasibility and acceptability of a remotely delivered walking study that included an HC; SMS text messaging; a wearable device (Fitbit); and specific, measurable, attainable, realistic, and time-bound goals within an ethnic minority patient population. Results support further development and testing in larger samples to explore efficacy.
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Affiliation(s)
- Mary H Smart
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, IL, United States
| | - Nadia A Nabulsi
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, IL, United States
| | - Ben S Gerber
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Itika Gupta
- Department of Computer Science, College of Engineering, University of Illinois Chicago, Chicago, IL, United States
| | - Barbara Di Eugenio
- Department of Computer Science, College of Engineering, University of Illinois Chicago, Chicago, IL, United States
| | - Brian Ziebart
- Department of Computer Science, College of Engineering, University of Illinois Chicago, Chicago, IL, United States
| | - Lisa K Sharp
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, IL, United States
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The Effect of a Physical Activity Coaching Intervention on Accelerometer-Measured Sedentary Behaviours in Insufficiently Physically Active Ambulatory Hospital Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115543. [PMID: 34067292 PMCID: PMC8196832 DOI: 10.3390/ijerph18115543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 11/17/2022]
Abstract
Little is known about the impact that physical activity (PA) coaching interventions have on sedentary behaviours. The aim of this study was to investigate if a coaching intervention that increases PA coincidentally influences objectively measured sedentary time in insufficiently physically active adults. We recruited 120 insufficiently physically active ambulatory hospital patients and randomized them to either receive a PA coaching intervention designed to increase objectively measured moderate-to-vigorous-intensity PA (MVPA) or be part of a control group. Participants wore an accelerometer for seven days at baseline, post-intervention (three months) and follow-up (nine months). Changes in the average length of sedentary bouts, proportion of time in sedentary behaviours and number of sedentary bouts were evaluated using mixed-model ANOVAs. At baseline, both groups undertook 67 ± 13 sedentary bouts and spent 69% ± 6% of their time in sedentary behaviours. Compared with control, the intervention group decreased the number of sedentary bouts by 24% and the proportion of time in sedentary behaviours by 7% (p < 0.001). Significant changes were not observed between the groups for average length of sedentary bouts. The PA intervention led to a decrease in the number of sedentary bouts and proportion of time in sedentary behaviours. Future research should investigate PA coaching interventions designed to target simultaneous changes in MVPA and sedentary behaviours.
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Barrett S, Rodda K, Begg S, O'Halloran PD, Kingsley MI. Exercise and COVID-19: reasons individuals sought coaching support to assist them to increase physical activity during COVID-19. Aust N Z J Public Health 2021; 45:133-137. [PMID: 33683771 PMCID: PMC8251065 DOI: 10.1111/1753-6405.13089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/01/2020] [Accepted: 01/01/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE This paper explores the experiences of individuals who reported substantially decreasing physical activity (PA) as a result of COVID-19 and sought coaching support to increase PA. METHODS A qualitative study using phenomenological analysis. Eight individuals participated in semi-structured interviews that focused on their experiences of decreasing PA as a result of physical distancing measures, and why they sought PA coaching to overcome these issues. Responses were analysed thematically. RESULTS The participants reported markedly decreasing their PA following the enactment of physical distancing measures. The inability to subsequently engage in regular PA was a source of frustration for participants. Interview analysis revealed two themes that contributed to the understanding of why these individuals felt they needed PA coaching to increase PA; namely, a desire for both listening support and PA self-regulation support. CONCLUSION The individuals who decreased PA due to COVID-19 desired an autonomy-supportive counselling style, centred on listening support and self-regulatory support. Online PA interventions were not highlighted as strategies to overcome PA barriers. Implications for public health: The effect of physical distancing measures on the determinants of overall PA is important, particularly if prolonged physical distancing is required.
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Affiliation(s)
- Stephen Barrett
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria,Health Promotion Department, Bendigo Health Care Group, Bendigo, Victoria
| | - Kane Rodda
- Outpatient Rehabilitation Services, Bendigo Health Care Group, Bendigo, Victoria
| | - Stephen Begg
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria
| | - Paul D. O'Halloran
- School of Psychology and Public Health, La Trobe University. Bundoora, Victoria
| | - Michael I. Kingsley
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria,Department of Exercise Sciences, University of Auckland, Newmarket, New Zealand,Correspondence to: Professor Michael Kingsley, Holsworth Research Initiative, La Trobe University, Victoria
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