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Bourne JE, Leary S, England C, Searle A. ''I felt marvellous e-cycling. If I had long hair I would have flicked it": a qualitative investigation of the factors associated with e-cycling engagement among adults with type 2 diabetes. Front Sports Act Living 2023; 5:1150724. [PMID: 37841890 PMCID: PMC10570523 DOI: 10.3389/fspor.2023.1150724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
Background Physical activity (PA) is a key component in the management of type 2 diabetes. However, this population have low rates of PA engagement. Electrically assisted cycling has been identified as a means through which to increase PA by incorporating activity into daily life, while overcoming some of the barriers to conventional cycling. The determinants of e-cycling among people living with chronic disease are largely unknown. The aim of this research was to explore the determinants of e-cycling among individuals with type 2 diabetes using the Theoretical Domains Framework (TDF) and the Capability, Opportunity and Motivation for Behaviour change model (COM-B). This information is important for determining the suitability of future e-cycling initiatives and, if appropriate, inform future e-cycling interventions. Method One-to-one semi structured interviews were conducted with 16 participants from the e-cycling arm of a pilot randomised controlled trial between September 2019 and April 2020. The TDF was used to develop the interview guide. The framework method of analysis was used, incorporating both deductive and inductive reasoning. A conceptual model of the factors that influence e-cycling in this population was created. Results The most commonly reported TDF domains were skills, knowledge, belief about capabilities, belief about consequences and environmental context and resources. Specifically, e-bike training facilitated e-cycling engagement by providing participants with the skills, knowledge, and confidence needed to ride the e-bike and ride on the road. In addition, the enjoyment of e-cycling was a key facilitator to engagement. Participants engaged in e-cycling to improve their health rather than for environmental reasons. Most barriers to e-cycling related to the natural or physical environment. Conclusion This study provides insight into the personal, social, and environmental factors associated with e-cycling in this population. The findings of this study can be used to develop a more refined e-cycling intervention targeting the factors identified as influencing e-cycling engagement. In addition, this information will help in the selection of mechanistic outcome measures for evaluation.
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Affiliation(s)
- Jessica E. Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Sam Leary
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Clare England
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Aidan Searle
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
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Bourne JE, Leary S, Page A, Searle A, England C, Thompson D, Andrews RC, Foster C, Cooper AR. Electrically assisted cycling for individuals with type 2 diabetes mellitus: a pilot randomized controlled trial. Pilot Feasibility Stud 2023; 9:60. [PMID: 37072802 PMCID: PMC10111297 DOI: 10.1186/s40814-023-01283-5] [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: 03/07/2022] [Accepted: 03/28/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and its associated complications puts considerable strain on healthcare systems. With the global incidence of T2DM increasing, effective disease management is essential. Physical activity (PA) is a key component of T2DM management; however, rates of PA engagement are low in this population. Developing effective and sustainable interventions that encourage PA is a high priority. Electrically assisted bicycles are becoming increasingly popular and may increase PA in healthy adults. This study aimed to provide evidence of the feasibility of conducting a randomized controlled trial to evaluate the efficacy of an e-cycling intervention to increase PA and improve health in individuals with T2DM. METHODS A parallel-group two-arm randomized, waitlist-controlled pilot study was conducted. Individuals were randomized to either an e-bike intervention or standard care. The intervention incorporated two one-to-one e-bike skills training and behavioural counselling sessions delivered by a community-based cycling charity, followed by a 12-week e-bike loan with two further sessions with the instructors. Feasibility was assessed via measures related to recruitment, retention and intervention implementation. Post-intervention interviews with instructors and participants explored the acceptability of the study procedures and intervention. Clinical, physiological and behavioural outcomes were collected at baseline and post-intervention to evaluate the intervention's potential. RESULTS Forty participants (Mage = 57) were randomized, of which 34 were recruited from primary care practices. Thirty-five participants were retained in the trial. The intervention was conducted with high fidelity (> 80% content delivered). E-bike training provided participants with the skills, knowledge and confidence needed to e-bike independently. Instructors reported being more confident delivering the skills training than behavioural counselling, despite acknowledging its importance. The study procedures were found to be acceptable to participants. Between-group differences in change during the intervention were indicative of the interventions potential for improving glucose control, health-related quality of life and cardiorespiratory fitness. Increases in overall device measured moderate-to-vigorous PA behaviour following the intervention were found, and there was evidence that this population self-selected to e-cycle at a moderate intensity. CONCLUSIONS The study's recruitment, retention, acceptability and potential efficacy support the development of a definitive trial subject to identified refinements. TRIAL REGISTRATION ISRCTN, ISRCTN67421464 . Registered 17/12/2018.
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Affiliation(s)
- Jessica E Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
| | - Sam Leary
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Angie Page
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Aidan Searle
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Clare England
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, BA2 7PB, UK
| | - Robert C Andrews
- Institute of Biomedical and Clinical Sciences, Medical Research, University of Exeter Medical School, RILD Level 3, Barrack Road, Exeter, EX2 5DW, Devon, UK
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
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Peruzzi M, Sanasi E, Pingitore A, Marullo AG, Carnevale R, Sciarretta S, Sciarra L, Frati G, Cavarretta E. An overview of cycling as active transportation and as benefit for health. Minerva Cardioangiol 2021; 68:81-97. [PMID: 32429627 DOI: 10.23736/s0026-4725.20.05182-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Active transportation is defined as travelling on foot, by bicycle or other non-motorized means, sometimes in combination with other forms of public transportation, in contrast with the use of motor vehicles. The prevalence of sedentary lifestyle and physical inactivity is a growing epidemic in most developed countries that spread over the last three decades; active transportation may be a promising approach to increase physical activity and reduce the risk of non-communicable diseases improving cardiorespiratory fitness and cardiometabolic health. The health benefits of physical activity in reducing mortality and morbidity have been proved by several publications. Cardiorespiratory fitness can be improved by regular physical activity with an amelioration of insulin sensitivity, blood lipid profile, body composition, inflammation, and blood pressure. Active transportation as a daily physical activity is less expensive compared to motor vehicle use. The advantages are remarkable in terms of contrasting obesity and sedentary lifestyle, decrease motor traffic congestion and mitigate climate change. Massive investments in policies and interventions aimed to increase active transportation are not generally promoted and there are differences in the prevalence of active transportation in the daily routine among different areas. As in the literature several studies as randomized trials or observational studies have been published, with different end-points, in order to investigate if active commuting may be the right answer to improve cardiorespiratory fitness and cardiometabolic health, we aimed to review the available evidences of cycling as an active transportation and to consider its benefits on health.
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Affiliation(s)
| | - Elena Sanasi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | | | - Antonino G Marullo
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Roberto Carnevale
- Mediterranea Cardiocentro, Naples, Italy.,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Sebastiano Sciarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Department of Angio-Cardio-Neurology, IRCCS NeuroMed, Pozzilli, Isernia, Italy
| | - Luigi Sciarra
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Department of Angio-Cardio-Neurology, IRCCS NeuroMed, Pozzilli, Isernia, Italy
| | - Elena Cavarretta
- Mediterranea Cardiocentro, Naples, Italy - .,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
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