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Pebole MM, Singleton CR, Hall KS, Petruzzello SJ, Alston R, Darroch FE, Gobin RL. Perceived Barriers and Benefits of Exercise Among Men with Histories of Sexual Violence: Impact of PTSD and Physical Activity Status. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11842-11869. [PMID: 37519195 DOI: 10.1177/08862605231188058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
This study reported on perceived benefits and barriers of exercise among men with histories of sexual violence (SV) and compared these perceptions by activity level and post-traumatic stress disorder (PTSD) status. An online, cross-sectional, survey of men with histories of SV (N = 198) was completed using Amazon Mechanical Turk. Inclusion criteria were identifying sex at birth as male, age between 18 and 65 years, self-reported history of SV, and living in the United States (U.S.). A total of 1,260 men were screened for the study, of which 316 met the inclusion criteria, and 198 met all data quality requirements and were included in the study. Sociodemographic information, exercise behavior, PTSD symptoms, and perceived exercise barriers/benefits were collected. Comparisons by activity and PTSD status were analyzed. Additionally, two open-ended qualitative research questions were included to provide nuance to perceived barriers/benefits of exercise. The most salient benefits included physical performance, psychological outlook, and preventative health. Open-ended responses also noted the mental and physical benefits of exercise. The most salient barrier was physical exercise, with open-ended responses emphasizing lack of time, chronic pain and health concerns, and poor mental health and lack of motivation as impediments to exercise. Significant differences were found in benefits (psychological outlook, physical performance) and barriers (exercise environment, high time expenditure, and family discouragement) between active and insufficiently active men with histories of SV (ps < .05; Cohen's ds = 0.32-0.57). Significant differences were found by PTSD status on benefits (physical performance, social interaction, and preventative health) and barriers (exercise milieu, time expenditure, hard physical exercise, family discouragement) (ps < .05; Cohen's ds = 0.40-1.10). Findings provide new gender-specific strategies for promoting exercise among men with histories of SV: integrating exercise physiologists into trauma recovery programs, psychoeducation, engaging friends and family members, peer-support, and building self-efficacy.
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Affiliation(s)
- Michelle M Pebole
- Veterans Affairs Boston Healthcare System, Boston, MA, USA
- University of Illinois at Urbana Champaign, Champaign, IL, USA
| | | | - Katherine S Hall
- VA Durham Healthcare System, Durham, NC, USA
- Duke University, Durham, NC, USA
| | | | - Reginald Alston
- University of Illinois at Urbana Champaign, Champaign, IL, USA
| | | | - Robyn L Gobin
- University of Illinois at Urbana Champaign, Champaign, IL, USA
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Pebole MM, Singleton CR, Hall KS, Petruzzello SJ, Alston R, Gobin RL. Perceived Barriers and Benefits of Exercise Among Women Survivors of Sexual Violence by Physical Activity Level and Posttraumatic Stress Disorder Status. Violence Against Women 2023:10778012231182412. [PMID: 37350105 DOI: 10.1177/10778012231182412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
An online, cross-sectional survey of women survivors of sexual violence (SV; N = 355) gathered information on perceived barriers and benefits of exercise, along with exercise level and posttraumatic stress disorder (PTSD) symptoms. This study reports exercise perceptions and provides comparisons by exercise level and PTSD status. Differences by exercise level were found in life enhancement, physical performance, psychological outlook, and social interaction (ps < 0.05; rs = -0.04-0.25). Differences were found by PTSD status in physical performance, social interaction, and preventative health and exercise milieu, time expenditure, and family discouragement (ps < 0.05; rs = -0.39-0.21). Findings provide new information relevant for promoting exercise among women survivors of SV.
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Affiliation(s)
- Michelle M Pebole
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, MA, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA
| | - Katherine S Hall
- Department of Medicine, Duke University, Durham NC, USA
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, Durham, NC, USA
| | - Steven J Petruzzello
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Reginald Alston
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Robyn L Gobin
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, USA
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Browne J, Morey MC, Beckham JC, Bosworth HB, Porter Starr KN, Bales CW, McDermott J, Sloane R, Gregg JJ, Hall KS. Diet quality and exercise in older veterans with PTSD: a pilot study. Transl Behav Med 2021; 11:2116-2122. [PMID: 34487181 PMCID: PMC8846334 DOI: 10.1093/tbm/ibab116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Older veterans with posttraumatic stress disorder (PTSD) are at increased risk of obesity and cardiometabolic disease. Physical activity and healthy eating are two behaviors that impact health, functional independence, and disease risk in later life, yet few studies have examined the relationship between PTSD and diet quality. This secondary analysis aimed to: (a) characterize the diet quality of older veterans with PTSD in comparison to U.S. dietary guidelines and (b) explore if participation in a supervised exercise intervention spurred simultaneous changes in dietary behavior. Diet quality was assessed with the Dietary Screener Questionnaire (DSQ), which measures daily intake of fiber, calcium, added sugar, whole grain, dairy, and fruits/vegetables/legumes. The sample included 54 military veterans ≥ 60 years old with PTSD who participated in a randomized controlled pilot trial comparing 12 weeks of supervised exercise (n = 36) to wait-list usual care (n = 18). The DSQ was administered at baseline and 12 weeks. Consumption of added sugar exceeded U.S. dietary guideline recommendations and consumption of whole grains, fruits/vegetables/legumes, fiber, calcium, and dairy fell short. Participation in the supervised exercise intervention was not associated with changes in diet quality. Results revealed that the diet quality of older veterans with PTSD is poor, and while the exercise intervention improved health through exercise, it did not make veterans any more likely to adopt a more healthful diet. Interventions targeting diet, or diet + exercise, are needed to manage the increased risk of obesity and cardiometabolic disease present in older veterans with PTSD.
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Affiliation(s)
- Julia Browne
- Geriatric Research, Education and Clinical Center, VA Durham Healthcare System, Durham, NC, USA
| | - Miriam C Morey
- Geriatric Research, Education and Clinical Center, VA Durham Healthcare System, Durham, NC, USA
- Department of Medicine, Division of Geriatrics, Duke University, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
| | - Jean C Beckham
- Mental Illness Research, Education, and Clinical Center, VA Durham Healthcare System, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Hayden B Bosworth
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Health Services Research and Development Service, Center of Innovation to Accelerate Discovery and Practice Transformation, VA Durham Healthcare System, Durham, NC, USA
| | - Kathryn N Porter Starr
- Geriatric Research, Education and Clinical Center, VA Durham Healthcare System, Durham, NC, USA
- Department of Medicine, Division of Geriatrics, Duke University, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
| | - Connie W Bales
- Geriatric Research, Education and Clinical Center, VA Durham Healthcare System, Durham, NC, USA
- Department of Medicine, Division of Geriatrics, Duke University, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
| | - Jessica McDermott
- Geriatric Research, Education and Clinical Center, VA Durham Healthcare System, Durham, NC, USA
| | - Richard Sloane
- Geriatric Research, Education and Clinical Center, VA Durham Healthcare System, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
| | - Jeffrey J Gregg
- Department of Medicine, Division of Geriatrics, Duke University, Durham, NC, USA
- Mental and Behavioral Health Service, Durham VA Health Care System, Durham, NC, USA
| | - Katherine S Hall
- Geriatric Research, Education and Clinical Center, VA Durham Healthcare System, Durham, NC, USA
- Department of Medicine, Division of Geriatrics, Duke University, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
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Hall KS, Morey MC, Beckham JC, Bosworth HB, Sloane R, Pieper CF, Pebole MM. Warrior Wellness: A Randomized Controlled Pilot Trial of the Effects of Exercise on Physical Function and Clinical Health Risk Factors in Older Military Veterans With PTSD. J Gerontol A Biol Sci Med Sci 2020; 75:2130-2138. [PMID: 31646339 DOI: 10.1093/gerona/glz255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Military veterans living with post-traumatic stress disorder (PTSD) face significant physical and functional health disparities, which are often aggravated over time and in the context aging. Evidence has shown that physical activity can positively impact age-related health conditions, yet exercise trials in older adults with mental disorders are rare. Our study was a tailored and targeted pilot exercise intervention for older veterans with PTSD. METHODS Fifty-four older veterans with PTSD (mean age = 67.4 years, 90.7% male, 85.2% non-white) were randomized to supervised exercise (n = 38) or wait-list usual care (n = 18) for 12 weeks. Physical activity (MET-min/wk) and aerobic endurance (assessed with the 6-minute walk test) were primary outcomes. Secondary outcomes were physical performance (strength, mobility, balance), cardiometabolic risk factors (eg, waist circumference), and health-related quality of life. RESULTS At 12 weeks, a large effect of the intervention on physical activity levels (Cohen's d = 1.37) was observed compared to wait-list usual care. Aerobic endurance improved by 69 m in the exercise group compared to 10 m in wait-list group, reflecting a moderate between-group effect (Cohen's d = 0.50). Between-group differences on 12-week changes in physical performance, cardiometabolic risk factors, and health-related quality of life ranged from small to large effects (Cohen's d = 0.28-1.48), favoring the exercise arm. CONCLUSION Participation in supervised exercise improved aerobic endurance, physical performance, and health-related clinical factors in older veterans with PTSD; a medically complex population with multiple morbidity. Group exercise is a low-cost, low-stigma intervention, and implementation efforts among older veterans with PTSD warrants further consideration.
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Affiliation(s)
- Katherine S Hall
- VA Durham Healthcare System, Geriatric Research, Education, and Clinical Center, North Carolina.,Department of Population Health Sciences, Duke University, Durham, North Carolina
| | - Miriam C Morey
- VA Durham Healthcare System, Geriatric Research, Education, and Clinical Center, North Carolina.,Department of Population Health Sciences, Duke University, Durham, North Carolina
| | - Jean C Beckham
- VA Durham Healthcare System, Mental Illness Research, Education, and Clinical Center, North Carolina.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
| | - Hayden B Bosworth
- Department of Population Health Sciences, Duke University, Durham, North Carolina.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina.,VA Durham Healthcare System, Health Services Research and Development, Center of Innovation to Accelerate Discovery and Practice Transformation, North Carolina
| | - Richard Sloane
- VA Durham Healthcare System, Geriatric Research, Education, and Clinical Center, North Carolina.,Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Carl F Pieper
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Michelle M Pebole
- VA Durham Healthcare System, Geriatric Research, Education, and Clinical Center, North Carolina
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Weiss EL, Kranke D, Barmak SA. Military Veterans Serving as Volunteers: What Social Workers Need to Know. SOCIAL WORK 2020; 65:299-301. [PMID: 32710118 DOI: 10.1093/sw/swaa023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/30/2019] [Accepted: 06/03/2019] [Indexed: 06/11/2023]
Affiliation(s)
- Eugenia L Weiss
- is clinical professor of social work, Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street, MRF 201, Los Angeles, CA 90089
| | - Derrick Kranke
- is health science specialist, Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, CA
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Insights Following Implementation of an Exercise Intervention in Older Veterans with PTSD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142630. [PMID: 31340588 PMCID: PMC6678353 DOI: 10.3390/ijerph16142630] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/16/2019] [Accepted: 07/19/2019] [Indexed: 12/23/2022]
Abstract
Individuals with post-traumatic stress disorder (PTSD) face numerous barriers to exercise. Little is known about behavioral strategies to promote participation in this population. This is a secondary analysis of individual barriers and goals, exercise prescription characteristics, and patient perceptions of a 12-week, community-based, randomized controlled exercise trial targeting older adults with PTSD, (N = 45; mean age = 68; male = 91%). The most common cited goals for participating included weight loss (65%) and increasing strength (65%). Exercise mode varied among those who completed the program (n = 37), with 14 (38%) using exclusively treadmill; eight (22%) using only bike, and 15 (41%) utilizing a combination. Patient-reported exercise duration and intensity progressively increased over the 12 weeks, and duration differed by mode of exercise. We observed high rates of attendance (84%) and completion (88%) to the program. Patient-reported barriers to attendance most often included health problems (62%) and medical appointments (55%). Participant responses to a program evaluation revealed high levels of satisfaction, preferences for group-based programs, and insights about the acceptability of the exercise environment (physical and social). This study is the first to report on goals, barriers, exercise prescription needs, and individual responses to supervised exercise training in a unique population, that is, older veterans with PTSD. Results of this study can inform future health promotion programs targeting older veterans with PTSD.
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Pilot randomized controlled trial of exercise training for older veterans with PTSD. J Behav Med 2019; 43:648-659. [PMID: 31264055 DOI: 10.1007/s10865-019-00073-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/19/2019] [Indexed: 01/22/2023]
Abstract
Exercise training positively impacts mental health, yet remains untested in older adults with posttraumatic stress disorder (PTSD). We conducted a randomized controlled pilot trial to test the feasibility and acceptability of exercise training in older veterans with PTSD. Fifty-four veterans ≥ 60 years, with a DSM-V diagnosis of PTSD, were randomized to supervised exercise (n = 36) or wait-list (WL; n = 18). Primary outcomes included recruitment rates, attendance, satisfaction, and retention. Secondary outcomes included changes in PTSD symptoms, depression, health-related quality of life, and sleep quality; assessed at baseline and 12 weeks. There were no adverse events. Attrition was minimal (14%), and adherence to the exercise intervention was high (82%). Clinically significant improvements in PTSD and related conditions were observed following exercise (Cohen's d = 0.36-0.81). Exercise training is safe and acceptable in older adults with PTSD, may improve PTSD symptoms, and broadly impacts PTSD-related conditions. Future definitive trials are warranted.
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