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Irandoust K, Parsakia K, Estifa A, Zoormand G, Knechtle B, Rosemann T, Weiss K, Taheri M. Predicting and comparing the long-term impact of lifestyle interventions on individuals with eating disorders in active population: a machine learning evaluation. Front Nutr 2024; 11:1390751. [PMID: 39171102 PMCID: PMC11337873 DOI: 10.3389/fnut.2024.1390751] [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: 02/23/2024] [Accepted: 07/15/2024] [Indexed: 08/23/2024] Open
Abstract
Objective This study aims to evaluate and predict the long-term effectiveness of five lifestyle interventions for individuals with eating disorders using machine learning techniques. Methods This study, conducted at Dr. Irandoust's Health Center at Qazvin from August 2021 to August 2023, aimed to evaluate the effects of five lifestyle interventions on individuals with eating disorders, initially diagnosed using The Eating Disorder Diagnostic Scale (EDDS). The interventions were: (1) Counseling, exercise, and dietary regime, (2) Aerobic exercises with dietary regime, (3) Walking and dietary regime, (4) Exercise with a flexible diet, and (5) Exercises through online programs and applications. Out of 955 enrolled participants, 706 completed the study, which measured Body Fat Percentage (BFP), Waist-Hip Ratio (WHR), Fasting Blood Sugar (FBS), Low-Density Lipoprotein (LDL) Cholesterol, Total Cholesterol (CHO), Weight, and Triglycerides (TG) at baseline, during, and at the end of the intervention. Random Forest and Gradient Boosting Regressors, following feature engineering, were used to analyze the data, focusing on the interventions' long-term effectiveness on health outcomes related to eating disorders. Results Feature engineering with Random Forest and Gradient Boosting Regressors, respectively, reached an accuracy of 85 and 89%, then 89 and 90% after dataset balancing. The interventions were ranked based on predicted effectiveness: counseling with exercise and dietary regime, aerobic exercises with dietary regime, walking with dietary regime, exercise with a flexible diet, and exercises through online programs. Conclusion The results show that Machine Learning (ML) models effectively predicted the long-term effectiveness of lifestyle interventions. The current study suggests a significant potential for tailored health strategies. This emphasizes the most effective interventions for individuals with eating disorders. According to the results, it can also be suggested to expand demographics and geographic locations of participants, longer study duration, exploring advanced machine learning techniques, and including psychological and social adherence factors. Ultimately, these results can guide healthcare providers and policymakers in creating targeted lifestyle intervention strategies, emphasizing personalized health plans, and leveraging machine learning for predictive healthcare solutions.
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Affiliation(s)
- Khadijeh Irandoust
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
| | - Kamdin Parsakia
- Department of Psychology and Counseling, KMAN Research Institute, Richmond Hill, ON, Canada
| | - Ali Estifa
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
| | - Gholamreza Zoormand
- Department of Physical Education, Huanggang Normal University, Huanggang, China
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
| | - Thomas Rosemann
- Institute of Primary Care, University of Zürich, Zürich, Switzerland
| | - Katja Weiss
- Institute of Primary Care, University of Zürich, Zürich, Switzerland
| | - Morteza Taheri
- Department of Cognitive and Behavioural Sciences in Sport, Faculty of Sport Science and Health, University of Tehran, Tehran, Iran
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Xu Z, Zheng X, Ding H, Zhang D, Cheung PMH, Yang Z, Tam KW, Zhou W, Chan DCC, Wang W, Wong SYS. The Effect of Walking on Depressive and Anxiety Symptoms: Systematic Review and Meta-Analysis. JMIR Public Health Surveill 2024; 10:e48355. [PMID: 39045858 PMCID: PMC11287235 DOI: 10.2196/48355] [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: 04/20/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 07/25/2024] Open
Abstract
Background Previous literature lacks summative information on the mental health benefits achieved from different forms of walking. Objective The aim of this study was to assess the effectiveness of different forms of walking in reducing symptoms of depression and anxiety. Methods This was a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effects of walking on depressive and anxiety symptoms. MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Allied and Complementary Medicine Database (AMED), CINAHL, and Web of Science were searched on April 5, 2022. Two authors independently screened the studies and extracted the data. Random-effects meta-analysis was used to synthesize the data. Results were summarized as standardized mean differences (SMDs) with 95% CIs in forest plots. The risk of bias was assessed by using the Cochrane Risk of Bias tool. Results This review included 75 RCTs with 8636 participants; 68 studies reported depressive symptoms, 39 reported anxiety symptoms, and 32 reported both as the outcomes. One study reported the results for adolescents and was not included in the meta-analysis. The pooled results for adults indicated that walking could significantly reduce depressive symptoms (RCTs: n=44; SMD -0.591, 95% CI -0.778 to -0.403; I2=84.8%; τ2=0.3008; P<.001) and anxiety symptoms (RCTs: n=26; SMD -0.446, 95% CI -0.628 to -0.265; I2=81.1%; τ2=0.1530; P<.001) when compared with the inactive controls. Walking could significantly reduce depressive or anxiety symptoms in most subgroups, including different walking frequency, duration, location (indoor or outdoor), and format (group or individual) subgroups (all P values were <.05). Adult participants who were depressed (RCTs: n=5; SMD -1.863, 95% CI -2.764 to -0.962; I2=86.4%; τ2=0.8929) and those who were not depressed (RCTs: n=39; SMD -0.442, 95% CI -0.604 to -0.280; I2=77.5%; τ2=0.1742) could benefit from walking effects on their depressive symptoms, and participants who were depressed could benefit more (P=.002). In addition, there was no significant difference between walking and active controls in reducing depressive symptoms (RCTs: n=17; SMD -0.126, 95% CI -0.343 to 0.092; I2=58%; τ2=0.1058; P=.26) and anxiety symptoms (14 RCTs, SMD -0.053, 95% CI -0.311 to 0.206, I2=67.7%, τ2=0.1421; P=.69). Conclusions Various forms of walking can be effective in reducing symptoms of depression and anxiety, and the effects of walking are comparable to active controls. Walking can be adopted as an evidence-based intervention for reducing depression and anxiety. More evidence on the effect of low-intensity walking is needed in the future.
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Affiliation(s)
- Zijun Xu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Xiaoxiang Zheng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Hanyue Ding
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Dexing Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Peter Man-Hin Cheung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Zuyao Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - King Wa Tam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Weiju Zhou
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Dicken Cheong-Chun Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Wenyue Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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Iqbal R, Naz S, Sheikh S, Qureshi R, Bhutta S, Yasmeen H, Azam I, Gill P. Conducting a diabetes mellitus prevention trial in women with GDM in Pakistan: a feasibility study. Pilot Feasibility Stud 2024; 10:92. [PMID: 38879496 PMCID: PMC11179295 DOI: 10.1186/s40814-024-01514-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 06/06/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Women with gestational diabetes mellitus (GDM) are at a greater risk of developing type 2 diabetes mellitus (T2DM) than women without GDM. Despite this elevated risk, few trials on the prevention of T2DM among South Asian women with GDM have been reported. Therefore, this study aimed to assess the feasibility of conducting a diabetes prevention program on women with a history of GDM to inform the development of a contextually relevant definitive trial. METHODS Using a randomized controlled trial, women with GDM (n = 180) who delivered at the study hospitals (one public and one private teaching hospital, Karachi) with fasting blood glucose levels < 120 mg/dl at 6 weeks postpartum were randomized to the intervention (n = 88) or control arms (n = 92). Women in the intervention group received individualized home-based educational sessions from trained community health workers at 0, 1, 3, 6, and 9 months. In addition, they received short text messages, prerecorded messages, and printed educational material (calendars and pamphlets) for reinforcement. The intervention was centered on equipping women with knowledge, skills, and confidence to eat a healthy diet rich in fruits, vegetables, and low-fat dairy products and perform regular physical activity based on walking and household chores to reduce weight (up to 5% of their initial body weight). Women in the control arm received standard care. The feasibility outcomes of the study included screening, recruitment, and retention rates and in-depth interviews at 6 months post-intervention to explore women's experiences with the intervention. Descriptive analysis and thematic analysis were performed. RESULTS Of the 324 women screened during the antenatal care visits and after delivery, 255 (78.7%) were contactable 6 weeks postpartum, and 180 (70.6%) were eligible and randomized to intervention (n = 88) and control (n = 92) groups. Loss to follow-up in the intervention and control arms was 22.7% (n = 20/88) and 18.5% (n = 17/92), respectively. Women expressed satisfaction with home-based counseling and follow-up visits, text message reminders, and printed material in the form of a calendar through our qualitative interviews. CONCLUSIONS Home-based lifestyle modification intervention augmented with text messages and printed material is feasible. However, to evaluate the intervention's effectiveness, a larger trial is warranted to assess its long-term impact on diabetes prevention. TRIAL REGISTRATION ISRCTN, ISRCTN11387113 . Registered 5 December 2017-retrospectively registered.
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Affiliation(s)
- Romaina Iqbal
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan.
| | - Sabahat Naz
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Sana Sheikh
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Rahat Qureshi
- Department of Obstetrics and Gynecology, The Aga Khan University, Karachi, Pakistan
| | | | | | - Iqbal Azam
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Paramjit Gill
- Division of Health Sciences, University of Warwick, Coventry, UK
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Ibeneme SC, Mah J, Omeje C, Fortwengel G, Nwosu AO, Irem FO, Ibeneme GC, Myezwa H, Nweke M. Effectiveness of pedometer-based walking programmes in improving some modifiable risk factors of stroke among community-dwelling older adults: a systematic review, theoretical synthesis and meta-analysis. BMC Geriatr 2024; 24:516. [PMID: 38872081 PMCID: PMC11177376 DOI: 10.1186/s12877-024-05069-z] [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: 01/04/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Pedometer-based walking programs hold promise as a health promotion strategy for stroke prevention in community-dwelling older adults, particularly when targeted at physical activity-related modifiable risk factors. The question arises: What is the effectiveness of pedometer-based walking program interventions in improving modifiable stroke risk factors among community-dwelling older adults? METHOD Eight databases were searched up to December 2nd, 2023, following the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Inclusion criteria focused on randomized controlled trials (RCTS) involving community-dwelling older adults and reported in English. Two independent reviewers utilized Physiotherapy Evidence Database (PEDro) tool to extract data, assess eligibility, evaluate study quality, and identify potential bias. Standardized mean difference (SMD) was employed as summary statistics for primary -physical activity level -and secondary outcomes related to cardiovascular function (blood pressure) and metabolic syndrome, including obesity (measured by body mass index and waist circumference), fasting blood sugar, glycated hemoglobin, high-density lipoprotein cholesterol (HDL-C), and triglycerides. A random-effects model was used to generate summary estimates of effects. RESULTS The review analyzed eight studies involving 1546 participants aged 60-85 years, with 1348 successfully completing the studies. Across these studies, pedometer-based walking programs were implemented 2-3 times per week, with sessions lasting 40-60 minutes, over a duration of 4-26 weeks. The risk of bias varied from high to moderate. Our narrative synthesis revealed positive trends in HDL-C levels, fasting blood sugar, and glycated hemoglobin, suggesting improved glycemic control and long-term blood sugar management. However, the impact on triglycerides was only marginal. Primary meta-analysis demonstrated significantly improved physical activity behavior (SMD=0.44,95%CI:0.26, 0.61,p=<0.00001;I2=0%;4 studies; 532 participants) and systolic blood pressure (SMD=-0.34,95%CI:-0.59,-0.09;p=<0.008;I2=65%,2 studies;249 participants), unlike diastolic blood pressure (SMD=0.13,95%CI:-0.13,-0.38,p=0.33; I2=91%; 2 studies; 237 participants). Interventions based on social cognitive, self-efficacy, and self-efficiency theory(ies), and social cognitive theory applied in an ecological framework, were linked to successful physical activity behavior outcomes. CONCLUSION Pedometer-based walking programs, utilizing interpersonal health behavior theory/ecological framework, enhance physical activity behavior and have antihypertensive effects in community-dwelling older adults. While they do not significantly affect diastolic blood pressure, these programs potentially serve as a primary stroke prevention strategy aligning with global health goals. TRIAL REGISTRATION Registration Number: INPLASY202230118.
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Affiliation(s)
- Sam Chidi Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria.
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies,University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, Gauteng, South Africa.
- Department of Physiotherapy, Faculty of Health Sciences & Technology, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria.
- Department of physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
| | - Juliet Mah
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Enugu, Nigeria
| | - Chidimma Omeje
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria
| | - Gerhard Fortwengel
- Faculty III, Hochschule Hannover University of Applied Sciences & Arts, 30159, Hannover, Lower Saxony, Germany
| | - Akachukwu Omumuagwula Nwosu
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria
| | - Frank Onyemaechi Irem
- Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Enugu, Nigeria
| | - Georgian Chiaka Ibeneme
- Department of Nursing Sciences, Faculty of Health Sciences & Technology, College of Health Sciences, Ebonyi State University, Ebonyi State, Abakaliki, Nigeria
- Department of Nursing Science, Faculty of Health Sciences & Technology, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
| | - Hellen Myezwa
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies,University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, Gauteng, South Africa
| | - Martins Nweke
- Department of Physiotherapy, Faculty of Health Sciences & Technology, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
- Department of physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Ao Z, He H, Shi H, Liu H. Step count and multiple health outcomes: An umbrella review. J Evid Based Med 2024; 17:278-295. [PMID: 38566344 DOI: 10.1111/jebm.12596] [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: 05/17/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This study aimed to quantify the association between step count and multiple health outcomes in a healthy population. METHODS PubMed, Embase, Web of Science, and The Cochrane Library were systematically searched for systematic reviews and meta-analyses from inception to April 1, 2022. Literature screening, data extraction, and data analysis were performed in this umbrella review. The intervention factor was daily step counts measured based on devices. Multiple health outcomes included metabolic diseases, cardiovascular diseases, all-cause mortality, and other outcomes in the healthy population. RESULTS Twenty studies with 94 outcomes were identified in this umbrella review. The increase in daily step count contributed to a range of human health outcomes. Furthermore, the special population, different age groups, countries, and cohorts should be carefully considered. Negative correlation between step counts and the following outcomes: metabolic outcomes, cardiovascular diseases, all-cause mortality, postural balance, cognitive function, and mental health. However, there was no association between participation in the outdoor walking group and the improvement of systolic blood pressure and diastolic blood pressure. Analysis of the dose-response association between increasing daily step count and the risk of cardiovascular disease events and all-cause mortality showed a substantially linear relationship. CONCLUSION A wide range of health outcomes can benefit from the right number of steps.
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Affiliation(s)
- Zhimin Ao
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hongbo He
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hongxia Shi
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Liu
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
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LeMense AT, Malone GT, Kinderman MA, Fedewa MV, Winchester LJ. Validity of Using the Load-Velocity Relationship to Estimate 1 Repetition Maximum in the Back Squat Exercise: A Systematic Review and Meta-Analysis. J Strength Cond Res 2024; 38:612-619. [PMID: 38416447 DOI: 10.1519/jsc.0000000000004709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
ABSTRACT LeMense, AT, Malone, GT, Kinderman, MA, Fedewa, MV, and Winchester, LJ. Validity of using the load-velocity relationship to estimate 1 repetition maximum in the back squat exercise: a systematic review and meta-analysis. J Strength Cond Res 38(3): 612-619, 2024-The one repetition maximum (1RM) test is commonly used to assess muscular strength. However, 1RM testing can be time consuming, physically taxing, and may be difficult to perform in athletics team settings with practice and competition schedules. Alternatively, 1RM can be estimated from bar or movement velocity at submaximal loads using the minimum velocity threshold (MVT) method based on the load-velocity relationship. Despite its potential utility, this method's validity has yielded inconsistent results. The purpose of this systematic review and meta-analysis was to assess the validity of estimated 1RM from bar velocity in the back squat exercise. A systematic search of 3 electronic databases was conducted using combinations of the following keywords: "velocity-based training," "load-velocity profiling," "mean velocity," "mean propulsive velocity," "peak velocity," "maximal strength," "1RM," "estimation," "prediction," "back squat," and "regression." The search identified 372 unique articles, with 4 studies included in the final analysis. Significance was defined as a p level less than 0.05. A total of 27 effects from 71 subjects between the ages of 17-25 years were analyzed; 85.2% of effects were obtained from male subjects. Measured 1RMs ranged from 86.5 to 153.1 kg, whereas estimated 1RMs ranged from 88.6 to 171.6 kg. Using a 3-level random effects model, 1RM back squat was overestimated when derived from bar velocity using the MVT method (effect sizes [ES] = 0.5304, 95% CI: 0.1878-0.8730, p = 0.0038). The MVT method is not a viable option for estimating 1RM in the free weight back squat. Strength and conditioning professionals should exercise caution when estimating 1RM from the load-velocity relationship.
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Affiliation(s)
- Andrew T LeMense
- Department of Kinesiology, University of Alabama, Tuscaloosa, Alabama
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Wang W, Ruan H, Shen Y, Cheng J, Sun W, Huang C. Effectiveness of utilizing step-monitoring devices to prevent and treat obesity in children and adolescents: A systematic review and meta-analysis. Digit Health 2024; 10:20552076241272589. [PMID: 39148809 PMCID: PMC11325471 DOI: 10.1177/20552076241272589] [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: 04/24/2024] [Accepted: 07/18/2024] [Indexed: 08/17/2024] Open
Abstract
Background Children and adolescents who are overweight and obese represent a growing public health issue. The use of step-monitoring devices as an intervention tool may be a simple, cost-effective, and easily replicable solution for addressing obesity in children and adolescents. No prior systematic reviews have evaluated the effectiveness of utilizing step-monitoring devices as an intervention method for obesity in children and adolescents. Methods Previous studies on using step-monitoring devices to prevent and treat obesity in children and adolescents were identified in the following databases: Web of Science, EMBASE, PubMed, Cochrane Library, SPORTDiscus, and SCOPUS. The search period for each database ranged from the year of their inception to 8 March 2023 (updated in June 2024). Meta-analyses were performed for mean differences (MDs) in body mass index (BMI), BMI z-score (BMI-Z), body fat, waist circumference, and body weight. Results From 12,907 relevant records, 23 studies were included in this meta-analysis. The included studies were mainly at low risk of bias, except for blinding. Step-monitoring device-based interventions had significant effects in reducing BMI-Z (MD -0.06; 95% CI -0.10 to -0.02), body fat (MD -0.95%; 95% CI -1.35 to -0.54), and body weight (MD -1.23 kg; 95% CI -2.36 to -0.10). However, there was no significant effect on BMI (MD -0.16 kg/m2; 95% CI -0.55 to 0.22) and waist circumference (MD -0.33 cm; 95% CI -1.23 to 0.58). Subgroup analyses indicated that participants who were overweight or obese showed greater intervention effects on BMI and BMI-Z compared to participants with normal weight. The programs with an intervention duration of ≤6 months presented a greater intervention effect on BMI-Z than those with an intervention duration of more than 6 months. The programs that established goals had a greater intervention effect on body fat than those that did not. Conclusions Step-monitoring devices may be an effective and generalizable intervention tool for the prevention and treatment of obesity in children and adolescents. Future studies should further explore how to set step goals and the duration of interventions to achieve better intervention effects.
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Affiliation(s)
- Wentao Wang
- Department of Basic Education, Zhejiang Tongji Vocational College of Science and Technology, Hangzhou, China
- Department of Sports and Exercise Science, Zhejiang University, Hangzhou, China
| | - Hongfang Ruan
- Department of Basic Education, Zhejiang Tongji Vocational College of Science and Technology, Hangzhou, China
| | - Yi Shen
- Department of Basic Education, Zhejiang Tongji Vocational College of Science and Technology, Hangzhou, China
| | - Jing Cheng
- Department of Basic Education, Zhejiang Tongji Vocational College of Science and Technology, Hangzhou, China
| | - Wei Sun
- Department of Military and Sports, Zhejiang University of Water Resources and Electric Power, Hangzhou, China
| | - Cong Huang
- Department of Sports and Exercise Science, Zhejiang University, Hangzhou, China
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India-Aldana S, Rundle AG, Quinn JW, Clendenen TV, Afanasyeva Y, Koenig KL, Liu M, Neckerman KM, Thorpe LE, Zeleniuch-Jacquotte A, Chen Y. Long-Term Exposure to Walkable Residential Neighborhoods and Risk of Obesity-Related Cancer in the New York University Women's Health Study (NYUWHS). ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:107001. [PMID: 37791759 PMCID: PMC10548871 DOI: 10.1289/ehp11538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/24/2023] [Accepted: 09/06/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Living in neighborhoods with higher levels of walkability has been associated with a reduced risk of obesity and higher levels of physical activity. Obesity has been linked to increased risk of 13 cancers in women. However, long-term prospective studies of neighborhood walkability and risk for obesity-related cancer are scarce. OBJECTIVES We evaluated the association between long-term average neighborhood walkability and obesity-related cancer risk in women. METHODS The New York University Women's Health Study (NYUWHS) is a prospective cohort with 14,274 women recruited between 1985 and 1991 in New York City and followed over nearly three decades. We geocoded residential addresses for each participant throughout follow-up and calculated an average annual measure of neighborhood walkability across years of follow-up using data on population density and accessibility to destinations associated with geocoded residential addresses. We used ICD-9 codes to characterize first primary obesity-related cancers and employed Cox proportional hazards models to assess the association between average neighborhood walkability and risk of overall and site-specific obesity-related cancers. RESULTS Residing in neighborhoods with a higher walkability level was associated with a reduced risk of overall and site-specific obesity-related cancers. The hazards ratios associated with a 1-standard deviation increase in average annual neighborhood walkability were 0.88 (95% CI: 0.85, 0.93) for overall obesity-related cancer, 0.89 (95% CI: 0.84, 0.95) for postmenopausal breast cancer, 0.82 (95% CI: 0.68, 0.99) for ovarian cancer, 0.87 (95% CI: 0.76, 0.99) for endometrial cancer, and 0.68 (95% CI: 0.49, 0.94) for multiple myeloma, adjusting for potential confounders at both the individual and neighborhood level. The association between neighborhood walkability and risk of overall obesity-related cancer was stronger among women living in neighborhoods with higher levels of poverty compared with women living in areas with lower poverty levels (p Interaction = 0.006 ). DISCUSSION Our study highlights a potential protective role of neighborhood walkability in preventing obesity-related cancers in women. https://doi.org/10.1289/EHP11538.
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Affiliation(s)
- Sandra India-Aldana
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Andrew G. Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - James W. Quinn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Tess V. Clendenen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Yelena Afanasyeva
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Karen L. Koenig
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Mengling Liu
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, New York, USA
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - Kathryn M. Neckerman
- Columbia Population Research Center, Columbia University, New York, New York, USA
| | - Lorna E. Thorpe
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - Anne Zeleniuch-Jacquotte
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Yu Chen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, New York, USA
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Bellanger W, Peurois M, Connan L, Navasiolava N, Missud D, Py T, Bègue C. Comparing physical activity prescription with verbal advice for general practice patients with cardiovascular risk factors: results from the PEPPER randomised controlled trial. BMC Public Health 2023; 23:1402. [PMID: 37475036 PMCID: PMC10360325 DOI: 10.1186/s12889-023-16302-6] [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: 10/04/2021] [Accepted: 07/12/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Regular physical activity improves health and quality of life for people with cardiovascular risk factors. However, few studies have demonstrated the applicability of strategies in health care to promote physical activity. OBJECTIVE To evaluate if a written physical activity prescription combined with pedometer increases physical activity over one year compared with verbal advice in patients with cardiovascular disease risk in primary care. METHODS The randomised-controlled, interventional, 12-month PEPPER study recruited patients aged 35 to 74 years, having quarterly followed-ups for hypertension, dyslipidaemia, or diabetes, and judged insufficiently active. Seventeen practices randomised patients into either the experimental group, who received a written, personalised prescription for daily step numbers, pedometer and logbook, or control group, who received verbal advice to do at least 15 min of rapid walking or equivalent daily. The primary outcome was the change in total weekly energy expenditure measured using an accelerometer at 3 months. The secondary outcomes were changes in step count, physical activity levels, quality of life, perceived obstacles to physical activity, and biomedical indicators at 3 and 12 months. RESULTS One hundred and twenty-one participants were randomised. Although, weekly energy expenditure did not differ between the prescription and verbal instruction group, the estimated time spent doing moderate-intensity activity was significantly higher in the prescription group than the verbal group by an average of four minutes/week (p = 0.018)(95% CI [0.7 - 7.4]) reaching 48 min after 12 months (95% CI: 8 - 89). Similarly, this was associated with a clinically, higher average step number of 5256 steps/week increase over a year (95% CI: 660 - 9852). Among the most sedentary subgroup, walking less than 5000 steps/day at baseline, an 8868 steps/week (95% CI [2988 - 14700]) increase was observed in the prescription group. CONCLUSION Prescribing physical activity did not significantly modify total weekly energy expenditure, but slightly increased moderate-intensity activity duration and step counts, particularly among the most sedentary participants. Prescribing personalised physical activity goals encourages sedentary patients to engage in physical activity. TRIAL REGISTRATION The PEPPER trial is registered in the US National Institutes of Health Clinical Trials Registry under number NCT02317003 (15/12/2014).
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Affiliation(s)
- William Bellanger
- Department of General Practice, University of Angers, 49000, Angers, France
| | - Matthieu Peurois
- Department of General Practice, University of Angers, 49000, Angers, France.
- University of Angers, Univ Rennes, EHESP, Inserm, IRSET-ESTER,, SFR ICAT, 49000, Angers, France.
| | - Laurent Connan
- Department of General Practice, University of Angers, 49000, Angers, France
| | - Nastassia Navasiolava
- University of Angers, CHU Angers, CRC, INSERM, CNRS, MITOVASC, Equipe CarMe, SFR ICAT, 49000, Angers, France
| | - David Missud
- Department of General Practice, University of Angers, 49000, Angers, France
| | - Thibaut Py
- Department of General Practice, University of Angers, 49000, Angers, France
| | - Cyril Bègue
- Department of General Practice, University of Angers, 49000, Angers, France
- University of Angers, Univ Rennes, EHESP, Inserm, IRSET-ESTER,, SFR ICAT, 49000, Angers, France
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Ray JL, Srinath R, Mechanick JI. The Negative Impact of Routine, Dietary Pattern, and Physical Activity on Obesity and Dysglycemia During the COVID-19 Pandemic. Am J Lifestyle Med 2023; 17:219-230. [PMID: 36883128 PMCID: PMC9024091 DOI: 10.1177/15598276221084923] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The global coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, has disrupted routines in education, work, exercise, and dining habits. To prevent viral spread, communal spaces including offices, schools, restaurants, and gyms have closed or drastically limited their capacity. Additionally, government-mandated lockdown orders have forced people to spend more time at home. Studies have shown that these COVID-19 restrictions have led to unhealthier eating patterns, increased sedentary behaviors, and decreased physical activity, leading to weight gain, dysglycemia, and increased metabolic risk. While strict social distancing measures have been necessary to curb the spread of the SARS-CoV-2 virus, people have been forced to adapt by altering their daily routines. Based on existing literature, a model is proposed for intentionally creating daily routines to ensure healthy habits, minimize weight gain, and prevent worsening dysglycemia.
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Affiliation(s)
- Justina L Ray
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Reshmi Srinath
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeffrey I Mechanick
- Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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11
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Xu L, Tong Q, Zhang X, Yu T, Lian X, Yu T, Falter M, Scherrenberg M, Kaihara T, Kizilkilic SE, Kindermans H, Dendale P, Li F. Smartphone-based gamification intervention to increase physical activity participation among patients with coronary heart disease: A randomized controlled trial. J Telemed Telecare 2023:1357633X221150943. [PMID: 36794484 DOI: 10.1177/1357633x221150943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Despite proven benefits, patients with coronary heart disease (CHD) typically fail to participate in sufficient physical activity (PA). Effective interventions should be implemented to help patients maintain a healthy lifestyle and modify their present behavior. Gamification is the use of game design features (such as points, leaderboards, and progress bars) to improve motivation and engagement. It shows the potential for encouraging patients to engage in PA. However, empirical evidence on the efficacy of such interventions among patients with CHD is still emerging. PURPOSE The aim of the study is to explore whether a smartphone-based gamification intervention could increase PA participation and other physical and psychological outcomes in CHD patients. METHODS Participants with CHD were randomly assigned to three groups (control group, individual group, and team group). The individual and team groups received gamified behavior intervention based on behavioral economics. The team group combined gamified intervention with social interaction. The intervention lasted for 12 weeks, and the follow-up was12 weeks. The primary outcomes included the change in daily steps and the proportion of patient days that step goals were achieved. The secondary outcomes included competence, autonomy, relatedness, and autonomous motivation. RESULTS For the individual group, smartphone-based gamification intervention significantly increased PA among CHD patients over the 12-week period (step count difference 988; 95% CI 259-1717; p < 0.01) and had a good maintenance effect during the follow-up period (step count difference 819; 95% CI 24-1613; p < 0.01). There are also significant differences in competence, autonomous motivation, body mass index (BMI), and waist circumference in 12 weeks between the control group and individual group. For the team group, gamification intervention with collaboration didn't result in significant increases in PA. But patients in this group had a significant increase in competence, relatedness, and autonomous motivation. CONCLUSION A smartphone-based gamification intervention was proven to be an effective way to increase motivation and PA engagement, with a substantial maintenance impact (Chinese Clinical Trial Registry Identifier: ChiCTR2100044879).
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Affiliation(s)
- Linqi Xu
- School of Nursing, 12510Jilin University, Changchun, China
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, 54496UHasselt, Diepenbeek, Belgium
| | - Qian Tong
- Department of Cardiology, First Hospital of Jilin University, Changchun, China
| | - Xin Zhang
- School of Nursing, 12510Jilin University, Changchun, China
| | - Tianzhuo Yu
- School of Nursing, 12510Jilin University, Changchun, China
| | - Xiaoqian Lian
- School of Nursing, 12510Jilin University, Changchun, China
| | - Tianyue Yu
- School of Nursing, 12510Jilin University, Changchun, China
| | - Maarten Falter
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, 54496UHasselt, Diepenbeek, Belgium
- Faculty of Medicine, Department of Cardiology, KU Leuven, Leuven, Belgium
| | - Martijn Scherrenberg
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, 54496UHasselt, Diepenbeek, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Leuven, Belgium
| | - Toshiki Kaihara
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, 54496UHasselt, Diepenbeek, Belgium
- Division of Cardiology, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Japan
| | - Sevda Ece Kizilkilic
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, 54496UHasselt, Diepenbeek, Belgium
| | - Hanne Kindermans
- Faculty of Medicine and Life Sciences, 54496UHasselt, Diepenbeek, Belgium
| | - Paul Dendale
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, 54496UHasselt, Diepenbeek, Belgium
| | - Feng Li
- School of Nursing, 12510Jilin University, Changchun, China
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12
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The effect of neighborhood walkability on changes in physical activity and sedentary behavior during a 12-week pedometer-facilitated intervention. PLoS One 2022; 17:e0278596. [PMID: 36455004 PMCID: PMC9714904 DOI: 10.1371/journal.pone.0278596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/19/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Pedometer-facilitated interventions encourage physical activity via the accumulation of steps. Mixed evidence suggests that neighborhood walkability might influence the effectiveness of physical activity interventions, including pedometer-facilitated interventions. Our study investigated the moderating effect of neighborhood walkability on immediate (4-week) and short-term (12-week) changes in self-reported neighborhood-specific leisure and transportation walking, leisure-based moderate and vigorous-intensity physical activity, and leisure-based screen time during a pedometer-facilitated intervention (UWALK). METHODS This quasi-experiment undertaken in Calgary (Canada) compared behavior changes during the 12-week intervention between two neighborhood groups classified as 'walkable' or 'car dependent' based on Walk Score®. Of the 573 volunteers (adults in the contemplation and preparation stages of physical activity behavior change), 466 participated in UWALK. Surveys captured sociodemographic characteristics, perceived neighborhood walkability, neighborhood preferences, motivation, physical activity and screen-based leisure. Covariate-adjusted linear mixed models estimated the differences in physical activity and leisure screen time between the neighborhood walkability groups at baseline, 4-weeks, and 12-weeks. RESULTS UWALK participants included mostly females (83%) and had an average age of 49.2 years. Weekly minutes of walking for transport inside the neighborhood was higher (p < .001) among participants from walkable versus car dependent neighborhoods at baseline (42.5 vs. 21.1), 4-weeks (81.2 vs. 48.2), and 12-weeks (87.2 vs. 48.0). Regardless of neighborhood walkability, all physical activity outcomes were higher and leisure screen time lower at 4-weeks and 12-weeks compared with baseline. We found no significant neighborhood group by time interactions. CONCLUSIONS Pedometer-facilitated interventions may be effective for supporting short-term changes in physical activity and sedentary behavior even among adults residing in low walkable neighborhoods.
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13
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Ferguson T, Olds T, Curtis R, Blake H, Crozier AJ, Dankiw K, Dumuid D, Kasai D, O'Connor E, Virgara R, Maher C. Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses. Lancet Digit Health 2022; 4:e615-e626. [PMID: 35868813 DOI: 10.1016/s2589-7500(22)00111-x] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/22/2022] [Accepted: 05/27/2022] [Indexed: 05/27/2023]
Abstract
Wearable activity trackers offer an appealing, low-cost tool to address physical inactivity. This systematic review of systematic reviews and meta-analyses (umbrella review) aimed to examine the effectiveness of activity trackers for improving physical activity and related physiological and psychosocial outcomes in clinical and non-clinical populations. Seven databases (Embase, MEDLINE, Ovid Emcare, Scopus, SPORTDiscus, the Cochrane Library, and Web of Science) were searched from database inception to April 8, 2021. Systematic reviews of primary studies using activity trackers as interventions and reporting physical activity, physiological, or psychosocial outcomes were eligible for inclusion. In total, 39 systematic reviews and meta-analyses were identified, reporting results from 163 992 participants spanning all age groups, from both healthy and clinical populations. Taken together, the meta-analyses suggested activity trackers improved physical activity (standardised mean difference [SMD] 0·3-0·6), body composition (SMD 0·7-2·0), and fitness (SMD 0·3), equating to approximately 1800 extra steps per day, 40 min per day more walking, and reductions of approximately 1 kg in bodyweight. Effects for other physiological (blood pressure, cholesterol, and glycosylated haemoglobin) and psychosocial (quality of life and pain) outcomes were typically small and often non-significant. Activity trackers appear to be effective at increasing physical activity in a variety of age groups and clinical and non-clinical populations. The benefit is clinically important and is sustained over time. Based on the studies evaluated, there is sufficient evidence to recommend the use of activity trackers.
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Affiliation(s)
- Ty Ferguson
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Rachel Curtis
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Henry Blake
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Alyson J Crozier
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Kylie Dankiw
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Daiki Kasai
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Edward O'Connor
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Rosa Virgara
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia.
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14
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Luu L, Pillai A, Lea H, Buendia R, Khan FM, Dennis G. Accurate Step Count with Generalized and Personalized Deep Learning on Accelerometer Data. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22113989. [PMID: 35684609 PMCID: PMC9183122 DOI: 10.3390/s22113989] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/05/2022] [Accepted: 05/20/2022] [Indexed: 05/15/2023]
Abstract
Physical activity (PA) is globally recognized as a pillar of general health. Step count, as one measure of PA, is a well known predictor of long-term morbidity and mortality. Despite its popularity in consumer devices, a lack of methodological standards and clinical validation remains a major impediment to step count being accepted as a valid clinical endpoint. Previous works have mainly focused on device-specific step-count algorithms and often employ sensor modalities that may not be widely available. This may limit step-count suitability in clinical scenarios. In this paper, we trained neural network models on publicly available data and tested on an independent cohort using two approaches: generalization and personalization. Specifically, we trained neural networks on accelerometer signals from one device and either directly applied them or adapted them individually to accelerometer data obtained from a separate subject cohort wearing multiple distinct devices. The best models exhibited highly accurate step-count estimates for both the generalization (96-99%) and personalization (98-99%) approaches. The results demonstrate that it is possible to develop device-agnostic, accelerometer-only algorithms that provide highly accurate step counts, positioning step count as a reliable mobility endpoint and a strong candidate for clinical validation.
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Affiliation(s)
- Long Luu
- Digital Health, Oncology R&D, AstraZeneca, Gaithersburg, MD 20878, USA;
- Correspondence:
| | - Arvind Pillai
- Department of Computer Science, Dartmouth College, Hanover, NH 03755, USA;
| | - Halsey Lea
- Digital Health, Oncology R&D, AstraZeneca, Gaithersburg, MD 20878, USA;
| | - Ruben Buendia
- Biometrics, Late-Stage Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, 43183 Gothenburg, Sweden;
| | - Faisal M. Khan
- AI & Analytics, Data Science & Artificial Intelligence R&D, AstraZeneca, Gaithersburg, MD 20878, USA; (F.M.K.); (G.D.)
| | - Glynn Dennis
- AI & Analytics, Data Science & Artificial Intelligence R&D, AstraZeneca, Gaithersburg, MD 20878, USA; (F.M.K.); (G.D.)
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15
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Dehghan Ghahfarokhi A, Vosadi E, Barzegar H, Saatchian V. The Effect of Wearable and Smartphone Applications on Physical Activity, Quality of Life, and Cardiovascular Health Outcomes in Overweight/Obese Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Biol Res Nurs 2022; 24:503-518. [PMID: 35535558 DOI: 10.1177/10998004221099556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Advances in the device and smartphone technology have resulted in a convenient option for providing physical activity strategies; this is especially important during the coronavirus disease 2019 pandemic. OBJECTIVE The purpose of this meta-analysis is to evaluate the efficacy of wearable and smartphone-based interventions to promote physical activity and improve quality of life and cardiovascular health outcomes among overweight/obese adults. DATA SOURCES We searched relevant databases up to 18 November 2021 for conducting a systematic review and meta-analysis of randomized controlled trials lasting 4 or more weeks that investigated the impacts of wearables and smartphone applications on physical activity, quality of life and health outcomes. RESULTS Twenty-six studies including 2373 participants were included. There was a significant pooled standard mean differences (SMD) for the comparison between intervention versus control in steps per day (SMD: 0.54; p = 0.0003), moderate-to-vigorous physical activity (SMD: 0.47; p = 0.02), quality of life (SMD: 0.33; p = 0.0006), body weight (mean difference (MD), -1.61 kg; p = 0.009), and BMI (MD, -0.59 kg/m2; p = 0.04). There were no significant differences between the intervention and control groups for systolic and diastolic blood pressure and resting heart rate (all p > 0.05). CONCLUSION Our findings suggest that wearable and smartphone-based interventions are effective strategies in promoting physical activity and can provide a direct contact line to health professionals.
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Affiliation(s)
- Amin Dehghan Ghahfarokhi
- Sport Management Department, Faculty of Physical Education and Sport Sciences, 48425University of Tehran, Tehran, Iran
| | - Elham Vosadi
- Department of Physical Education and Sport Sciences, 68259Shahrood University of Technology, Shahrood, Iran
| | - Hamed Barzegar
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, 48425University of Tehran, Tehran, Iran
| | - Vahid Saatchian
- Department of Physical Education and Sport Sciences, 305467Imam Reza international University, Mashhad, Iran
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Lahtio H, Rintala A, Immonen J, Sjögren T. The Effectiveness of Physical Activity-Promoting Web- and Mobile-Based Distance Weight Loss Interventions on Body Composition in Rehabilitation Settings: Systematic Review, Meta-analysis, and Meta-Regression Analysis. J Med Internet Res 2022; 24:e25906. [PMID: 35323126 PMCID: PMC8990343 DOI: 10.2196/25906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/06/2021] [Accepted: 12/28/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Overweight and obesity are major problems worldwide, and they lead to an increased risk for several diseases. The use of technology in the treatment of obesity is promising, but in the existing literature, there is considerable uncertainty regarding its efficacy. In this review, we included web- and mobile-based weight loss interventions that were implemented remotely in rehabilitation settings. OBJECTIVE The aim of this systematic review is to study the effectiveness of physical activity-promoting web- and mobile-based distance weight loss interventions in rehabilitation settings on body composition in comparison with control groups that did not use technology. METHODS Studies were searched from 9 databases. The inclusion criteria were as follows: population: age 18-65 years; intervention: physical activity-promoting web- and mobile-based distance weight loss interventions; comparison: control groups without the use of technology; outcome: changes in BMI, waist circumference, or body fat percentage; study design: randomized controlled trial. The quality of the studies was assessed by 2 researchers. Meta-analysis was performed, and we also conducted a meta-regression analysis to evaluate the factors associated with the changes in body composition outcomes if statistical heterogeneity was observed. RESULTS The meta-analysis included 30 studies. The mean quality of the studies was 7 of 13 (SD 1.9; range 3-10). A statistically significant difference was observed in BMI (mean difference [MD] 0.83, 95% CI 0.51-1.15 kg/m2; P<.001), waist circumference (MD 2.45, 95% CI 1.83-3.07 cm; P<.001), and body fat percentage (MD 1.07%, 95% CI 0.74%-1.41%; P<.001) in favor of the weight loss groups using web- or mobile-based interventions. Meta-regression analyses found an association between personal feedback and BMI (P=.04), but other factors did not play a role in explaining statistical heterogeneity. CONCLUSIONS Web- and mobile-based distance weight loss interventions significantly reduced BMI, waist circumference, and body fat percentage. Future studies should focus on the comparability of the intervention content. Future studies are needed to better understand weight loss and identify which components are essential in achieving it. TRIAL REGISTRATION PROSPERO CRD42016035831; https://tinyurl.com/7c93tvd4.
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Affiliation(s)
- Heli Lahtio
- Faculty of Sport and Health Sciences, The University of Jyväskylä, Jyväskylä, Finland.,Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland
| | - Aki Rintala
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland.,Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Jaakko Immonen
- Faculty of Mathematics and Science, The University of Jyväskylä, Jyväskylä, Finland
| | - Tuulikki Sjögren
- Faculty of Sport and Health Sciences, The University of Jyväskylä, Jyväskylä, Finland
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López-Roig S, Ecija C, Peñacoba C, Ivorra S, Nardi-Rodríguez A, Lecuona O, Pastor-Mira MA. Assessing Walking Programs in Fibromyalgia: A Concordance Study between Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2995. [PMID: 35270687 PMCID: PMC8910142 DOI: 10.3390/ijerph19052995] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 02/04/2023]
Abstract
This study analyzes the degree of agreement between three self-report measures (Walking Behavior, WALK questionnaire and logbooks) assessing adherence to walking programs through reporting their components (minutes, rests, times a week, consecutive weeks) and their concordance with a standard self-report of physical activity (IPAQ-S questionnaire) and an objective, namely number of steps (pedometer), in 275 women with fibromyalgia. Regularized partial correlation networks were selected as the analytic framework. Three network models based on two different times of assessment, namely T1 and T2, including 6 weeks between both, were used. WALK and the logbook were connected with Walking Behavior and also with the IPAQ-S. The logbook was associated with the pedometers (Z-score > 1 in absolute value). When the behavior was assessed specifically and in a detailed manner, participants’ results for the different self-report measures were in agreement. Specific self-report methods provide detailed information that is consistent with validated self-report measures (IPAQ-S) and objective measures (pedometers). The self-report measures that assess the behavioral components of physical activity are useful when studying the implementation of walking as physical exercise.
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Affiliation(s)
- Sofía López-Roig
- Department of Behavioral Sciences and Health, University Miguel Hernández, 03540 San Juan de Alicante, Spain; (S.L.-R.); (A.N.-R.); (M.A.P.-M.)
| | - Carmen Ecija
- Department of Psychology, Rey Juan Carlos University, 28922 Madrid, Spain; (C.P.); (O.L.)
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, 28922 Madrid, Spain; (C.P.); (O.L.)
| | - Sofía Ivorra
- Official College of Nursing, 03007 Alicante, Spain;
| | - Ainara Nardi-Rodríguez
- Department of Behavioral Sciences and Health, University Miguel Hernández, 03540 San Juan de Alicante, Spain; (S.L.-R.); (A.N.-R.); (M.A.P.-M.)
| | - Oscar Lecuona
- Department of Psychology, Rey Juan Carlos University, 28922 Madrid, Spain; (C.P.); (O.L.)
| | - María Angeles Pastor-Mira
- Department of Behavioral Sciences and Health, University Miguel Hernández, 03540 San Juan de Alicante, Spain; (S.L.-R.); (A.N.-R.); (M.A.P.-M.)
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18
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Lugones-Sanchez C, Recio-Rodriguez JI, Agudo-Conde C, Repiso-Gento I, G Adalia E, Ramirez-Manent JI, Sanchez-Calavera MA, Rodriguez-Sanchez E, Gomez-Marcos MA, Garcia-Ortiz L. Long-term Effectiveness of a Smartphone App Combined With a Smart Band on Weight Loss, Physical Activity, and Caloric Intake in a Population With Overweight and Obesity (Evident 3 Study): Randomized Controlled Trial. J Med Internet Res 2022; 24:e30416. [PMID: 35103609 PMCID: PMC8848250 DOI: 10.2196/30416] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/18/2021] [Accepted: 11/30/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Multicomponent mobile health approaches can improve lifestyle intervention results, although little is known about their long-term effectiveness. OBJECTIVE This study aims to evaluate the long-term effectiveness (12 months) of a multicomponent mobile health intervention-combining a smartphone app, an activity tracker wristband, and brief counseling, compared with a brief counseling group only-on weight loss and improving body composition, physical activity, and caloric intake in Spanish sedentary adults with overweight or obesity. METHODS We conducted a randomized controlled, multicenter clinical trial (Evident 3). A total of 650 participants were recruited from 5 primary care centers, with 318 participants in the intervention group (IG) and 332 in the control group (CG). All participants were briefly counseled about a healthy diet and physical activity at the baseline visit. For the 3-month intervention period, the IG received training to use the app to promote healthy lifestyles and the smart band (Mi Band 2, Xiaomi). All measurements were performed at baseline and at 3 and 12 months. Physical activity was measured using the International Physical Activity Questionnaire-Short Form. Nutritional habits were assessed using the Food Frequency Questionnaire and Adherence to Mediterranean diet questionnaire. RESULTS Of the 650 participants included, 563 (86.6%) completed the 3-month visit and 443 (68.2%) completed the 12-month visit. After 12 months, the IG showed net differences in weight (-0.26, 95% CI -1.21 to 0.70 kg; P=.02), BMI (-0.06, 95% CI -0.41 to 0.28 points; P=.01), waist-height ratio (-0.25, 95% CI -0.94 to 0.44; P=.03), body adiposity index (-0.33, 95% CI -0.77 to 0.11; P=.03), waist circumference (-0.48, 95% CI -1.62 to 0.66 cm, P=.04) and hip circumference (-0.69, 95% CI -1.62 to 0.25 cm; P=.03). Both groups lowered daily caloric intake and increased adherence to the Mediterranean diet, with no differences between the groups. The IG increased light physical activity time (32.6, 95% CI -30.3 to 95.04 min/week; P=.02) compared with the CG. Analyses by subgroup showed changes in body composition variables in women, people aged >50 years, and married people. CONCLUSIONS The low-intensity intervention of the Evident 3 study showed, in the IG, benefits in weight loss, some body composition variables, and time spent in light physical activity compared with the CG at 3 months, but once the devices were collected, the downward trend was not maintained at the 12-month follow-up. No differences in nutritional outcomes were observed between the groups. TRIAL REGISTRATION ClinicalTrials.gov NCT03175614; https://clinicaltrials.gov/ct2/show/NCT03175614. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1097/MD.0000000000009633.
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Affiliation(s)
- Cristina Lugones-Sanchez
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca, Health Service of Castilla y León, Salamanca, Spain
| | - Jose I Recio-Rodriguez
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca, Health Service of Castilla y León, Salamanca, Spain.,Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca, Health Service of Castilla y León, Salamanca, Spain
| | - Irene Repiso-Gento
- Renedo de Esgueva Health Center, Health Service of Castilla y León, Valladolid, Spain
| | - Esther G Adalia
- Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain
| | - José Ignacio Ramirez-Manent
- Calvià Primary Care Center, The Health Research Institute of the Balearic Islands, Health Service of Balearic Islands, Palma de Mallorca, Spain.,Department of Medicine, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Maria Antonia Sanchez-Calavera
- Las Fuentes Norte Health Center, Aragonese Group of Primary Care Research (GAIAP), Aragon Health Research Institute (IISA), Aragon Health Service, Zaragoza, Spain.,Department of Internal Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Emiliano Rodriguez-Sanchez
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca, Health Service of Castilla y León, Salamanca, Spain.,Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Manuel A Gomez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca, Health Service of Castilla y León, Salamanca, Spain.,Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Luis Garcia-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Institute of Biomedical Research of Salamanca, Health Service of Castilla y León, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
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- See Acknowledgements, Barcelona, Spain
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19
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McClung HL, Raynor HA, Volpe SL, Dwyer JT, Papoutsakis C. A Primer for the Evaluation and Integration of Dietary Intake and Physical Activity Digital Measurement Tools into Nutrition and Dietetics Practice. J Acad Nutr Diet 2022; 122:207-218. [PMID: 33863675 PMCID: PMC8593109 DOI: 10.1016/j.jand.2021.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Holly L McClung
- US Army Research Institute of Environmental Medicine, Natick, MA
| | - Hollie A Raynor
- Department of Nutrition with the University of Tennessee Knoxville, Knoxville, TN
| | - Stella L Volpe
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA
| | - Johanna T Dwyer
- Frances Stern Nutrition Center, Tufts Medical Center, Boston, MA
| | - Constantina Papoutsakis
- Nutrition and Dietetics Data Science Center, Research International and Scientific Affairs with the Academy of Nutrition and Dietetics, Chicago, IL.
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20
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Delahanty LM, Wadden TA, Goodwin PJ, Alfano CM, Thomson CA, Irwin ML, Neuhouser ML, Crane TE, Frank E, Spears PA, Gillis BP, Hershman DL, Paskett ED, Hopkins J, Bernstein V, Stearns V, White J, Hudis C, Winer EP, Carey LA, Partridge AH, Ligibel JA. The Breast Cancer Weight Loss trial (Alliance A011401): A description and evidence for the lifestyle intervention. Obesity (Silver Spring) 2022; 30:28-38. [PMID: 34932888 PMCID: PMC9186690 DOI: 10.1002/oby.23287] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/03/2023]
Abstract
The Breast Cancer Weight Loss (BWEL) trial is a randomized controlled trial designed to determine whether weight loss after a breast cancer diagnosis can reduce the risk of cancer recurrence in women with overweight or obesity. The BWEL trial will compare the efficacy of a telephone-based weight-loss intervention plus health education materials versus health education materials alone on invasive disease-free survival in 3,181 women with stage II or III breast cancer and BMI > 27 kg/m2 . This report provides a detailed description of the goals and methods of the lifestyle intervention and the evidence supporting the intervention used in the BWEL trial. The intervention's primary goal for participants is to achieve and maintain a weight loss ≥ 10% of baseline weight through increased physical activity and caloric restriction. The evidence supporting the diet, physical activity, and behavioral components of this telephone-based weight-loss intervention, as well as strategies to promote participant engagement and retention, is described. The intervention is provided through 42 sessions delivered by trained health coaches over a 2-year period. If the BWEL lifestyle intervention is successful in improving cancer outcomes, then weight loss will be incorporated into the care of thousands of breast cancer patients.
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Affiliation(s)
- Linda M. Delahanty
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Thomas A. Wadden
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Pamela J. Goodwin
- Mount Sinai Hospital/Lunenfeld Tanenbaum Research Institute, University of Toronto. Toronto, Ontario, Canada
| | - Catherine M. Alfano
- Northwell Health Cancer Institute; and Institute of Health System Science, Feinstein Institutes, for Medical Research; New York, NY, USA
| | - Cynthia A. Thomson
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Melinda L. Irwin
- Yale School of Public Health,Yale University, New Haven, CT, USA
| | - Marian L. Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tracy E. Crane
- Biobehavioral Health Sciences Division, College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Elizabeth Frank
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Patricia A. Spears
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel, Hill, NC, USA
| | - Bonnie P. Gillis
- University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dawn L. Hershman
- Division of Medical Oncology, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Electra D. Paskett
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Judith Hopkins
- Novant Health Cancer Institute/SCOR NCORP, Novant Health Oncology Specialists, Winston-Salem, NC, USA
| | - Vanessa Bernstein
- Division of Medical Oncology, Department of Medicine, University of British Columbia, Vancouver, Victoria BC, Canada
| | - Vered Stearns
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Julia White
- Department of Radiation Oncology, the Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Clifford Hudis
- American Society of Clinical Oncology, Alexandria, VA, USA and Department of Medicine Memorial Sloan Kettering Cancer Center, New York, NY, NY, USA
| | - Eric P. Winer
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Lisa A. Carey
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel, Hill, NC, USA
| | - Ann H. Partridge
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Jennifer A. Ligibel
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
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21
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YOSHIMURA EIICHI, Tajiri E, Michiwaki R, Matsumoto N, Hatamoto Y, Tanaka S. Long-term effects of the use of a step count-specific smartphone application on physical activity and weight loss: a randomized clinical trial (Preprint). JMIR Mhealth Uhealth 2021; 10:e35628. [DOI: 10.2196/35628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/31/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
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22
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Xu Y, Yue LZ, Wang W, Wu XJ, Liang ZY. Gender-Specific Impact of Self-Monitoring and Social Norm Information on Walking Behavior Among Chinese College Students Assessed Using WeChat: Longitudinal Tracking Study. J Med Internet Res 2021; 23:e29167. [PMID: 34878992 PMCID: PMC8693203 DOI: 10.2196/29167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 10/23/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Walking is a simple but beneficial form of physical activity (PA). Self-monitoring and providing information about social norms are the 2 most widely used "mobile health (mHealth)" strategies to promote walking behavior. However, previous studies have failed to discriminate the effect of self-monitoring from the combination of the 2 strategies, and provide practical evidence within Chinese culture. Some essential moderators, such as gender and group identity, were also overlooked. OBJECTIVE We aimed to investigate the effectiveness of social norm and self-monitoring interventions for walking behavior and assess the moderating effects of gender and group identity, which could guide optimal mHealth intervention projects in China. METHODS In 2 longitudinal tracking studies (study 1, 22 days; study 2, 31 days), Chinese college students wore trackers for at least 8 hours per day (MASAI 3D Pedometer and Xiaomi Wristband 2) to record their daily step counts in baseline, intervention, and follow-up stages. In each study, participants (study 1: n=117, 54% female, mean age 25.60 years; study 2: n=180, 51% female, mean age 22.60 years) were randomly allocated to 1 of the following 3 groups: a self-monitoring group and 2 social norm intervention groups. In the 2 intervention groups and during the intervention stage, participants received different social norm information regarding group member step rankings corresponding to their grouping type of social norm information. In study 1, participants were grouped by within-group member PA levels (PA consistent vs PA inconsistent), and in study 2, participants were grouped by their received gender-specific social norm information (gender consistent vs gender inconsistent). Piece-wise linear mixed models were used to compare the difference in walking steps between groups. RESULTS In study 1, for males in the self-monitoring group, walking steps significantly decreased from the baseline stage to the intervention stage (change in slope=-1422.16; P=.02). However, additional social norm information regardless of group consistency kept their walking unchanged. For females, social norm information did not provide any extra benefit beyond self-monitoring. Females exposed to PA-inconsistent social norm information even walked less (slope during the intervention=-122.18; P=.03). In study 2, for males, a similar pattern was observed, with a decrease in walking steps in the self-monitoring group (change in slope=-151.33; P=.08), but there was no decrease in the 2 social norm intervention groups. However, for females, gender-consistent social norm information decreased walking steps (slope during the intervention=-143.68; P=.03). CONCLUSIONS Both gender and group identity moderated the effect of social norm information on walking. Among females, social norm information showed no benefit for walking behavior and may have exerted a backfire effect. Among males, while walking behavior decreased with self-monitoring only, the inclusion of social norm information held the level of walking behavior steady.
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Affiliation(s)
- Yuepei Xu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ling-Zi Yue
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wei Wang
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Xiao-Ju Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhu-Yuan Liang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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23
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Futami K, Terada T, Tsukamoto M. A Method for Behavior Change Support by Controlling Psychological Effects on Walking Motivation Caused by Step Count Log Competition System. SENSORS 2021; 21:s21238016. [PMID: 34884020 PMCID: PMC8659773 DOI: 10.3390/s21238016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/22/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
Abstract
Systems presenting information that encourages competition by using rankings and scores (hereafter referred to as competition information) have become widespread to support behavioral change. However, users without high levels of motivation, such as behavior change support targets, do not necessarily benefit from competition information. In this study, we propose a method to control the psychological effects caused by competition information to support behavior change. We implemented a competition information presentation system using step counts logs to support increasing one’s daily steps. We designed two patterns of competition information considering psychological effects. One is likely to have good effects, using three mechanisms to easily obtain results corresponding to the effort, make closely matched rivals with similar abilities, and pay attention to a small number of rivals. The other is unlikely to have positive effects and may potentially even have negative ones, using a mechanism that brings about the opposite results of the former pattern. We evaluated 42 participants with low levels of motivation over six weeks. The results showed that the former information pattern increased participants’ step counts by about 1000 steps per day, and the latter information pattern did not lead to an increase. We confirmed the feasibility of the proposed method and discussed the possibility of the appropriate use and potential abuse of such techniques for manipulating motivation. Our study can be helpful in designing a competition information presentation system considering psychological effects.
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Affiliation(s)
- Kyosuke Futami
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu 525-8577, Japan
- Correspondence:
| | - Tsutomu Terada
- Graduate School of Engineering, Kobe University, Kobe 657-8501, Japan; (T.T.); (M.T.)
| | - Masahiko Tsukamoto
- Graduate School of Engineering, Kobe University, Kobe 657-8501, Japan; (T.T.); (M.T.)
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24
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Hajek A, König HH. Frequency and correlates of use of applications for monitoring and increasing health and well-being in middle-aged and older adults. Findings from the German Ageing Survey. Arch Gerontol Geriatr 2021; 98:104571. [PMID: 34794078 DOI: 10.1016/j.archger.2021.104571] [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: 09/14/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 11/02/2022]
Abstract
AIM To clarify the frequency and correlates of using applications for monitoring and increase of health and well-being among middle-aged and older adults during the COVID-19 pandemic in Germany. METHODS Data were used from the nationally representative German Ageing Survey (n = 3,174 individuals in the analytical sample; June/July 2020). The frequency of using applications for monitoring and increasing health and well-being (from daily to never) was used as main outcome measure. RESULTS Among individuals with access to the internet, 76% never used applications for monitoring and increase of health and well-being, whereas about 13% were rare and 11% were frequent users of such applications. Multinomial regressions showed that the likelihood of being a rare user (compared to never users of such applications) was positively associated with being male [RRR: 0.74, 95% CI: 0.59-0.93], the frequency of walks [e.g., several times a week compared to never: RRR: 2.76, 95% CI: 1.15-6.59] and worse self-rated health [RRR: 1.33, 95% CI: 1.11-1.59]. Furthermore, the likelihood of being a frequent user (compared to never users) was positively associated with younger age [RRR: 0.96, 95% CI: 0.94-0.98] and the frequency of walks [daily compared to never: RRR: 2.61, 95% CI: 1.07-6.35]. CONCLUSIONS Applications for monitoring and increasing health and well-being are used by about one out of four middle-aged and older individuals with access to the internet in Germany during the COVID-19 pandemic. In international comparison, the proportion of users is rather low. Determining the factors associated with such use may help to address non-users.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246 Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246 Hamburg, Germany
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25
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Accelerometer-Measured Daily Steps, Physical Function, and Subsequent Fall Risk in Older Women: The Objective Physical Activity and Cardiovascular Disease in Older Women Study. J Aging Phys Act 2021; 30:635-645. [PMID: 34627127 DOI: 10.1123/japa.2021-0159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/26/2021] [Accepted: 09/04/2021] [Indexed: 11/18/2022]
Abstract
Steps per day were measured by accelerometer for 7 days among 5,545 women aged 63-97 years between 2012 and 2014. Incident falls were ascertained from daily fall calendars for 13 months. Median steps per day were 3,216. There were 5,473 falls recorded over 61,564 fall calendar-months. The adjusted incidence rate ratio comparing women in the highest versus lowest step quartiles was 0.71 (95% confidence interval [0.54, 0.95]; ptrend across quartiles = .01). After further adjustment for physical function using the Short Physical Performance Battery, the incidence rate ratio was 0.86 ([0.64, 1.16]; ptrend = .27). Mediation analysis estimated that 63.7% of the association may be mediated by physical function (p = .03). In conclusion, higher steps per day were related to lower incident falls primarily through their beneficial association with physical functioning. Interventions that improve physical function, including those that involve stepping, could reduce falls in older adults.
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26
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Hutchesson MJ, Gough C, Müller AM, Short CE, Whatnall MC, Ahmed M, Pearson N, Yin Z, Ashton LM, Maher C, Staiano AE, Mauch CE, DeSmet A, Vandelanotte C. eHealth interventions targeting nutrition, physical activity, sedentary behavior, or obesity in adults: A scoping review of systematic reviews. Obes Rev 2021; 22:e13295. [PMID: 34159684 DOI: 10.1111/obr.13295] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 12/11/2022]
Abstract
A vast body of evidence regarding eHealth interventions for nutrition, physical activity, sedentary behavior, and obesity exists. This scoping review of systematic reviews aimed to evaluate the current level of evidence in this growing field. Seven electronic databases were searched for systematic reviews published until October 27, 2019. The systematic reviews must have included adult participants only and have evaluated eHealth behavioral interventions with the primary aim of changing nutrition, physical activity, and sedentary behavior or treating or preventing overweight and obesity. One hundred and six systematic reviews, published from 2006 to 2019, were included. Almost all (n = 98) reviews evaluated the efficacy of interventions. Over half (n = 61) included interventions focused on physical activity, followed by treatment of obesity (n = 28), nutrition (n = 22), prevention of obesity (n = 18), and sedentary behavior (n = 6). Many reviews (n = 46) evaluated one type of eHealth intervention only, while 60 included two or more types. Most reviews (n = 67) were rated as being of critically low methodological quality. This scoping review identified an increasing volume of systematic reviews evaluating eHealth interventions. It highlights several evidence gaps (e.g., evaluation of other outcomes, such as reach, engagement, or cost effectiveness), guiding future research efforts in this area.
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Affiliation(s)
- Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Claire Gough
- Flinders Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | - Camille E Short
- Melbourne School of Psychological Sciences and Melbourne School of Health Sciences, Faculty of Dentistry, Medicine and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Megan C Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Mavra Ahmed
- Department of Nutritional Sciences and Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Pearson
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Zenong Yin
- UT Health San Antonio Graduate School of Biomedical Sciences, University of Texas, San Antonio, Texas, USA
| | - Lee M Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Amanda E Staiano
- Population and Public Health, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Chelsea E Mauch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.,Nutrition and Health Program, Health & Biosecurity Business Unit, CSIRO, Canberra, ACT, Australia
| | - Ann DeSmet
- Faculty of Psychology and Educational Sciences, Université Libre de Bruxelles, Brussels, Belgium.,Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Rockhampton, Queensland, Australia
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27
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Washburn BD, Ihm JM. Using Step Counts to Prescribe Physical Activity: What Is the Optimal Dose? Curr Sports Med Rep 2021; 20:402-409. [PMID: 34357886 DOI: 10.1249/jsr.0000000000000868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT An activity goal of 10,000 steps per day is widely known but was not initially developed based on scientific evidence. The last several years have seen an increase in both the availability of consumer-based step counting devices and research examining the link between daily step counts and various health outcomes. Daily step counts are an intuitive metric of physical activity and are useful for goal-setting and motivating behavioral change. This article reviews the current evidence for daily step counts as related to common health conditions to determine activity goals to prescribe to patients, and also discusses factors to consider when counseling patients on physical activity.
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28
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Litrownik D, Gilliam EA, Wayne PM, Richardson CR, Kadri R, Rist PM, Moy ML, Yeh GY. Development of a Novel Intervention (Mindful Steps) to Promote Long-Term Walking Behavior in Chronic Cardiopulmonary Disease: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e27826. [PMID: 33913819 PMCID: PMC8120426 DOI: 10.2196/27826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/14/2021] [Accepted: 02/22/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite current rehabilitation programs, long-term engagement in physical activity remains a significant challenge for patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF). Novel strategies to promote physical activity in these populations are greatly needed. Emerging literature on the benefits of both mind-body interventions and web-based interventions provide the rationale for the development of the Mindful Steps intervention for increasing walking behavior. OBJECTIVE This study aims to develop a novel multimodal mind-body exercise intervention through adaptation of an existing web-based physical activity intervention and incorporation of mind-body exercise, and to pilot test the delivery of the new intervention, Mindful Steps, in a randomized controlled feasibility trial in older adults with COPD and/or HF. METHODS In phase 1, guided by a theoretical conceptual model and review of the literature on facilitators and barriers of physical activity in COPD and HF, we convened an expert panel of researchers, mind-body practitioners, and clinicians to inform development of the novel, multimodal intervention. In phase 2, we are conducting a pilot randomized controlled feasibility trial of the Mindful Steps intervention that includes in-person mind-body exercise classes, an educational website, online mind-body videos, and a pedometer with step-count feedback and goals to increase walking behavior in patients with COPD and/or HF. Outcomes include feasibility measures as well as patient-centered measures. RESULTS The study is currently ongoing. Phase 1 intervention development was completed in March 2019, and phase 2 data collection began in April 2019. CONCLUSIONS Through the integration of components from a web-based physical activity intervention and mind-body exercise, we created a novel, multimodal program to impact long-term physical activity engagement for individuals with COPD and HF. This developmental work and pilot study will provide valuable information needed to design a future clinical trial assessing efficacy of this multimodal approach. TRIAL REGISTRATION ClinicalTrials.gov NCT03003780; https://clinicaltrials.gov/ct2/show/NCT03003780. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/27826.
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Affiliation(s)
- Daniel Litrownik
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Elizabeth A Gilliam
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
| | | | - Reema Kadri
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Pamela M Rist
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
| | - Marilyn L Moy
- Pulmonary and Critical Care Section, Department of Medicine, Veterans Administration Boston Healthcare System, Boston, MA, United States
| | - Gloria Y Yeh
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
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Swift DL, Nevels TR, Solar CA, Brophy PM, McGee JE, Barefoot SG, Clark A, Houmard JA, Lutes LD. The Effect of Aerobic Training and Increasing Nonexercise Physical Activity on Cardiometabolic Risk Factors. Med Sci Sports Exerc 2021; 53:2152-2163. [PMID: 33867498 DOI: 10.1249/mss.0000000000002675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Epidemiological studies suggest that sedentary behavior is an independent risk factor for cardiovascular mortality independent of meeting physical activity guidelines. However, limited evidence of this relationship is available from prospective interventions. The purpose of the present study is to evaluate the combined effect of aerobic training and increasing non-exercise physical activity on body composition and cardiometabolic risk factors. METHODS Obese adults (N=45) were randomized to 6-months of aerobic training (AERO), aerobic training and increasing non-exercise physical activity (~3,000 steps above baseline levels) (AERO-PA), or a control group (CON). The AERO and AERO-PA groups performed supervised aerobic training (3-4 times per week). The AERO-PA group wore Fitbit One accelerometers and received behavioral coaching to increase non-exercise physical activity. RESULTS There was a larger increase in fitness in the AERO-PA group (0.27 L/min, 0.16 to 0.40) compared to the AERO group (0.09 L/min, CI: -0.04 to 0.22) and the CON (0.01, CI: -0.11 to 0.12) groups. While significant findings were not observed in the entire study sample, when the analysis was restricted to participants compliant to the intervention (N=33), we observed significant reductions in waist circumference, percent weight loss, body fat, 2-hr glucose and 2-hr insulin in comparison to the CON group (p<0.05), but not the AERO group. Further, linear regression models showed that change in steps was associated with 21% and 26% of the variation in percent weight loss and percent fat loss, respectively. CONCLUSION Increasing non-exercise physical activity with aerobic training may represent a viable strategy to augment the fitness response in comparison to aerobic training alone and has promise for other health indicators.
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Affiliation(s)
- Damon L Swift
- Department of Kinesiology Human Performance Laboratory Department of Psychology East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC Department of Emergency Services, VA Boston Healthcare System, Boston, MA Department of Psychology, University of British Columbia, Kelowna, BC, Canada
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Hollander JB, Folta SC, Graves EM, Allen JD, Situ M. A Fitness App for Monitoring Walking Behavior and Perception (Runkeeper): Mixed Methods Pilot Study. JMIR Form Res 2021; 5:e22571. [PMID: 33646132 PMCID: PMC7961398 DOI: 10.2196/22571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/22/2020] [Accepted: 01/17/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Physical activity has a strong positive impact on both physical and mental health, and public health interventions often encourage walking as a means to promote physical activity. Social connectivity, such as that among spouses, families, friends, and colleagues, highly influences physical activity. Although technology-based interventions have some influence on human behavior, they have not been fully implemented and evaluated for their influence on walking through social connectivity. OBJECTIVE We aimed to pilot-test the organization of neighborhood walking clubs and use of a mobile app (Runkeeper) to encourage social connectedness and neighborhood cohesion, as well as to increase physical activity. METHODS We used a convenience sampling method to recruit 46 adults from an urban location in Greater Boston, Massachusetts. We assigned participants to teams based on their geographic location and neighborhood and required them to use the app (Runkeeper). Participants completed 2 self-administered web-based surveys before and after the intervention period. The surveys included standard measures to evaluate physical activity, social connectedness, perceived social support, and neighborhood cohesion (Buckner Neighborhood Cohesion Scale) before and after the intervention. Following the intervention, we randomly selected 14 participants to participate in postintervention, in-depth phone interviews to gain an understanding of their experiences. RESULTS This study was approved by the institutional review board in June 2018 and funded in January 2018. Recruitment started in May 2019 and lasted for 2 months. Data were collected from July 2019 to January 2020. In this study, Runkeeper was of limited feasibility as an app for measuring physical activity or promoting social connectedness. Data from the app recorded sparse and uneven walking behaviors among the participants. Qualitative interviews revealed that users experienced difficulties in using the settings and features of the app. In the questionnaire, there was no change between pre-post assessments in walking minutes (b=-.79; 95% CI -4.0 to 2.4; P=.63) or miles (b=-.07; 95% CI -0.15 to 0.01; P=.09). We observed a pre-post increase in social connectedness and a decrease in neighborhood cohesion. Both quantitative and qualitative results indicated that the psychosocial aspects of walking motivated the participants and helped them relieve stress. Interview results showed that participants felt a greater virtual connection in their assigned groups and enhanced connections with friends and family members. CONCLUSIONS Our study found that Runkeeper created a virtual connection among walking group members and its data sharing and ranking motivated walking. Participants felt that walking improved their mental health, helped to relieve stress, and made them feel more connected with friends or family members. In future studies, it will be important to use an app that integrates with a wearable physical activity device. There is also a need to develop and test intervention components that might be more effective in fostering neighborhood cohesion.
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Affiliation(s)
- Justin B Hollander
- Department of Urban and Environmental Policy and Planning, School of Arts and Sciences, Tufts University, Medford, MA, United States
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Medford, MA, United States
| | | | - Jennifer D Allen
- Department of Community Health, Tufts University, Medford, MA, United States
| | - Minyu Situ
- Graduate Program of Community and Regional Planning, School of Architecture, University of Texas Austin, Austin, TX, United States
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Buresh R, Kliszczewicz B, Hayes K, Julian J. Steps expressed relative to body fat mass predicts body composition and cardiometabolic risk in adults eating ad libitum. J Sports Med Phys Fitness 2021; 62:65-73. [PMID: 33565754 DOI: 10.23736/s0022-4707.21.12038-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Excess body fatness is a consequence of a chronic energy surplus (energy intake is greater than energy expenditure). Given the serious health consequences of excess body fatness, factors that influence energy balance and body composition are increasingly important to understand. Methods - A total of 34 adults between the ages of 19-40 years made a laboratory visit in which height, weight, body composition, and cardiometabolic risk factors were quantified. Participants wore accelerometers for 21-28 days, then returned to the laboratory for a second body composition assessment. Changes in weight and body composition were used to quantify energy balance, and data derived from accelerometers provided markers of physical activity and sedentariness. Results - Of the markers of physical activity that we measured, daily step counts expressed relative to fat mass was most strongly and consistently associated with body fatness and cardiometabolic risk status. Conclusions - Step counts expressed relative to fat mass were strongly associated with body composition and cardiometabolic risk in adults eating ad libitum. Longitudinal interventional studies are necessary to determine the efficacy of step count prescriptions expressed relative to existing and target body fatness and cardiometabolic risk levels for improving weight management and metabolic outcomes.
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Affiliation(s)
- Robert Buresh
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA -
| | - Brian Kliszczewicz
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Katy Hayes
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Jennifer Julian
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
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Orleans-Pobee M, Browne J, Ludwig K, Merritt C, Battaglini CL, Jarskog LF, Sheeran P, Penn DL. Physical Activity Can Enhance Life (PACE-Life): results from a 10-week walking intervention for individuals with schizophrenia spectrum disorders. J Ment Health 2021; 31:357-365. [PMID: 33527859 DOI: 10.1080/09638237.2021.1875403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Premature mortality in individuals with schizophrenia spectrum disorders (SSDs) is largely due to high rates of chronic health conditions. Although exercise has been shown to improve health in this population, scalable and accessible interventions are limited. AIM To examine the impact of Physical Activity Can Enhance Life (PACE-Life), a novel walking intervention, on physical activity, and on secondary outcomes of cardiorespiratory fitness (CRF), physical health, autonomous motivation, social support, and quality of life. METHOD Sixteen individuals with SSDs were enrolled in a 10-week open trial. The intervention included walking groups, home-based walks, Fitbit use, and goal-setting and if-then plans. Within-group effect sizes were calculated to represent changes from baseline to post-test and 1-month follow-up. RESULTS Participants increased self-reported weekly walking minutes and decreased daily hours spent sitting; however, Fitbit-recorded exercise behavior changed only minimally. There were also improvements in secondary outcomes including autonomous motivation and hip circumference. CRF improved only minimally, and findings were relatively unchanged with outliers removed from the full sample. CONCLUSIONS This open trial demonstrates modest improvements in key parameters of exercise behavior and physical health from participating in PACE-Life. Future research should assess the efficacy of this intervention in a randomized controlled trial.
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Affiliation(s)
- Maku Orleans-Pobee
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julia Browne
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kelsey Ludwig
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carrington Merritt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Claudio L Battaglini
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - L Fredrik Jarskog
- Department of Psychiatry, University of North Carolina School of Medicine, NC, USA
| | - Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David L Penn
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
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Deluty SB, Scott DM, Waugh SC, Martin VK, McCaw KA, Rupert JR, Webb TL, Baumgarn SA, Carpenter MJ, Duncan CG. Client Choice May Provide an Economic Incentive for Veterinary Practices to Invest in Sustainable Infrastructure and Climate Change Education. Front Vet Sci 2021; 7:622199. [PMID: 33537357 PMCID: PMC7848204 DOI: 10.3389/fvets.2020.622199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/14/2020] [Indexed: 11/15/2022] Open
Abstract
Objective: To assess how pet owners perceive the role of veterinary medicine in addressing climate change and animal health and determine if there is a client-driven economic incentive to establish sustainable veterinary business practices. Sample: 1,044 dog and/or cat owners residing in the United States who had used veterinary services within the last 3 years. Procedures: An online Amazon mTurk survey about climate change and the perceived effects on client-owned dogs and cats was distributed to pet owners. Results: Most respondents believe climate change is occurring, and two-thirds of pet owners would value knowing their veterinarian received training on the animal health impacts of climate change. Over half of the respondents would pay more for veterinary services at a clinic with a reduced environmental impact. Additionally, clients would value some form of sustainability certification to aid in identification of such practices. Demographic influences found to be statistically significant included age, political ideology and where one resides (i.e., urban, suburban, or rural) whereas gender and income level, were not found to be significant. Conclusions and Clinical Relevance: Our data suggest there is an economic incentive for veterinary professionals to be knowledgeable about the health impacts of climate change and to implement and market sustainable practice initiatives. Prioritizing sustainable practice initiatives and climate change education in veterinary practices has the potential to mutually benefit both practitioner and client through shared patient health and financial incentives.
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Affiliation(s)
- Sarah B Deluty
- College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, United States
| | - Danielle M Scott
- College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, United States
| | - Sabrina C Waugh
- College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, United States
| | - Veronica K Martin
- College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, United States
| | - Katherine A McCaw
- College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, United States
| | - Jessica R Rupert
- College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, United States
| | - Tracy L Webb
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, United States
| | | | - Molly J Carpenter
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, United States
| | - Colleen G Duncan
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO, United States
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Beagle AJ, Tison GH, Aschbacher K, Olgin JE, Marcus GM, Pletcher MJ. Comparison of the Physical Activity Measured by a Consumer Wearable Activity Tracker and That Measured by Self-Report: Cross-Sectional Analysis of the Health eHeart Study. JMIR Mhealth Uhealth 2020; 8:e22090. [PMID: 33372896 PMCID: PMC7803477 DOI: 10.2196/22090] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/20/2020] [Accepted: 11/12/2020] [Indexed: 11/13/2022] Open
Abstract
Background Commercially acquired wearable activity trackers such as the Fitbit provide objective, accurate measurements of physically active time and step counts, but it is unclear whether these measurements are more clinically meaningful than self-reported physical activity. Objective The aim of this study was to compare self-reported physical activity to Fitbit-measured step counts and then determine which is a stronger predictor of BMI by using data collected over the same period reflecting comparable physical activities. Methods We performed a cross-sectional analysis of data collected by the Health eHeart Study, a large mobile health study of cardiovascular health and disease. Adults who linked commercially acquired Fitbits used in free-living conditions with the Health eHeart Study and completed an International Physical Activity Questionnaire (IPAQ) between 2013 and 2019 were enrolled (N=1498). Fitbit step counts were used to quantify time by activity intensity in a manner comparable to the IPAQ classifications of total active time and time spent being sedentary, walking, or doing moderate activities or vigorous activities. Fitbit steps per day were computed as a measure of the overall activity for exploratory comparisons with IPAQ-measured overall activity (metabolic equivalent of task [MET]-h/wk). Measurements of physical activity were directly compared by Spearman rank correlation. Strengths of associations with BMI for Fitbit versus IPAQ measurements were compared using multivariable robust regression in the subset of participants with BMI and covariates measured. Results Correlations between synchronous paired measurements from Fitbits and the IPAQ ranged in strength from weak to moderate (0.09-0.48). In the subset with BMI and covariates measured (n=586), Fitbit-derived predictors were generally stronger predictors of BMI than self-reported predictors. For example, an additional hour of Fitbit-measured vigorous activity per week was associated with nearly a full point reduction in BMI (–0.84 kg/m2, 95% CI –1.35 to –0.32) in adjusted analyses, whereas the association between self-reported vigorous activity measured by IPAQ and BMI was substantially smaller in magnitude (–0.17 kg/m2, 95% CI –0.34 to –0.00; P<.001 versus Fitbit) and was dominated by the Fitbit-derived predictor when compared head-to-head in a single adjusted multivariable model. Similar patterns of associations with BMI, with Fitbit dominating self-report, were seen for moderate activity and total active time and in comparisons between overall Fitbit steps per day and IPAQ MET-h/wk on standardized scales. Conclusions Fitbit-measured physical activity was more strongly associated with BMI than self-reported physical activity, particularly for moderate activity, vigorous activity, and summary measures of total activity. Consumer-marketed wearable activity trackers such as the Fitbit may be useful for measuring health-relevant physical activity in clinical practice and research.
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Affiliation(s)
- Alexander J Beagle
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Geoffrey H Tison
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Kirstin Aschbacher
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Jeffrey E Olgin
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Gregory M Marcus
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Mark J Pletcher
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
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Consoli A, Nettel-Aguirre A, Spence JC, McHugh TL, Mummery K, McCormack GR. Associations between objectively-measured and self-reported neighbourhood walkability on adherence and steps during an internet-delivered pedometer intervention. PLoS One 2020; 15:e0242999. [PMID: 33270692 PMCID: PMC7714347 DOI: 10.1371/journal.pone.0242999] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/12/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that the built environment is associated with physical activity. The extent to which the built environment may support adherence to physical activity interventions is unclear. The aim of this study was to investigate whether the neighbourhood built environment constrains or facilitates adherence and steps taken during a 12-week internet-delivered pedometer-based physical activity intervention (UWALK). METHOD The study was undertaken in Calgary (Canada) between May 2016 and August 2017. Inactive adults (n = 573) completed a telephone survey measuring sociodemographic characteristics and perceived neighbourhood walkability. Following the survey, participants were mailed a pedometer and instructions for joining UWALK. Participants were asked to report their daily pedometer steps into the online program on a weekly basis for 12 weeks (84 days). Walk Score® estimated objective neighbourhood walkability and the Neighbourhood Environment Walkability Scale-Abbreviated (NEWS-A) measured participants self-reported neighbourhood walkability. Regression models estimated covariate-adjusted associations of objective and self-reported walkability with: 1) adherence to the UWALK intervention (count of days with steps reported and count of days with 10000 steps reported), and; 2) average daily pedometer steps. RESULTS On average, participants undertook 8565 (SD = 3030) steps per day, reported steps on 67 (SD = 22.3) of the 84 days, and achieved ≥10000 steps on 22 (SD = 20.5) of the 84 days. Adjusting for covariates, a one-unit increase in self-reported walkability was associated on average with 45.76 (95CI 14.91, 76.61) more daily pedometer steps. Walk Score® was not significantly associated with steps. Neither objective nor self-reported walkability were significantly associated with the UWALK adherence outcomes. CONCLUSION The neighbourhood built environment may support pedometer-measured physical activity but may not influence adherence to pedometer interventions. Perceived walkability may be more important than objectively-measured walkability in supporting physical activity during pedometer interventions.
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Affiliation(s)
- Anna Consoli
- Cumming School of Medicine, University of Calgary, Alberta, Canada
| | | | - John C. Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Alberta, Canada
| | - Tara-Leigh McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Alberta, Canada
| | - Kerry Mummery
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Alberta, Canada
| | - Gavin R. McCormack
- Cumming School of Medicine, University of Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Alberta, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Alberta, Canada
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
- * E-mail:
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Ballin M, Nordström P, Niklasson J, Alamäki A, Condell J, Tedesco S, Nordström A. Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study. BMC Public Health 2020; 20:1830. [PMID: 33256704 PMCID: PMC7706282 DOI: 10.1186/s12889-020-09929-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background Older adults with diabetes take fewer steps per day than those without diabetes. The purpose of the present study was to investigate the association of daily step count with incident diabetes in community-dwelling 70-year-olds. Methods This prospective cohort study included N = 3055 community-dwelling 70-year-olds (52% women) who participated in a health examination in Umeå, Sweden during 2012–2017, and who were free from diabetes at baseline. Daily step count was measured for 1 week using Actigraph GT3X+ accelerometers. Cases of diabetes were collected from the Swedish National Patient Register. The dose-response association was evaluated graphically using a flexible parametric model, and hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regressions. Results During a mean follow-up of 2.6 years, diabetes was diagnosed in 81 participants. There was an inverse nonlinear dose-response association between daily step count and incident diabetes, with a steep decline in risk of diabetes from a higher daily step count until around 6000 steps/day. From there, the risk decreased at a slower rate until it leveled off at around 8000 steps/day. A threshold of 4500 steps/day was found to best distinguish participants with the lowest risk of diabetes, where those taking ≥ 4500 steps/day, had 59% lower risk of diabetes, compared to those taking fewer steps (HR, 0.41, 95% CI, 0.25–0.66). Adjusting for visceral adipose tissue (VAT) attenuated the association (HR, 0.64, 95% CI, 0.38–1.06), which was marginally altered after further adjusting for sedentary time, education and other cardiometabolic risk factors and diseases (HR, 0.58, 95% CI, 0.32–1.05). Conclusions A higher daily step count is associated with lower risk of incident diabetes in community-dwelling 70-year-olds. The greatest benefits occur at the lower end of the activity range, and much earlier than 10,000 steps/day. With the limitation of being an observational study, these findings suggest that promoting even a modest increase in daily step count may help to reduce the risk of diabetes in older adults. Because VAT appears to partly mediate the association, lifestyle interventions targeting diabetes should apart from promoting physical activity also aim to prevent and reduce central obesity. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09929-2.
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Affiliation(s)
- Marcel Ballin
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden. .,Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Johan Niklasson
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Antti Alamäki
- Department of Physiotherapy, Karelia University of Applied Sciences, Joensuu, Finland
| | - Joan Condell
- School of Computing, Engineering and Intelligent Systems, Ulster University, Londonderry, UK
| | | | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,School of Sport Sciences, UiT the Arctic University of Norway, Tromsø, Norway
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Ha L, Mizrahi D, Wakefield CE, Cohn RJ, Simar D, Signorelli C. The Use of Activity Trackers in Interventions for Childhood Cancer Patients and Survivors: A Systematic Review. J Adolesc Young Adult Oncol 2020; 10:1-14. [PMID: 32897805 DOI: 10.1089/jayao.2020.0099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Activity trackers have emerged as promising devices used to motivate and/or objectively monitor physical activity (PA) levels. It is unknown how activity trackers have been used in interventions for children and adolescents affected by cancer. This review aimed to investigate the effectiveness of wearable activity trackers to monitor and/or improve PA levels and health outcomes in pediatric oncology. Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we conducted an electronic search of four databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], Medline, Embase, and SportDiscus) between January 2000 and March 2020. The review included PA interventions that used an activity tracker with children (≤18 years) diagnosed with cancer. We excluded studies including adult participants (>18 at time of study participation) and cross-sectional or case-report studies. Twelve studies examining 517 children and adolescent patients and survivors of pediatric cancer (age range: 4-18 years) were included. Intervention delivery ranged from 2 weeks to 12 months. Two of 12 studies reported increases in PA and 6 showed improvements in health outcomes, including aerobic fitness and negative mood. PA interventions using activity trackers within pediatric oncology are highly diverse in study design, study population, and intervention features. Preliminary data suggest that interventions using wearable activity trackers may have a positive impact on health outcomes in children and adolescents affected by cancer. Future research is needed to establish optimal intervention approaches to using activity trackers to increase PA in children affected by cancer.
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Affiliation(s)
- Lauren Ha
- School of Medical Sciences, UNSW Medicine, UNSW Sydney, Sydney, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - David Mizrahi
- Prince of Wales Clinical School, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - David Simar
- School of Medical Sciences, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - Christina Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia
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Lystrup R, Carlsen D, Sharon DJ, Crawford P. Wearable and interactive technology to share fitness goals results in weight loss but not improved diabetes outcomes. Obes Res Clin Pract 2020; 14:443-448. [DOI: 10.1016/j.orcp.2020.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 01/22/2020] [Accepted: 08/27/2020] [Indexed: 12/16/2022]
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Factors Related to Sports Participation in Brazil: An Analysis Based on the 2015 National Household Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176011. [PMID: 32824883 PMCID: PMC7504227 DOI: 10.3390/ijerph17176011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 11/25/2022]
Abstract
The academic interest in analyzing the correlates of sports participation in several countries has increased recently. Nevertheless, in developing countries, which do not monitor sportive data, this type of investigation is still scarce. This study aims to analyze socioeconomic, motivational, and supportive factors related to sports participation in Brazil. Data from the 2015 National Household Survey—Supplementary Questionnaire of Sports and Physical Activities are examined. In the survey, 71,142 individuals older than 15 years were interviewed (mean age 43.12 years; 53.83% women and 46.17% men). Logistic regression is used for analyzing the data. Results demonstrate a low participation in sports (23.38%). Sports participation declines with increasing age (2% less per year), increases with higher educational level (graduated 5.9 times more), and males prevail in the sporting context (2.3 times more). The main obstacle to women’s participation is the lack of sports facilities, and for men the lack of time and health problems. Men practice sports mainly due to socialization, fun, and competition, and women due to medical recommendation. Soccer was the most practiced sport (28.1%), predominating among men. Public policies on sports promotion for fun and socialization may increase male participation, and investments in sports facilities may increase female participation.
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Damschroder LJ, Buis LR, McCant FA, Kim HM, Evans R, Oddone EZ, Bastian LA, Hooks G, Kadri R, White-Clark C, Richardson CR, Gierisch JM. Effect of Adding Telephone-Based Brief Coaching to an mHealth App (Stay Strong) for Promoting Physical Activity Among Veterans: Randomized Controlled Trial. J Med Internet Res 2020; 22:e19216. [PMID: 32687474 PMCID: PMC7435619 DOI: 10.2196/19216] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/11/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023] Open
Abstract
Background Though maintaining physical conditioning and a healthy weight are requirements of active military duty, many US veterans lose conditioning and rapidly gain weight after discharge from active duty service. Mobile health (mHealth) interventions using wearable devices are appealing to users and can be effective especially with personalized coaching support. We developed Stay Strong, a mobile app tailored to US veterans, to promote physical activity using a wrist-worn physical activity tracker, a Bluetooth-enabled scale, and an app-based dashboard. We tested whether adding personalized coaching components (Stay Strong+Coaching) would improve physical activity compared to Stay Strong alone. Objective The goal of this study is to compare 12-month outcomes from Stay Strong alone versus Stay Strong+Coaching. Methods Participants (n=357) were recruited from a national random sample of US veterans of recent wars and randomly assigned to the Stay Strong app alone (n=179) or Stay Strong+Coaching (n=178); both programs lasted 12 months. Personalized coaching components for Stay Strong+Coaching comprised of automated in-app motivational messages (3 per week), telephone-based human health coaching (up to 3 calls), and personalized weekly goal setting. All aspects of the enrollment process and program delivery were accomplished virtually for both groups, except for the telephone-based coaching. The primary outcome was change in physical activity at 12 months postbaseline, measured by average weekly Active Minutes, captured by the Fitbit Charge 2 device. Secondary outcomes included changes in step counts, weight, and patient activation. Results The average age of participants was 39.8 (SD 8.7) years, and 25.2% (90/357) were female. Active Minutes decreased from baseline to 12 months for both groups (P<.001) with no between-group differences at 6 months (P=.82) or 12 months (P=.98). However, at 12 months, many participants in both groups did not record Active Minutes, leading to missing data in 67.0% (120/179) for Stay Strong and 61.8% (110/178) for Stay Strong+Coaching. Average baseline weight for participants in Stay Strong and Stay Strong+Coaching was 214 lbs and 198 lbs, respectively, with no difference at baseline (P=.54) or at 6 months (P=.28) or 12 months (P=.18) postbaseline based on administrative weights, which had lower rates of missing data. Changes in the number of steps recorded and patient activation also did not differ by arm. Conclusions Adding personalized health coaching comprised of in-app automated messages, up to 3 coaching calls, plus automated weekly personalized goals, did not improve levels of physical activity compared to using a smartphone app alone. Physical activity in both groups decreased over time. Sustaining long-term adherence and engagement in this mHealth intervention proved difficult; approximately two-thirds of the trial’s 357 participants failed to sync their Fitbit device at 12 months and, thus, were lost to follow-up. Trial Registration ClinicalTrials.gov NCT02360293; https://clinicaltrials.gov/ct2/show/NCT02360293 International Registered Report Identifier (IRRID) RR2-10.2196/12526
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Affiliation(s)
- Laura J Damschroder
- Veterans Affairs Center for Clinical Management Research, Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Lorraine R Buis
- University of Michigan, Department of Family Medicine, Ann Arbor, MI, United States
| | - Felicia A McCant
- Veterans Affairs Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Hyungjin Myra Kim
- Veterans Affairs Center for Clinical Management Research, Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Richard Evans
- Veterans Affairs Center for Clinical Management Research, Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Eugene Z Oddone
- Veterans Affairs Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States.,Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Lori A Bastian
- Veterans Affairs Pain Research, Informatics, Multimorbidities, and Education Center, Veterans Affairs Connecticut, West Haven, CT, United States.,Division of General Internal Medicine, Department of Medicine, Yale University, West Haven, CT, United States
| | - Gwendolyn Hooks
- Veterans Affairs Center for Clinical Management Research, Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Reema Kadri
- University of Michigan, Department of Family Medicine, Ann Arbor, MI, United States
| | - Courtney White-Clark
- Veterans Affairs Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | | | - Jennifer M Gierisch
- Veterans Affairs Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States.,Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, NC, United States.,Department of Population Health Sciences, Duke University Medical Center, Durham, NC, United States
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Freak-Poli RLA, Cumpston M, Albarqouni L, Clemes SA, Peeters A. Workplace pedometer interventions for increasing physical activity. Cochrane Database Syst Rev 2020; 7:CD009209. [PMID: 32700325 PMCID: PMC7389933 DOI: 10.1002/14651858.cd009209.pub3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends undertaking 150 minutes of moderate-intensity physical activity per week, but most people do not. Workplaces present opportunities to influence behaviour and encourage physical activity, as well as other aspects of a healthy lifestyle. A pedometer is an inexpensive device that encourages physical activity by providing feedback on daily steps, although pedometers are now being largely replaced by more sophisticated devices such as accelerometers and Smartphone apps. For this reason, this is the final update of this review. OBJECTIVES To assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving long-term health outcomes. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Occupational Safety and Health (OSH) UPDATE, Web of Science, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform from the earliest record to December 2016. We also consulted the reference lists of included studies and contacted study authors to identify additional records. We updated this search in May 2019, but these results have not yet been incorporated. One more study, previously identified as an ongoing study, was placed in 'Studies awaiting classification'. SELECTION CRITERIA We included randomised controlled trials (RCTs) of workplace interventions with a pedometer component for employed adults, compared to no or minimal interventions, or to alternative physical activity interventions. We excluded athletes and interventions using accelerometers. The primary outcome was physical activity. Studies were excluded if physical activity was not measured. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. When studies presented more than one physical activity measure, we used a pre-specified list of preferred measures to select one measure and up to three time points for analysis. When possible, follow-up measures were taken after completion of the intervention to identify lasting effects once the intervention had ceased. Given the diversity of measures found, we used ratios of means (RoMs) as standardised effect measures for physical activity. MAIN RESULTS We included 14 studies, recruiting a total of 4762 participants. These studies were conducted in various high-income countries and in diverse workplaces (from offices to physical workplaces). Participants included both healthy populations and those at risk of chronic disease (e.g. through inactivity or overweight), with a mean age of 41 years. All studies used multi-component health promotion interventions. Eleven studies used minimal intervention controls, and four used alternative physical activity interventions. Intervention duration ranged from one week to two years, and follow-up after completion of the intervention ranged from three to ten months. Most studies and outcomes were rated at overall unclear or high risk of bias, and only one study was rated at low risk of bias. The most frequent concerns were absence of blinding and high rates of attrition. When pedometer interventions are compared to minimal interventions at follow-up points at least one month after completion of the intervention, pedometers may have no effect on physical activity (6 studies; very low-certainty evidence; no meta-analysis due to very high heterogeneity), but the effect is very uncertain. Pedometers may have effects on sedentary behaviour and on quality of life (mental health component), but these effects were very uncertain (1 study; very low-certainty evidence). Pedometer interventions may slightly reduce anthropometry (body mass index (BMI) -0.64, 95% confidence interval (CI) -1.45 to 0.18; 3 studies; low-certainty evidence). Pedometer interventions probably had little to no effect on blood pressure (systolic: -0.08 mmHg, 95% CI -3.26 to 3.11; 2 studies; moderate-certainty evidence) and may have reduced adverse effects (such as injuries; from 24 to 10 per 100 people in populations experiencing relatively frequent events; odds ratio (OR) 0.50, 95% CI 0.30 to 0.84; low-certainty evidence). No studies compared biochemical measures or disease risk scores at follow-up after completion of the intervention versus a minimal intervention. Comparison of pedometer interventions to alternative physical activity interventions at follow-up points at least one month after completion of the intervention revealed that pedometers may have an effect on physical activity, but the effect is very uncertain (1 study; very low-certainty evidence). Sedentary behaviour, anthropometry (BMI or waist circumference), blood pressure (systolic or diastolic), biochemistry (low-density lipoprotein (LDL) cholesterol, total cholesterol, or triglycerides), disease risk scores, quality of life (mental or physical health components), and adverse effects at follow-up after completion of the intervention were not compared to an alternative physical activity intervention. Some positive effects were observed immediately at completion of the intervention periods, but these effects were not consistent, and overall certainty of evidence was insufficient to assess the effectiveness of workplace pedometer interventions. AUTHORS' CONCLUSIONS Exercise interventions can have positive effects on employee physical activity and health, although current evidence is insufficient to suggest that a pedometer-based intervention would be more effective than other options. It is important to note that over the past decade, technological advancement in accelerometers as commercial products, often freely available in Smartphones, has in many ways rendered the use of pedometers outdated. Future studies aiming to test the impact of either pedometers or accelerometers would likely find any control arm highly contaminated. Decision-makers considering allocating resources to large-scale programmes of this kind should be cautious about the expected benefits of incorporating a pedometer and should note that these effects may not be sustained over the longer term. Future studies should be designed to identify the effective components of multi-component interventions, although pedometers may not be given the highest priority (especially considering the increased availability of accelerometers). Approaches to increase the sustainability of intervention effects and behaviours over a longer term should be considered, as should more consistent measures of physical activity and health outcomes.
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Affiliation(s)
- Rosanne LA Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Miranda Cumpston
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Loai Albarqouni
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Stacy A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Anna Peeters
- Institute for Health Transformation, Deakin University, Geelong, Australia
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Chudowolska-Kiełkowska M, Małek ŁA. A nurse-led intervention to promote physical activity in sedentary older adults with cardiovascular risk factors: a randomized clinical trial (STEP-IT-UP study). Eur J Cardiovasc Nurs 2020; 19:638-645. [DOI: 10.1177/1474515120920450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Regular physical activity should constitute the essence of treatment in patients with cardiovascular risk factors. We sought to determine the benefits of nurse-led intervention to promote physical activity in sedentary older adults in a primary care setting. Methods A group of 199 sedentary older adults (mean age 62.7±6.9, 34.2% male) with at least one more cardiovascular risk factor were randomized 1:1 to receive a nurse-led tutorial on lifestyle modification, including pedometer hand-out – with a daily goal of at least 7000 steps – and supporting phone calls (study group), or without a goal or calls (control group). Body weight (BW), resting heart rate, systolic and diastolic blood pressure (SBP/DBP), total cholesterol (TC) and glucose were assessed at baseline and after 3 months. Results Subjects in the study group ( n = 86) achieved higher daily step count in comparison to the control group ( n = 78), 10,648±3098 vs. 3589±2000, p < 0.0001. The study group presented an improvement in all analysed parameters but glucose, including BW (−2.5±1.9 kg), SBP and DBP (−7.9±7.6 mmHg and −6.2±6.5 mmHg) and TC (−14.7±30.4 mg%), all p < 0.0001. In the control group, all parameters increased or remained unchanged. An inverse correlation between the daily step count and delta of the analysed parameters ( r = −0.26 to −0.72, p < 0.001) was found. Conclusion Nurse-led intervention with pedometer, goal setting and supporting phone calls is an effective way to promote physical activity in sedentary older adults and leads to improvement of cardiovascular risk factors within 3 months.
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Affiliation(s)
| | - Łukasz A Małek
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology in Warsaw, Poland
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Tanikawa Y, Kimachi M, Ishikawa M, Hisada T, Fukuhara S, Yamamoto Y. Association between work schedules and motivation for lifestyle change in workers with overweight or obesity: a cross-sectional study in Japan. BMJ Open 2020; 10:e033000. [PMID: 32354776 PMCID: PMC7213847 DOI: 10.1136/bmjopen-2019-033000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To investigate the association between work schedules and motivation for behavioural change of lifestyle, based on the transtheoretical model (TTM) in workers with overweight or obesity. DESIGN A cross-sectional observational study. SETTING A healthcare examination centre in Japan. PARTICIPANTS Between April 2014 and March 2016, we recruited 9243 participants who underwent healthcare examination and met the inclusion criteria, namely, age 20-65 years, body mass index (BMI) ≥25 kg/m2 and full-time workers. EXPOSURE Night and shift (night/shift) workers were compared with daytime workers in terms of motivation for behavioural change. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was action and maintenance stages of change (SOC) for lifestyle in TTM. In a subgroup analysis, we investigated interactions between characteristics, including age, sex, BMI, current smoking, alcohol habits, hours of sleep and working hours. RESULTS Overall, 1390 participants (15.0%) were night/shift workers; night/shift workers were younger (median age (IQR): 46 (40-54) vs 43 (37-52) years) and the proportion of men was lesser (75.4 vs 60.9%) compared with daytime workers. The numbers of daytime and night/shift workers in the action and maintenance SOC were 2113 (26.9%) and 309 (22.2%), respectively. Compared with daytime workers, night/shift workers were less likely to demonstrate action and maintenance SOC (adjusted OR (AOR): 0.85, 95% CI: 0.74 to 0.98). In a subgroup analysis that included only those with long working hours (≥10 hours/day), results revealed a strong inverse association between night/shift work and action and maintenance SOC (AOR: 0.65, 95% CI: 0.48 to 0.86). A significant interaction was observed between long working hours and night/shift work (P for interaction=0.04). CONCLUSIONS In workers with overweight or obesity, a night/shift work schedule was associated with a lower motivation for behavioural change in lifestyle, and the association was strengthened in those with long working hours.
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Affiliation(s)
- Yukihiro Tanikawa
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Miho Kimachi
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Minoru Ishikawa
- Health Examination Centre, Urasoe General Hospital, Urasoe, Japan
| | | | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University, Kyoto, Japan
- Centre for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
- Shirakawa STAR for General Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Alayli A, Krebs F, Lorenz L, Nawabi F, Bau AM, Lück I, Moreira A, Kuchenbecker J, Tschiltschke E, John M, Klose S, Häusler B, Giertz C, Korsten-Reck U, Stock S. Evaluation of a computer-assisted multi-professional intervention to address lifestyle-related risk factors for overweight and obesity in expecting mothers and their infants: protocol for an effectiveness-implementation hybrid study. BMC Public Health 2020; 20:482. [PMID: 32293391 PMCID: PMC7158079 DOI: 10.1186/s12889-020-8200-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The first 1000 days after conception are a critical period to encourage lifestyle changes to reduce the risk of childhood obesity and early programming of chronic diseases. A healthy lifestyle during pregnancy is also crucial to avoid high post-partum weight retention. Currently, lifestyle changes are not consistently discussed during routine health services in Germany. The objective of this study is to evaluate a novel computer-assisted lifestyle intervention embedded in prenatal visits and infant check-ups. The intervention seeks to reduce lifestyle-related risk factors for overweight and obesity among expecting mothers and their infants. METHODS The study is designed as a hybrid effectiveness-implementation trial to simultaneously collect data on the effectiveness and implementation of the lifestyle intervention. The trial will take place in eight regions of the German state Baden-Wuerttemberg. Region were matched using propensity score matching. Expecting mothers (n = 1860) will be recruited before 12 weeks of gestation through gynecological practices and followed for 18 months. During 11 routine prenatal visits and infant check-ups gynecologists, midwives and pediatricians provide lifestyle counseling using Motivational Interviewing techniques. The primary outcome measure is the proportion of expecting mothers with gestational weight gain within the recommended range. To understand the process of implementation (focus group) interviews will be conducted with providers and participants of the lifestyle intervention. Additionally, an analysis of administrative data and documents will be carried out. An economic analysis will provide insights into cost and consequences compared to routine health services. DISCUSSION Findings of this study will add to the evidence on lifestyle interventions to reduce risk for overweight and obesity commenced during pregnancy. Insights gained will contribute to the prevention of early programming of chronic disease. Study results regarding implementation fidelity, adoption, reach and cost-effectiveness of the lifestyle intervention will inform decisions about scale up and public funding. TRIAL REGISTRATION German Clinical Trials Register (DRKS00013173). Registered 3rd of January 2019, https://www.drks.de.
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Affiliation(s)
- Adrienne Alayli
- Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (IGKE), Cologne, Germany.
- Federal Centre for Health Education (BZgA), Cologne, Germany.
| | - Franziska Krebs
- Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (IGKE), Cologne, Germany
| | - Laura Lorenz
- Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (IGKE), Cologne, Germany
| | - Farah Nawabi
- Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (IGKE), Cologne, Germany
| | | | - Isabel Lück
- Platform Nutrition and Physical Activity (peb), Berlin, Germany
| | - Andrea Moreira
- Platform Nutrition and Physical Activity (peb), Berlin, Germany
| | | | | | - Michael John
- Fraunhofer Institute for Open Communication Systems (FOKUS), Berlin, Germany
| | - Stefan Klose
- Fraunhofer Institute for Open Communication Systems (FOKUS), Berlin, Germany
| | - Benny Häusler
- Fraunhofer Institute for Open Communication Systems (FOKUS), Berlin, Germany
| | - Christian Giertz
- Fraunhofer Institute for Open Communication Systems (FOKUS), Berlin, Germany
| | | | - Stephanie Stock
- Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (IGKE), Cologne, Germany
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Monteiro JLGC, de Arruda JAA, Silva EDDOE, Vasconcelos BCDE. Is Single-Puncture TMJ Arthrocentesis Superior to the Double-Puncture Technique for the Improvement of Outcomes in Patients With TMDs? J Oral Maxillofac Surg 2020; 78:1319.e1-1319.e15. [PMID: 32343959 DOI: 10.1016/j.joms.2020.03.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/19/2020] [Accepted: 03/15/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Arthrocentesis is a common treatment for temporomandibular joint disorders. Although modifications of the standard double-puncture technique have been described, no consensus has been reached regarding which is the best. The aim of the present study was to compare the outcomes of the single- and double-puncture arthrocentesis techniques (SPT and DPT, respectively). MATERIALS AND METHODS A systematic review following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines was performed. Two independent reviewers conducted electronic searches in the MEDLINE/PubMed, Cochrane Library, and Scopus databases for relevant studies reported up to January 2019. Studies comparing type I SPT (only 1 cannula) or type II SPT (2 soldered cannulas) to conventional DPT were considered. Data regarding the maximal mouth opening (MMO), joint pain, and operative time were extracted for the meta-analysis. In the case of statistically significant heterogeneity (P < .10), a random effects model was used to assess the significance of the treatment effects. Otherwise, a fixed effects model was used. The included randomized controlled trials (RCTs) were assessed for methodologic quality using the Cochrane Collaboration tool. RESULTS Nine studies were included for qualitative synthesis. Two were suitable for quantitative synthesis per outcome. The meta-analysis did not find any differences between SPT and DPT in relation to the MMO. However, in relation to joint pain, the results slightly favored the use of DPT. No differences in operative time were found between type I SPT and DPT (P = .49). CONCLUSIONS The present study found no differences between the SPT and DPT in relation to the MMO, and no difference was found in operative time between the DPT and type I SPT. Because of the heterogeneity between studies, it might be interesting to conduct more homogeneous RCTs to elucidate which technique results in better clinical outcomes.
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Affiliation(s)
- João Luiz Gomes Carneiro Monteiro
- Postgraduate Student, Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de Pernambuco, Camaragibe, Brazil.
| | - José Alcides Almeida de Arruda
- Postgraduate Student, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Emanuel Dias de Oliveira E Silva
- Adjunct Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de Pernambuco, Camaragibe, Brazil
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Van Rhoon L, Byrne M, Morrissey E, Murphy J, McSharry J. A systematic review of the behaviour change techniques and digital features in technology-driven type 2 diabetes prevention interventions. Digit Health 2020; 6:2055207620914427. [PMID: 32269830 PMCID: PMC7093696 DOI: 10.1177/2055207620914427] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/21/2020] [Indexed: 12/14/2022] Open
Abstract
Objectives Our aim was to conduct a systematic review to determine which technology-driven diabetes prevention interventions were effective in producing clinically significant weight loss, and to identify the behaviour change techniques and digital features frequently used in effective interventions. Methods We searched five databases (CINAHL, EMBASE, MEDLINE, PsychINFO, and Pubmed) from inception to September 2018 and reviewed 19 experimental and non-experimental studies of 21 technology-driven diet plus physical activity interventions for adults (≥18 years) at risk of developing type 2 diabetes. Behaviour change techniques were coded using the BCT taxonomy v1, and digital features were identified via thematic analysis of intervention descriptions. Results Sixty-three per cent of interventions were effective in the short term (achieving ≥3% weight loss at ≤6 months), using an average of 5.6 more behaviour change techniques than non-effective interventions, and 33% were effective in the long term (achieving ≥5% weight loss at ≥12 months), using 3.7 more behaviour change techniques than non-effective interventions. The techniques of social support (unspecified), goal setting (outcome/behaviour), feedback on behaviour, and self-monitoring of outcome(s) of behaviour were identified in over 90% of effective interventions. Interventions containing digital features that facilitated health and lifestyle education, behaviour/outcome tracking, and/or online health coaching were most effective. Conclusion The integration of specific behaviour change techniques and digital features may optimise digital diabetes prevention interventions to achieve clinically significant weight loss. Additional research is needed to identify the mechanisms in which behaviour change techniques and digital features directly influence physical activity, dietary behaviours, and intervention engagement.
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Affiliation(s)
- Luke Van Rhoon
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Ireland
| | - Eimear Morrissey
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Ireland
| | - Jane Murphy
- Medication Adherence Across the Lifespan Research Group, School of Psychology, National University of Ireland Galway, Ireland
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Ireland
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Jang JY, Oh HS, Lim Y, Cheung YK. Ensemble clustering for step data via binning. Biometrics 2020; 77:293-304. [PMID: 32150282 DOI: 10.1111/biom.13258] [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: 08/04/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 11/29/2022]
Abstract
This paper considers the clustering problem of physical step count data recorded on wearable devices. Clustering step data give an insight into an individual's activity status and further provide the groundwork for health-related policies. However, classical methods, such as K-means clustering and hierarchical clustering, are not suitable for step count data that are typically high-dimensional and zero-inflated. This paper presents a new clustering method for step data based on a novel combination of ensemble clustering and binning. We first construct multiple sets of binned data by changing the size and starting position of the bin, and then merge the clustering results from the binned data using a voting method. The advantage of binning, as a critical component, is that it substantially reduces the dimension of the original data while preserving the essential characteristics of the data. As a result, combining clustering results from multiple binned data can provide an improved clustering result that reflects both local and global structures of the data. Simulation studies and real data analysis were carried out to evaluate the empirical performance of the proposed method and demonstrate its general utility.
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Affiliation(s)
- Ja-Yoon Jang
- Department of Statistics, Stanford University, Stanford, California
| | - Hee-Seok Oh
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
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Sumner J, Uijtdewilligen L, Yee ACH, Xian SNH, Barreira TV, Sloan RA, Van Dam RM, Müller-Riemenschneider F. Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030863. [PMID: 32019086 PMCID: PMC7037023 DOI: 10.3390/ijerph17030863] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 01/24/2020] [Indexed: 11/16/2022]
Abstract
The health benefits of objectively measured physical activity volume versus intensity have rarely been studied, particularly in non-western populations. The aim of this study was to investigate the association between cardiometabolic risk factors and stepping activity including; volume (step count), intensity (cadence) or inactivity (zero-steps/minute/day), in a multi-ethnic Asian population. Participants clinical data was collected at baseline and their physical activity was monitored for seven days, using an accelerometer (Actigraph GT3X+) in 2016. Tertiles (low, moderate, high) of the mean daily step count, peak one-minute, 30-min, 60-min cadences and time/day spent at zero-steps/minute were calculated. Adjusted linear regressions explored the association between stepping activity tertiles and cardiometabolic risk factors. A total of 635 participants (41% male, 67% Chinese, mean age 48.4 years) were included in the analyses. The mean daily step count was 7605 (median daily step count 7310) and 7.8 h of awake time per day were spent inactive (zero-steps/minute). A greater number of associations were found for step intensity than volume. Higher step intensity was associated with reduced body mass index (BMI), waist circumference, blood pressures and higher high-density lipoprotein (HDL). Future health promotion initiatives should consider the greater role of step intensity to reduce cardiometabolic risk.
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Affiliation(s)
- Jennifer Sumner
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
- Medical Affairs—Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore 117549, Singapore
- Department of Health Sciences, University of York, York YO10 5DD, UK
- Correspondence:
| | - Léonie Uijtdewilligen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (L.U.); (A.C.H.Y.); (S.N.H.X.); (R.M.V.D.)
| | - Anne Chu Hin Yee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (L.U.); (A.C.H.Y.); (S.N.H.X.); (R.M.V.D.)
| | - Sheryl Ng Hui Xian
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (L.U.); (A.C.H.Y.); (S.N.H.X.); (R.M.V.D.)
| | - Tiago V Barreira
- Department of Exercise Science, School of Education, Syracuse University, Syracuse, NY 13244, USA;
| | - Robert Alan Sloan
- Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan;
| | - Rob M Van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (L.U.); (A.C.H.Y.); (S.N.H.X.); (R.M.V.D.)
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (L.U.); (A.C.H.Y.); (S.N.H.X.); (R.M.V.D.)
- Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre, 10117 Berlin, Germany
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Okwose NC, Avery L, O'Brien N, Cassidy S, Charman SJ, Bailey K, Velicki L, Olivotto I, Brennan P, MacGowan GA, Jakovljevic DG. Acceptability, Feasibility and Preliminary Evaluation of a Novel, Personalised, Home-Based Physical Activity Intervention for Chronic Heart Failure (Active-at-Home-HF): a Pilot Study. SPORTS MEDICINE-OPEN 2019; 5:45. [PMID: 31776701 PMCID: PMC6881484 DOI: 10.1186/s40798-019-0216-x] [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: 04/12/2019] [Accepted: 09/24/2019] [Indexed: 02/08/2023]
Abstract
Purpose Less than 10% of heart failure patients in the UK participate in cardiac rehabilitation programmes. The present pilot study evaluated feasibility, acceptability and physiological effects of a novel, personalised, home-based physical activity intervention in chronic heart failure. Methods Twenty patients (68 ± 7 years old, 20% females) with stable chronic heart failure due to reduced left ventricular ejection fraction (31 ± 8 %) participated in a single-group, pilot study assessing the feasibility and acceptability of a 12-week personalised home-based physical activity intervention aiming to increase daily number of steps by 2000 from baseline (Active-at-Home-HF). Patients completed cardiopulmonary exercise testing with non-invasive gas exchange and haemodynamic measurements and quality of life questionnaire pre- and post-intervention. Patients were supported weekly via telephone and average weekly step count data collected using pedometers. Results Forty-three patients were screened and 20 recruited into the study. Seventeen patients (85%) completed the intervention, and 15 (75%) achieved the target step count. Average step count per day increased significantly from baseline to 3 weeks by 2546 (5108 ± 3064 to 7654 ± 3849, P = 0.03, n = 17) and was maintained until week 12 (9022 ± 3942). Following completion of the intervention, no adverse events were recorded and quality of life improved by 4 points (26 ± 18 vs. 22 ± 19). Peak exercise stroke volume increased by 19% (127 ± 34 vs. 151 ± 34 m/beat, P = 0.05), while cardiac index increased by 12% (6.8 ± 1.5 vs. 7.6 ± 2.0 L/min/m2, P = 0.19). Workload and oxygen consumption at anaerobic threshold also increased by 16% (49 ± 16 vs. 59 ± 14 watts, P = 0.01) and 10% (11.5 ± 2.9 vs. 12.8 ± 2.2 ml/kg/min, P = 0.39). Conclusion The Active-at-Home-HF intervention is feasible, acceptable and effective for increasing physical activity in CHF. It may lead to improvements in quality of life, exercise tolerance and haemodynamic function. Trial Registration www.clinicaltrials.gov NCT0367727. Retrospectively registered on 17 September 2018.
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Affiliation(s)
- Nduka C Okwose
- Cardiovascular Research Theme, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, William Leech Building M4.074, Newcastle upon Tyne, NE2 4HH, UK
| | - Leah Avery
- Centre for Rehabilitation, Exercise and Sports Science, School of Health & Social Care, Teesside University, Tees Valley, UK
| | - Nicola O'Brien
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Sophie Cassidy
- Cardiovascular Research Theme, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, William Leech Building M4.074, Newcastle upon Tyne, NE2 4HH, UK
| | - Sarah J Charman
- Cardiovascular Research Theme, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, William Leech Building M4.074, Newcastle upon Tyne, NE2 4HH, UK
| | - Kristian Bailey
- Newcastle upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Lazar Velicki
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia
| | - Iacopo Olivotto
- Cardiomyopathy Unit and Genetic Unit, Careggi University Hospital, Florence, Italy
| | - Paul Brennan
- Newcastle upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK.,Institute of Genetic Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Guy A MacGowan
- Cardiovascular Research Theme, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, William Leech Building M4.074, Newcastle upon Tyne, NE2 4HH, UK.,Newcastle upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK.,Institute of Genetic Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Djordje G Jakovljevic
- Cardiovascular Research Theme, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, William Leech Building M4.074, Newcastle upon Tyne, NE2 4HH, UK. .,Newcastle upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK. .,RCUK Centre for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
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Fedewa MV, Spencer SO, Williams TD, Becker ZE, Fuqua CA. Effect of branched-Chain Amino Acid Supplementation on Muscle Soreness following Exercise: A Meta-Analysis. INT J VITAM NUTR RES 2019; 89:348-356. [DOI: 10.1024/0300-9831/a000543] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Abstract. Delayed onset muscle soreness (DOMS) is a symptom of exercise-induced muscle damage that occurs following exercise. Previous research has indicated that branched-chain amino acid (BCAA) supplementation may attenuate exercise-induced muscle damage that causes delayed onset muscle soreness, however the results are inconsistent. The primary aim of this study was to examine the previous literature assessing the effect of BCAA supplementation on DOMS following an acute bout of exercise in adults. This review was conducted in accordance with PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses), and identified peer-reviewed articles comparing a BCAA supplement to a placebo non-BCAA supplement following an acute bout of exercise. An electronic search of three databases (EbscoHost, Web of Science, and SPORTDiscus) yielded 42 articles after duplicates were removed. All studies included in the current analyis were: 1) peer-reviewed publications; 2) available in English; 3) utilized a random control design that compared a BCAA group to a placebo control group following exercise; 4) and assessed soreness of muscle tissue during recovery. DOMS was assessed in 61 participants following ingestion of a BCAA supplement over the course of these interventions. The cumulative results of 37 effects gathered from 8 studies published between 2007 and 2017 indicated that BCAA supplementation reduced DOMS following exercise training (ES = 0.7286, 95% CI: 0.5017 to 0.9555, p < 0.001). A large decrease in DOMS occurs following BCAA supplementation after exercise compared to a placebo supplement.
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Affiliation(s)
- Michael V. Fedewa
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, United States
| | - Steven O. Spencer
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, United States
| | - Tyler D. Williams
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, United States
- Department of Kinesiology, Samford University, Birmingham, Alabama, United States
| | - Zachery E. Becker
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, United States
| | - Collin A. Fuqua
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, United States
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