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Cebrick-Grossman JA, Fetherman DL. A Workplace Physical Activity Intervention and a Smartphone App for Overweight and Obese Sedentary Women. Workplace Health Saf 2024:21650799241265131. [PMID: 39169847 DOI: 10.1177/21650799241265131] [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: 08/23/2024]
Abstract
BACKGROUND The sedentary aspects of many U.S. occupations and the amount of time American workers spend in the workplace make it an ideal location to implement health promotion programs. METHODS This study assessed the effectiveness of a free smartphone app with a goal-setting feature to increase physical activity (PA) and impact anthropometric, body mass (BM), and body composition (BC) changes among overweight and obese women within a community health workforce. Eighteen overweight and obese (body mass index [BMI] = 32.18 ± 4.48 kg/m2), adult (50.73 ± 8.76 years), female volunteers, tracked daily steps with a free smartphone app (StridekickTM) over an 8-week period. Pre- and post-program body composition (BC) measurements included: relative (%) body fat (BF), fat mass (FM), fat-free mass (FFM), and lean mass (LM), using dual X-ray absorptiometry (DEXA scan), and five anthropometric measurements (biceps, waist, abdomen, hips, and thigh). FINDINGS Pre- to post-program average daily steps resulted in significant anthropometric changes for biceps, hips, and thigh measures, with encouraging changes in FFM, LM, and relative (%) BF. The goal-setting feature of the app did not result in significant differences between the experimental and control groups. No differences were noted in FM, BMI, waist, and abdomen or step goals compared with steps completed. CONCLUSIONS An occupational PA health promotion intervention program that tracked daily steps through the StridekickTM smartphone app resulted in anthropometric, BM, and BC changes. APPLICATION TO PRACTICE The workplace is an ideal location to affect change in health behaviors via a free smartphone app to increase PA and improve health.
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Thøgersen-Ntoumani C, Grunseit A, Holtermann A, Steiner S, Tudor-Locke C, Koster A, Johnson N, Maher C, Ahmadi M, Chau JY, Stamatakis E. Promoting vigorous intermittent lifestyle physical activity (vilpa) in middle-aged adults: an evaluation of the movsnax mobile app. BMC Public Health 2024; 24:2182. [PMID: 39135030 PMCID: PMC11318164 DOI: 10.1186/s12889-024-19549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/22/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Most adults fail to meet the moderate to vigorous physical activity-based recommendations needed to maintain or improve health. Vigorous Intermittent Lifestyle Physical Activity (VILPA) refers to short (1-2 min) high-intensity activities that are integrated into activities of daily living. VILPA has shown strong potential to improve health and addresses commonly reported barriers to physical activity. However, it is unknown how VILPA can best be promoted among the adult population. This study aimed to evaluate the usability, user engagement, and satisfaction of a mobile application (MovSnax) designed to promote VILPA. METHODS A concurrent mixed methods design was used. It comprised four parts. Part A was a survey with n = 8 mHealth and physical activity experts who had used the app over 7-10 days. Part B was think-aloud interviews with n = 5 end-users aged 40-65 years old. Part C was a survey with a new group of 40-65-year-old end-users (n = 35) who had used the MovSnax app over 7-10 days. Part D was semi-structured interviews with n = 18 participants who took part in Part C. Directed content analysis was used to analyze the results from Parts A, B, and D, and descriptive statistics were used to analyze findings from Part C. RESULTS Participants reported positive views on the MovSnax app for promoting VILPA but also identified usability issues such as unclear purpose, difficulties in manual data entry, and limited customization options. Across the different data collections, they consistently emphasized the need for more motivational features, clearer feedback, and gamification elements to enhance engagement. Quantitative assessment showed satisfactory scores on objective measures but lower ratings on subjective aspects, possibly due to unfamiliarity with the VILPA concept and/or technical barriers. CONCLUSIONS The MovSnax app, tested in the present study, is the world's first digital tool aimed specifically at increasing VILPA. The findings of the present study underscore the need for further app refinement, focusing on clarifying its purpose and instructions, boosting user engagement through personalization and added motivational elements, enhancing accuracy in detecting VILPA bouts, implementing clearer feedback mechanisms, expanding customization choices (such as font size and comparative data), and ensuring transparent and meaningful activity tracking.
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Affiliation(s)
- Cecilie Thøgersen-Ntoumani
- Danish Centre for Motivation and Behaviour Science (DRIVEN), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anne Grunseit
- School of Public Health, Faculty of Health, University of Technology Sydney, Broadway, Ultimo, NSW, 2007, Australia
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sarah Steiner
- Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, 1 John Hopkins Drive, Camperdown, Sydney, New South Wales, 2050, Australia
| | - Catrine Tudor-Locke
- College of Health and Human Service, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Annemarie Koster
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Nathan Johnson
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, 1 John Hopkins Drive, Camperdown, Sydney, New South Wales, 2050, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Matthew Ahmadi
- Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, 1 John Hopkins Drive, Camperdown, Sydney, New South Wales, 2050, Australia
| | - Josephine Y Chau
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Emmanuel Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, 1 John Hopkins Drive, Camperdown, Sydney, New South Wales, 2050, Australia
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Mazéas A, Forestier C, Harel G, Duclos M, Chalabaev A. The Impact of a Gamified Intervention on Daily Steps in Real-Life Conditions: Retrospective Analysis of 4800 Individuals. J Med Internet Res 2024; 26:e47116. [PMID: 39133533 PMCID: PMC11347891 DOI: 10.2196/47116] [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: 04/25/2023] [Revised: 03/10/2024] [Accepted: 05/01/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Digital interventions integrating gamification features hold promise to promote daily steps. However, results regarding the effectiveness of this type of intervention are heterogeneous and not yet confirmed in real-life contexts. OBJECTIVE This study aims to examine the effectiveness of a gamified intervention and its potential moderators in a large sample using real-world data. Specifically, we tested (1) whether a gamified intervention enhanced daily steps during the intervention and follow-up periods compared to baseline, (2) whether this enhancement was higher in participants in the intervention than in nonparticipants, and (3) what participant characteristics or intervention parameters moderated the effect of the program. METHODS Data from 4819 individuals who registered for a mobile health Kiplin program between 2019 and 2022 were retrospectively analyzed. In this intervention, participants could take part in one or several games in which their daily step count was tracked, allowing individuals to play with their overall activity. Nonparticipants were people who registered for the program but did not take part in the intervention and were considered as a control group. Daily step counts were measured via accelerometers embedded in either commercial wearables or smartphones of the participants. Exposure to the intervention, the intervention content, and participants' characteristics were included in multilevel models to test the study objectives. RESULTS Participants in the intervention group demonstrated a significantly greater increase in mean daily steps from baseline than nonparticipants (P<.001). However, intervention effectiveness depended on participants' initial physical activity. The daily steps of participants with <7500 baseline daily steps significantly improved from baseline both during the Kiplin intervention (+3291 daily steps) and the follow-up period (+945 daily steps), whereas participants with a higher baseline had no improvement or significant decreases in daily steps after the intervention. Age (P<.001) and exposure (P<.001) positively moderated the intervention effect. CONCLUSIONS In real-world settings and among a large sample, the Kiplin intervention was significantly effective in increasing the daily steps of participants from baseline during intervention and follow-up periods compared to nonparticipants. Interestingly, responses to the intervention differed based on participants' initial steps, with the existence of a plateau effect. Drawing on the insights of self-determination theory, we can assume that the effect of gamification could depend of the initial motivation and activity of participants.
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Affiliation(s)
- Alexandre Mazéas
- Laboratoire Sport et Environnement Social (SENS), Université Grenoble Alpes, Grenoble, France
- National Research Institute for Agriculture, Food and Environment (INRAE), Clermont-Ferrand, France
- Kiplin, Nantes, France
| | - Cyril Forestier
- Laboratoire Motricité, Interactions, Performance (MIP - UR4334), Nantes Université, Nantes, France
| | | | - Martine Duclos
- National Research Institute for Agriculture, Food and Environment (INRAE), Clermont-Ferrand, France
- Department of Sport Medicine and Functional Exploration, University Hospital Clermont-Ferrand, Hospital G. Montpied, Clermont-Ferrand, France
| | - Aïna Chalabaev
- Laboratoire Sport et Environnement Social (SENS), Université Grenoble Alpes, Grenoble, France
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Shi B, Li G, Wu S, Ge H, Zhang X, Chen S, Pan Y, He Q. Assessing the Effectiveness of eHealth Interventions to Manage Multiple Lifestyle Risk Behaviors Among Older Adults: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e58174. [PMID: 39083787 PMCID: PMC11325121 DOI: 10.2196/58174] [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: 03/08/2024] [Revised: 05/24/2024] [Accepted: 06/01/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Developing adverse lifestyle behaviors increases the risk of a variety of chronic age-related diseases, including cardiovascular disease, obesity, and Alzheimer disease. There is limited evidence regarding the effectiveness of eHealth-based multiple health behavior change (MHBC) interventions to manage lifestyle risk behaviors. OBJECTIVE The purpose of this systematic evaluation was to assess the effectiveness of eHealth MHBC interventions in changing ≥2 major lifestyle risk behaviors in people aged ≥50 years. METHODS The literature search was conducted in 6 electronic databases-PubMed, Embase, Web of Science, Scopus, Cochrane Library, and SPORTDiscus-from inception to May 1, 2024. Eligible studies were randomized controlled trials of eHealth interventions targeting ≥2 of 6 behaviors of interest: alcohol use, smoking, diet, physical activity (PA), sedentary behavior, and sleep. RESULTS A total of 34 articles with 35 studies were included. eHealth-based MHBC interventions significantly increased smoking cessation rates (odds ratio 2.09, 95% CI 1.62-2.70; P<.001), fruit intake (standardized mean difference [SMD] 0.18, 95% CI 0.04-0.32; P=.01), vegetable intake (SMD 0.17, 95% CI 0.05-0.28; P=.003), self-reported total PA (SMD 0.22, 95% CI 0.02-0.43; P=.03), and objectively measured moderate to vigorous PA (SMD 0.25, 95% CI 0.09-0.41; P=.002); in addition, the interventions decreased fat intake (SMD -0.23, 95% CI -0.33 to -0.13; P<.001). No effects were observed for alcohol use, sedentary behavior, or sleep. A sensitivity analysis was conducted to test the robustness of the pooled results. Moreover, the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. CONCLUSIONS eHealth-based MHBC interventions may be a promising strategy to increase PA, improve diet, and reduce smoking among older adults. However, the effect sizes were small. Further high-quality, older adult-oriented research is needed to develop eHealth interventions that can change multiple behaviors. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42023444418; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023444418.
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Affiliation(s)
- Beibei Shi
- School of Physical Education, Shandong University, Jinan, China
| | - Guangkai Li
- School of Physical Education, Shandong University, Jinan, China
| | - Shuang Wu
- School of Physical Education, Shandong University, Jinan, China
| | - Hongli Ge
- School of Physical Education, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yang Pan
- School of Physical Education, Shandong University, Jinan, China
| | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
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Ang G, Tan CS, Lim N, Tan J, Müller-Riemenschneider F, Cook AR, Chen C. Hourly step recommendations to achieve daily goals for working and older adults. COMMUNICATIONS MEDICINE 2024; 4:132. [PMID: 38971929 PMCID: PMC11227519 DOI: 10.1038/s43856-024-00537-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 05/31/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND The widespread use of physical activity trackers enables the collection of high-resolution health data, such as hourly step counts, to evaluate health promotion programmes. We aim to investigate how participants meet their daily step goals. METHODS We used 24-h steps data from the National Steps ChallengeTM Season 3, wherein participants were rewarded with vouchers when achieving specified goals of 5000, 7500, and 10,000 steps per day. We extracted data from 3075 participants' including a total of 52,346 participant-days. We modelled the hourly step counts using a two-part model, in which the distribution for step counts was allowed to depend on the sum of step counts up to the previous hour and participant demographics. RESULTS Participants have a mean age of 44.2 years (standard deviation = 13.9), and 40.4% are males. We show that on weekdays, the hourly mean step counts among participants aged 60 and above are higher than participants aged 30 to 59 from the start of the day till 6 p.m. We also find that participants who accumulate at least 7000 steps by 7 p.m. are associated with higher success of achieving 10,000 steps. CONCLUSIONS We provide recommendations on the hourly targets to achieve daily goals, based on different participants' characteristics. Future studies could experimentally test if prompts and nudges at the recommended times of day could promote reaching step goals.
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Affiliation(s)
- Gregory Ang
- Department of Statistics and Data Science, National University of Singapore, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nicole Lim
- Health Promotion Board, Ministry of Health, Singapore, Singapore
| | - Jeremy Tan
- Health Promotion Board, Ministry of Health, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Alex R Cook
- Department of Statistics and Data Science, National University of Singapore, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
- Department of Non-Communicable Disease Epidemiology, The London School of Hygiene & Tropical Medicine, London, UK.
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Peña JC, Martin WF, Cardozo LA, Rodriguez JF, Peña C, Cardenas LF, Tellez LA. Effects of Remote Versus In-Person Training on Metabolic Profiles and Body Composition of Physically Inactive Adults: Randomized Clinical Trial. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2024; 17:1016-1025. [PMID: 39253052 PMCID: PMC11382774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
The COVID-19 pandemic has pushed the population to adopt increasingly sedentary lifestyles. Faced with this problem, remote training appears as a practical and inexpensive strategy to promote physically active lifestyles. The aim of this research was to compare the effects of remote versus in-person training on metabolic profiles and body composition of physically inactive adults. This research was conducted through a randomized, single-blind clinical trial with balanced block randomization. The sample consisted of 30 physically inactive subjects of both sexes between 18 and 30 years of age. The sample was selected using a voluntary public call. The 30 subjects were randomized into three groups of 10 people each. One group trained for 36 sessions remotely, and the other did so in person. The control group did not have a training plan. The variables evaluated pre- and post-intervention were body composition by bioimpedance, grip strength through dynamometry, primary outcome, and metabolic profile assessed from a capillary sample using the CARDIOCHEK equipment. In the remote training group, significant gains were evident in the variables of weight (p = 0.042, d = 1.119), muscle percentage (p = 0.032, d = 0.499), and fat percentage (p = 0.001, d = 1.132), visceral fat (p = 0.032, d = 0.424), total cholesterol (p = 0.001, d = 1.213), HDL (p = 0.001, d = 0.534), LDL (p = 0.001, d = 0.973), triglycerides (p = 0.001, d = 0.583), and grip strength (p = 0.001, d = 1.201). When comparing the effects between the remote and in-person training groups, it is evident that the improvements were similar in all variables, except for glucose, in which the in-person group had a greater value reduction.
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Affiliation(s)
- Jhonatan C Peña
- Sports Training Research and Measurement Group (IMED), Sports Training Undergraduate Program, Faculty of Health and Sports Sciences, Fundación Universitaria del Área Andina, Bogotá, Cundinamarca, Colombia
| | - William F Martin
- Sports Training Research and Measurement Group (IMED), Sports Training Undergraduate Program, Faculty of Health and Sports Sciences, Fundación Universitaria del Área Andina, Bogotá, Cundinamarca, Colombia
| | - Luis A Cardozo
- Sports Training Research and Measurement Group (IMED), Sports Training Undergraduate Program, Faculty of Health and Sports Sciences, Fundación Universitaria del Área Andina, Bogotá, Cundinamarca, Colombia
| | - John Fredy Rodriguez
- Sports Training Research and Measurement Group (IMED), Sports Training Undergraduate Program, Faculty of Health and Sports Sciences, Fundación Universitaria del Área Andina, Bogotá, Cundinamarca, Colombia
| | - Cristian Peña
- Sports Training Research and Measurement Group (IMED), Sports Training Undergraduate Program, Faculty of Health and Sports Sciences, Fundación Universitaria del Área Andina, Bogotá, Cundinamarca, Colombia
| | - Luisa F Cardenas
- Sports Training Research and Measurement Group (IMED), Sports Training Undergraduate Program, Faculty of Health and Sports Sciences, Fundación Universitaria del Área Andina, Bogotá, Cundinamarca, Colombia
| | - Luis A Tellez
- Grupo de investigación en entrenamiento deportivo y actividad física para la salud (GIEDAF), Universidad Santo Tomas, seccional Tunja, Tunja, Boyacá, Colombia
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Piqueras-Sola B, Cortés-Martín J, Rodríguez-Blanque R, Menor-Rodríguez MJ, Mellado-García E, Merino Lobato C, Sánchez-García JC. Systematic Review on the Impact of Mobile Applications with Augmented Reality to Improve Health. Bioengineering (Basel) 2024; 11:622. [PMID: 38927858 PMCID: PMC11200493 DOI: 10.3390/bioengineering11060622] [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: 05/24/2024] [Revised: 06/08/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Physical inactivity represents a significant public health challenge globally. Mobile applications, particularly those utilizing augmented reality (AR), have emerged as innovative tools for promoting physical activity. However, a systematic evaluation of their efficacy is essential. This systematic review aims to evaluate and synthesize the evidence regarding the effectiveness and benefits of mobile applications with augmented reality in enhancing physical activity and improving health outcomes. A comprehensive search was conducted in Scopus, PubMed, WOS, and the Cochrane Library databases following PRISMA guidelines. Observational and interventional studies evaluating AR mobile applications for physical exercise were included, without restrictions on publication date or language. The search terms included "Mobile Applications", "Augmented Reality", "Physical Fitness", "Exercise Therapy", and "Health Behavior". The methodological quality was assessed using the ROBINS tool. The review identified twelve eligible studies encompassing 5,534,661 participants. The findings indicated significant increases in physical activity and improvements in mental health associated with the use of AR applications, such as Pokémon GO. However, potential risk behaviors were also noted. The evidence suggests that AR interventions can effectively promote physical activity and enhance health. Nonetheless, further research is needed to address limitations and optimize their efficacy. Future interventions should be tailored to diverse cultural contexts to maximize benefits and mitigate risks. AR mobile applications hold promise for promoting physical activity and improving health outcomes. Strategies to optimize their effectiveness and address identified risks should be explored to fully realize their potential.
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Affiliation(s)
| | - Jonathan Cortés-Martín
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.C.-M.); (E.M.-G.); (J.C.S.-G.)
| | - Raquel Rodríguez-Blanque
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.C.-M.); (E.M.-G.); (J.C.S.-G.)
- San Cecilio University Hospital, 18071 Granada, Spain;
| | | | - Elena Mellado-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.C.-M.); (E.M.-G.); (J.C.S.-G.)
| | | | - Juan Carlos Sánchez-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.C.-M.); (E.M.-G.); (J.C.S.-G.)
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Tabira K, Oguma Y, Yoshihara S, Shibuya M, Nakamura M, Doihara N, Hirata A, Manabe T. Digital Peer-Supported App Intervention to Promote Physical Activity Among Community-Dwelling Older Adults: Nonrandomized Controlled Trial. JMIR Aging 2024; 7:e56184. [PMID: 38814686 PMCID: PMC11176879 DOI: 10.2196/56184] [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: 01/14/2024] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND The use of mobile apps has promoted physical activity levels. Recently, with an increasing number of older adults accessing the internet, app-based interventions may be feasible in older populations. Peer support-based interventions have become a common method for promoting health-related behavior change. To our knowledge, the feasibility of using digital peer support apps (DPSAs) to increase physical activity among older adults and its impact on physical activity and physical function have not been investigated. OBJECTIVE This study aims to assess the feasibility of using DPSAs in older adults and to assess changes in physical activity and physical function in DPSA users. METHODS We conducted a nonrandomized controlled trial of older adults aged ≥65 years. We recruited participants for 2 distinct 12-week programs designed to increase physical activity. Participants could choose between an intervention group (app program and exercise instruction) or a control group (exercise instruction only). DPSA creates a group chat for up to 5 people with a common goal, and participants anonymously post to each other in the group. Once a day, participants posted a set of their step counts, photos, and comments on a group chat box. The intervention group used the DPSA after receiving 2 face-to-face lectures on its use. The participants were characterized using questionnaires, accelerometers, and physical function assessments. The feasibility of the DPSA was assessed using retention and adherence rates. Physical activity was assessed using accelerometers to measure the daily step count, light intensity physical activity, moderate to vigorous intensity physical activity (MVPA), and sedentary behavior. Physical function was assessed using grip strength and the 30-second chair-stand test. RESULTS The participants in the intervention group were more frequent users of apps, were more familiar with information and communication technology, and had a higher baseline physical activity level. The retention and adherence rates for the DPSA intervention were 88% (36/41) and 87.7%, respectively, indicating good feasibility. Participants in the intervention group increased their step count by at least 1000 steps and their MVPA by at least 10 minutes using the DPSA. There was a significant difference in the interaction between groups and intervention time points in the daily step count and MVPA (step count, P=.04; duration of MVPA, P=.02). The DPSA increased physical activity, especially in older adults with low baseline physical activity levels. CONCLUSIONS The feasibility of DPSA was found to be good, with the intervention group showing increases in daily steps and MVPA. The effects of DPSA on step count, physical activity, and physical function in older adults with low baseline physical activity should be investigated using randomized controlled trials.
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Affiliation(s)
- Kento Tabira
- Graduate School of Health Management, Keio University, Kanagawa, Japan
- Sports Medicine Research Center, Keio University, Kanagawa, Japan
| | - Yuko Oguma
- Graduate School of Health Management, Keio University, Kanagawa, Japan
- Sports Medicine Research Center, Keio University, Kanagawa, Japan
| | - Shota Yoshihara
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
- A10 Lab Inc, Tokyo, Japan
| | | | - Manabu Nakamura
- Graduate School of Health Management, Keio University, Kanagawa, Japan
- Sports Medicine Research Center, Keio University, Kanagawa, Japan
| | - Natsue Doihara
- Sports Medicine Research Center, Keio University, Kanagawa, Japan
| | - Akihiro Hirata
- Graduate School of Health Management, Keio University, Kanagawa, Japan
- Sports Medicine Research Center, Keio University, Kanagawa, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Tomoki Manabe
- Graduate School of Health Management, Keio University, Kanagawa, Japan
- Sports Medicine Research Center, Keio University, Kanagawa, Japan
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Sañudo B, Sanchez-Trigo H, Domínguez R, Flores-Aguilar G, Sánchez-Oliver A, Moral JE, Oviedo-Caro MÁ. A randomized controlled mHealth trial that evaluates social comparison-oriented gamification to improve physical activity, sleep quantity, and quality of life in young adults. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 72:102590. [PMID: 38218327 DOI: 10.1016/j.psychsport.2024.102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 12/05/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
INTRODUCTION The integration of gamification in mHealth interventions presents a novel approach to enhance user engagement and health outcomes. This study aims to evaluate whether comparison-oriented gamification can effectively improve various aspects of health and well-being, including physical activity, sedentary behavior, sleep, and overall quality of life among young adults. METHODS Potential 107 young adults (from 19 to 28 years old) participated in an 8-week trial. Participants were assigned to either a gamified mHealth intervention (LevantApp) with daily leaderboards and progress bars (n = 53, 26 % dropped-out), or a control condition without gamification (n = 52, 29 % dropped-out). Physical activity (number of steps, moderate and moderate-to-vigorous physical activity -MVPA-) and sleep quantity were measured objectively via accelerometry and subjectively using the International Physical Activity Questionnaire(IPAQ), Pittsburgh Sleep Quality Index(PSQI), Sedentary Behavior Questionnaire(SBQ), and Short Form Health Survey(SF-36). RESULTS This mHealth intervention with social comparison-oriented gamification significantly improved moderate physical activity to a greater extent than the control group. Additionally, the intervention group showed improvements in the number of steps, moderate physical activity, sedentary time, emotional wellbeing, and social functioning. However, no significant group by time interaction was observed. No significant differences were observed in sleep quality or quantity. CONCLUSION s: The LevantApp gamified mHealth intervention was effective in improving moderate physical activity, physical functioning, and role-emotional in young adults. No significant effects were found on step counts, MVPA or sleep, suggesting that while gamification can enhance specific aspects of physical activity and quality of life, its impact may vary across different outcomes.
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Affiliation(s)
- Borja Sañudo
- Physical Education and Sports Department, University of Seville, 41013, Seville, Spain
| | - Horacio Sanchez-Trigo
- Physical Education and Sports Department, University of Seville, 41013, Seville, Spain.
| | - Raúl Domínguez
- Departamento de Motricidad Humana y Rendimiento deportivo, University of Seville, 41013, Seville, Spain
| | | | - Antonio Sánchez-Oliver
- Departamento de Motricidad Humana y Rendimiento deportivo, University of Seville, 41013, Seville, Spain
| | - José E Moral
- Physical Education and Sports Department, University of Seville, 41013, Seville, Spain
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He Z, Hassan MA, Saiz-González P, Ryu S, Wang R, Gao Z. Smartphone app-based interventions on physical activity behaviors and psychological correlates in healthy young adults: A systematic review. PLoS One 2024; 19:e0301088. [PMID: 38578729 PMCID: PMC10997080 DOI: 10.1371/journal.pone.0301088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 03/09/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The issue of low physical activity (PA) levels among the youth is a longstanding concern. Smartphone applications offer a promising avenue for delivering interventions that are both accessible and engaging. Up to now, there appears to be a gap in the literature, with no systematic reviews assessing the efficacy of smartphone apps in encouraging increased physical activity among healthy young adults. OBJECTIVE To synthesize the effects of a smartphone app-based intervention on PA and PA-related psychological correlates in healthy young adults (18-35 years old). METHODS A search was conducted on eighteen databases: PubMed, Medline, Web of Science, SPORTDiscus, Scopus, Academic Search Premier, Communication and Mass Media Complete, Article First, Biomed Central, BioOne, EBSCOHost, JSTOR, ProQuest, SAGE Reference Online, ScienceDirect, SpringerLink, Taylor&Francis, and Wiley Online. The search covered the period up until December 2023. This research included all randomized controlled trials (RCTs) that evaluated the effectiveness of smartphone app-based interventions on PA and PA related psychological outcomes in healthy young adults. The overall impact was determined by vote counting based on the direction of effect and aggregating p values. The quality of the evidence was evaluated using an 8-item scale. This study has been registered in the PROSPERO database with the identification number CRD42023390033. RESULTS A total of 8403 articles were retrieved, and based on the predefined inclusion and exclusion criteria, seven articles were selected for inclusion. Among these articles, four high-quality RCTs were identified, and the results of vote counting and combining p values methods suggested that smartphone-based app interventions did not demonstrate significant effectiveness in improving PA and PA-related psychological outcomes. However, some improvements were observed. The analysis results, which were categorized into fitness apps and health apps based on the characteristics of the interventions, also failed to demonstrate significant intervention effects. CONCLUSION The findings indicate that, currently, there are no significant effects of smartphone app interventions on improving PA and PA-related psychological outcomes in healthy young adults aged 18-35 years. It is important to note that these findings should be interpreted with caution due to the limited number of included studies. Future research should focus on employing high-quality study designs to determine the true effects of interventions and analyze various smartphone app interventions. These analyses should encompass different app characteristics (e.g., fitness app and health app), various combinations (e.g., fitness app alone and fitness app in combination with other interventions), diverse intervention goals (e.g., PA and PA along with other outcomes), and multiple intervention characteristics (e.g., frequency and duration).
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Affiliation(s)
- Zihao He
- School of Sport Science, Beijing Sport University, Haidian, Beijing, China
| | - Mohamed A. Hassan
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, Minnesota, United States of America
- Department of Methods and Curriculum, Physical Education College for Men, Helwan University, Cairo, Egypt
| | - Pablo Saiz-González
- Faculty of Teacher Training and Education, University of Oviedo, Asturias, Spain
| | - Suryeon Ryu
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, Minnesota, United States of America
| | - Ronghui Wang
- School of Sport Science, Beijing Sport University, Haidian, Beijing, China
| | - Zan Gao
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Tennessee, United States of America
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Große J, Huppertz C, Röh A, Oertel V, Andresen S, Schade N, Goerke-Arndt F, Kastinger A, Schoofs N, Thomann PA, Henkel K, Malchow B, Plag J, Terziska A, Brand R, Helmig F, Schorb A, Wedekind D, Jockers-Scherübl M, Schneider F, Petzold MB, Ströhle A. Step away from depression-results from a multicenter randomized clinical trial with a pedometer intervention during and after inpatient treatment of depression. Eur Arch Psychiatry Clin Neurosci 2024; 274:709-721. [PMID: 37589727 PMCID: PMC10995038 DOI: 10.1007/s00406-023-01646-2] [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: 03/14/2023] [Accepted: 07/07/2023] [Indexed: 08/18/2023]
Abstract
Evidence for the effectiveness of physical activity (PA) in the treatment of depression prevails for outpatients with mild and moderate symptom levels. For inpatient treatment of severe depression, evidence-based effectiveness exists only for structured and supervised group PA interventions. The Step Away from Depression (SAD) study investigated the effectiveness of an individual pedometer intervention (PI) combined with an activity diary added to inpatient treatment as usual (TAU). In this multicenter randomized controlled trial, 192 patients were randomized to TAU or TAU plus PI. The two primary outcomes at discharge were depression-blindly rated with the Montgomery-Åsberg Depression Rating Scale (MADRS)-and average number of daily steps measured by accelerometers. Secondary outcomes were self-rated depression and PA, anxiety, remission and response rates. Multivariate analysis of variance (MANOVA) revealed no significant difference between both groups for depression and daily steps. Mean MADRS scores at baseline were 29.5 (SD = 8.3) for PI + TAU and 28.8 (SD = 8.1) for TAU and 16.4 (SD = 10.3) and 17.2 (SD = 9.9) at discharge, respectively. Daily steps rose from 6285 (SD = 2321) for PI + TAU and 6182 (SD = 2290) for TAU to 7248 (SD = 2939) and 7325 (SD = 3357). No differences emerged between groups in secondary outcomes. For severely depressed inpatients, a PI without supervision or further psychological interventions is not effective. Monitoring, social reinforcement and motivational strategies should be incorporated in PA interventions for this population to reach effectiveness.
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Affiliation(s)
- Julia Große
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
| | - Charlotte Huppertz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Astrid Röh
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Viola Oertel
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Frankfurt/Main, Frankfurt am Main, Germany
| | - Sara Andresen
- Fachklinik für Psychiatrie, Psychosomatik und Psychotherapie Flensburg der DIAKO NF, Flensburg, Germany
| | - Niklas Schade
- Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Franziska Goerke-Arndt
- Department of Psychiatry and Psychotherapy, Oberhavel Kliniken GmbH, Hennigsdorf, Germany
| | - Anna Kastinger
- Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Paracelsus Medical University, Salzburg, Austria
| | - Nikola Schoofs
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | | | - Karsten Henkel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
| | - Jens Plag
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Aleksandra Terziska
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Ralf Brand
- Sport and Exercise Psychology, University of Potsdam, Potsdam, Germany
| | - Frank Helmig
- Fachklinik für Psychiatrie, Psychosomatik und Psychotherapie Flensburg der DIAKO NF, Flensburg, Germany
| | - Alexander Schorb
- Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Paracelsus Medical University, Salzburg, Austria
| | - Dirk Wedekind
- Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
| | - Maria Jockers-Scherübl
- Department of Psychiatry and Psychotherapy, Oberhavel Kliniken GmbH, Hennigsdorf, Germany
| | - Frank Schneider
- University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Moritz Bruno Petzold
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Psychology, Medical School Berlin, Berlin, Germany
| | - Andreas Ströhle
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Flores Aniotz A, Reyes-Molina D, Cigarroa I, García-Merino S, Rubio Alonso M, Pérez Ruiz M, Zapata-Lamana R. Effect of Physical Exercise Programs Based on Mobile Health and Ecological Momentary Assessment on the Physical and Mental Health, Cognitive Functions, and Social Environment of Adults in Developing Countries: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:578. [PMID: 38674224 PMCID: PMC11052404 DOI: 10.3390/medicina60040578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Although there is strong evidence of the positive effects of physical exercise on health, adherence to face-to-face exercise programs in the adult population is low, identifying several barriers that hinder their practice. There is research that demonstrates the viability of physical exercise programs with the use of Mobile Health in Ecological Momentary Assessment (EMA) mode, which contributes to overcoming many reported barriers. To synthesize the methodological characteristics and health effects of physical exercise programs based on mobile health in EMA modality in adults in developing countries. Materials and Methods: This systematic review was conducted according to guidelines established by the PRISMA statement in APA PsycArticles and CINAHL databases by EBSCOhost, Cochrane Library, PubMed, and Web of Science for articles published between 2008 and March 2024. Results: Telephone counseling on clinical-behavioral factors is believed to reduce morbidity and mortality in developed countries, but this aspect is not explored in developing countries. We included nine randomized controlled trials with a total of 4394 male and female participants aged 18 to 60 years. The interventions were mainly carried out by text messages, lasting between 20 to 80 min per session, 3 to 5 days per week, and most were carried out over 12 months. The interventions on the variables of physical activity, nutrition, and medical assessments showed significant effects, and variables such as quality of life and anthropometric measurements were not significant in most studies. Conclusions: This systematic review included studies from different developing countries, the most common diseases being diabetes, overweight, obesity, and hypertension. All the studies used mobile devices as the technology, finding a profile of the adults studied, as well as the characteristics of exercise programs based on mobile health in EMA modality.
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Affiliation(s)
- Alejandro Flores Aniotz
- Programa Vida Saludable, Universidad de Talca, Talca 3460000, Chile;
- Facultad de Ciencias de la Actividad Física y el Deporte y Fisioterapia, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Daniel Reyes-Molina
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile;
- Facultad de Ciencias Sociales, Universidad de Concepción, Concepción 4070386, Chile
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica Silva Henríquez, Santiago 8240000, Chile
- Facultad de Ciencias de la Salud, Universidad Arturo Prat, Victoria 4720000, Chile
| | - Sonia García-Merino
- Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, 28223 Pozuelo, Spain;
| | - Margarita Rubio Alonso
- Departamento de Medicina, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, 28670 Madrid, Spain;
| | - Margarita Pérez Ruiz
- Departamento Salud y Rendimiento Humano, Facultad de Ciencias de la Actividad Física y el Deporte Universidad Politécnica, C. de Martín Fierro, 7, Moncloa-Aravaca, 28040 Madrid, Spain;
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13
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Bonn SE, Hummel M, Peveri G, Eke H, Alexandrou C, Bellocco R, Löf M, Trolle Lagerros Y. Effectiveness of a Smartphone App to Promote Physical Activity Among Persons With Type 2 Diabetes: Randomized Controlled Trial. Interact J Med Res 2024; 13:e53054. [PMID: 38512333 PMCID: PMC10995783 DOI: 10.2196/53054] [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: 09/26/2023] [Revised: 12/22/2023] [Accepted: 02/07/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Physical activity is well known to have beneficial effects on glycemic control and to reduce risk factors for cardiovascular disease in persons with type 2 diabetes. Yet, successful implementation of lifestyle interventions targeting physical activity in primary care has shown to be difficult. Smartphone apps may provide useful tools to support physical activity. The DiaCert app was specifically designed for integration into primary care and is an automated mobile health (mHealth) solution promoting daily walking. OBJECTIVE This study aimed to investigate the effect of a 3-month-long intervention promoting physical activity through the use of the DiaCert app among persons with type 2 diabetes in Sweden. Our primary objective was to assess the effect on moderate to vigorous physical activity (MVPA) at 3 months of follow-up. Our secondary objective was to assess the effect on MVPA at 6 months of follow-up and on BMI, waist circumference, hemoglobin A1c, blood lipids, and blood pressure at 3 and 6 months of follow-up. METHODS We recruited men and women with type 2 diabetes from 5 primary health care centers and 1 specialized center. Participants were randomized 1:1 to the intervention or control group. The intervention group was administered standard care and access to the DiaCert app at baseline and 3 months onward. The control group received standard care only. Outcomes of objectively measured physical activity using accelerometers, BMI, waist circumference, biomarkers, and blood pressure were assessed at baseline and follow-ups. Linear mixed models were used to assess differences in outcomes between the groups. RESULTS A total of 181 study participants, 65.7% (119/181) men and 34.3% (62/181) women, were recruited into the study and randomized to the intervention (n=93) or control group (n=88). The participants' mean age and BMI were 60.0 (SD 11.4) years and 30.4 (SD 5.3) kg/m2, respectively. We found no significant effect of the intervention (group by time interaction) on MVPA at either the 3-month (β=1.51, 95% CI -5.53 to 8.55) or the 6-month (β=-3.53, 95% CI -10.97 to 3.92) follow-up. We found no effect on any of the secondary outcomes at follow-ups, except for a significant effect on BMI at 6 months (β=0.52, 95% CI 0.20 to 0.84). However, mean BMI did not differ between the groups at the 6-month follow-up. CONCLUSIONS We found no evidence that persons with type 2 diabetes being randomized to use an app promoting daily walking increased their levels of MVPA at 3 or 6 months' follow-up compared with controls receiving standard care. The effect of the app on BMI was unclear, and we found nothing to support an effect on secondary outcomes. Further research is needed to determine what type of mHealth intervention could be effective to increase physical activity among persons with type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT03053336; https://clinicaltrials.gov/study/NCT03053336.
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Affiliation(s)
- Stephanie E Bonn
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Madeleine Hummel
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Giulia Peveri
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Helén Eke
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Christina Alexandrou
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Rino Bellocco
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
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14
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Tong HL, Alnasser A, Alshahrani NZ, Bawaked RA, AlAhmed R, Alsukait RF, Rakic S, Cetinkaya V, Al-Hazzaa HM, Alqahtani SA. The Use of Mobile Technologies to Promote Physical Activity and Reduce Sedentary Behaviors in the Middle East and North Africa Region: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e53651. [PMID: 38502160 PMCID: PMC10988381 DOI: 10.2196/53651] [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: 10/13/2023] [Revised: 12/01/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The Middle East and North Africa (MENA) region faces unique challenges in promoting physical activity and reducing sedentary behaviors, as the prevalence of insufficient physical activity is higher than the global average. Mobile technologies present a promising approach to delivering behavioral interventions; however, little is known about the effectiveness and user perspectives on these technologies in the MENA region. OBJECTIVE This study aims to evaluate the effectiveness of mobile interventions targeting physical activity and sedentary behaviors in the MENA region and explore users' perspectives on these interventions as well as any other outcomes that might influence users' adoption and use of mobile technologies (eg, appropriateness and cultural fit). METHODS A systematic search of 5 databases (MEDLINE, Embase, CINAHL, Scopus, and Global Index Medicus) was performed. Any primary studies (participants of all ages regardless of medical condition) conducted in the MENA region that investigated the use of mobile technologies and reported any measures of physical activity, sedentary behaviors, or user perceptions were included. We conducted a narrative synthesis of all studies and a meta-analysis of randomized controlled trials (RCTs). The Cochrane risk-of-bias tool was used to assess the quality of the included RCTs; quality assessment of the rest of the included studies was completed using the relevant Joanna Briggs Institute critical appraisal tools. RESULTS In total, 27 articles describing 22 interventions (n=10, 37% RCTs) and 4 (15%) nonexperimental studies were included (n=6141, 46% women). Half (11/22, 50%) of the interventions included mobile apps, whereas the other half examined SMS. The main app functions were goal setting and self-monitoring of activity, whereas SMS interventions were primarily used to deliver educational content. Users in experimental studies described several benefits of the interventions (eg, gaining knowledge and receiving reminders to be active). Engagement with the interventions was poorly reported; few studies (8/27, 30%) examined users' perspectives on the appropriateness or cultural fit of the interventions. Nonexperimental studies examined users' perspectives on mobile apps and fitness trackers, reporting several barriers to their use, such as perceived lack of usefulness, loss of interest, and technical issues. The meta-analysis of RCTs showed a positive effect of mobile interventions on physical activity outcomes (standardized mean difference=0.45, 95% CI 0.17-0.73); several sensitivity analyses showed similar results. The trim-and-fill method showed possible publication bias. Only 20% (2/10) of the RCTs measured sedentary behaviors; both reported positive changes. CONCLUSIONS The use of mobile interventions for physical activity and sedentary behaviors in the MENA region is in its early stages, with preliminary evidence of effectiveness. Policy makers and researchers should invest in high-quality studies to evaluate long-term effectiveness, intervention engagement, and implementation outcomes, which can inform the design of culturally and socially appropriate interventions for countries in the MENA region. TRIAL REGISTRATION PROSPERO CRD42023392699; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392699.
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Affiliation(s)
- Huong Ly Tong
- Cultural and Indigenous Research Centre Australia, Redfern, Australia
- The World Bank Group, Washington, DC, United States
| | - Aroub Alnasser
- Department of Food Science and Nutrition, King Saud University, Riyadh, Saudi Arabia
| | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Rowaedh A Bawaked
- Department of Public Health, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Reem AlAhmed
- Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | | | | | - Hazzaa M Al-Hazzaa
- Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Saleh A Alqahtani
- Organ Transplant Center of Excellence, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- Division of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, United States
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15
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Selles WL, Santos EC, Romero BD, Lunardi AC. Effectiveness of gamified exercise programs on the level of physical activity in adults with chronic diseases: a systematic review. Disabil Rehabil 2024:1-9. [PMID: 38444153 DOI: 10.1080/09638288.2024.2323614] [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: 11/20/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE to assess the effects of supervised and unsupervised gamified exercise programs on physical activity level, sedentary behavior and quality of life in patients with non-communicable chronic diseases. MATERIALS AND METHODS Six database were searched. Methodological quality of included studies, the quality of reporting interventions and the quality of the applications were assessed using the PEDro, TIDieR and MARS, respectively. RESULTS Nine studies were included (n = 974; 60.2 ± 5.7 years). Three of them enrolled individuals with cancer, one with stroke, one with multiple sclerosis, one with COPD, two with Diabetes Mellitus, and one with knee and hip osteoarthritis. Gamification was performed via a smartphone application in three studies (MARS = 13.4 ± 9.75pts, ranging from 10.9 to 16.9pts). The intervention was supervised in six studies. The PEDro and TIDIeR scores were 5.5 ± 1.3 (ranging 0-8pts) and 16.11 ± 3.14 (ranging 10-20pts), respectively. Supervised gamified interventions increased the level of physical activity compared to usual supervised exercises. Quality of life was similar between groups. Unsupervised interventions were similar for all outcomes evaluated. CONCLUSIONS Supervised gamified exercise programs seem to increase the level of physical activity compared to usual exercises in patients with chronic diseases. However, studies with better methodological qualities and subgroup analyzes are needed.
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Affiliation(s)
- William L Selles
- Physical Therapy Programs, Universidade Cidade de São Paulo, Sao Paulo, Brazil
| | - Elinaldo C Santos
- Physical Therapy Programs, Universidade Cidade de São Paulo, Sao Paulo, Brazil
- Department of Biological and Health Sciences, Universidade Federal do Amapá, Macapá, Brazil
| | - Bianka D Romero
- Physical Therapy Programs, Universidade Cidade de São Paulo, Sao Paulo, Brazil
| | - Adriana C Lunardi
- Physical Therapy Programs, Universidade Cidade de São Paulo, Sao Paulo, Brazil
- Department of Physical Therapy of School of Medicine, Universidade de São Paulo, São Paulo, Brazil
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16
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Waki K, Tsurutani Y, Waki H, Enomoto S, Kashiwabara K, Fujiwara A, Orime K, Kinguchi S, Yamauchi T, Hirawa N, Tamura K, Terauchi Y, Nangaku M, Ohe K. Efficacy of StepAdd, a Personalized mHealth Intervention Based on Social Cognitive Theory to Increase Physical Activity Among Patients With Type 2 Diabetes Mellitus: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e53514. [PMID: 38393770 PMCID: PMC10924262 DOI: 10.2196/53514] [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: 10/10/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Increasing physical activity improves glycemic control in patients with type 2 diabetes (T2D). Mobile health (mHealth) interventions have been proven to increase exercise, but engagement often fades with time. As the use of health behavior theory in mHealth design can increase effectiveness, we developed StepAdd, an mHealth intervention based on the constructs of social cognitive theory (SCT). StepAdd improves exercise behavior self-efficacy and self-regulation through the use of goal-setting, barrier-identifying, and barrier-coping strategies, as well as automatic feedback functions. A single-arm pilot study of StepAdd among 33 patients with T2D showed a large increase in step count (mean change of 4714, SD 3638 daily steps or +86.7%), along with strong improvements in BMI (mean change of -0.3 kg/m2) and hemoglobin A1c level (mean change of -0.79 percentage points). OBJECTIVE In this study, we aim to investigate the efficacy and safety of StepAdd, an mHealth exercise support system for patients with T2D, via a large, long, and controlled follow-up to the pilot study. METHODS This is a randomized, open-label, multicenter study targeting 160 patients with T2D from 5 institutions in Japan with a 24-week intervention. The intervention group will record daily step counts, body weight, and blood pressure using the SCT-based mobile app, StepAdd, and receive feedback about these measurements. In addition, they will set weekly step count goals, identify personal barriers to walking, and define strategies to overcome these barriers. The control group will record daily step counts, body weight, and blood pressure using a non-SCT-based placebo app. Both groups will receive monthly consultations with a physician who will advise patients regarding lifestyle modifications and use of the app. The 24-week intervention period will be followed by a 12-week observational period to investigate the sustainability of the intervention's effects. The primary outcome is between-group difference in the change in hemoglobin A1c values at 24 weeks. The secondary outcomes include other health measures, measurements of steps, measurements of other behavior changes, and assessments of app use. The trial began in January 2023 and is intended to be completed in December 2025. RESULTS As of September 5, 2023, we had recruited 44 patients. We expect the trial to be completed by October 8, 2025, with the follow-up observation period being completed by December 31, 2025. CONCLUSIONS This trial will provide important evidence about the efficacy of an SCT-based mHealth intervention in improving physical activities and glycemic control in patients with T2D. If this study proves the intervention to be effective and safe, it could be a key step toward the integration of mHealth as part of the standard treatment received by patients with T2D in Japan. TRIAL REGISTRATION Japan Registry of Clinical Trials (JRCT) jRCT2032220603; https://rctportal.niph.go.jp/en/detail?trial_id=jRCT2032220603. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53514.
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Affiliation(s)
- Kayo Waki
- Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuya Tsurutani
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama, Japan
| | - Hironori Waki
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, Akita, Japan
| | - Syunpei Enomoto
- Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan
| | - Kosuke Kashiwabara
- Data Science Office, Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Akira Fujiwara
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazuki Orime
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama, Japan
| | - Sho Kinguchi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhito Hirawa
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasuo Terauchi
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Ohe
- Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan
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Elfghi M, Dunne D, Jones J, Gibson I, Flaherty G, McEvoy JW, Sultan S, Jordan F, Tawfick W. Mobile health technologies to improve walking distance in people with intermittent claudication. Cochrane Database Syst Rev 2024; 2:CD014717. [PMID: 38353263 PMCID: PMC10865447 DOI: 10.1002/14651858.cd014717.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BACKGROUND Peripheral arterial disease (PAD) is the obstruction or narrowing of the large arteries of the lower limbs, which can result in impaired oxygen supply to the muscle and other tissues during exercise, or even at rest in more severe cases. PAD is classified into five categories (Fontaine classification). It may be asymptomatic or various levels of claudication pain may be present; at a later stage, there may be ulceration or gangrene of the limb, with amputation occasionally being required. About 20% of people with PAD suffer from intermittent claudication (IC), which is muscular discomfort in the lower extremities induced by exertion and relieved by rest within 10 minutes; IC causes restriction of movement in daily life. Treatment for people with IC involves addressing lifestyle risk factors. Exercise is an important part of treatment, but supervised exercise programmes for individuals with IC have low engagement levels and high attrition rates. The use of mobile technologies has been suggested as a new way to engage people with IC in walking exercise interventions. The novelty of the intervention, low cost for the user, automation, and ease of access are some of the advantages mobile health (mhealth) technologies provide that give them the potential to be effective in boosting physical activity in adults. OBJECTIVES To assess the benefits and harms of mobile health (mhealth) technologies to improve walking distance in people with intermittent claudication. SEARCH METHODS The Cochrane Vascular Information Specialist conducted systematic searches of the Cochrane Vascular Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and CINAHL, and also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov. The most recent searches were carried out on 19 December 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) in people aged 18 years or over with symptomatic PAD and a clinical diagnosis of IC. We included RCTs comparing mhealth interventions to improve walking distance versus usual care (no intervention or non-exercise advice), exercise advice, or supervised exercise programmes. We excluded people with chronic limb-threatening ischaemia (Fontaine III and IV). DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were change in absolute walking distance from baseline, change in claudication distance from baseline, amputation-free survival, revascularisation-free survival. Our secondary outcomes were major adverse cardiovascular events, major adverse limb events, above-ankle amputation, quality of life, and adverse events. We used GRADE to assess the certainty of the evidence. MAIN RESULTS We included four RCTs involving a total of 614 participants with a clinical diagnosis of IC. The duration of intervention of the four included RCTs ranged from 3 to 12 months. Participants were randomised to either mhealth or control (usual care or supervised exercise programme). All four studies had an unclear or high risk of bias in one or several domains. The most prevalent risk of bias was in the area of performance bias, which was rated high risk as it is not possible to blind participants and personnel in this type of trial. Based on GRADE criteria, we downgraded the certainty of the evidence to low, due to concerns about risk of bias, imprecision, and clinical inconsistency. Comparing mhealth with usual care, there was no clear evidence of an effect on absolute walking distance (mean difference 9.99 metres, 95% confidence interval (CI) -27.96 to 47.93; 2 studies, 503 participants; low-certainty evidence). None of the included studies reported on change in claudication walking distance, amputation-free survival, or revascularisation-free survival. Only one study reported on major adverse cardiovascular events (MACE) and found no clear difference between groups (risk ratio 1.37, 95% CI 0.07 to 28.17; 1 study, 305 participants; low-certainty evidence). None of the included studies reported on major adverse limb events (MALE) or above-ankle amputations. AUTHORS' CONCLUSIONS Mobile health technologies can be used to provide lifestyle interventions for people with chronic conditions, such as IC. We identified a limited number of studies that met our inclusion criteria. We found no clear difference between mhealth and usual care in improving absolute walking distance in people with IC; however, we judged the evidence to be low certainty. Larger, well-designed RCTs are needed to provide adequate statistical power to reliably evaluate the effects of mhealth technologies on walking distance in people with IC.
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Affiliation(s)
- Marah Elfghi
- School of Medicine, University of Galway, Galway, Ireland
| | - Denise Dunne
- National Institute for Prevention and Cardiovascular Health, Croí Heart and Stroke Centre, Newcastle, Galway, Ireland
- Croí Heart and Stroke Centre, Newcastle, Galway, Ireland
| | - Jennifer Jones
- Croí, The West of Ireland Cardiac Foundation, Galway, Ireland
| | - Irene Gibson
- Croí, The West of Ireland Cardiac Foundation, Galway, Ireland
| | | | | | - Sherif Sultan
- Vascular Surgery, Galway University Hospital, Galway, Ireland
| | - Fionnuala Jordan
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Wael Tawfick
- Department of Vascular and Endovascular Surgery, Western Vascular Institute, University College Hospital, Galway, Ireland
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Dehainault M, Gaillard O, Ouattara B, Peurois M, Begue C. Physical activity advice given by French general practitioners for low back pain and the role of digital e-health applications: a qualitative study. BMC PRIMARY CARE 2024; 25:44. [PMID: 38287271 PMCID: PMC10823670 DOI: 10.1186/s12875-024-02284-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/21/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Low back pain is the fourth most common reason for consulting a general practitioner (GP) among people aged 40-50 years. Beyond the overall benefits of physical activity (PA) on health (psychological, cardiovascular, etc.), PA for low back pain seems to improve the prognosis in terms of pain, disability, and quality of life. The French National Health Insurance developed media campaigns to promote physical activity with low back pain and a smartphone application (app). Despite the known benefits and campaigns, GPs do not routinely provide advice about physical activity during low back pain consultations. To promote giving physical activity advice for low back pain, there is a need to understand how GPs currently provide this advice and whether technology could help. This study aims to explore the content of physical activity advice for low back pain that GPs provide in France, and their opinion about healthcare smartphone app provided electronically via the internet (e-health apps) as a support for this advice. METHODS This qualitative study was conducted with semi-structured individual interviews among French GPs. The verbatim was double coded using a coding tree. Thematic analysis was performed using an inductive approach. RESULTS Sixteen GPs from Maine et Loire, Sarthe, and Mayenne were included. The thematic analysis identified the following themes: GPs use a global patient-centred approach to physical activity advice for low back pain. The main goal is to enable patients to participate in their care. Advice was almost always general with little information about duration and frequency. The importance of patient-appropriate and easily achievable activities was emphasised. GPs referred patients to physiotherapists to reinforce regular physical activity, maintain motivation and improve patient adherence through supervision and follow-up. GPs knew little about e-health apps but felt they could be useful with young patients. The main barriers to their use included poor internet connection, lack of technical knowledge and no supervision meaning patients could injure themselves. CONCLUSIONS This is one of the first studies to assess the contents of physical activity advice GPs provide for low back pain. Further research is needed into the implementation of e-health apps for low back pain management. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Marion Dehainault
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France.
| | - Olivia Gaillard
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France
| | - Bintou Ouattara
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France
| | - Matthieu Peurois
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France
- Univ Angers, CHU Angers, Univ Rennes, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Inserm, Angers, F- 49000, France
| | - Cyril Begue
- Faculty of Health, General Practice Department, University of Angers, Angers, F-49000, France
- Univ Angers, CHU Angers, Univ Rennes, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Inserm, Angers, F- 49000, France
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19
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Symons M, Vandebosch H, Poels K. Boosts for walking: how humorous messages increase brisk walking among cognitively fatigued individuals. BMC Public Health 2024; 24:128. [PMID: 38195517 PMCID: PMC10775479 DOI: 10.1186/s12889-023-17464-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: 11/21/2022] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND A well-studied internal barrier to regular physical activity, and more specifically brisk walking, is cognitive fatigue. However, thus far little research examined how cognitively fatigued individuals can be motivated to exercise, more specifically to engage in brisk walking. This study investigates whether humorous intervention messages might be an effective strategy to motivate cognitively fatigued individuals to brisk walk, and through which underlying processes. METHODS An online experiment was performed in which variation in cognitive fatigue was induced through mental arithmetic questions. Afterwards, participants (n = 250) recruited through Prolific, randomly received either humorous or non-humorous intervention messages related to brisk walking. Potential mediators of the relations between physical activity, humour and cognitive fatigue were measured, were self-efficacy, self-control, and motivation. RESULTS First, regression analyses confirmed that cognitive fatigue negatively influences brisk walking intentions and that the perceived humour of the intervention messages moderated this relationship. Second, results showed that self-control and self-efficacy are mediators explaining the relationship between cognitive fatigue and brisk walking intentions. Lastly, this study found that perceived humour of the intervention messages moderated the relationship between cognitive fatigue and self-control, indicating that perceptions of self-control were positively changed after receiving messages that were perceived as humorous compared to messages that were not perceived as humorous, subsequently increasing brisk walking intentions. CONCLUSIONS This study is the first to unravel the underlying relationship between humorous intervention messages and brisk walking intentions through positive changes in perceptions of self-control within a cognitively fatigued sample. Results of this study suggest that existing smartphone applications monitoring and promoting brisk walking should integrate tailored message strategies within their cues to brisk walk by implementing humour as a strategy to motivate users when they are cognitively fatigued.
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Affiliation(s)
- Michelle Symons
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium.
| | - Heidi Vandebosch
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Karolien Poels
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
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Wurhofer D, Neunteufel J, Strumegger EM, Höppchen I, Mayr B, Egger A, Sareban M, Reich B, Neudorfer M, Niebauer J, Smeddinck JD, Kulnik ST. Investigating shared decision-making during the use of a digital health tool for physical activity planning in cardiac rehabilitation. Front Digit Health 2024; 5:1324488. [PMID: 38239278 PMCID: PMC10794499 DOI: 10.3389/fdgth.2023.1324488] [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: 10/19/2023] [Accepted: 12/05/2023] [Indexed: 01/22/2024] Open
Abstract
Background Shared decision making (SDM) between healthcare professionals and persons with CVD can have a positive impact on motivation, adherence, or sustainability regarding long-term goals and integration of cardiovascular disease (CVD) rehabilitation in the everyday lives of persons with CVD. SDM can foster the transition between regular heart-healthy activity at rehabilitation facilities and more independent activity at home, but it is often challenging to implement SDM given limited time and resources, e.g., in the daily practice of rehabilitation. Digital tools can help but must be appropriately tailored for situated use and user needs. Objective We aimed to (1) describe in how far SDM is manifested in the situated context when using a digital tool developed by our group, and, based on that, (2) reflect on how digital health tools can be designed to facilitate and improve the SDM process. Methods In the context of a field study, we investigated how SDM is already naturally applied and manifested when using a digital tool for joint physical activity planning in cardiac rehabilitation in clinical practice. In a two-week qualitative study, we collected data on expectations, experiences and interactions during the use of a digital health tool by seven persons with CVD and five healthcare professionals. Data was collected by means of observations, interviews, questionnaires and a self-reported diary, and analysed with a particular focus on episodes related to SDM. Results We found that SDM was manifested in the situated context to limited extent. For example, we identified high improvement potential for more structured goal-setting and more explicit consideration of preferences and routines. Based on mapping our findings to temporal phases where SDM can be adopted, we highlight implications for design to further support SDM in clinical practice. We consider this as "SDM supportive design in digital health apps," suggesting for example step-by-step guidance to be used during the actual consultation. Conclusion This study contributes to further understanding and integration of SDM in digital health tools with a focus on rehabilitation, to empower and support both persons with CVD and healthcare professionals.
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Affiliation(s)
- Daniela Wurhofer
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Julia Neunteufel
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | | | - Isabel Höppchen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Barbara Mayr
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Andreas Egger
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Mahdi Sareban
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Reich
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Michael Neudorfer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Josef Niebauer
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Jan David Smeddinck
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Stefan Tino Kulnik
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
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Petersen JM, Drummond M, Rasheed K, Elliott S, Drummond C, Smith JA, Wadham B, Prichard I. Promoting mental health among young males in sporting contexts: A systematic review. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102551. [PMID: 37866686 DOI: 10.1016/j.psychsport.2023.102551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/18/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Young males experience markedly poorer mental health outcomes. Organised sport settings provide novel prospects to improve the mental health of this subpopulation. AIM This systematic review aimed to evaluate interventions targeted at the promotion of mental health and wellbeing among young males in organised sporting contexts. METHODS Six databases (SportDiscus, PsycInfo, Medline, Web of Science, Scopus, CINAHL) were searched from inception to June 2022 (and updated in September 2023). Eligible studies examined interventions targeting the mental health and wellbeing (e.g., depression, anxiety, resilience) or mental health literacy (e.g., stigmatising attitudes, help-seeking) of young males aged 10-24 years (or associated stakeholder samples; e.g., parents or coaches of male youth). RESULTS A total of 15 studies were included in this review. Overall, the findings indicate promising effects of sport-based interventions on the mental health and mental health literacy outcomes of young males. CONCLUSIONS This review suggests that there is scope to improve the capacity of sports-based interventions to affect positive change in the mental health of male youth. The findings from this review also have important implications for the development and evaluation of sports-based interventions targeted at young males in future.
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Affiliation(s)
- Jasmine M Petersen
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia; SHAPE Research Centre, Flinders University, Adelaide, South Australia, Australia.
| | - Murray Drummond
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia; SHAPE Research Centre, Flinders University, Adelaide, South Australia, Australia
| | - Kate Rasheed
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia; SHAPE Research Centre, Flinders University, Adelaide, South Australia, Australia
| | - Sam Elliott
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia; SHAPE Research Centre, Flinders University, Adelaide, South Australia, Australia
| | - Claire Drummond
- SHAPE Research Centre, Flinders University, Adelaide, South Australia, Australia; College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - James A Smith
- Rural and Remote Health, College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia
| | - Ben Wadham
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Ivanka Prichard
- SHAPE Research Centre, Flinders University, Adelaide, South Australia, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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22
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Altmannshofer S, Flaucher M, Beierlein M, Eskofier BM, Beckmann MW, Fasching PA, Huebner H. A content-based review of mobile health applications for breast cancer prevention and education: Characteristics, quality and functionality analysis. Digit Health 2024; 10:20552076241234627. [PMID: 38528967 PMCID: PMC10962048 DOI: 10.1177/20552076241234627] [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: 06/13/2023] [Accepted: 01/26/2024] [Indexed: 03/27/2024] Open
Abstract
Objective Mobile Health apps could be a feasible and effective tool to raise awareness for breast cancer prevention and to support women to change their behaviour to a healthier lifestyle. The aim of this study was to analyse the characteristics and quality of apps designed for breast cancer prevention and education. Methods We conducted a systematic search for apps covering breast cancer prevention topics in the Google Play and Apple App Store accessible from Germany using search terms either in German or in English. Only apps with a last update after June 2020 were included. The apps identified were downloaded and evaluated by two independent researchers. App quality was analysed using the Mobile Application Rating Scale (MARS). Associations of app characteristics and MARS rating were analysed. Results We identified 19 apps available in the Google Play Store and seven apps available in the Apple App Store that met all inclusion criteria. The mean MARS score was 3.07 and 3.50, respectively. Functionality was the highest-scoring domain. Operating system, developer (healthcare), download rates and time since the last update were significantly associated with overall MARS score. In addition, the presence of the following app functions significantly influenced MARS rating: breast self-examination tutorial, reminder for self-examination, documentation feature and education about breast cancer risk factors. Conclusions Although most of the apps offer important features for breast cancer prevention, none of the analysed apps combined all functions. The absence of healthcare professionals' expertise in developing apps negatively affects the overall quality.
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Affiliation(s)
- Stefanie Altmannshofer
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
| | - Madeleine Flaucher
- Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Milena Beierlein
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
| | - Bjoern M Eskofier
- Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
| | - Hanna Huebner
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
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Chen S, Wu Y, Bushey EL, Pescatello LS. Evaluation of Exercise Mobile Applications for Adults with Cardiovascular Disease Risk Factors. J Cardiovasc Dev Dis 2023; 10:477. [PMID: 38132645 PMCID: PMC10743387 DOI: 10.3390/jcdd10120477] [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: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To conduct a systematic review to determine if there are exercise mobile applications (apps) that can produce evidence-based, individualized exercise plans. MATERIALS AND METHODS We searched the Apple Store and Google Play for exercise apps with terms related to exercise and health. Exercise apps were eligible if they: (1) had a ≥4 out of 5 overall rating with ≥1000 reviews; (2) were free to download; and (3) were not gender specific. Exercise apps were evaluated via the evidence-based exercise prescription (ExRx) standards of the American College of Sports Medicine (ACSM) and American Heart Association. For the exercise app evaluation criteria, an app was included if it (1) was evidence-based; (2) contained a preparticipation health screening protocol; (3) built a cardiovascular disease (CVD) risk factor profile; (4) prioritized one chronic disease or health condition to focus on; (5) framed the exercise plan by the frequency, intensity, time, and type principle (FITT) of ExRx; and (6) specified special considerations. RESULTS Of the 531 potentially qualifying apps, 219 qualified. The qualifying apps were rarely evidenced-based (0.5%) or had a preparticipation screening protocol (3.7%). Only 27.7% built CVD risk factor profiles. Most apps (64.8%) focused on body image and/or athletic performance. Only 4.3% focused on chronic diseases or health conditions, while the remainder (34.5%) did not disclose a focus. No app framed the exercise plans by the FITT of ExRx. Only 1.4% of the apps specified special considerations. CONCLUSION There are no commercially available exercise apps that generate an evidence-based, individualized exercise plan for adults with CVD risk factors.
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Affiliation(s)
- Shiqi Chen
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
- Institute for Collaboration on Health Intervention and Policy, University of Connecticut, Storrs, CT 06269, USA
- Department of Research, Hartford Hospital, Hartford, CT 06102, USA
| | - Erica L. Bushey
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
| | - Linda S. Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
- Institute for Collaboration on Health Intervention and Policy, University of Connecticut, Storrs, CT 06269, USA
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Nurmi J, Knittle K, Naughton F, Sutton S, Ginchev T, Khattak F, Castellano-Tejedor C, Lusilla-Palacios P, Ravaja N, Haukkala A. Biofeedback and Digitalized Motivational Interviewing to Increase Daily Physical Activity: Series of Factorial N-of-1 Randomized Controlled Trials Piloting the Precious App. JMIR Form Res 2023; 7:e34232. [PMID: 37995122 DOI: 10.2196/34232] [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: 10/21/2021] [Revised: 10/06/2022] [Accepted: 05/03/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Insufficient physical activity is a public health concern. New technologies may improve physical activity levels and enable the identification of its predictors with high accuracy. The Precious smartphone app was developed to investigate the effect of specific modular intervention elements on physical activity and examine theory-based predictors within individuals. OBJECTIVE This study pilot-tested a fully automated factorial N-of-1 randomized controlled trial (RCT) with the Precious app and examined whether digitalized motivational interviewing (dMI) and heart rate variability-based biofeedback features increased objectively recorded steps. The secondary aim was to assess whether daily self-efficacy and motivation predicted within-person variability in daily steps. METHODS In total, 15 adults recruited from newspaper advertisements participated in a 40-day factorial N-of-1 RCT. They installed 2 study apps on their phones: one to receive intervention elements and one to collect ecological momentary assessment (EMA) data on self-efficacy, motivation, perceived barriers, pain, and illness. Steps were tracked using Xiaomi Mi Band activity bracelets. The factorial design included seven 2-day biofeedback interventions with a Firstbeat Bodyguard 2 (Firstbeat Technologies Ltd) heart rate variability sensor, seven 2-day dMI interventions, a wash-out day after each intervention, and 11 control days. EMA questions were sent twice per day. The effects of self-efficacy, motivation, and the interventions on subsequent steps were analyzed using within-person dynamic regression models and aggregated data using longitudinal multilevel modeling (level 1: daily observations; level 2: participants). The analyses were adjusted for covariates (ie, within- and between-person perceived barriers, pain or illness, time trends, and recurring events). RESULTS All participants completed the study, and adherence to activity bracelets and EMA measurements was high. The implementation of the factorial design was successful, with the dMI features used, on average, 5.1 (SD 1.0) times of the 7 available interventions. Biofeedback interventions were used, on average, 5.7 (SD 1.4) times out of 7, although 3 participants used this feature a day later than suggested and 1 did not use it at all. Neither within- nor between-person analyses revealed significant intervention effects on step counts. Self-efficacy predicted steps in 27% (4/15) of the participants. Motivation predicted steps in 20% (3/15) of the participants. Aggregated data showed significant group-level effects of day-level self-efficacy (B=0.462; P<.001), motivation (B=0.390; P<.001), and pain or illness (B=-1524; P<.001) on daily steps. CONCLUSIONS The automated factorial N-of-1 trial with the Precious app was mostly feasible and acceptable, especially the automated delivery of the dMI components, whereas self-conducted biofeedback measurements were more difficult to time correctly. The findings suggest that changes in self-efficacy and motivation may have same-day effects on physical activity, but the effects vary across individuals. This study provides recommendations based on the lessons learned on the implementation of factorial N-of-1 RCTs.
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Affiliation(s)
- Johanna Nurmi
- Social Psychology, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Keegan Knittle
- Social Psychology, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Felix Naughton
- Behavioural and Implementation Science Group, School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Stephen Sutton
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Todor Ginchev
- Department of Communications and Networking, Aalto University, Espoo, Finland
| | - Fida Khattak
- Department of Communications and Networking, Aalto University, Espoo, Finland
| | - Carmina Castellano-Tejedor
- Grupo de Investigación en Estrés y Salud, Basic Psychology Department, Autonomous University of Barcelona, Barcelona, Spain
- Research Group on Aging, Frailty and Care Transitions in Barcelona, Parc Sanitari Pere Virgili & Vall d'Hebron Research Institute, Barcelona, Spain
- Psiquiatría, Salud Mental y Adicciones, Vall d'Hebron Institut de Recerca, Barcelona, Spain
| | - Pilar Lusilla-Palacios
- Psiquiatría, Salud Mental y Adicciones, Vall d'Hebron Institut de Recerca, Barcelona, Spain
- Servicio de Psiquiatría, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Niklas Ravaja
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ari Haukkala
- Social Psychology, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
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Eguchi A, Kawamura Y, Kawashima T, Ghaznavi C, Ishimura K, Kohsaka S, Matsuo S, Mizuno S, Sasaki Y, Takahashi A, Tanoue Y, Yoneoka D, Miyata H, Nomura S. The Efficacy of an mHealth App in Facilitating Weight Loss Among Japanese Fitness Center Members: Regression Analysis Study. JMIR Form Res 2023; 7:e48435. [PMID: 37938885 PMCID: PMC10666009 DOI: 10.2196/48435] [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: 04/24/2023] [Revised: 08/09/2023] [Accepted: 08/29/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Self-tracking smartphone apps have emerged as promising tools to encourage healthy behaviors. In this longitudinal study, we used gym use data from members of a major fitness club that operates gyms throughout Japan from January 2014 to December 2019. OBJECTIVE Our objective was to assess the extent to which a health and fitness self-tracking mobile app introduced to gym members on January 1, 2018, contributed to their weight loss. The app allows users to input information regarding diet, sleep, weight, and gym exercise so that they can receive personalized feedback from an artificial intelligence chatbot to improve their health behaviors. METHODS We used linear regression to quantify the association between app use and weight loss. The primary outcome of the study was the weight loss achieved by each gym user, which was calculated as the difference between their initial and final weights in kilograms, as recorded in the app. Individuals who did not attend the gym or failed to use the mobile app at least twice during the study period were excluded from the analysis. The model accounted for age, gender, distance between the gym and the member's residence, average weekly number of times a member used the gym, user's gym membership length in weeks, average weekly number of times a member input information into the app, and the number of weeks that the app was used at least once. RESULTS Data from 26,589 participants were analyzed. Statistically significant associations were detected between weight loss and 2 metrics related to app use: the average weekly frequency of use and the total number of weeks in which the app was used at least once. One input per week was found to be associated with a loss of 62.1 (95% CI 53.8-70.5) g, and 1 week of app use was associated with 21.7 (95% CI 20.5-22.9) g of weight loss from the day of the first input to that of the final input to the app. Furthermore, the average number of times that a member used the gym weekly was also shown to be statistically significantly associated with weight loss: 1 use per week was associated with 255.5 (95% CI 228.5-282.6) g of weight loss. CONCLUSIONS This empirical study demonstrated a significant association between weight loss among gym members and not only the frequency of weekly gym use but also the use of a health and fitness self-tracking app. However, further work is needed to examine the mechanisms through which mobile apps affect health behaviors and to identify the specific app features that are most effective in promoting weight loss.
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Affiliation(s)
- Akifumi Eguchi
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Yumi Kawamura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Takayuki Kawashima
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - Cyrus Ghaznavi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | | | - Shun Kohsaka
- Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan
| | - Satoru Matsuo
- Communication Design Division, RENAISSANCE INC, Tokyo, Japan
| | | | | | - Arata Takahashi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Yuta Tanoue
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Faculty of Marine Technology, Tokyo University of Marine Science and Technology, Tokyo, Japan
| | - Daisuke Yoneoka
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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26
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Jahre LM, Lortz J, Rassaf T, Rammos C, Mallien C, Skoda EM, Teufel M, Bäuerle A. Needs and demands for mHealth cardiac health promotion among individuals with cardiac diseases: a patient-centred design approach. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2023; 4:393-401. [PMID: 37794866 PMCID: PMC10545514 DOI: 10.1093/ehjdh/ztad038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/05/2023] [Indexed: 10/06/2023]
Abstract
Aims Cardiovascular diseases are one of the main contributors to disability and mortality worldwide. Meanwhile, risk factors can be modified by lifestyle changes. mHealth is an innovative and effective way to deliver cardiac health promotion. This study aims to examine the needs and demands regarding the design and contents of an mHealth intervention for cardiac health promotion among individuals with cardiac diseases. Different clusters were determined and analysed in terms of the intention to use an mHealth intervention. Methods and results A cross-sectional study was conducted via a web-based survey. Three hundred and four individuals with coronary artery diseases (CADs) and/or congestive heart failure (CHF) were included in the data analysis. Descriptive statistics were applied to evaluate needs and demands regarding an mHealth intervention. A k-medoids cluster analysis was performed. Individuals with CAD and CHF favoured an mHealth intervention that supports its users permanently and is easily integrated into everyday life. Handheld devices and content formats that involve active user participation and regular updates were preferred. Three clusters were observed and labelled high, moderate, and low burden, according to their psychometric properties. The high burden cluster indicated higher behavioural intention towards use of an mHealth intervention than the other clusters. Conclusion The results of the study are a valuable foundation for the development of an mHealth intervention for cardiac health promotion following a user-centred design approach. Individuals with cardiac diseases report positive attitudes in the form of high usage intention regarding mHealth. Highly burdened individuals report a high intention to use such interventions.
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Affiliation(s)
- Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - Charlotta Mallien
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
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Schootemeijer S, de Vries NM, Macklin EA, Roes KCB, Joosten H, Omberg L, Ascherio A, Schwarzschild MA, Bloem BR. The STEPWISE study: study protocol for a smartphone-based exercise solution for people with Parkinson's Disease (randomized controlled trial). BMC Neurol 2023; 23:323. [PMID: 37700241 PMCID: PMC10496249 DOI: 10.1186/s12883-023-03355-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/02/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Exercise has various health benefits for people with Parkinson's disease (PD). However, implementing exercise into daily life and long-term adherence remain challenging. To increase a sustainable engagement with physical activity of people with PD, interventions that are motivating, accessible, and scalable are needed. We primarily aim to investigate whether a smartphone app (STEPWISE app) can increase physical activity (i.e., step count) in people with PD over one year. Our second aim is to investigate the potential effects of the intervention on physical fitness, and motor- and non-motor function. Our third aim is to explore whether there is a dose-response relationship between volume of physical activity and our secondary endpoints. METHODS STEPWISE is a double-blind, randomized controlled trial. We aim to include 452 Dutch people with PD who can walk independently (Hoehn & Yahr stages 1-3) and who do not take more than 7,000 steps per day prior to inclusion. Physical activity levels are measured as step counts on the participant's own smartphone and scaled as percentage of each participant's baseline. Participants are randomly assigned to an active control group with an increase of 5-20% (active controls) or any of the three intervention arms with increases of 25-100% (intermediate dose), 50-200% (large dose), or 100-400% (very large dose). The primary endpoint is change in step count as measured by the STEPWISE smartphone app from baseline to 52 weeks. For our primary aim, we will evaluate the between-group difference in average daily step count change from baseline to 52 weeks. For our second aim, measures of physical fitness, and motor- and non-motor function are included. For our third aim, we will associate 52-week changes in step count with 52-week changes in secondary outcomes. DISCUSSION This trial evaluates the potential of a smartphone-based intervention to increase activity levels in people with PD. We envision that motivational apps will increase adherence to physical activity recommendations and could permit conduct of remote clinical trials of exercise for people with PD or those at risk of PD. TRIAL REGISTRATION ClinicalTrials.gov; NCT04848077; 19/04/2021. CLINICALTRIALS gov/ct2/show/NCT04848077.
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Affiliation(s)
- Sabine Schootemeijer
- DisordersDonders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nienke M de Vries
- DisordersDonders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Eric A Macklin
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Kit C B Roes
- Department of Health Evidence, Section Biostatistics, Radboud University Medical Center, PO Box 9101, Nijmegen, 6500 HB, the Netherlands
| | - Hilde Joosten
- Department of Sports Medicine, Canisius Wilhelmina Hospital, Burgemeester Daleslaan 27, Nijmegen, 6532 CL, the Netherlands
| | | | - Alberto Ascherio
- Harvard Medical School, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michael A Schwarzschild
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Mass General Institute for Neurodegenerative Disease, Massachusetts General Hospital, Boston, MA, USA
| | - Bastiaan R Bloem
- DisordersDonders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Nijmegen, the Netherlands.
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Abdoli N, Sadeghi-Bahmani D, Salari N, Khodamoradi M, Farnia V, Jahangiri S, Brühl AB, Dürsteler KM, Stanga Z, Brand S. Nomophobia (No Mobile Phone Phobia) and Psychological Health Issues among Young Adult Students. Eur J Investig Health Psychol Educ 2023; 13:1762-1775. [PMID: 37754467 PMCID: PMC10527744 DOI: 10.3390/ejihpe13090128] [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: 08/15/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Smart phone use has become a part of people's everyday life. However, when the lack of using the smart phone to establish and maintain electronic communication is related to psychological distress, such a behavior may be considered a modern-age phobia, or nomophobia (no mobile phone phobia). The aims of the present study were to investigate among a sample of young adults the associations between scores for nomophobia and symptoms of depression, anxiety, stress, insomnia, and obsessive-compulsive disorders. METHODS A total of 537 students (mean age: 25.52 years; 42.3% females) participated in the study. They completed a booklet of self-rating questionnaires covering sociodemographic information and symptoms of nomophobia, depression, anxiety, stress, insomnia, and obsessive-compulsive disorders. RESULTS Higher scores for nomophobia were associated with higher scores for depression, anxiety, and stress, but not with scores for insomnia and obsessive-compulsive disorders. The regression model confirmed that symptoms of anxiety predicted nomophobia. CONCLUSIONS The present results support the assumption that nomophobia appears to be a mood disturbance related to stronger associations with symptoms of anxiety and, to a lesser extent, with symptoms of depression and stress. By contrast, nomophobia appeared to be unrelated to insomnia and symptoms of obsessive-compulsive disorders.
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Affiliation(s)
- Nasrin Abdoli
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
| | - Dena Sadeghi-Bahmani
- Department of Psychology, Stanford University, Stanford, CA 94305, USA;
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA 94305, USA
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran;
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
| | - Mehdi Khodamoradi
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
| | - Somayeh Jahangiri
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disturbances, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
| | - Kenneth M. Dürsteler
- Division of Substance Use Disorders, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
- Department for Psychiatry, Psychotherapy and Psychosomatic, Psychiatric Hospital, University of Zurich, 8001 Zurich, Switzerland
| | - Zeno Stanga
- Centre of Competence for Military and Disaster Medicine, Swiss Armed Forces, 3008 Bern, Switzerland;
| | - Serge Brand
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA 94305, USA
- Center for Affective, Stress and Sleep Disturbances, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise, and Health, Faculty of Medicine, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Teheran 1417466191, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
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Supples MW, McIlwain JS, Snavely AC, Powell SL, Winslow JE, Stopyra JP, Mahler SA. Workplace Health Promotion Programs Available to Emergency Medical Services Clinicians in North Carolina. PREHOSP EMERG CARE 2023; 28:335-341. [PMID: 37669502 DOI: 10.1080/10903127.2023.2256391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Emergency medical services (EMS) clinicians demonstrate a high prevalence of chronic medical conditions that place them at risk for early mortality. Workplace health promotion programs improve health outcomes, but the availably of such programs for EMS clinicians has not been described. We investigate the availability, scope, and participation of workplace health promotion programs available to EMS clinicians in North Carolina (NC). METHODS We administered an electronic survey based on the Centers for Disease Control and Prevention Worksite Health ScoreCard to key representatives of EMS agencies within NC that provide primarily transport-capable 9-1-1 response with ground ambulances. We collected information on agency size, rurality, elements of health promotion programs offered, incentives for participation, and participation rate. We calculated descriptive statistics using frequency and percentage for worksite and health promotion program characteristics. We compared the participation rate for agencies who did and did not incentivize participation using Fisher's exact test. RESULTS Complete responses were received from 69 of 92 agencies (response = 75%) that collectively employ 6679 EMS clinicians [median employees per agency 71 (IQR 50-131)]. Most agencies (88.4%, 61/69) offered at least one element of a worksite health program, but only 13.0% (9/69) offered all elements of a worksite health program. In descending order, the availability of program elements were employee assistance programs (73.9%, 51/69), supportive physical and social environment (66.7%, 46/69), health education (62.3%, 43/69), health risk assessments (52.2%, 36/69), and organization culture of health promotion (20.3%, 14/69). Of agencies with programs, few (11.5%, 7/61) required participation, but most (59.0%, 36/61) offered incentives to participate. Participation rates were <25% among nearly all of the agencies that did not offer incentives, but >50% among most agencies that did offer incentives (p < 0.001). CONCLUSION While most agencies offer at least one element of a worksite health promotion program, few agencies offer all elements and participation rates are low.
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Affiliation(s)
- Michael W Supples
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Joseph S McIlwain
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Anna C Snavely
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Stephen L Powell
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - James E Winslow
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- North Carolina Department of Health and Human Services, Office of Emergency Medical Services, Raleigh, North Carolina, USA
| | - Jason P Stopyra
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Simon A Mahler
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Bonn SE, Hult M, Spetz K, Eke H, Andersson E, Wirén M, Löf M, Trolle Lagerros Y. Effect of a Smartphone Application on Physical Activity and Weight Loss After Bariatric Surgery-Results from a Randomized Controlled Trial. Obes Surg 2023; 33:2841-2850. [PMID: 37500930 PMCID: PMC10435407 DOI: 10.1007/s11695-023-06753-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE Ways to motivate and support patients in being physically active after bariatric surgery are needed. This trial was aimed at evaluating the effect of using a smartphone application targeting physical activity during 12 weeks on moderate-to-vigorous physical activity (MVPA, primary outcome) and secondary outcomes of inactivity, light physical activity (LPA), body mass index (BMI), and percent total weight loss (%TWL) after bariatric surgery. MATERIALS AND METHODS Data from a randomized controlled trial comprising 146 patients (79.5% women) undergoing bariatric surgery was analyzed. Mean age and BMI pre-surgery were 40.9 years and 40.5 kg/m2, respectively. Participants were randomized 1:1 to an intervention or a control group. Physical activity and body weight were objectively measured at baseline pre-surgery and post-surgery follow-ups after 6 weeks (weight only), 18 weeks, 6 months, and 1 year. Linear mixed models were fitted to assess longitudinal differences in outcomes between the groups. RESULTS A significant effect of the intervention (group-by-time interaction 16.2, 95% CI 3.5 to 28.9) was seen for MVPA at 18 weeks; the intervention group had increased their MVPA since baseline, while the control group had decreased their MVPA. The control group had lowered their BMI approximately 1 kg/m2 more than the intervention group at follow-up after 18 weeks and 12 months, yet, mean BMI did not differ between the groups. No intervention effect was seen on inactivity, LPA, or %TWL. CONCLUSION Our results indicate that use of a smartphone application targeting physical activity may have the potential to promote short-term MVPA post bariatric surgery. TRIAL REGISTRATION Clinicaltrials.gov : NCT03480464.
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Affiliation(s)
- Stephanie E Bonn
- Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institutet, Maria Aspmans Gata 30A, SE-171 64, Stockholm, Sweden.
| | - Mari Hult
- Unit of Gastroenterology, Department of Medicine (Huddinge), Karolinska Institutet, Stockholm, Sweden
- Department for Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Spetz
- Department of Surgery, Linköping University, Norrköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Helén Eke
- Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institutet, Maria Aspmans Gata 30A, SE-171 64, Stockholm, Sweden
| | - Ellen Andersson
- Department of Surgery, Linköping University, Norrköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Mikael Wirén
- Department of Surgery, Ersta Hospital, Stockholm, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institutet, Maria Aspmans Gata 30A, SE-171 64, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm, Sweden
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Sze WT, Waki K, Enomoto S, Nagata Y, Nangaku M, Yamauchi T, Ohe K. StepAdd: A personalized mHealth intervention based on social cognitive theory to increase physical activity among type 2 diabetes patients. J Biomed Inform 2023; 145:104481. [PMID: 37648101 DOI: 10.1016/j.jbi.2023.104481] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Investigate the preliminary efficacy and feasibility of a personalized mobile health (mHealth) intervention based on social cognitive theory (SCT) to promote physical activity among type 2 diabetes patients via self-monitoring, goal setting, and automatic feedback. METHODS We conducted a pilot study involving 33 type 2 diabetes patients attending Mitsui Memorial Hospital in Japan using a pre-post evaluation design over 12 weeks. Participants measured daily step count, body weight, and blood pressure at home, with the measurements synchronized with the StepAdd application (app) automatically. Participants used the app to review daily results, update personalized step goals, identify individualized barriers to achieving the step goals, find coping strategies to overcome each barrier, and implement these strategies, thereby building effective coping skills to meet the goals. Pharmacists examined the usage of the app and provided coaching on lifestyle modifications. Ultimately, patients established skills to enhance diabetes self-care by using the app. RESULTS Daily step count increased dramatically with high statistical significance (p < 0.0001), from a mean of 5436 steps/day to 10,150 steps/day, an 86.7 % increase. HbA1c (p = 0.0001) and BMI (p = 0.0038) also improved. Diabetes self-care in diet, exercise, and foot care as well as self-management behavior, self-regulation, and self-efficacy in achieving daily step goals showed significant improvements. The retention rate of the study was very high, at 97.0 % (n = 32). CONCLUSIONS A personalized smartphone-based mHealth intervention based on SCT is feasible and effective at promoting physical activity among type 2 diabetes patients. The methodology of the intervention could be readily applied to other patient populations.
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Affiliation(s)
- Wei Thing Sze
- Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan
| | - Kayo Waki
- Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan; Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Syunpei Enomoto
- Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuuki Nagata
- Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Ohe
- Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan
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Huang CF, Chou FH, Chang CH, Guo SE. The Associations of Body Mass Index, Body Image, Perceived Stress, and Mental Health among Female Nursing Students: A Cross-Sectional Study in Taiwan. Healthcare (Basel) 2023; 11:2426. [PMID: 37685460 PMCID: PMC10487090 DOI: 10.3390/healthcare11172426] [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: 07/08/2023] [Revised: 08/19/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Maintaining a healthy caloric intake and expenditure balance is challenging. The preliminary study examined (a) the associations of Body Mass Index (BMI), body image, perceived stress, mental health, dietary habits, and exercise participation among 310 female college nursing students and (b) the differences in these factors among BMI subgroups. The cutoffs for underweight, normal weight, overweight, and obesity were <18.5 kg/m2, ≥18.5 but <23 kg/m2, ≥23 but <25 kg/m2, and ≥25 kg/m2, respectively. The survey used Multidimensional Body-Self Relations Questionnaire-Appearance Scale, Perceived Stress Scale, and Chinese Health Questionnaire (CHQ). Because of a non-normal distribution, non-parametric statistics were used. The study found that BMI correlated with body image. The lower the BMI, the higher the satisfactory score the participants rated. BMI was irrelated to diet, exercise, stress, and mental health. The participants were unlikely to eat under stress and negative moods. The underweight group (17.1%) had the highest satisfactory score on their appearance evaluation. There was no difference between the overweight (14.2%) and obese (11.0%) groups. Meanwhile, the median of perceived stress was 18 and the prevalence of mental disturbance was 45.2% based on the CHQ. Underweight, overweight, obesity, high perceived stress, and poor mental health among nursing students warrant attention. Nurse educators should strengthen their coping strategies and provide support. A longitudinal study may consider incorporating coping strategies into the study design.
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Affiliation(s)
- Ching-Feng Huang
- Department of Nursing, Chiayi Campus, Chang Gung University of Science and Technology, Chiayi County 613016, Taiwan; (C.-F.H.); (C.-H.C.)
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung City 807378, Taiwan
| | - Chia-Hao Chang
- Department of Nursing, Chiayi Campus, Chang Gung University of Science and Technology, Chiayi County 613016, Taiwan; (C.-F.H.); (C.-H.C.)
| | - Su-Er Guo
- Department of Nursing, Chronic Diseases and Health Promotion Research Center, Chiayi Campus, Chang Gung University of Science and Technology, Chiayi County 613016, Taiwan;
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Michalsen H, Henriksen A, Pettersen G, Hartvigsen G, Wangberg S, Thrane G, Jahnsen R, Anke A. Using mobile health to encourage physical activity in individuals with intellectual disability: a pilot mixed methods feasibility study. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1225641. [PMID: 37691911 PMCID: PMC10483399 DOI: 10.3389/fresc.2023.1225641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/04/2023] [Indexed: 09/12/2023]
Abstract
Background Many individuals with intellectual disability (ID) have a sedentary lifestyle. Few interventions aimed at increasing their level of physical activity (PA) have shown lasting effects. Aim To assess the feasibility and acceptability of a pilot intervention study using innovative mobile health (mHealth) support systems to encourage PA in individuals with ID. Methods Nine individuals with ID and a low level of PA, aged 16-36 years, were included in the present convergent triangulation mixed method design. Two mHealth support systems (apps) were developed and tested. PA was measured with a Fitbit smartwatch, accelerometer, the International Physical Activity Questionnaire-Short Form (IPAQ-S), and Goal attainment scaling. Data were collected through online pre-, mid- (4 weeks), and post-intervention (12 weeks) questionnaires and activity trackers. Semi-structured qualitative interviews with participants and/or a family or staff member were held after the 12-week follow-up. Data were analyzed using conventional nonparametric statistics and thematic analyses. Results The response rate and retention to the trial were 16% and 100%, respectively. Data quality was high, except for missing data from Fitbit activity trackers of approximately 30% from the 4- and 12-week follow-up stages. The feasibility challenges with activity trackers include rashes, size, non-acceptance, and loss of motivation. Participants and family members/staff reported interest in the study theme and were pleased with the data collection method. All but one participant achieved their PA goals. Most participants reported being satisfied with the apps as they were enjoyable or provided a reminder for performing physical and other activities. Social support for PA among family members also increased. However, app support from staff and family members was needed, and apps were not used regularly. Two of nine participants (22%) had increased their PA measured as steps per day with Fitbit at the 12-week follow-up. Conclusions The acceptability and feasibility of using tailored mobile applications in natural settings to increase PA among adults with ID are promising. This study aligns with previous studies in showing the challenges to increasing PA, which requires the inclusion of family members, staff, and stakeholders. The intervention requires modifications before a randomized controlled trial can be conducted.
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Affiliation(s)
- Henriette Michalsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, UiT—The Artic University of Norway, Tromsø, Norway
| | - André Henriksen
- Faculty of Science and Technology, Department of Computer Science, UiT—The Artic University of Norway, Tromsø, Norway
| | - Gunn Pettersen
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Gunnar Hartvigsen
- Faculty of Science and Technology, Department of Computer Science, UiT—The Artic University of Norway, Tromsø, Norway
| | - Silje Wangberg
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT—The Arctic University of Norway, Narvik, Norway
| | - Gyrd Thrane
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Reidun Jahnsen
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, UiT—The Artic University of Norway, Tromsø, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
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Sofro ZM, Wibowo RA, Wasityastuti W, Kusumadewi AF, Utomo PS, Ekawati FM, Putri RE, Aldrin E, Fatmawati JS, Chang TC, Pratista MI, Agustiningsih D. Physical activity virtual intervention for improving mental health among university students during the COVID-19 pandemic: A Co-creation process and evaluation using the Behavior Change Wheel. Heliyon 2023; 9:e18915. [PMID: 37588605 PMCID: PMC10425908 DOI: 10.1016/j.heliyon.2023.e18915] [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: 09/19/2022] [Revised: 07/22/2023] [Accepted: 08/02/2023] [Indexed: 08/18/2023] Open
Abstract
Background During the COVID-19 pandemic, there were reductions in university students' physical activity, which further increased their mental distress, calling for technology-based physical activity interventions to address the challenges in delivering in-person interventions. This study aimed to develop a technology-based physical activity intervention and pilot test it. Methods We developed a virtually-delivered team-based physical activity challenge using the Behavior Change Wheel and Co-creation Framework based on Self-determination Theory. A pilot study was conducted in the evaluation phase to measure the recruitment rate, dropout rate, change in physical activity, and mental distress while identifying problems and collecting participants' opinions regarding the challenge. Wilcoxon signed-rank tests were conducted to assess the change in physical activity and mental distress. Qualitative data were analyzed using thematic analysis. Results A three-week physical activity challenge comprising five identified intervention functions was held with 480 participants. The recruitment rate was 84.8% resulting from 407 virtual challenge participants who were conveniently joined as research participants. The dropout rate for the pilot study was 10.96% resulting from the incompatibility problems with the application. Among sample participants who lacked physical activity, participation in this challenge improved their physical activity by 52.5 min of moderate-intensity physical activity per week and reduced their mental distress by three points of self-reporting questionnaire-20 score. Issues regarding the virtual application and the influence of participation in the challenge on basic psychological needs emerged. Participants' opinions identified lack of time as the main barrier to physical activity. Conclusion A co-created physical activity intervention developed using the Behavioral Change Wheel Framework inspired high interest from university students and may increase their physical activity and improve their mental health. Several suggestions were discussed to address the identified problems and improve the internal and external validity of the evaluation phase. Trial registration TCTR20220720004 (retrospectively registered on July 19, 2022).
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Affiliation(s)
- Zaenal Muttaqien Sofro
- Department of Physiology, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rakhmat Ari Wibowo
- Department of Physiology, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Physical Activity for Health Research Centre (PAHRC), Institute for Sport, Physical Education and Health Sciences, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, United Kingdom
| | - Widya Wasityastuti
- Department of Physiology, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Andrian Fajar Kusumadewi
- Department of Psychiatry, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Prattama Santoso Utomo
- Department of Medical Education and Bioethics, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fitriana Murriya Ekawati
- Department of Family and Community Medicine, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rayhani Erika Putri
- Medical School, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Enrique Aldrin
- Medical School, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Jihan Santika Fatmawati
- Medical School, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Trisha Cheeren Chang
- Medical School, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Muhammad Ivan Pratista
- Medical School, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Denny Agustiningsih
- Department of Physiology, Faculty of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Hietbrink EAG, Oude Nijeweme-d'Hollosy W, Middelweerd A, Konijnendijk AAJ, Schrijver LK, Ten Voorde AS, Fokkema EMS, Laverman GD, Vollenbroek-Hutten MMR. A Digital Coach (E-Supporter 1.0) to Support Physical Activity and a Healthy Diet in People With Type 2 Diabetes: Acceptability and Limited Efficacy Testing. JMIR Form Res 2023; 7:e45294. [PMID: 37505804 PMCID: PMC10422172 DOI: 10.2196/45294] [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: 12/23/2022] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND A healthy lifestyle, including regular physical activity and a healthy diet, is increasingly part of type 2 diabetes (T2D) management. As many people with T2D have difficulty living and maintaining a healthy lifestyle, there is a need for effective interventions. eHealth interventions that incorporate behavior change theories and tailoring are considered effective tools for supporting a healthy lifestyle. The E-Supporter 1.0 digital coach contains eHealth content for app-based eHealth interventions and offers tailored coaching regarding physical activity and a healthy diet for people with T2D. OBJECTIVE This study aimed to assess the acceptability of E-Supporter 1.0 and explore its limited efficacy on physical activity, dietary behavior, the phase of behavior change, and self-efficacy levels. METHODS Over a span of 9 weeks, 20 individuals with T2D received daily motivational messages and weekly feedback derived from behavioral change theories and determinants through E-Supporter 1.0. The acceptability of the intervention was assessed using telephone-conducted, semistructured interviews. The interview transcripts were coded using inductive thematic analysis. The limited efficacy of E-Supporter 1.0 was explored using the Fitbit Charge 2 to monitor step count to assess physical activity and questionnaires to assess dietary behavior (using the Dutch Healthy Diet index), phase of behavior change (using the single-question Self-Assessment Scale Stages of Change), and self-efficacy levels (using the Exercise Self-Efficacy Scale). RESULTS In total, 5 main themes emerged from the interviews: perceptions regarding remote coaching, perceptions regarding the content, intervention intensity and duration, perceived effectiveness, and overall appreciation. The participants were predominantly positive about E-Supporter 1.0. Overall, they experienced E-Supporter 1.0 as a useful and easy-to-use intervention to support a better lifestyle. Participants expressed a preference for combining E-Supporter with face-to-face guidance from a health care professional. Many participants found the intensity and duration of the intervention to be acceptable, despite the coaching period appearing relatively short to facilitate long-term behavior maintenance. As expected, the degree of tailoring concerning the individual and external factors that influence a healthy lifestyle was perceived as limited. The limited efficacy testing showed a significant improvement in the daily step count (z=-2.040; P=.04) and self-efficacy levels (z=-1.997; P=.046) between baseline and postintervention. Diet was improved through better adherence to Dutch dietary guidelines. No significant improvement was found in the phase of behavior change (P=.17), as most participants were already in the maintenance phase at baseline. CONCLUSIONS On the basis of this explorative feasibility study, we expect E-Supporter 1.0 to be an acceptable and potentially useful intervention to promote physical activity and a healthy diet in people with T2D. Additional work needs to be done to further tailor the E-Supporter content and evaluate its effects more extensively on lifestyle behaviors.
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Affiliation(s)
- Eclaire A G Hietbrink
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente (ZGT), Almelo, Netherlands
| | | | - Anouk Middelweerd
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Annemieke A J Konijnendijk
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Office of Research and Innovation, Santeon, Utrecht, Netherlands
| | - Laura K Schrijver
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente (ZGT), Almelo, Netherlands
| | - Anouk S Ten Voorde
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Elise M S Fokkema
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Gozewijn D Laverman
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente (ZGT), Almelo, Netherlands
| | - Miriam M R Vollenbroek-Hutten
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Board of Directors, Medisch Spectrum Twente (MST), Enschede, Netherlands
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Silva J, Hipólito N, Machado P, Flora S, Cruz J. Technological features of smartphone apps for physical activity promotion in patients with COPD: A systematic review. Pulmonology 2023:S2531-0437(23)00124-1. [PMID: 37394341 DOI: 10.1016/j.pulmoe.2023.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Low physical activity (PA) levels have a negative impact on the health status of patients with Chronic Obstructive Pulmonary Disease (COPD). Smartphone applications (apps) focused on PA promotion may mitigate this problem; however, their effectiveness depends on patient adherence, which can be influenced by the technological features of the apps. This systematic review identified the technological features of smartphone apps aiming to promote PA in patients with COPD. METHODS A literature search was performed in the databases ACM Digital Library, IEEE Xplore, PubMed, Scopus and Web of Science. Papers including the description of a smartphone app for PA promotion in patients with COPD were included. Two researchers independently selected studies and scored the apps features based on a previously developed framework (38 possible features). RESULTS Twenty-three studies were included and 19 apps identified, with an average of 10 technological features implemented. Eight apps could be connected to wearables to collect data. The categories 'Measuring and monitoring' and 'Support and Feedback' were present in all apps. Overall, the most implemented features were 'progress in visual format' (n = 13), 'advice on PA' (n = 14) and 'data in visual format' (n = 10). Only three apps included social features, and two included a web-based version of the app. CONCLUSIONS The existing smartphone apps include a relatively small number of features to promote PA, which are mostly related to monitoring and providing feedback. Further research is warranted to explore the relationship between the presence/absence of specific features and the impact of interventions on patients' PA levels.
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Affiliation(s)
- J Silva
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Portugal
| | - N Hipólito
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal; Health Data Science of the Department of Community Medicine, Information and Health Decision Sciences of the Faculty of Medicine of the University of Porto, Porto, Portugal
| | - P Machado
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal
| | - S Flora
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal
| | - J Cruz
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Portugal; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal.
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Domal SV, Chandrasekaran B, Palanisamy HP. Influence of smartphone-based physical activity intervention on executive functions and cardiometabolic disease risk in obese young adults: a pilot randomised controlled trial. J Diabetes Metab Disord 2023; 22:619-628. [PMID: 37255799 PMCID: PMC10225455 DOI: 10.1007/s40200-023-01182-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/24/2022] [Accepted: 12/31/2022] [Indexed: 06/01/2023]
Abstract
Purpose Smartphone is an impending solution to influence long-term behavior change, including physical activity; however, the evidence regarding personalized prescription remains mixed in obese. We aimed to explore the influence of smartphone-based physical activity promotion on weight loss and cognitive functions in obese young adults. Methods In our pilot randomised controlled trial, 24 obese adults were randomized to two conditions: (1) EXI group receiving a smartphone-application based personalized physical activity prescription; (2) CONT group continuing their routine work for eight weeks. Executive functions and cardiometabolic risk variables [body and fat mass, waist circumference (WC), blood pressure (BP)] and executive functions were measured before and after eight weeks. Results Our study findings revealed a significant improvement in reaction times with overall (H = 7.71, p = 0.005), congruent stimuli (H = 4.43, p = 0.03) and incongruent stimuli (H = 5.35, p = 0.02) between groups. Though EXI participants reduced their fat mass by 5.07 kg more than CONT group users after eight weeks, the findings were statistically insignificant. Similarly, our study did not find significant differences in body mass, WC, BP or accuracy between EXI and CONT groups. There was a decreased user engagement (H = 5.80, p = 0.564) after the 3rd week of the study period. Conclusion Short-term smartphone-based physical activity programs may offer favourable cognitive benefits to young adults; however, the weight loss benefits remain unconvincing. Trial Registration The study was registered prospectively with the Clinical Trials Registry of India (CTRI/2022/02/040202). Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01182-9.
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Affiliation(s)
- Sapna Vithoba Domal
- Department of Exercise and Sport Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Madhav Nagar, 576104 Manipal, Karnataka India
| | - Baskaran Chandrasekaran
- Department of Exercise and Sport Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Madhav Nagar, 576104 Manipal, Karnataka India
| | - Hari Prakash Palanisamy
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, 576104 Manipal, Karnataka India
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Li X, Zhang M. How digital health technologies promote healthy life in the Post-COVID-19 Era: evidences from national survey on Chinese adolescents and youngsters. Front Public Health 2023; 11:1135313. [PMID: 37228730 PMCID: PMC10203178 DOI: 10.3389/fpubh.2023.1135313] [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: 01/24/2023] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
The rapid development of intelligent technologies coupled with the stay-at-home trends in the Post-COVID-19 Era has significantly changed youth's health behavior as well as reshaped their lifestyles. Digital health technologies (DHTs) have been more and more used for health management among youngsters. However, little was known about the use of DHTs among youths and its consequences on their health, especially in developing countries like China. Inspired by behavior intervention technology (BIT) model, this study examined the underlying mechanisms of use and social interactions of DHTs on Chinese adolescents' and youngsters' healthy lifestyles and mental health, using a representatively national survey among high school and freshman students in China (N = 2,297). It found that use of DHTs had a significantly positive effect on Chinese youths' healthy lifestyles and mental health, with behavioral regulation as a mediator. However, social interactions of DHTs were negatively associated with their mental health. The findings contribute to a better guidance on health promotion, as well as the enhanced design of DHTs' products.
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Deniz-Garcia A, Fabelo H, Rodriguez-Almeida AJ, Zamora-Zamorano G, Castro-Fernandez M, Alberiche Ruano MDP, Solvoll T, Granja C, Schopf TR, Callico GM, Soguero-Ruiz C, Wägner AM. Quality, Usability, and Effectiveness of mHealth Apps and the Role of Artificial Intelligence: Current Scenario and Challenges. J Med Internet Res 2023; 25:e44030. [PMID: 37140973 PMCID: PMC10196903 DOI: 10.2196/44030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/19/2023] [Accepted: 03/10/2023] [Indexed: 03/12/2023] Open
Abstract
The use of artificial intelligence (AI) and big data in medicine has increased in recent years. Indeed, the use of AI in mobile health (mHealth) apps could considerably assist both individuals and health care professionals in the prevention and management of chronic diseases, in a person-centered manner. Nonetheless, there are several challenges that must be overcome to provide high-quality, usable, and effective mHealth apps. Here, we review the rationale and guidelines for the implementation of mHealth apps and the challenges regarding quality, usability, and user engagement and behavior change, with a special focus on the prevention and management of noncommunicable diseases. We suggest that a cocreation-based framework is the best method to address these challenges. Finally, we describe the current and future roles of AI in improving personalized medicine and provide recommendations for developing AI-based mHealth apps. We conclude that the implementation of AI and mHealth apps for routine clinical practice and remote health care will not be feasible until we overcome the main challenges regarding data privacy and security, quality assessment, and the reproducibility and uncertainty of AI results. Moreover, there is a lack of both standardized methods to measure the clinical outcomes of mHealth apps and techniques to encourage user engagement and behavior changes in the long term. We expect that in the near future, these obstacles will be overcome and that the ongoing European project, Watching the risk factors (WARIFA), will provide considerable advances in the implementation of AI-based mHealth apps for disease prevention and health promotion.
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Affiliation(s)
- Alejandro Deniz-Garcia
- Endocrinology and Nutrition Department, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Himar Fabelo
- Complejo Hospitalario Universitario Insular - Materno Infantil, Fundación Canaria Instituto de Investigación Sanitaria de Canarias, Las Palmas de Gran Canaria, Spain
- Research Institute for Applied Microelectronics, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Antonio J Rodriguez-Almeida
- Research Institute for Applied Microelectronics, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Garlene Zamora-Zamorano
- Endocrinology and Nutrition Department, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Maria Castro-Fernandez
- Research Institute for Applied Microelectronics, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Maria Del Pino Alberiche Ruano
- Endocrinology and Nutrition Department, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Terje Solvoll
- Norwegian Centre for E-health Research, University Hospital of North-Norway, Tromsø, Norway
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Conceição Granja
- Norwegian Centre for E-health Research, University Hospital of North-Norway, Tromsø, Norway
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Thomas Roger Schopf
- Norwegian Centre for E-health Research, University Hospital of North-Norway, Tromsø, Norway
| | - Gustavo M Callico
- Research Institute for Applied Microelectronics, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Cristina Soguero-Ruiz
- Departamento de Teoría de la Señal y Comunicaciones y Sistemas Telemáticos y Computación, Universidad Rey Juan Carlos, Madrid, Spain
| | - Ana M Wägner
- Endocrinology and Nutrition Department, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Zhang N, Zhou M, Li M, Ma G. Effects of Smartphone-Based Remote Interventions on Dietary Intake, Physical Activity, Weight Control, and Related Health Benefits Among the Older Population With Overweight and Obesity in China: Randomized Controlled Trial. J Med Internet Res 2023; 25:e41926. [PMID: 37115608 PMCID: PMC10182459 DOI: 10.2196/41926] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 02/20/2023] [Accepted: 03/23/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Traditional health management requires many human and material resources and cannot meet the growing needs. Remote medical technology provides an opportunity for health management; however, the research on it is insufficient. OBJECTIVE The objective of this study was to assess the effects of remote interventions on weight management. METHODS In this randomized controlled study, 750 participants were randomly assigned to a remote dietary and physical activity intervention group (group DPI), remote physical activity intervention group (group PI), or control group (group C). At baseline (time 1), day 45 (time 2), and day 90 (time 3), data were collected, including data on dietary intake, physical activity, indexes related to weight control, and health benefits. RESULTS A total of 85.6% (642/750) of participants completed the follow-up. Compared with group C, group DPI showed a significant decrease in energy intake (-581 vs -82 kcal; P<.05), protein intake (-17 vs -3 g; P<.05), fat intake (-8 vs 3 g; P<.05), and carbohydrate intake (-106.5 vs -4.7 g; P<.05) at time 3. Compared with time 1, groups DPI and PI showed a significant decrease in cereal and potato intake (P<.05). Compared with time 1, the physical activity levels related to transportation (group PI: 693 vs 597 metabolic equivalent [MET]-min/week, group C: 693 vs 594 MET-min/week; P<.05) and housework and gardening (group PI: 11 vs 0 MET-min/week, group C: 11 vs 4 MET-min/week; P<.05) in groups PI and C were improved at time 3. Compared with groups PI and C, group DPI showed a significant decrease in weight (-1.56 vs -0.86 kg and -1.56 vs -0.66 kg, respectively; P<.05) and BMI (-0.61 vs -0.33 kg/m2 and -0.61 vs -0.27 kg/m2, respectively; P<.05) at time 2. Compared with groups PI and C, group DPI showed a significant decrease in body weight (-4.11 vs -1.01 kg and -4.11 vs -0.83 kg, respectively; P<.05) and BMI (-1.61 vs -0.40 kg/m2 and -1.61 vs -0.33 kg/m2, respectively; P<.05) at time 3. Compared with group C, group DPI showed a significant decrease in triglyceride (-0.06 vs 0.32 mmol/L; P<.05) at time 2. Compared with groups PI and C, group DPI showed a significant decrease in systolic blood pressure (-8.15 vs -3.04 mmHg and -8.15 vs -3.80 mmHg, respectively; P<.05), triglyceride (-0.48 vs 0.11 mmol/L and -0.48 vs 0.18 mmol/L, respectively; P<.05), and fasting blood glucose (-0.77 vs 0.43 mmol/L and -0.77 vs 0.14 mmol/L, respectively; P<.05). There were significant differences in high-density lipoprotein cholesterol (-0.00 vs -0.07 mmol/L; P<.05) and hemoglobin A1c (-0.19% vs -0.07%; P<.05) between groups DPI and C. CONCLUSIONS Remote dietary and physical activity interventions can improve dietary intake among participants with overweight and obesity, are beneficial for weight control, and have potential health benefits. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900023355; https://www.chictr.org.cn/showproj.html?proj=38976.
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Affiliation(s)
- Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Mingzhu Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Muxia Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
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Martyn-Nemeth P, Hayman LL. Digital Technology in Cardiovascular Health: Role and Evidence Supporting Its Use. J Cardiovasc Nurs 2023; 38:207-209. [PMID: 37027125 DOI: 10.1097/jcn.0000000000000985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Evans HL, Scalea J. Impact of Digital Health upon the Surgical Patient Experience: The Patient as Consumer. Surg Clin North Am 2023; 103:357-368. [PMID: 36948724 DOI: 10.1016/j.suc.2022.11.006] [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: 03/22/2023]
Abstract
The adoption of digital health services in surgical care delivery is changing the patient experience. The goal of patient-generated health data monitoring incorporated with patient-centered education and feedback is to optimally prepare patients for surgery and personalize postoperative care to improve outcomes that matter to both patients and surgeons. Challenges include the need for the adoption of new methods for implementation and evaluation and equitable application of surgical digital health interventions, with considerations for accessibility as well as the development of new diagnostics and decision support that include the needs and characteristics of all populations served.
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Affiliation(s)
- Heather L Evans
- Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB 417, Charleston, SC 29425, USA.
| | - Joseph Scalea
- Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB 417, Charleston, SC 29425, USA
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Wei W, Liu H, Cheng B, Qin X, He D, Zhang N, Zhao Y, Cai Q, Shi S, Chu X, Wen Y, Jia Y, Zhang F. Association between electronic device use and health status among a middle-aged and elderly population: a cross-sectional analysis in the UK Biobank. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-10. [PMID: 37361277 PMCID: PMC10041511 DOI: 10.1007/s10389-023-01886-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/07/2023] [Indexed: 03/29/2023]
Abstract
Aim Few previous studies have investigated the impact of multiple types of electronic devices on health status, and the moderating effects of gender, age, and BMI. Our aim is to examine the relationships between the use of four types of electronics and three health status indicators in a middle-aged and elderly population, and how these relationships varied by gender, age, and BMI. Subject and methods Using data from 376,806 participants aged 40-69 years in the UK Biobank, we conducted a multivariate linear regression to estimate the association between electronic device use and health status. Electronics use was categorized as TV watching, computer use, computer gaming, and mobile phone use, and health status included self-rated health (SRH), multisite chronic pain (MCP), and total physical activity (TPA). Interaction terms were utilized to assess whether the above associations were modified by BMI, gender, and age. Further stratified analysis was performed to explore the role of gender, age, and BMI. Results Higher levels of TV watching (BSRH = 0.056, BMCP = 0.044, BTPA= -1.795), computer use (BSRH = 0.007, BTPA= -3.469), and computer gaming (BSRH = 0.055, BMCP = 0.058, BTPA= -6.076) were consistently associated with poorer health status (all P < 0.05). Contrastingly, earlier exposure to mobile phones (BSRH = -0.048, BTPA= 0.933, BMCP = 0.056) was inconsistent with health (all P < 0.05). Additionally, BMI (Bcomputer use-SRH= 0.0026, Bphone-SRH= 0.0049, BTV-MCP= 0.0031, and BTV-TPA= -0.0584) exacerbated the negative effects of electronics use, and male (Bphone-SRH = -0.0414, Bphone-MCP = -0.0537, Bphone-TPA= 2.8873) were healthier with earlier exposure to mobile phones (all P < 0.05). Conclusion Our findings suggest that the adverse health effects associated with watching TV, computer use, and computer gaming were consistent and were moderated by BMI, gender, and age, which advances a comprehensive understanding of the association between multiple types of electronic devices and health status, and provides new perspectives for future research. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01886-5.
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Affiliation(s)
- Wenming Wei
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Huan Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Xiaoyue Qin
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Dan He
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Na Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Yijing Zhao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Qingqing Cai
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Sirong Shi
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Xiaoge Chu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi’an Jiaotong University, No. 76 Yan Ta West Road, Shaanxi 710061 Xi’an, People’s Republic of China
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Ferreira Silva RM, Fonseca Terra L, da Silva Valadão Fernandes M, Noll PRES, de Almeida AA, Noll M. Physical Activity and Sedentary Behavior in High School Students: A Quasi Experimental Study via Smartphone during the COVID-19 Pandemic. CHILDREN 2023; 10:children10030479. [PMID: 36980037 PMCID: PMC10047413 DOI: 10.3390/children10030479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/03/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023]
Abstract
The objective of this study was to evaluate whether exposure to information about physical activity and its barriers can increase the level of physical activity and reduce the time exposed to sedentary behaviors in high school students involved in integrated professional and technological education during the coronavirus disease 2019 pandemic. This quasi experimental study was conducted with integrated education high school students, divided into two groups: Intervention Group (IG; n = 59) and Control Group (CG; n = 54). Physical activity and sedentary behavior were identified and measured using the International Physical Activity Questionnaire pre-and post-intervention for both groups. IG students received educational material thrice a week for four weeks. The focus of the material was the importance of physical activity and need to reduce the time exposed to sedentary behavior. The results revealed that IG students showed an average daily reduction of 47.14 min in time exposed to sedentary behaviors, while the CG students showed an increase of 31.37 min. Despite this, the intervention was not effective in improving physical activity levels in the IG and the mean reduction in the time exposed to sedentary behavior was not significant (p = 0.556). The intervention was ineffective in increasing the practice of physical activity and reducing the time exposed to sedentary behavior.
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Affiliation(s)
| | | | | | | | | | - Matias Noll
- Department of Education, Federal Institute Goiano, Ceres 76300-000, Brazil
- Health Science Graduate Program, Faculty of Medicine, Federal University of Goiás, Goiânia 74001-970, Brazil
- Correspondence: (R.M.F.S.); (M.N.)
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Ang G, Edney SM, Tan CS, Lim N, Tan J, Müller-Riemenschneider F, Chen C. Physical Activity Trends Among Adults in a National Mobile Health Program: A Population-Based Cohort Study of 411,528 Adults. Am J Epidemiol 2023; 192:397-407. [PMID: 36345089 PMCID: PMC9985108 DOI: 10.1093/aje/kwac193] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 09/13/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022] Open
Abstract
Physical inactivity is a global public health challenge, and effective, large-scale interventions are needed. We examined the effectiveness of a population-wide mobile health (mHealth) intervention in Singapore, National Steps Challenge Season 3 (NSC3) and 2 booster challenges (Personal Pledge and Corporate Challenge). The study includes 411,528 participants. We used regression discontinuity design and difference-in-difference with fixed-effects regression to examine the association of NSC3 and the additional booster challenges on daily step counts. Participants tended to be female (58.5%), with an average age of 41.5 years (standard deviation, 13.9) and body mass index (weight (kg)/height (m)2) of 23.8 (standard deviation, 4.5). We observed that NSC3 was associated with a mean increase of 1,437 steps (95% confidence interval (CI): 1,408, 1,467) per day. Enrollments in Personal Pledge and Corporate Challenge were associated with additional mean increases of 1,172 (95% CI: 1,123, 1,222) and 896 (95% CI: 862, 930) steps per day, respectively. For NSC3, the associated mean increase in the step counts across different sex and age groups varied, with greater increases for female participants and those in the oldest age group. We provide real-world evidence suggesting that NSC3 was associated with improvements in participants' step counts. Results suggest NSC3 is an effective and appealing population-wide mHealth physical activity intervention.
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Affiliation(s)
- Gregory Ang
- Department of Statistics and Data Science, National University of Singapore, Singapore
| | - Sarah Martine Edney
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicole Lim
- Health Promotion Board, Ministry of Health, Singapore
| | - Jeremy Tan
- Health Promotion Board, Ministry of Health, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Berlin Institute of Health, Charité University Medical Centre, Berlin, Germany
| | - Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.,Schaeffer Center for Health Policy and Economics, University of Southern California, USA.,Department of Non-Communicable Disease Epidemiology, The London School of Hygiene & Tropical Medicine, UK
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Latrille C, Chapel B, Héraud N, Bughin F, Hayot M, Boiché J. An individualized mobile health intervention to promote physical activity in adults with obstructive sleep apnea: An intervention mapping approach. Digit Health 2023; 9:20552076221150744. [PMID: 36776408 PMCID: PMC9909081 DOI: 10.1177/20552076221150744] [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: 05/02/2022] [Accepted: 12/26/2022] [Indexed: 02/10/2023] Open
Abstract
Objective Combining continuous positive airway pressure with physical activity (PA) might be a promising strategy to treat obstructive sleep apnea (OSA). This article describes how intervention mapping (IM) can guide the development, content, and mechanisms of action of a mobile application to promote PA in adults with OSA. Methods To develop the program, the IM approach was followed. This article presents the first three steps of IM to develop a mixed intervention (with interventionists and a digital application) aiming to: (1) assess patients' health problems and needs in a literature review to determine their expectations and perceived facilitators and barriers to PA behavior change and thus select the determinants of behavior; (2) formulate the expected intervention outcomes and objectives to be met to achieve the overall program goals; and (3) select and implement the behavior change techniques (BCTs) to achieve the change objectives. Results The literature review identified the relevant determinants (e.g., self-efficacy, coping, planning, and habit) of PA behavior using the health action process approach and multiprocess action control. These results were used to specify the program outcomes for PA adapted to physical, psychological, and social parameters. Overall, 11 performance objectives and 30 change objectives were defined. Lastly, BCTs and practical applications were identified. Conclusions The study provides a theoretical and methodological basis for researchers and practitioners given the current paucity of evidence-based PA interventions for adults with OSA. It addresses the lack of BCTs (framing and prompts/cue techniques) and meaningful behavioral determinants (identity and habit) in most interventions.
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Affiliation(s)
- Christophe Latrille
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France,PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France,Christophe Latrille, University of Montpellier, 700 avenue du Pic Saint-Loup, Montpellier 34090, France.
| | - Blandine Chapel
- Montpellier Research of Management MRM, University of Montpellier, Montpellier, France
| | - Nelly Héraud
- Direction de la recherche clinique et de l'innovation en santé, Korian SA, Lodève, France
| | - François Bughin
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Julie Boiché
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France
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Rodríguez-González P, Iglesias D, Fernandez-Rio J, Gao Z. Effectiveness of interventions using apps to improve physical activity, sedentary behavior and diet: An umbrella review. Complement Ther Clin Pract 2023; 50:101711. [PMID: 36509032 DOI: 10.1016/j.ctcp.2022.101711] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
Technology has been recently found to be an effective tool to deliver public health interventions [1]. More specifically, the effects of interventions using apps to improve health have been targeted lately [2]. The goal of the present study was to conduct a systematic review of systematic reviews to summarize the scientific evidence. Three research questions were formulated to guide the research: RQ1. Are interventions using apps effective to improve PA? RQ2. Are interventions using apps effective to improve sedentary behavior? RQ3. Are interventions using apps effective to improve diet? This review of reviews was registered with PROSPERO (CRD42022345909). Systematic reviews were included following the PICOTS framework (population, intervention, comparator, outcomes, time and setting). In addition, reviews with several research objectives were included only when they comprised more than two-thirds of the studies analyzing one or more of the objectives of this review. As a result, 12 systematic reviews were selected for data extraction. Findings uncovered that apps could be effective to improve individuals' PA, sedentary behavior and diet. However, elements like the intervention components, the context/environment/setting, the length of the intervention or the population targeted should be carefully considered in future studies.
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Affiliation(s)
- Pablo Rodríguez-González
- School of Kinesiology, University of Minnesota Twin Cities, USA; Faculty of Teacher Training and Education, University of Oviedo, Asturias, Spain
| | - Damián Iglesias
- Teacher Training College, University of Extremadura, Cáceres, Spain
| | - Javier Fernandez-Rio
- Faculty of Teacher Training and Education, University of Oviedo, Asturias, Spain
| | - Zan Gao
- School of Kinesiology, University of Minnesota Twin Cities, USA.
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Albers N, Hizli B, Scheltinga BL, Meijer E, Brinkman WP. Setting Physical Activity Goals with a Virtual Coach: Vicarious Experiences, Personalization and Acceptance. J Med Syst 2023; 47:15. [PMID: 36710276 PMCID: PMC9884656 DOI: 10.1007/s10916-022-01899-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/05/2022] [Indexed: 01/31/2023]
Abstract
Goal-setting is often used in eHealth applications for behavior change as it motivates and helps to stay focused on a desired outcome. However, for goals to be effective, they need to meet criteria such as being specific, measurable, attainable, relevant and time-bound (SMART). Moreover, people need to be confident to reach their goal. We thus created a goal-setting dialog in which the virtual coach Jody guided people in setting SMART goals. Thereby, Jody provided personalized vicarious experiences by showing examples from other people who reached a goal to increase people's confidence. These experiences were personalized, as it is helpful to observe a relatable other succeed. Data from an online study with a between-subjects with pre-post measurement design (n=39 participants) provide credible support that personalized experiences are seen as more motivating than generic ones. Motivational factors for participants included information about the goal, path to the goal, and the person who accomplished a goal, as well as the mere fact that a goal was reached. Participants also had a positive attitude toward Jody. We see these results as an indication that people are positive toward using a goal-setting dialog with a virtual coach in eHealth applications for behavior change. Moreover, contrary to hypothesized, our observed data give credible support that participants' self-efficacy was lower after the dialog than before. These results warrant further research on how such dialogs affect self-efficacy, especially whether these lower post-measurements of self-efficacy are associated with people's more realistic assessment of their abilities.
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Affiliation(s)
- Nele Albers
- Intelligent Systems, Delft University of Technology, Delft, The Netherlands.
| | - Beyza Hizli
- Intelligent Systems, Delft University of Technology, Delft, The Netherlands
| | - Bouke L Scheltinga
- Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands
| | - Eline Meijer
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Kukafka R, Evans K, Murnane E, Santoro E, Baiocchi M, Landay J, Delp S, Crum A. Effects of Wearable Fitness Trackers and Activity Adequacy Mindsets on Affect, Behavior, and Health: Longitudinal Randomized Controlled Trial. J Med Internet Res 2023; 25:e40529. [PMID: 36696172 PMCID: PMC9909519 DOI: 10.2196/40529] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/14/2022] [Accepted: 11/13/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is some initial evidence suggesting that mindsets about the adequacy and health consequences of one's physical activity (activity adequacy mindsets [AAMs]) can shape physical activity behavior, health, and well-being. However, it is unknown how to leverage these mindsets using wearable technology and other interventions. OBJECTIVE This research examined how wearable fitness trackers and meta-mindset interventions influence AAMs, affect, behavior, and health. METHODS A total of 162 community-dwelling adults were recruited via flyers and web-based platforms (ie, Craigslist and Nextdoor; final sample size after attrition or exclusion of 45 participants). Participants received an Apple Watch (Apple Inc) to wear for 5 weeks, which was equipped with an app that recorded step count and could display a (potentially manipulated) step count on the watch face. After a baseline week of receiving no feedback about step count, participants were randomly assigned to 1 of 4 experimental groups: they received either accurate step count (reference group; 41/162, 25.3%), 40% deflated step count (40/162, 24.7%), 40% inflated step count (40/162, 24.7%), or accurate step count+a web-based meta-mindset intervention teaching participants the value of adopting more positive AAMs (41/162, 25.3%). Participants were blinded to the condition. Outcome measures were taken in the laboratory by an experimenter at the beginning and end of participation and via web-based surveys in between. Longitudinal analysis examined changes within the accurate step count condition from baseline to treatment and compared them with changes in the deflated step count, inflated step count, and meta-mindset conditions. RESULTS Participants receiving accurate step counts perceived their activity as more adequate and healthier, adopted a healthier diet, and experienced improved mental health (Patient-Reported Outcomes Measurement Information System [PROMIS]-29) and aerobic capacity but also reduced functional health (PROMIS-29; compared with their no-step-count baseline). Participants exposed to deflated step counts perceived their activity as more inadequate; ate more unhealthily; and experienced more negative affect, reduced self-esteem and mental health, and increased blood pressure and heart rate (compared with participants receiving accurate step counts). Inflated step counts did not change AAM or most other outcomes (compared with accurate step counts). Participants receiving the meta-mindset intervention experienced improved AAM, affect, functional health, and self-reported physical activity (compared with participants receiving accurate step counts only). Actual step count did not change in either condition. CONCLUSIONS AAMs--induced by trackers or adopted deliberately--can influence affect, behavior, and health independently of actual physical activity. TRIAL REGISTRATION ClinicalTrials.gov NCT03939572; https://www.clinicaltrials.gov/ct2/show/NCT03939572.
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Affiliation(s)
| | - Kristopher Evans
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Elizabeth Murnane
- Department of Computer Science, Stanford University, Stanford, CA, United States
| | - Erik Santoro
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Michael Baiocchi
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, United States
| | - James Landay
- Department of Computer Science, Stanford University, Stanford, CA, United States
| | - Scott Delp
- Department of Mechanical Engineering, Department of Bioengineering, Stanford University, Stanford, CA, United States
| | - Alia Crum
- Department of Psychology, Stanford University, Stanford, CA, United States
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Standen EC, Rothman AJ. Capitalizing on the potential of mobile health applications as behavioral interventions: A research agenda for calorie‐tracking and activity‐tracking applications. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2023. [DOI: 10.1111/spc3.12731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Erin C. Standen
- Department of Psychology University of Minnesota Minnesota Minneapolis USA
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