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Takano K, Oba T, Katahira K, Kimura K. Deconstructing Fitbit to Specify the Effective Features in Promoting Physical Activity Among Inactive Adults: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e51216. [PMID: 38996332 PMCID: PMC11282379 DOI: 10.2196/51216] [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: 07/26/2023] [Revised: 02/28/2024] [Accepted: 03/22/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Wearable activity trackers have become key players in mobile health practice as they offer various behavior change techniques (BCTs) to help improve physical activity (PA). Typically, multiple BCTs are implemented simultaneously in a device, making it difficult to identify which BCTs specifically improve PA. OBJECTIVE We investigated the effects of BCTs implemented on a smartwatch, the Fitbit, to determine how each technique promoted PA. METHODS This study was a single-blind, pilot randomized controlled trial, in which 70 adults (n=44, 63% women; mean age 40.5, SD 12.56 years; closed user group) were allocated to 1 of 3 BCT conditions: self-monitoring (feedback on participants' own steps), goal setting (providing daily step goals), and social comparison (displaying daily steps achieved by peers). Each intervention lasted for 4 weeks (fully automated), during which participants wore a Fitbit and responded to day-to-day questionnaires regarding motivation. At pre- and postintervention time points (in-person sessions), levels and readiness for PA as well as different aspects of motivation were assessed. RESULTS Participants showed excellent adherence (mean valid-wear time of Fitbit=26.43/28 days, 94%), and no dropout was recorded. No significant changes were found in self-reported total PA (dz<0.28, P=.40 for the self-monitoring group, P=.58 for the goal setting group, and P=.19 for the social comparison group). Fitbit-assessed step count during the intervention period was slightly higher in the goal setting and social comparison groups than in the self-monitoring group, although the effects did not reach statistical significance (P=.052 and P=.06). However, more than half (27/46, 59%) of the participants in the precontemplation stage reported progress to a higher stage across the 3 conditions. Additionally, significant increases were detected for several aspects of motivation (ie, integrated and external regulation), and significant group differences were identified for the day-to-day changes in external regulation; that is, the self-monitoring group showed a significantly larger increase in the sense of pressure and tension (as part of external regulation) than the goal setting group (P=.04). CONCLUSIONS Fitbit-implemented BCTs promote readiness and motivation for PA, although their effects on PA levels are marginal. The BCT-specific effects were unclear, but preliminary evidence showed that self-monitoring alone may be perceived demanding. Combining self-monitoring with another BCT (or goal setting, at least) may be important for enhancing continuous engagement in PA. TRIAL REGISTRATION Open Science Framework; https://osf.io/87qnb/?view_only=f7b72d48bb5044eca4b8ce729f6b403b.
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Affiliation(s)
- Keisuke Takano
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Takeyuki Oba
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Kentaro Katahira
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Kenta Kimura
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
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2
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Peterson NE, Bate DA, Macintosh JL, Trujillo Tanner C. Wearable Activity Trackers That Motivate Women to Increase Physical Activity: Mixed Methods Study. JMIR Form Res 2023; 7:e48704. [PMID: 38096000 PMCID: PMC10755652 DOI: 10.2196/48704] [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: 05/03/2023] [Revised: 10/21/2023] [Accepted: 11/09/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Physical inactivity is a significant public health concern, particularly among women in the United States. Wearable activity trackers (WATs) have been proposed as a potential solution to increase awareness of and engagement in physical activity (PA). However, to be effective, WATs must include features and designs that encourage daily use. OBJECTIVE This study aims to explore the features and designs of WATs that appeal to women and determine whether devices with these attributes are effective motivators for women to be physically active. METHODS A mixed methods study guided by the self-determination theory was conducted among 15 women. Participants trialed 3 WATs with influence in their respective accessory domains: Apple Watch for the wrist; Oura Ring for the finger; and Bellabeat Leaf Urban for multiple sites (it can be worn as a bracelet, necklace, or clip). Participants documented their daily PA levels and rated their satisfaction with each device's comfort, features, and motivational effect. Focus groups were also conducted to gather additional feedback and experiences within the a priori areas of comfort, features, and motivation. RESULTS Behavioral Regulation in Exercise Questionnaire-2 scores indicated that most participants (14/15, 93%) were motivated at baseline (amotivation score: mean 0.13, SD 0.45), but on average, participants did not meet the national minimum PA guidelines according to the self-reported Physical Activity Vital Sign questionnaire (moderate to vigorous PA score: mean 144, SD 97.5 min/wk). Mean WAT wear time was 16.9 (SD 4.4) hours, 19.4 (SD 5.3) hours, and 20.4 (SD 4.7) hours for Apple Watch, Bellabeat Leaf Urban, and Oura Ring, respectively. During focus groups, participants reinforced their quantitative ratings and rankings of the WATs based on personal experiences. Participants shared a variety of both activity-related and non-activity-related features that they look for in a motivating device. When considering what the ideal WAT would be for a woman, participants suggested features of (1) comfort, (2) extended battery life, (3) durability, (4) immediate PA feedback, (5) intuitive PA sensing, and (6) programmability. CONCLUSIONS This study is the first to specifically address women's experiences with and preferences for different types of WATs. Those who work with women should realize how they view WATs and the role they play in motivation to be active.
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Affiliation(s)
- Neil E Peterson
- College of Nursing, Brigham Young University, Provo, UT, United States
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3
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Dunn R, Tamminen KA, Kim J, Vanderloo LM. Promotion of physical activity among people who identify as women through the ParticipACTION mobile app. Psychol Health 2023:1-20. [PMID: 37870144 DOI: 10.1080/08870446.2023.2269422] [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: 04/18/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE Health and fitness mobile applications can increase users' physical activity (PA) levels (Lister et al., 2014). ParticipACTION is a national non-profit organization that developed a mobile app to target PA among adults (Truelove et al., 2020). The aim of this research was to examine how women's PA is related to their use of the ParticipACTION app. METHODS AND MEASUREMENT Using a mixed-methods design, participants (n = 3,493) completed a survey regarding their PA levels, motivation for PA (capability, opportunity, motivation; COM-B, Keyworth et al., 2020), and motivation for using the ParticipACTION app. Nine focus groups were conducted (n = 37) to discuss the mobile app further. RESULTS Path analyses revealed that users' app use was positively associated with motivations for various app functions (e.g. self-monitoring, seeking exercise guidance), however, only motivation in-turn predicted PA. Descriptive results indicated that many women in Canada who used the app do not meet national guidelines for PA per week. Qualitative findings highlight women's motivation for using the app, concerns with app functionality, and feelings of guilt for not engaging in PA. CONCLUSION The ParticipACTION app may have some benefit for improving women's PA; intervention studies are needed to determine efficacy of mobile applications.
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Affiliation(s)
- Rachel Dunn
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Katherine A Tamminen
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Jeemin Kim
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
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4
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Buis L, Guo H, Rookes T, Frost R, Hamilton FL. Assessing the Acceptability and Effectiveness of Mobile-Based Physical Activity Interventions for Midlife Women During Menopause: Systematic Review of the Literature. JMIR Mhealth Uhealth 2022; 10:e40271. [PMID: 36485026 PMCID: PMC9789501 DOI: 10.2196/40271] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/26/2022] [Accepted: 10/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Midlife women with menopausal symptoms are less likely to meet the recommended level of physical activity (PA). Promoting PA among women in midlife could reduce their risk of cardiovascular diseases and perhaps improve menopausal symptoms. Mobile PA interventions in the form of smartphone apps and wearable activity trackers can potentially encourage users to increase PA levels and address time and resource barriers to PA. However, evidence on the acceptability and effectiveness of these interventions among midlife women is unclear. OBJECTIVE This systematic review evaluated the effectiveness, acceptability, and active behavior change techniques (BCTs) of mobile PA technologies among midlife menopausal women. METHODS A mixed methods systematic review of qualitative and quantitative studies was conducted. MEDLINE (Ovid), Embase, Scopus, CINAHL, Web of Science, SPORTDiscus, CENTRAL, PsycINFO, and the ProQuest Sports Medicine and Education Index were systematically searched. Studies were selected and screened according to predetermined eligibility criteria. In total, 2 reviewers independently assessed the risk of bias using the Mixed Methods Appraisal Tool and completed BCT mapping of the included interventions using the BCT Taxonomy v1. RESULTS A total of 12 studies were included in this review. Overall risk of bias was "Moderate to high" in 58% (7/12) of the included studies and "low" in 42% (5/12) of the studies. Of the 12 studies, 7 (58%) assessed changes in PA levels. The pooled effect size of 2 randomized controlled trials resulted in a small to moderate increase in moderate to vigorous PA of approximately 61.36 weekly minutes among midlife women, at least in the short term (95% CI 17.70-105.01; P=.006). Although a meta-analysis was not feasible because of heterogeneity, positive improvements were also found in a range of menopause-related outcomes such as weight reduction, anxiety management, sleep quality, and menopause-related quality of life. Midlife women perceived mobile PA interventions to be acceptable and potentially helpful in increasing PA and daily steps. The average number of BCTs per mobile PA intervention was 8.8 (range 4-13) according to the BCT Taxonomy v1. "Self-monitoring of behaviour," "Biofeedback," and "Goal setting (behaviour)" were the most frequently described BCTs across the included interventions. CONCLUSIONS This review demonstrated that mobile PA interventions in the form of smartphone apps and wearable trackers are potentially effective for small to moderate increases in moderate to vigorous PA among midlife women with menopausal symptoms. Although menopause is a natural condition affecting half the population worldwide, there is a substantial lack of evidence to support the acceptability and effectiveness of mobile PA interventions on menopause-related outcomes, which needs further investigation. TRIAL REGISTRATION PROSPERO CRD42021273062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273062.
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Affiliation(s)
| | - Haoyue Guo
- UCL Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Tasmin Rookes
- UCL Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Rachael Frost
- UCL Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Fiona L Hamilton
- UCL Research Department of Primary Care and Population Health, University College London, London, United Kingdom
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5
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Wallbank G, Haynes A, Tiedemann A, Sherrington C, Grunseit AC. Designing physical activity interventions for women aged 50+: a qualitative study of participant perspectives. BMC Public Health 2022; 22:1855. [PMID: 36195939 PMCID: PMC9531643 DOI: 10.1186/s12889-022-14237-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Active Women over 50 trial tested a scalable program for increasing physical activity among women aged 50+. The program included information, activity tracker and email support. This study sought to describe the participant perspectives of the Active Women over 50 program and considerations for designing physical activity interventions for this demographic. METHODS Women who completed the Active Women over 50 trial were purposively recruited for maximum variation in age, employment, carer responsibility, medical conditions and physical activity. Individual semi-structured interviews explored their perspectives on physical activity, Active Women over 50 program components and suggestions for future iterations. Data were thematically analysed. RESULTS Participants' capacity to be physically active was shaped by an interplay of factors. Our analysis generated four main themes relating to physical activity in general and to the program: Age and gender matters, Physical activity is social, Strategising for physical activity and the Self-responsibility discourse. At this midlife stage, physical activity participation was challenged by personal, life-stage and cultural factors, alongside a tension of the self-responsibility discourse which also impacted the program experience. Social factors and finding a suitable strategy for motivation were deemed integral aspects of being active. Future programs could consider facilitation of social networks and accountability, life-stage health information and positive framing to support self-responsibility. CONCLUSION A range of strategies is key to supporting women over 50 to be more physically active due to the variety of circumstances and levels of agency experienced. We offer suggestions that do not need to be resource intensive but could be incorporated into a scaled program.
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Affiliation(s)
- Geraldine Wallbank
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, Australia. .,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,, Missenden Road, PO Box M179, 2050, Camperdown, NSW, Australia.
| | - Abby Haynes
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Anne C Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
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6
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Hartman SJ, Chen R, Tam RM, Narayan HK, Natarajan L, Liu L. Fitbit Use and Activity Levels From Intervention to 2 Years After: Secondary Analysis of a Randomized Controlled Trial. JMIR Mhealth Uhealth 2022; 10:e37086. [PMID: 35771607 PMCID: PMC9284361 DOI: 10.2196/37086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background There has been a rapid increase in the use of commercially available activity trackers, such as Fitbit, in physical activity intervention research. However, little is known about the long-term sustained use of trackers and behavior change after short-term interventions. Objective This study aims to use minute-level data collected from a Fitbit tracker for up to 2 years after the end of a randomized controlled trial to examine patterns of Fitbit use and activity over time. Methods Participants in this secondary data analysis were 75 female breast cancer survivors who had been enrolled in a 12-week physical activity randomized controlled trial. Participants randomized to the exercise intervention (full intervention arm) received a Fitbit One, which was worn daily throughout the 12-week intervention, and then were followed for 2 years after the intervention. Participants randomized to the waitlist arm, after completing the randomized controlled trial, received a Fitbit One and a minimal version of the exercise intervention (light intervention arm), and then were followed for 2 years after the intervention. Average and daily adherence and MVPA were compared between the 2 groups in the interventional and postinterventional periods using both linear and generalized additive mixed effects models. Results Adherence to wearing the Fitbit during the 12-week intervention period was significantly higher in the full intervention arm than in the light intervention arm (85% vs 60%; P<.001). Average adherence was significantly lower for both study arms during the follow-up period than in the intervention period; however, there were statistically different patterns of adherence during the follow-up period, with the light intervention arm having steeper declines than the full intervention arm over time (P<.001). Similar to the adherence results, mean minutes of Fitbit-measured MVPA was higher for the full intervention arm than for the light intervention arm during the 12-week intervention period (mean MVPA 27.89 minutes/day, SD 16.38 minutes/day vs 18.35 minutes/day, SD 12.64 minutes/day; P<.001). During the follow-up period, average MVPA was significantly lower than the 12-week intervention period for both the full intervention arm (21.74 minutes/day, SD 24.65 minutes/day; P=.002) and the light intervention arm (15.03 minutes/day, SD 13.27 minutes/day; P=.004). Although the mean MVPA in each arm was similar across the follow-up period (P=.33), the pattern of daily MVPA was significantly different between the 2 groups (P<.001). Conclusions While adherence to wearing activity trackers and maintaining physical activities declined after completion of a 12-week exercise intervention, a more active interventional strategy resulted in greater wear time and activity levels during the intervention and more stable patterns of adherence and activity in the long term. An improved understanding of long-term maintenance patterns may inform improved exercise interventions that result in sustained increases in physical activity. Trial Registration ClinicalTrials.gov NCT02332876; https://clinicaltrials.gov/ct2/show/NCT02332876
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Affiliation(s)
- Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
- Moores Cancer Center, University of California, San Diego, San Diego, CA, United States
| | - Ruohui Chen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
- Moores Cancer Center, University of California, San Diego, San Diego, CA, United States
| | - Rowena M Tam
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Hari K Narayan
- Moores Cancer Center, University of California, San Diego, San Diego, CA, United States
- Department of Pediatrics, University of California, San Diego, San Diego, CA, United States
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
- Moores Cancer Center, University of California, San Diego, San Diego, CA, United States
| | - Lin Liu
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
- Moores Cancer Center, University of California, San Diego, San Diego, CA, United States
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7
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Dharanikota S, LeRouge CM, Lyon V, Durneva P, Thompson M. Identifying Enablers of Participant Engagement in Clinical Trials of Consumer Health Technologies: Qualitative Study of Influenza Home Testing. J Med Internet Res 2021; 23:e26869. [PMID: 34519664 PMCID: PMC8479603 DOI: 10.2196/26869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/13/2021] [Accepted: 07/27/2021] [Indexed: 01/26/2023] Open
Abstract
Background A rise in the recent trend of self-managing health using consumer health technologies highlights the importance of efficient and successful consumer health technology trials. Trials are particularly essential to support large-scale implementations of consumer health technologies, such as smartphone-supported home tests. However, trials are generally fraught with challenges, such as inadequate enrollment, lack of fidelity to interventions, and high dropout rates. Understanding the reasons underlying individuals’ participation in trials can inform the design and execution of future trials of smartphone-supported home tests. Objective This study aims to identify the enablers of potential participants’ trial engagement for clinical trials of smartphone-supported home tests. We use influenza home testing as our instantiation of a consumer health technology subject to trial to investigate the dispositional and situational enablers that influenced trial engagement. Methods We conducted semistructured interviews with 31 trial participants using purposive sampling to facilitate demographic diversity. The interviews included a discussion of participants’ personal characteristics and external factors that enabled their trial engagement with a smartphone-supported home test for influenza. We performed both deductive and inductive thematic analyses to analyze the interview transcripts and identify enabler themes. Results Our thematic analyses revealed a structure of dispositional and situational enablers that enhanced trial engagement. Situationally, clinical affiliation, personal advice, promotional recruitment strategies, financial incentives, and insurance status influenced trial engagement. In addition, digital health literacy, motivation to advance medical research, personal innovativeness, altruism, curiosity, positive attitude, and potential to minimize doctors’ visits were identified as the dispositional enablers for trial engagement in our study. Conclusions We organized the identified themes for dispositional and situational enablers of trial engagement with a smartphone-supported home test into a research framework that can guide future research as well as the trial design and execution of smartphone-supported home tests. We suggest several trial design and engagement strategies to enhance the financial and scientific viability of these trials that pave the way for advancements in patient care. Furthermore, our study also offers practical strategies to trial organizers to enhance participants’ enrollment and engagement in clinical trials of these home tests.
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Affiliation(s)
- Spurthy Dharanikota
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States
| | - Cynthia M LeRouge
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States
| | - Victoria Lyon
- Primary Care Innovation Lab, Department of Family Medicine, University of Washington, Seattle, WA, United States
| | - Polina Durneva
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States
| | - Matthew Thompson
- Primary Care Innovation Lab, Department of Family Medicine, University of Washington, Seattle, WA, United States
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8
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Nezami BT, Valle CG, Nulty AK, Espeland M, Wing RR, Tate DF. Predictors and Outcomes of Digital Weighing and Activity Tracking Lapses Among Young Adults During Weight Gain Prevention. Obesity (Silver Spring) 2021; 29:698-705. [PMID: 33759388 PMCID: PMC7995618 DOI: 10.1002/oby.23123] [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: 07/31/2020] [Revised: 12/22/2020] [Accepted: 12/29/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Self-monitoring is critical for weight management, but little is known about lapses in the use of digital self-monitoring. The objectives of this study were to examine whether lapses in self-weighing and wearing activity trackers are associated with weight and activity outcomes and to identify objective predictors of lapses. METHODS Participants (N = 160, BMI = 25.5 ± 3.3 kg/m2 , 33.1 ± 4.6 years old) were drawn from a sample of young adults in the Study of Novel Approaches to Prevention-Extension (SNAP-E) weight gain prevention trial. Analyses evaluated associations between weighing and tracker lapses and changes in weight and steps/day during the first 90 days after receiving a smart scale and activity tracker. RESULTS On average, participants self-weighed 49.6% of days and wore activity trackers 75.2% of days. Every 1-day increase in a weighing lapse was associated with a 0.06-lb gain. Lapses in tracker wear were not associated with changes in steps/day or weight between wear days. Weight gain predicted a higher likelihood of starting a lapse in weighing and tracker wear, whereas lower steps predicted a higher likelihood of a tracker lapse. CONCLUSIONS Weight gain may discourage adherence to self-monitoring. Future research could examine just-in-time supports to anticipate and reduce the frequency or length of self-monitoring lapses.
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Affiliation(s)
- Brooke T. Nezami
- Department of Nutrition, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
| | - Carmina G. Valle
- Department of Nutrition, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alison K. Nulty
- Department of Anthropology, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
| | - Mark Espeland
- Division of Gerontology and Geriatric Medicine, Wake Forest
School of Medicine, Winston-Salem, NC, USA
| | - Rena R. Wing
- Department of Psychiatry and Human Behavior, Alpert Medical
School of Brown University, Miriam Hospital, Providence, RI, USA
| | - Deborah F. Tate
- Department of Nutrition, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, University of North Carolina
at Chapel Hill, Chapel Hill, NC, USA
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9
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Figueroa CA, Vittinghoff E, Aguilera A, Fukuoka Y. Differences in objectively measured daily physical activity patterns related to depressive symptoms in community dwelling women - mPED trial. Prev Med Rep 2021; 22:101325. [PMID: 33659156 PMCID: PMC7890210 DOI: 10.1016/j.pmedr.2021.101325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/08/2021] [Accepted: 01/20/2021] [Indexed: 11/28/2022] Open
Abstract
Physical activity (PA) is an effective depression treatment. However, knowledge on how variation in day-to-day PA relates to depression in women is lacking. The purposes of this study were to 1) compare overall objectively measured baseline daily steps and duration of moderate to vigorous PA (MVPA) and 2) examine differences in steps and MVPA on days of the week between women aged 25–65 years, who were physically inactive, with high and low depressive symptoms, enrolled in a run-in period of the mobile phone based physical activity education (mPED) trial. The Center for Epidemiological Studies Depression Scale was used to categorize low/high depressive symptom groups. We used linear mixed-effects models to examine the associations between steps and MVPA and depression-status overall and by day of the week, adjusting for selected demographic variables and their interactions with day of the week. 274 women were included in the final analysis, of which 58 had high depressive symptoms. Overall physical activity levels did not differ. However, day of the week modified the associations of depression with MVPA (p = 0.015) and daily steps (p = 0.08). Women with high depression were characterized by reduced activity at the end of the week (Posthoc: Friday: 791 fewer steps, 95% CI: 73–1509, p = 0.03; 8.8 lower MVPA, 95% CI: 2.16–15.5, p = 0.0098) compared to women with low depression, who showed increased activity. Day of the week might be an important target for personalization of physical activity interventions. Future work should evaluate potential causes of daily activity alterations in depression in women.
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Affiliation(s)
| | - Eric Vittinghoff
- Department of Epidemiology & Biostatistics, University of California, San Francisco, United States
| | - Adrian Aguilera
- School of Social Welfare, University of California, Berkeley, United States.,Zuckerberg San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Yoshimi Fukuoka
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, United States
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10
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Parker K, Uddin R, Ridgers ND, Brown H, Veitch J, Salmon J, Timperio A, Sahlqvist S, Cassar S, Toffoletti K, Maddison R, Arundell L. The Use of Digital Platforms for Adults' and Adolescents' Physical Activity During the COVID-19 Pandemic (Our Life at Home): Survey Study. J Med Internet Res 2021; 23:e23389. [PMID: 33481759 PMCID: PMC7857525 DOI: 10.2196/23389] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/12/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Government responses to managing the COVID-19 pandemic may have impacted the way individuals were able to engage in physical activity. Digital platforms are a promising way to support physical activity levels and may have provided an alternative for people to maintain their activity while at home. OBJECTIVE This study aimed to examine associations between the use of digital platforms and adherence to the physical activity guidelines among Australian adults and adolescents during the COVID-19 stay-at-home restrictions in April and May 2020. METHODS A national online survey was distributed in May 2020. Participants included 1188 adults (mean age 37.4 years, SD 15.1; 980/1188, 82.5% female) and 963 adolescents (mean age 16.2 years, SD 1.2; 685/963, 71.1% female). Participants reported demographic characteristics, use of digital platforms for physical activity over the previous month, and adherence to moderate- to vigorous-intensity physical activity (MVPA) and muscle-strengthening exercise (MSE) guidelines. Multilevel logistic regression models examined differences in guideline adherence between those who used digital platforms (ie, users) to support their physical activity compared to those who did not (ie, nonusers). RESULTS Digital platforms include streaming services for exercise (eg, YouTube, Instagram, and Facebook); subscriber fitness programs, via an app or online (eg, Centr and MyFitnessPal); facilitated online live or recorded classes, via platforms such as Zoom (eg, dance, sport training, and fitness class); sport- or activity-specific apps designed by sporting organizations for participants to keep up their skills (eg, TeamBuildr); active electronic games (eg, Xbox Kinect); and/or online or digital training or racing platforms (eg, Zwift, FullGaz, and Rouvy). Overall, 39.5% (469/1188) of adults and 26.5% (255/963) of adolescents reported using digital platforms for physical activity. Among adults, MVPA (odds ratio [OR] 2.0, 95% CI 1.5-2.7), MSE (OR 3.3, 95% CI 2.5-4.5), and combined (OR 2.7, 95% CI 2.0-3.8) guideline adherence were higher among digital platform users relative to nonusers. Adolescents' MVPA (OR 2.4, 95% CI 1.3-4.3), MSE (OR 3.1, 95% CI 2.1-4.4), and combined (OR 4.3, 95% CI 2.1-9.0) guideline adherence were also higher among users of digital platforms relative to nonusers. CONCLUSIONS Digital platform users were more likely than nonusers to meet MVPA and MSE guidelines during the COVID-19 stay-at-home restrictions in April and May 2020. Digital platforms may play a critical role in helping to support physical activity engagement when access to facilities or opportunities for physical activity outside the home are restricted.
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Affiliation(s)
- Kate Parker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Riaz Uddin
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Helen Brown
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Shannon Sahlqvist
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Samuel Cassar
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Kim Toffoletti
- School of Humanities and Social Sciences, Faculty of Arts and Education, Deakin University, Burwood, Australia
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Lauren Arundell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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Lee H, Lee H, Kim Y, Kim S, Lee YM. Network Support Using Social Networking Services to Increase Exercise Adherence Among Korean-Chinese Middle-Aged Migrant Women: Mixed Methods Study. JMIR Mhealth Uhealth 2020; 8:e19159. [PMID: 33151155 PMCID: PMC7677014 DOI: 10.2196/19159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/23/2020] [Accepted: 08/11/2020] [Indexed: 12/11/2022] Open
Abstract
Background Social networking services (SNSs) are recognized to be a promising approach to easily deliver health interventions and to enhance social support for exercise adherence. However, the patterns and aspects of social support through SNSs have not been reported and their influence on other social-cognitive factors remains inconclusive. Objective Our objective is to explore how social support delivered through SNSs impacts interactions among Korean-Chinese (KC) middle-aged women and to identify how this approach influences social-cognitive factors for exercise (eg, sense of community, self-efficacy for exercise, and social support for exercise). Methods A mixed methods design was used. Text analysis of SNS messages and text mining using the Korean Natural Language Application (KoALA) were conducted. Social-cognitive factors (eg, sense of community, self-efficacy for exercise, and social support for exercise) were assessed at baseline and after 12 weeks using a structured questionnaire. A comparison of social-cognitive factors at baseline and at 12 weeks was conducted to identify any potential significant changes, using the Wilcoxon signed-rank test. Results A total of 259 SNS messages were collected from 24 KC women, distributed among four chat groups, who participated in a 12-week walking intervention program between August and October 2018. The individual average frequency of chatting via the SNS was 10.79 (range 0-34) and the most frequent type of social support through the SNS was network support (172/259, 66.4%). The most common words extracted from the SNS were Health, Exercise, Participation, and We. Overall, the perceived levels of sense of community (P<.001) and social support for exercise (P=.002) were significantly increased at 12 weeks compared with baseline. Group 1 (P=.03) and Group 4 (P=.03), whose members demonstrated the highest frequency of network support, experienced a significant increase only in the level of sense of community. Conclusions By integrating these data and conducting a mixed methods analysis, we observed that among the types of social support, network support was a key point for the promotion of social-cognitive factors in increasing exercise adherence. Therefore, network support through SNS-based interventions should be considered as a useful strategy to help vulnerable migrant populations make changes to exercise behaviors.
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Affiliation(s)
- Hyeyeon Lee
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Hyeonkyeong Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Youlim Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Sookyung Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Young-Me Lee
- School of Nursing, College of Science and Health, Depaul University, Chicago, IL, United States
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Fortune J, Norris M, Stennett A, Kilbride C, Lavelle G, Victor C, De Souza L, Hendrie W, Ryan J. Pedometers, the frustrating motivators: a qualitative investigation of users' experiences of the Yamax SW-200 among people with multiple sclerosis. Disabil Rehabil 2020; 44:436-442. [PMID: 32515233 DOI: 10.1080/09638288.2020.1770344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Self-monitoring may represent a mechanism to enhance physical activity among people with multiple sclerosis. To optimise activity monitoring as a behavioural tool to increase physical activity, user experience must be understood. This study evaluated user experience of the Yamax SW-200 Digi-walker pedometer in a group of people with MS.Methods: Semi-structured interviews were conducted with 15 adults who participated in a 12-week pedometer-supported behavioural change intervention, the iStep-MS trial. Interviews were audio-recorded and transcribed verbatim. Data were analysed using the Framework Method.Results: An overarching theme Pedometers, the frustrating motivators captures the complex and often contradictory experience of the pedometer. Sub-themes include: Increasing activity awareness, which describes the pedometer's utility in raising activity consciousness; Numeric motivation provides insight into dual motivating and demotivating experiences of using an objective feedback device; (Un) usability focuses on practical concerns encountered in the day-to-day use of the monitor.Conclusion: The Yamax SW-200 Digi-walker raised awareness and enhanced participant motivation to engage in physical activity. Accuracy and usability concerns highlighted warrant consideration in the selection of this pedometer within a population with multiple sclerosis. Trial registration: Changing physical activity behaviour in people with MS: the iStep-MS trial; ISRCTN15343862; https://doi.org/10.1186/ISRCTN15343862Implications for rehabilitationUse of self-monitoring tools such as pedometers can enhance physical activity awareness.Objective, numeric step count feedback is an effective motivational tool for physical activity.Accuracy and usability concerns may limit the value of the Yamax SW-200 Digiwalker for people with MS.Identification of individualised, reliable, usable and acceptable tools is important to ensure engagement with self-monitoring.
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Affiliation(s)
- Jennifer Fortune
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | - Meriel Norris
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University, London, UK
| | - Andrea Stennett
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University, London, UK
| | - Cherry Kilbride
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University, London, UK
| | - Grace Lavelle
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University, London, UK
| | - Christina Victor
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University, London, UK
| | - Lorraine De Souza
- Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University, London, UK
| | | | - Jennifer Ryan
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,Ageing Studies Theme, Institute of Environment, Health and Societies, Brunel University, London, UK
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Setchell J, Turpin M, Costa N, Hodges P. Web-Based Consumer Health Education About Back Pain: Findings of Potential Tensions From a Photo-Elicitation and Observational Study. JMIR Rehabil Assist Technol 2020; 7:e17130. [PMID: 32478663 PMCID: PMC7296418 DOI: 10.2196/17130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/24/2020] [Accepted: 03/20/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a leading cause of disability worldwide, with huge social and economic impact. There is extensive extant literature investigating the efficacy of various management approaches ranging from surgery to psychological interventions to exercise. However, this work has focused almost entirely on efficacy in terms of pain reduction, functional improvement, and psychological changes. This focus has meant that unanticipated social or socio-cultural effects of back pain health care have received little attention. OBJECTIVE This study aimed to scrutinize some of the conceptual tensions inherent in contemporary LBP health care approaches and to highlight their material effects. METHODS We used a qualitative research design adapted from discourse analysis, which was able to consider key discursive tensions underpinning a LBP website. Data collection involved observing the interaction between adult participants with LBP and the website in the following two ways: (1) observational interview, where participants were observed interacting with the website for the first time and asked to discuss their responses to it as they moved through the website and (2) photo-elicitation, where for a month after their first use of the website, people took photographs of what was happening in their lives when they thought of the website and discussed them in a follow-up interview. We used a postcritical discourse analysis approach to examine data produced from these methods. RESULTS Our postcritical discourse analysis identified key discursive tensions, including between living with and reducing LBP, keeping active and resting, and patient choice and giving guidance. CONCLUSIONS Our analysis suggests ways for considering less dominant perspectives without having to discard the benefits of dominant ones. Although the focus of LBP discourses has changed (less biomedical and less about cure), they still hold on to some of the problematic dominant paradigmatic concepts such as biomedicine and individualism. The tensions we highlight are likely to be highly useful for teaching and implementing LBP care across multiple health care settings.
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Affiliation(s)
- Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Merrill Turpin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nathalia Costa
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Paul Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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