Assessing the Acceptability and Effectiveness of Mobile-Based Physical Activity Interventions for Midlife Women During Menopause: Systematic Review of the Literature

Patient-Reported Perception of Exercise and Receptiveness to Mobile Technology in Cancer Survivors Living in Rural and Remote Areas

PURPOSE

Cancer survivors in rural and underserved areas face barriers such as limited access to oncology exercise programs and limited facilities, contributing to health inequities in cancer survivorship. This study explored cancer survivors' thoughts on exercise and mobile technology for exercising with a mobile application (app) during and after treatment in rural and remote areas.

METHODS

Three online focus groups were conducted in February 2024 using semi-structured interviews with 12 open-ended questions. Eligible participants were adult cancer survivors or caregivers living in medically underserved areas, English-speaking, consented to being audiotaped, and attended one 60-min group interview. The discussions were transcribed verbatim and analyzed via a content analysis approach with consensus.

RESULTS

Fifteen participants attended from four States. None of the participants were advised to exercise; availability of exercise resources depended on geographic location and a cancer-specific exercise app was desired. They understood the benefits of exercise after diagnosis but expressed a need for more guidance during treatment. Geographic location shaped their activities, with most engaging in daily physical tasks rather than structured exercise. Most participants were receptive to using an exercise app to manage fatigue. Suggested key features to exercise with an app included live trainers, exercise checklists, visual benchmarks, and programs tailored to different fitness levels.

CONCLUSIONS

These results emphasize the need for personalized resources, guidance, and on-demand accessibility to an exercise oncology app. A cancer-specific exercise mobile app will mitigate health inequities for cancer survivors residing in rural and remote areas.

Effectiveness of Mobile-Based Progressive and Fixed Physical Activity on Depression, Stress, Anxiety, and Quality of Life Outcomes Among Adults in South Korea: Randomized Controlled Trial

BACKGROUND

Depression acts as a significant obstacle to the overall well-being of individuals. Given the significant consequences, timely recognition and proactive steps to manage symptoms of depression become essential. Such actions not only reduce personal distress but also play a crucial role in reducing its far-reaching impact on society as a whole.

OBJECTIVE

In response to this concern, the objective of this study was to explore the use of mobile-based interventions as a possible remedy. More specifically, this study aimed to investigate the effectiveness of 2 types of physical activity (PA), progressive and fixed, within a mobile-based app on depression, perceived stress, anxiety, physical health, and psychological health, aiming to contribute to the optimization of mental health benefits.

METHODS

Participants (N=60; mean age 25.29, SD 6.10 years) were recruited using a combination of web-based and offline methods, and the study lasted for 8 weeks. The baseline and posttest questionnaires were administered to all participants. The participants were randomly assigned to 1 of the 3 groups: progressive group (n=20; performing mobile-based progressive PA), fixed group (n=20; performing mobile-based fixed intensity PA), and control group C (n=20). Data analysis involved comparing scores between the experimental and control groups using a one-way ANOVA, paired sample t tests (2-tailed), and repeated measures ANOVA with a 3 (group)×2 (time) design.

RESULTS

The findings revealed significant improvements in mental health indicators among participants engaged in both fixed and progressive PA groups compared with the control group. However, the fixed PA group demonstrated more significant reductions in symptoms. Specifically, the progressive PA group showed significant reductions in depression (F1,36=6.941; P=.01; ηp2=0.16) and perceived stress (F1,36=5.47; P=.03; ηp2=0.13), while the fixed PA group exhibited significant reductions in depression (F1,37=5.36; P=.03; ηp2=0.12), perceived stress (F1,37=7.81; P=.008; ηp2=0.17), and general anxiety disorder (F1,37=5.45; P=.03; ηp2=0.13) compared with the control group.

CONCLUSIONS

This study underscores the potential of mobile-based PA in improving mental health outcomes. The findings offer significant insights for mental health professionals and researchers aiming to optimize mental well-being through innovative mobile therapies.

TRIAL REGISTRATION

Clinical Research Information Service KCT0009100; https://tinyurl.com/mr33fmur.

Attitudes, Barriers, and Motivators Toward Daily Walking and a Mobile App to Increase Walking Among Women: Web-Based Anonymous Survey

BACKGROUND

There are disparities in the prevalence of physical activity (PA) with women engaging in less PA than men, a gap which widens during midlife. Walking is a generally accepted form of PA among women and should be encouraged. Motivations, barriers, and attitudes to engaging in walking change with age, but the influencing factors are not well understood nor are the features of mobile apps that facilitate daily walking.

OBJECTIVE

This study explores the relationship between age and women's self-reported motivations, barriers, attitudes, and beliefs toward daily walking. It further assesses attitudes toward features of a mobile app designed to sync with a wearable step tracker to increase and maintain levels of daily walking among women.

METHODS

A web-based anonymous survey was completed by 400 women, aged 21-75 years. The 31-item survey captured women's perceived barriers and motivators toward daily walking and attitudes toward mobile apps to support and maintain daily walking. For analysis, responses to the survey were grouped into 2 categories of women: ages 21-49 years and ages 50-75 years. Bivariate analyses were conducted through SPSS (IBM Corp) for each of the survey questions using chi-square for dichotomous variables and 1-tailed t tests for scales and continuous variables to identify significant differences between the groups. One-tailed t tests were run for scaled variables to identify significant differences between the 10-year age increments.

RESULTS

Significant barriers to daily walking were observed in the 21-49-year group for personal and work responsibilities, motivational and psychosocial factors, and physical and environmental factors. Motivators to walk daily in the 21- 49-year group were significantly higher to reduce stress and anxiety, and motivators to walk daily in the 50-75-year group were significantly higher to help manage or lose weight and to reduce the risk of chronic illness. Women's walking preferences, beliefs around their walking behaviors, and their perceived importance of the features of a future mobile app for walking designed specifically for women showed significant variation according to age. When asked about the importance of features for a mobile app, women aged 21-49 years indicated a significantly higher number of positive responses for the following features: digital community support, rewards or point system, and seeing a daily or weekly or monthly progress chart.

CONCLUSIONS

Our findings indicate that barriers, motivators, and beliefs around daily walking and the importance of preferred features of a mobile app vary according to women's ages. Messaging and app features should be tailored to different age groups of women. These study results can be viewed as a foundation for future research and development of mobile health interventions to effectively increase daily walking among women of all ages.

Level of adherence to diet and physical activity among menopausal women and influencing factors in Jordan: a descriptive cross-sectional study

Background

During menopause, a woman's lifestyle may change significantly, which will have implications on her quality of life. Women will experience menopause for more than a third of their life; therefore, maintaining good health during this period is crucial. A healthy diet and physical activity can help women maintain their health during menopause. Hence, assessing adherence to a healthy diet and physical activity among menopausal women is important.

Purpose

This study aims to assess the degree of adherence to a healthy diet and physical activity of menopausal women in Jordan and determine the most influential factors.

Methods

A descriptive cross-sectional design was used in this study, and an online self-administered questionnaire was sent to 299 menopausal women selected through simple random sampling. A valid and reliable questionnaire was used to assess the menopausal women's adherence to a healthy diet and physical activity. The questionnaire consisted of 14 items covering two domains: 12 questions for the diet domain and two questions for the physical activity domain. Descriptive statistics were obtained, mean weight and body mass index (BMI) were calculated, and stepwise regression was conducted for the data analysis.

Results

The overall degree of adherence to a healthy diet and physical activity of the women was moderate (49.25, SD = 7.17). Most of the participants reported eating refined food items once a month or less (n = 188, 62.9%) and not exercising weekly (n = 119, 39.8%), and only a few reported eating refined food items at least once a day (n = 5, 1.7%) and exercising 5-6 times a week (n = 15, 5%). The regression analysis showed that age (B = 0.145, p = 0.014), having two children (B = 0.123, p = 0.034) and completing primary or secondary education (B = 0.120, p = 0.038) were statistically significant and the strongest predictors of adherence. The predictors accounted for 68% of the variance in adherence to a healthy diet and physical activity (R2 = 0.068, F [343.54] = 7.123, p = 0.000).

Conclusion

The majority of the middle-aged menopausal women in this study showed moderate adherence to a healthy diet and physical activity. Age, having two children and completing primary or secondary education were associated with degree of adherence to a healthy diet and physical activity. Therefore, healthcare intervention, such as physical activity and dietary control programs, should target women in this age group and stage in life.

Challenges and Implications for Menopausal Health and Help-Seeking Behaviors in Midlife Women From the United States and China in Light of the COVID-19 Pandemic: Web-Based Panel Surveys

BACKGROUND

The global population of women of menopausal age is quickly increasing. The COVID-19 pandemic has led to an accelerated increase in the use of telehealth services, especially technological solutions targeting women's health. Understanding the factors behind midlife women's help-seeking behaviors amidst the pandemic will assist in the development of person-centered holistic telehealth solutions targeting menopausal and postreproductive health.

OBJECTIVE

This study aimed to compare the factors underlying help-seeking for menopausal distress among midlife women in the United States and China.

METHODS

We conducted 2 web-based panel surveys in the United States using Amazon Mechanical Turk and in China using Credamo between July and October 2022. A total of 1002 American and 860 Chinese women aged between 40 and 65 years took part in the survey. The survey was designed based on the Health Belief Model with questions related to their menopausal knowledge, perceived severity of menopausal symptoms, perceived susceptibility to menopausal distress, perceived benefits of help-seeking, perceived COVID-19- and non-COVID-19-related barriers against help-seeking, self-efficacy, and motivation to seek help. Structural equations models were fitted for the data using full information maximum likelihood to manage missing data.

RESULTS

Knowledge was not directly related to help-seeking motivation in both samples. Among the Chinese sample, knowledge was negatively related to perceived severity but positively related to COVID-19-related barriers; in turn, higher perceived severity, benefits, COVID-19-related barriers, and self-efficacy and lower non-COVID-19-related barriers were related to more motivation to seek help. In the US sample, knowledge was negatively related to perceived severity, susceptibility, benefits, barriers (COVID-19- and non-COVID-19-related), and self-efficacy; in turn, higher self-efficacy, COVID-19-related barriers, and benefits were associated with more help-seeking motivation. The factors explained 53% and 45.3% of the variance of help-seeking motivation among the American and Chinese participants, respectively.

CONCLUSIONS

This study revealed disparate pathways between knowledge, health beliefs, and the motivation for help-seeking among American and Chinese midlife women with respect to menopausal distress. Our findings show that knowledge may not directly influence help-seeking motivation. Instead, perceived benefits and self-efficacy consistently predicted help-seeking motivation. Interestingly, concern over COVID-19 infection was related to higher help-seeking motivation in both samples. Hence, our findings recommend the further development of telehealth services to (1) develop content beyond health education and symptom management that serves to enhance the perceived benefits of addressing women's multidimensional menopausal health needs, (2) facilitate patient-care provider communication with a focus on self-efficacy and a propensity to engage in help-seeking behaviors, and (3) target women who have greater midlife health concerns in the postpandemic era.