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Dawe J, Cavicchiolo E, Palombi T, Baiocco R, Antoniucci C, Pistella J, Alessandri G, Filosa L, Tavolucci S, Borghi AM, Fini C, Chirico A, Alivernini F, Lucidi F. Measuring Self-Efficacy for Exercise among Older Adults: Psychometric Properties and Measurement Invariance of a Brief Version of the Self-Efficacy for Exercise (SEE) Scale. Healthcare (Basel) 2024; 12:1642. [PMID: 39201200 PMCID: PMC11353483 DOI: 10.3390/healthcare12161642] [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: 07/18/2024] [Revised: 08/12/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024] Open
Abstract
(1) Background: Physical activity is known to promote health and psychological well-being in older adults, yet global inactivity rates in this population remain high. Among the factors associated with physical activity, self-efficacy for exercise represents a key predictor for developing effective interventions in older adults. This study aimed to validate the Self-Efficacy for Exercise Scale (SEE) in individuals over 65. (2) Methods: A sample of 726 older adults from the USA and Italy (51.1% females; age range = 65-95 years; Mage = 72.57, SDage = 6.49) completed the SEE, along with the Godin-Shepard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), the Big Five Inventory 2-Extra Short Form (BFI-2-XS), and the 12-item Short Form Health Survey (SF-12). (3) Results: The SEE showed a Cronbach's Alpha of 0.88 and a Composite Reliability of 0.89. Moreover, it demonstrated a unidimensional factor structure and good fit indices. Full measurement invariance was achieved across gender and age, while partial scalar invariance was found across countries, suggesting minor cultural differences. Correlation with the GSLTPAQ, the BFI-2-XS, and the SF-12 support the convergent and nomological validity of the SEE. (4) Conclusions: These findings provide evidence that the SEE is a reliable and valid measure of self-efficacy for exercise among older adults and that the items are interpreted similarly across different ages, genders, and cultures.
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Affiliation(s)
- James Dawe
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (T.P.); (R.B.); (C.A.); (J.P.); (A.C.); (F.A.); (F.L.)
| | - Elisa Cavicchiolo
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Tommaso Palombi
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (T.P.); (R.B.); (C.A.); (J.P.); (A.C.); (F.A.); (F.L.)
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (T.P.); (R.B.); (C.A.); (J.P.); (A.C.); (F.A.); (F.L.)
| | - Chiara Antoniucci
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (T.P.); (R.B.); (C.A.); (J.P.); (A.C.); (F.A.); (F.L.)
| | - Jessica Pistella
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (T.P.); (R.B.); (C.A.); (J.P.); (A.C.); (F.A.); (F.L.)
| | - Guido Alessandri
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (G.A.); (L.F.); (S.T.)
| | - Lorenzo Filosa
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (G.A.); (L.F.); (S.T.)
| | - Simone Tavolucci
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (G.A.); (L.F.); (S.T.)
| | - Anna M. Borghi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, 00185 Rome, Italy; (A.M.B.); (C.F.)
| | - Chiara Fini
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, 00185 Rome, Italy; (A.M.B.); (C.F.)
| | - Andrea Chirico
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (T.P.); (R.B.); (C.A.); (J.P.); (A.C.); (F.A.); (F.L.)
| | - Fabio Alivernini
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (T.P.); (R.B.); (C.A.); (J.P.); (A.C.); (F.A.); (F.L.)
| | - Fabio Lucidi
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy; (T.P.); (R.B.); (C.A.); (J.P.); (A.C.); (F.A.); (F.L.)
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Hayotte M, Roubaud P, Bersia B, Nègre V, d'Arripe-Longueville F. Associations Between ADHD Symptomatology, Motivation for Physical Activity, and Technology Acceptability in Young Adult Women With Obesity. J Atten Disord 2024; 28:1406-1411. [PMID: 38742744 DOI: 10.1177/10870547241253157] [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: 05/16/2024]
Abstract
OBJECTIVE This study examined the relationships between ADHD symptomatology, the motivations for physical activity (PA) according to self-determination theory, and the acceptability of three PA promotion technologies (active video game, mobile application, and telehealth) according to the dimensions of the unified theory of acceptance and use of technology-2 (UTAUT2). METHOD A total of 312 women, aged 30.7 ± 7.1 years, followed for obesity with an average body mass index of 34.5 ± 7.8 kg/m², were included in this sub-analysis. RESULTS Fifty-seven individuals (18.3%) were identified with positive screening symptoms of ADHD. No differences emerged regarding acceptability of technology-based PA. However, individuals with positive screening for ADHD tended to have higher scores for acceptability of active video game on the UTAUT2 dimensions of effort expectancy and hedonic motivation. CONCLUSION This study suggests that active video game may be more appropriate than other technologies for individuals with obesity and ADHD symptoms.
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Affiliation(s)
| | | | | | - Véronique Nègre
- Université Côte d'Azur, CHU Nice, Centre Spécialisé Obésité PACA Est, France
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Katigbak C, Cheng SF, Matz C, Jimison H. Let's Walk: A Quasi-Experimental Multi-Component Intervention to Improve Physical Activity and Social Engagement for Older Chinese American Adults. J Immigr Minor Health 2024; 26:651-659. [PMID: 38349468 PMCID: PMC11288783 DOI: 10.1007/s10903-024-01584-8] [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] [Accepted: 01/29/2024] [Indexed: 07/31/2024]
Abstract
Physical activity (PA) is critical for healthy aging, yet < 16% of U.S. older adults meet federal recommendations for moderate to vigorous PA. Asian Americans are a rapidly growing segment of the older adult population, who are less likely to meet these guidelines, and are frequently under-represented in clinical trials. This quasi-experimental pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of a culturally tailored walking program to improve PA and social engagement for older Chinese Americans in Boston, MA. Participants at two community organizations were assigned to an enhanced walking or walking only condition for 12 weeks. Mixed effect repeated measures analysis addressed the study aims. The enhanced walking group (intervention) had fewer steps at baseline and less of a reduction in steps by 12 weeks as compared with the walking only (control) condition. Mean social engagement scores were significantly higher at 12 weeks (p = .03) for the intervention group. A culturally tailored walking intervention was feasible and acceptable for older Chinese Americans, improving social engagement and PA scores.
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Affiliation(s)
- Carina Katigbak
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Ssu-Fang Cheng
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Holly Jimison
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
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Leyk D, Hartmann N, Vits E, Rüther T, Klatt S, Lämmel R, Löllgen H. Health, Performance Ratings and Approachability of 50-60-Year-Old Sedentary Adults (ActIv-Study): Key Insights for Health Economy and Exercise Promotion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:969. [PMID: 39200580 PMCID: PMC11353363 DOI: 10.3390/ijerph21080969] [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: 04/30/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 09/02/2024]
Abstract
Despite significant prevention efforts, the numbers of physically inactive individuals, chronic illnesses, exhaustion syndromes and sick leaves are increasing. A still unresolved problem with exercise promotion is the low participation of sedentary persons. This collective term covers heterogeneous subgroups. Their engagement with movement campaigns and resistance to change are influenced by numerous factors. Our aim was to analyse survey data on health, performance, lifestyle habits and the approachability to physical activity campaigns obtained from the Germany-wide ActIv survey. From 2888 study participants aged 50-60 years, 668 persons were categorised into the subgroups "never-athletes", "sports-dropouts", "always-athletes" and "sports-beginners". Large and significant group differences were found for BMI, assessment of quality of life, health and fitness, risk factors and health problems. In total, 42.5% of "never-athletes" and 32.5% of "sports-dropouts" did not state any barriers to sport. There are substantial disparities between the non-athlete groups in terms of their motivation to exercise. In contrast, there are comparatively minor differences in motivation between "sports-dropouts" and "sports-beginners", whose health and fitness are the primary motivators for sport. Our analyses suggest that (i) negative health and performance trends cannot be compensated for by appeals for voluntary participation in exercise programmes and (ii) powerful incentive systems are required.
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Affiliation(s)
- Dieter Leyk
- Research Group Exercise Epidemiology, German Sport University Cologne, 50933 Cologne, Germany; (N.H.); (E.V.); (T.R.); (H.L.)
- Faculty of Computer Science, University Koblenz, 56070 Koblenz, Germany;
| | - Nadine Hartmann
- Research Group Exercise Epidemiology, German Sport University Cologne, 50933 Cologne, Germany; (N.H.); (E.V.); (T.R.); (H.L.)
| | - Emanuel Vits
- Research Group Exercise Epidemiology, German Sport University Cologne, 50933 Cologne, Germany; (N.H.); (E.V.); (T.R.); (H.L.)
- Department X-Anesthesia, Bundeswehr Central Hospital Koblenz, 56072 Koblenz, Germany
| | - Thomas Rüther
- Research Group Exercise Epidemiology, German Sport University Cologne, 50933 Cologne, Germany; (N.H.); (E.V.); (T.R.); (H.L.)
| | - Stefanie Klatt
- Institute of Exercise Training and Sport Informatics, German Sport University Cologne, 50933 Cologne, Germany;
| | - Ralf Lämmel
- Faculty of Computer Science, University Koblenz, 56070 Koblenz, Germany;
| | - Herbert Löllgen
- Research Group Exercise Epidemiology, German Sport University Cologne, 50933 Cologne, Germany; (N.H.); (E.V.); (T.R.); (H.L.)
- Faculty of Medicine, University Mainz, 55131 Mainz, Germany
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Shi Y, Sasaki Y, Ishimura K, Mizuno S, Nakata Y. Exploring Determinants of Successful Weight Loss with the Use of a Smartphone Healthcare Application: Secondary Analysis of a Randomized Clinical Trial. Nutrients 2024; 16:2108. [PMID: 38999857 PMCID: PMC11243466 DOI: 10.3390/nu16132108] [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: 05/27/2024] [Revised: 06/10/2024] [Accepted: 06/29/2024] [Indexed: 07/14/2024] Open
Abstract
Dietary and physical activity interventions through smartphone healthcare applications (apps) have recently surged in popularity as effective methods for weight loss. However, the specific factors contributing to successful weight loss remain uncertain. We conducted an analysis of baseline characteristics and app usage frequencies over three months among 68 Japanese adults with overweight and obesity who were assigned to the intervention group in a previous randomized controlled trial. Logistic regression analysis revealed a negative association (OR: 0.248; p = 0.018) between having a walking habit at baseline and successful weight loss, defined as a 3% reduction in initial weight. Additionally, slower walking speeds and family medical history were identified as potential predictors of successful weight loss. These findings offer insights into the profile of individuals who achieve success in weight loss through our smartphone app, providing valuable guidance for the development of future healthcare apps.
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Affiliation(s)
- Yutong Shi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan;
| | - Yuki Sasaki
- Wellmira Inc., Chiyoda-ku, Tokyo 101-0041, Japan; (Y.S.); (S.M.)
| | - Keiko Ishimura
- Wellmira Inc., Chiyoda-ku, Tokyo 101-0041, Japan; (Y.S.); (S.M.)
| | | | - Yoshio Nakata
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
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Loder AKF, van Poppel MNM. Associations of smart device apps with and without a perceived self-efficacy component in a physical activity context with BMI. J Health Psychol 2024:13591053241258254. [PMID: 38898618 DOI: 10.1177/13591053241258254] [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: 06/21/2024] Open
Abstract
Smart device apps can be used to promote physical activity, decrease sedentariness, or increase self-efficacy to get active in college students, possibly reducing their obesity risk. This study assessed associations of college students' smart device use with body mass index (BMI), expecting associations between physical activity parameters and self-efficacy with BMI, moderated by app type. In an online survey, app data of a week from student's devices, weight, height, physical activity, and self-efficacy to get active were collected from 120 students. Apps were categorized "physical activity," "physical activity with a self-efficacy component," or "unrelated." Use time of physical activity apps is not associated with BMI, while self-efficacy app time show negative and unrelated app time positive associations. Self-efficacy may be an important component in app design for obesity risk reduction of college students. Test economy was low, which is why future studies need to concentrate on better data extraction methods.
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de Looff PC, Noordzij ML, Nijman HLI, Goedhard L, Bogaerts S, Didden R. Putting the usability of wearable technology in forensic psychiatry to the test: a randomized crossover trial. Front Psychiatry 2024; 15:1330993. [PMID: 38947186 PMCID: PMC11212012 DOI: 10.3389/fpsyt.2024.1330993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/02/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction Forensic psychiatric patients receive treatment to address their violent and aggressive behavior with the aim of facilitating their safe reintegration into society. On average, these treatments are effective, but the magnitude of effect sizes tends to be small, even when considering more recent advancements in digital mental health innovations. Recent research indicates that wearable technology has positive effects on the physical and mental health of the general population, and may thus also be of use in forensic psychiatry, both for patients and staff members. Several applications and use cases of wearable technology hold promise, particularly for patients with mild intellectual disability or borderline intellectual functioning, as these devices are thought to be user-friendly and provide continuous daily feedback. Method In the current randomized crossover trial, we addressed several limitations from previous research and compared the (continuous) usability and acceptance of four selected wearable devices. Each device was worn for one week by staff members and patients, amounting to a total of four weeks. Two of the devices were general purpose fitness trackers, while the other two devices used custom made applications designed for bio-cueing and for providing insights into physiological reactivity to daily stressors and events. Results Our findings indicated significant differences in usability, acceptance and continuous use between devices. The highest usability scores were obtained for the two fitness trackers (Fitbit and Garmin) compared to the two devices employing custom made applications (Sense-IT and E4 dashboard). The results showed similar outcomes for patients and staff members. Discussion None of the devices obtained usability scores that would justify recommendation for future use considering international standards; a finding that raises concerns about the adaptation and uptake of wearable technology in the context of forensic psychiatry. We suggest that improvements in gamification and motivational aspects of wearable technology might be helpful to tackle several challenges related to wearable technology.
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Affiliation(s)
- Peter C. de Looff
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Science and Treatment Innovation, Fivoor, Rotterdam, Netherlands
- National Expercentre Intellectual Disabilities and Severe Behavioral Problems, De Borg, Bilthoven, Netherlands
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Matthijs L. Noordzij
- Department of Psychology, Health and Technology, Twente University, Enschede, Netherlands
| | - Henk L. I. Nijman
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Science and Treatment Innovation, Fivoor, Rotterdam, Netherlands
| | | | - Stefan Bogaerts
- Science and Treatment Innovation, Fivoor, Rotterdam, Netherlands
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Trajectum, Specialized and Forensic Care, Zwolle, Netherlands
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Timm L, Guidetti S, Taloyan M. POSITIVE: experiences of an intervention aiming for reversing and preventing frailty using a home monitoring and communication platform within primary health care. BMC Geriatr 2024; 24:382. [PMID: 38689226 PMCID: PMC11061984 DOI: 10.1186/s12877-024-04990-7] [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: 01/15/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Frailty is increasing worldwide as the population ages. Physical activity is one component that has been shown to hinder and even reverse the process. The POSITIVE system (i.e., maintaining and imPrOving the intrinSIc capaciTy Involving primary care and caregiVErs) is a prevention program that consists of home-monitoring equipment and a communication platform to support the initial treatment of frailty symptoms in primary health care. The participants, older aged (+ 70) frail persons and those at risk for frailty, took part in the program that promoted physical activity at home for six months. The aim was to explore and describe older persons' experiences of participating in a new prevention program using the POSITIVE system including technological tools intended to prevent the development of frailty. METHODS Nine interviews were conducted about experiences of participating in an intervention including use of technological tools to support physical activity. Qualitative content analysis was applied. RESULTS Two themes revealed: (1) Perceptions of being old are seldom positive, and (2) A rewarding and fruitful participation in the project with suggestions for improvement. Becoming older was related to physical pain and tiredness reducing the performance of former meaningful activities as well as an increase in mental stress. There was also a tendency to postpone the start of everyday activities, and in general, fewer activities were planned for one day than at younger ages. Participating in a physical activity intervention, including the use of technical tools, was considered meaningful and added motivation for engaging in other physical activities, this despite some difficulties with technical tools provided by the program. The contact with health care and the research team was appreciated. In addition, contact with other participants was requested and reported to be highly valued if added to the intervention, which could have been an expression of loneliness. CONCLUSION Participation in a prevention program motivated activities and social interaction. Adding opportunities for participants to meet each other is suggested for improving the intervention in terms of increasing the social dimensions. Our findings conclude that despite difficulties with handling the technical tools for the home-monitoring and communication platform, participation in the POSITIVE intervention was in general a positive experience.
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Affiliation(s)
- Linda Timm
- Division of Occupational Therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Alfred Nobels Alle 23, B4, Huddinge, Stockholm 141 83, Stockholm, Sweden.
| | - Susanne Guidetti
- Division of Occupational Therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Alfred Nobels Alle 23, B4, Huddinge, Stockholm 141 83, Stockholm, Sweden
- Medical Unit Occupational Therapy and Physiotherapy, Women´s Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Marina Taloyan
- Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Academic Primary Healthcare Centre, Karolinska Institutet, Region Stockholm, Sweden
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Parés-Salomón I, Señé-Mir AM, Martín-Bozas F, Loef B, Coffey A, Dowd KP, Jabardo-Camprubí G, Proper KI, Puig-Ribera A, Bort-Roig J. Effectiveness of workplace interventions with digital elements to reduce sedentary behaviours in office employees: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2024; 21:41. [PMID: 38641816 PMCID: PMC11031993 DOI: 10.1186/s12966-024-01595-6] [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: 07/07/2023] [Accepted: 04/14/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Digital interventions are potential tools for reducing and limiting occupational sedentary behaviour (SB) in sedentary desk-based jobs. Given the harmful effects of sitting too much and sitting for too long while working, the aim of this systematic review and meta-analysis was to examine the effectiveness of workplace interventions, that incorporated digital elements, to reduce the time spent in SB in office workers. METHODS Randomised control trials that evaluated the implementation of workplace interventions that incorporated digital elements for breaking and limiting SB among desk-based jobs were identified by literature searches in six electronic databases (PubMed, Web of Science, Scopus, CINAHL, PsycINFO and PEDro) published up to 2023. Studies were included if total and/or occupational SB were assessed. Only studies that reported pre- and postintervention mean differences and standard deviations or standard errors for both intervention arms were used for the meta-analysis. The meta-analysis was conducted using Review Manager 5 (RevMan 5; Cochrane Collaboration, Oxford, UK). Risk of bias was assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields QUALSYST tool. RESULTS Nineteen studies were included in the systematic review. The most employed digital elements were information delivery and mediated organisational support and social influences. Multicomponent, information, and counselling interventions measuring total and/or occupational/nonoccupational SB time by self-report or via device-based measures were reported. Multicomponent interventions were the most represented. Eleven studies were included in the meta-analysis, which presented a reduction of 29.9 (95% CI: -45.2, -14.5) min/8 h workday in SB (overall effect: Z = 3.81). CONCLUSIONS Multicomponent interventions, using a wide range of digital features, have demonstrated effectiveness in reducing time spent in SB at the workplace among desk-based employees. However, due to hybrid work (i.e., work in the office and home) being a customary mode of work for many employees, it is important for future studies to assess the feasibility and effectiveness of these interventions in the evolving work landscape. TRIAL REGISTRATION The review protocol was registered in the Prospero database (CRD42022377366).
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Affiliation(s)
- Iris Parés-Salomón
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC) and University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Anna M Señé-Mir
- Sports and Physical Activity Research Group, Sport and Physical Activity Studies Centre, University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain.
| | | | - Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Alan Coffey
- SHE Research Group, Department of Sport and Health Sciences, Technological University of the Shannon, Athlone, Ireland
| | - Kieran P Dowd
- SHE Research Group, Department of Sport and Health Sciences, Technological University of the Shannon, Athlone, Ireland
| | - Guillem Jabardo-Camprubí
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC) and Faculty of Health Science at Manresa, University of Vic-Central University of Catalonia, Manresa, Spain
| | - Karin I Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Anna Puig-Ribera
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC) and University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Judit Bort-Roig
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC) and University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
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Faria BSFD, Carvalho C, Triches MI, Vieira LMSMDA, Sato TDO. Mobile health technologies for workers' health and wellbeing: A systematic search of mHealth applications in Brazil. J Bodyw Mov Ther 2024; 38:54-59. [PMID: 38763605 DOI: 10.1016/j.jbmt.2024.01.023] [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: 05/19/2023] [Accepted: 01/13/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Inadequate working conditions and sedentary work can exert a negative impact on workers' health and wellbeing, leading to musculoskeletal disorders and disability. Mobile health (mHealth) applications (apps) have high potential for the self-management of workers' health. OBJECTIVE To identify mHealth apps aimed at promoting workers' health and wellbeing available in Brazilian online stores and assess these apps in terms of engagement, functionality, aesthetics and information quality. METHODS A systematic search for apps was conducted in the Brazilian online App Store and Play Store in December 2022. Only smartphone apps in Brazilian Portuguese directed at workers' health were assessed. The appraisal of the quality of the applications was performed using the Mobile App Rating Scale (MARS). RESULTS Among the 3449 mHealth apps found, ten were eligible for inclusion. The mean overall score was 3.15 ± 0.91 on a scale of 1-5. The lowest score was found for the "credibility" item. Exercises and breaks were the most frequent strategies. Most apps provided low-quality information from questionable sources and therefore received a mean score of 2.1 ± 1.5 on the MARS information subscale. CONCLUSION Ten relevant mHealth apps were eligible for inclusion. The mHealth apps for the promotion of workers' health and wellbeing currently available in Brazil exhibited moderate quality and limited functionality.
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Affiliation(s)
| | - Cristiano Carvalho
- Biosciences Department, Universidade Federal de São Paulo, Baixada Santista Campus, Santos, Brazil
| | - Maria Isabel Triches
- Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, Brazil
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Jones C, Chandarana S, Vyas A, Napolitano M. Attitudes, Barriers, and Motivators Toward Daily Walking and a Mobile App to Increase Walking Among Women: Web-Based Anonymous Survey. JMIR Form Res 2024; 8:e48668. [PMID: 38319695 PMCID: PMC10879972 DOI: 10.2196/48668] [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: 05/02/2023] [Revised: 11/03/2023] [Accepted: 11/30/2023] [Indexed: 02/07/2024] Open
Abstract
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.
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Affiliation(s)
- Catherine Jones
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Shikha Chandarana
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Amita Vyas
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Melissa Napolitano
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
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12
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Cai J, Li G. Exercise or lie down? The impact of fitness app use on users' wellbeing. Front Public Health 2024; 11:1281323. [PMID: 38269388 PMCID: PMC10806118 DOI: 10.3389/fpubh.2023.1281323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/27/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction The use of fitness apps is becoming more and more widespread, and its impact on people's well-being has received more and more attention. Methods The relationship between fitness app use and users' well-being and the influence mechanism was explored using structural equation modeling with upward social comparison as the mediating variable and self-control as the moderating variable. Results The questionnaire survey of 1,452 fitness app users over 18 years old shows that: (1) fitness app use is associated with users' well-being; (2) upward social comparison plays a mediating role in the relationship between fitness app use and users' well-being; (3) self-control has a moderating effect on the relationship between fitness app use and users' well-being. Discussion Self-control plays a significant moderating role between social comparison and well-being, upward social comparison can improve the well-being of high self-control users but reduce the well-being of low self-control users.
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Affiliation(s)
| | - Gang Li
- School of Sports, Shandong University of Finance and Economics, Jinan, China
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13
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Manskow US, Sagelv EH, Antypas K, Zanaboni P. Adoption, acceptability and sustained use of digital interventions to promote physical activity among inactive adults: a mixed-method study. Front Public Health 2024; 11:1297844. [PMID: 38239801 PMCID: PMC10794730 DOI: 10.3389/fpubh.2023.1297844] [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: 09/20/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Despite the positive effects of physical activity (PA) to prevent lifestyle diseases and improve health and well-being, only one-third of Norwegian adults meet the minimum recommendations on PA. Digital interventions to promote PA in inactive adults may improve health and well-being by being available, personalized and adequate. Knowledge on users' adoption, acceptability and sustainability of digital interventions to promote PA is still limited. Objective To investigate the adoption, acceptability and sustained use of three digital interventions for promoting PA among inactive adults. Design A randomized control trial (ONWARDS) with 183 participants assigned to 3 groups and followed up for 18 months. All participants received a wearable activity tracker with the personalized metric Personal Activity Intelligence (PAI) on a mobile app, two groups received additional access to online training and one group had also access to online social support. Methods A mixed-methods approach was used to address the study objective. Acceptability was evaluated through the System Usability Scale (SUS) (n = 134) at 6 months. Adoption and sustained use were evaluated through a set of questions administered at 12 months (n = 109). Individual interviews were performed at 6 months with a sample of participants (n = 18). Quantitative data were analyzed with descriptive statistics, whereas qualitative data were analyzed using the Framework approach. Results PAI was the most successful intervention, with satisfactory usability and positive effects on motivation and behavior change, contributing to high adoption and sustained use. Online social support had a high acceptability and sustained use, but the intervention was not perceived as motivational to increase PA. Online training had low adoption, usability and sustained use. The qualitative interviews identified five main themes: (1) overall approach to physical activity, (2) motivation, (3) barriers to perform PA, (4) effects of PA, and (5) usability and acceptability of the digital interventions. Conclusion Personalized digital interventions integrating behavior change techniques such as individual feedback and goal setting are more likely to increase acceptability, adoption and sustained use. Future studies should investigate which digital interventions or combinations of different interventions are more successful in promoting PA among inactive adults according to the characteristics and preferences of the users. Trial registration Clinical trial registered at ClinicalTrials.gov: NCT04526444.
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Affiliation(s)
- Unn S. Manskow
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Health and Care Sciences, Faculty of Health Sciences, The Arctic University of Norway UiT, Tromsø, Norway
| | - Edvard H. Sagelv
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Konstantinos Antypas
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- SINTEF Digital, Oslo, Norway
| | - Paolo Zanaboni
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Zheng X, Li W. Association between fitness technology use and physical activity mediated by communication behaviors on social media. Digit Health 2024; 10:20552076241266367. [PMID: 39055784 PMCID: PMC11271164 DOI: 10.1177/20552076241266367] [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: 01/23/2024] [Accepted: 06/12/2024] [Indexed: 07/27/2024] Open
Abstract
Objective Fitness technologies, such as smartphone applications and wearable tracking devices, have gained widespread popularity. This study had two main objectives: 1) to examine whether fitness technology use is associated with increased physical activity (PA) levels and 2) to investigate whether communication behaviors on social media mediated the association between fitness technology use and PA. Methods Data were from the U.S. Health Information National Trends Survey 2022 (N = 6,252, weighted N = 258,418,467). Weighted linear regressions were conducted to examine the associations between fitness technology usage, physical activities, and communication behaviors on social media. Mediations were tested using PROCESS macro, a path-analysis based tool. Results Controlling for demographic and other known influences on PA, the findings revealed that users of fitness technology reported higher levels of both moderate PA (β = .41, p < 0.001) and strength training (β = .29, p < 0.001). Additionally, communication behaviors (i.e., sharing personal health information on social media and watching health-related videos on social media) mediated the relationship between fitness technology use and frequencies of strength training. Conclusion The results underscored the potential of fitness technologies in enhancing PA levels through promoting communication behaviors on social media.
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Affiliation(s)
- Xia Zheng
- School of Communication and Journalism, the Alan Alda Center for Communicating Science, Stony Brook University, Stony Brook, NY, USA
| | - Wenbo Li
- School of Communication and Journalism, the Alan Alda Center for Communicating Science, Stony Brook University, Stony Brook, NY, USA
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15
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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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Barakou I, Hackett KL, Finch T, Hettinga FJ. Self-regulation of effort for a better health-related quality of life: a multidimensional activity pacing model for chronic pain and fatigue management. Ann Med 2023; 55:2270688. [PMID: 37871249 PMCID: PMC10595396 DOI: 10.1080/07853890.2023.2270688] [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] [Received: 07/20/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
PURPOSE To propose a comprehensive multidimensional model of activity pacing that improves health-related quality of life and promotes sustained physical activity engagement among adults with chronic conditions. MATERIALS AND METHODS A narrative review was conducted to examine the existing literature on activity pacing, health-related quality of life, pain and fatigue management, and physical activity promotion in chronic conditions. RESULTS The literature revealed a lack of a cohesive approach towards a multidimensional model for using activity pacing to improve health-related quality of life. A comprehensive multidimensional model of activity pacing was proposed, emphasizing the importance of considering all aspects of pacing for sustained physical activity engagement and improved health-related quality of life. The model incorporates elements such as rest breaks, self-regulatory skills, environmental factors, and effective coping strategies for depression/anxiety. It takes into account physical, psychological, and environmental factors, all of which contribute significantly to the enhancement of health-related quality of life, physical function, and overall well-being, reflecting a holistic approach. CONCLUSIONS The model offers guidance to researchers and clinicians in effectively educating patients on activity pacing acquisition and in developing effective interventions to enhance physical activity engagement and health outcomes among adults with chronic conditions. Additionally, it serves as a tool towards facilitating discussions on sustained physical activity and a healthy lifestyle for patients, which can eventually lead to improved quality of life.
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Affiliation(s)
- Ioulia Barakou
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
| | - Katie L. Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
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17
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Sanabria G, Bushover B, Ashrafnia S, Cordoba E, Schnall R. Understanding Physical Activity Determinants in an HIV Self-Management Intervention: Qualitative Analysis Guided by the Theory of Planned Behavior. JMIR Form Res 2023; 7:e47666. [PMID: 37707942 PMCID: PMC10540011 DOI: 10.2196/47666] [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: 03/28/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND People living with HIV have long life expectancy and are experiencing more comorbid conditions, being at an increased risk for developing cardiovascular disease (CVD) and diabetes, further exacerbated due to the HIV or inflammatory process. One effective intervention shown to decrease mortality and improve health outcomes related to CVD and diabetes in people living with HIV is increased regular physical activity. However, people living with HIV often fall short of the daily recommended physical activity levels. While studies show that mobile health (mHealth) can potentially help improve people's daily activity levels and reduce mortality rates due to comorbid conditions, these studies do not specifically focus on people living with HIV. As such, it is essential to understand how mHealth interventions, such as wearables, can improve the physical activity of people living with HIV. OBJECTIVE This study aimed to understand participants' experiences wearing a fitness tracker and an app to improve their physical activity. METHODS In total, 6 focus groups were conducted with participants who completed the control arm of a 6-month randomized controlled trial (ClinicalTrials.gov NCT03205982). The control arm received daily walk step reminders to walk at least 5000 steps per day and focused on the overall wellness of the individual. The analysis of the qualitative focus groups used inductive content analysis using the theory of planned behavior as a framework to guide and organize the analysis. RESULTS In total, 41 people living with HIV participated in the focus groups. The majority (n=26, 63%) of participants reported their race as Black or African American, and 32% (n=13) of them identified their ethnicity as Hispanic or Latino. In total, 9 major themes were identified and organized following the theory of planned behavior constructs. Overall, 2 major themes (positive attitude toward tracking steps and tracking steps is motivating) related to attitudes toward the behavior, 2 major themes (social support or motivation from the fitness tracker and app and encouragement from family and friends) related to participant's subjective norms, 1 theme (you can adjust your daily habits with time) related to perceived behavioral control, 2 themes (reach their step goal and have a healthier lifestyle) related to participant's intention, and 2 themes (continuing to walk actively and regularly wearing the fitness tracker) related to participant's changed behavior. Participants highlighted how the mHealth interface with the avatar and daily step tracking motivated them to both begin and continue to engage in physical activity by adjusting their daily routines. CONCLUSIONS Findings from this study illustrate how features of mHealth apps may motivate people living with HIV to start and continue sustained engagement in physical activities. This sustained increase in physical activity is crucial for reducing the risk of comorbid conditions such as diabetes or CVD. TRIAL REGISTRATION ClinicalTrials.gov NCT03205982; https://classic.clinicaltrials.gov/ct2/show/NCT03205982.
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Affiliation(s)
- Gabriella Sanabria
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Brady Bushover
- Columbia University Mailman School of Public Health, New York, NY, United States
| | - Sarah Ashrafnia
- Division of Scholarship and Research, Columbia University School of Nursing, New York, NY, United States
| | - Evette Cordoba
- Division of Scholarship and Research, Columbia University School of Nursing, New York, NY, United States
| | - Rebecca Schnall
- Columbia University Mailman School of Public Health, New York, NY, United States
- Division of Scholarship and Research, Columbia University School of Nursing, New York, NY, United States
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18
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Ma H, Wang A, Pei R, Piao M. Effects of habit formation interventions on physical activity habit strength: meta-analysis and meta-regression. Int J Behav Nutr Phys Act 2023; 20:109. [PMID: 37700303 PMCID: PMC10498635 DOI: 10.1186/s12966-023-01493-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/23/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Interventions aimed at promoting physical activity (PA) behavior through habit formation pathways are gaining popularity, as they differ from conventional interventions that rely on intention pathways. Past research has established a positive correlation between PA habits and behavior. However, the efficacy of current interventions designed to form PA habits and improve PA automaticity is not yet fully ascertained. Additionally, the intervention components that significantly impact the effectiveness of these interventions are yet to be determined. METHODS This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted a search of three databases (PubMed, Embase, and Cochrane Library) from January 2000 to December 2022, with a focus on interventions for developing PA habits. Two independent authors conducted paper selection, quality assessment, data extraction, and coding of behavior change techniques (BCTs). The effect size of interventions was calculated using standardized mean difference. Subgroup analyses were carried out based on follow-up duration, delivery method, sample characteristics, and theory. Furthermore, we employed meta-regression to investigate the association between BCTs and PA habits. RESULTS Ten eligible studies with relatively high quality were included in the final data set. Characteristics of studies varied in intervention sample and delivery way. The habit formation interventions significantly increased PA habit (SMD = 0.31, 95% CI 0.14-0.48, P < .001) compared to the control groups. Subgroup analysis demonstrated that the duration of follow-up ≤ 12 weeks have a higher effect size on PA habit than the duration > 12 weeks. Meta-regression revealed that problem solving has a significant positive association with effectiveness improvement (β = 0.36, 95% CI 0.17-0.55), while social reward is linked with a reduction in effectiveness (β = -0.40, 95% CI -0.74-0.06). CONCLUSIONS Our findings reveal that habit formation interventions are effective in fostering PA habit. Future studies could leverage the insights form this study to optimize the intervention design and achieve better effectiveness.
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Affiliation(s)
- Haoming Ma
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Aoqi Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Runyuan Pei
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Meihua Piao
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing, 100144, People's Republic of China.
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19
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Lev V, Oppezzo MA. Measuring intra-individual physical activity variability using consumer-grade activity devices. Front Digit Health 2023; 5:1239759. [PMID: 37744687 PMCID: PMC10516569 DOI: 10.3389/fdgth.2023.1239759] [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: 06/13/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Many existing sedentary behavior and physical activity studies focus on primary outcomes that assess change by comparing participants' activity from baseline to post-intervention. With the widespread availability of consumer-grade devices that track activity daily, researchers do not need to rely on those endpoint measurements alone. Using activity trackers, researchers can collect remote data about the process of behavior change and future maintenance of the change by measuring participants' intra-individual physical activity variability. Measuring intra-individual physical activity variability can enable researchers to create tailored and dynamic interventions that account for different physical activity behavior change trajectories, and by that, improve participants' program adherence, enhance intervention design and management, and advance interventions measurements' reliability. We propose an application of intra-individual physical activity variability as a measurement and provide three use cases within interventions. Intra-individual physical activity variability can be used: prior to the intervention period, where relationships between participants' intra-individual physical activity variability and individual characteristics can be used to predict adherence and subsequently tailor interventions; during the intervention period, to assess progress and subsequently boost interventions; and after the intervention, to obtain a reliable representation of the change in primary outcome.
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Affiliation(s)
- Vered Lev
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States
| | - Marily A. Oppezzo
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA, United States
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20
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Thielen SC, Reusch JEB, Regensteiner JG. A narrative review of exercise participation among adults with prediabetes or type 2 diabetes: barriers and solutions. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1218692. [PMID: 37711232 PMCID: PMC10499496 DOI: 10.3389/fcdhc.2023.1218692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/02/2023] [Indexed: 09/16/2023]
Abstract
Type 2 diabetes (T2D) has been rising in prevalence over the past few decades in the US and worldwide. T2D contributes to significant morbidity and premature mortality, primarily due to cardiovascular disease (CVD). Exercise is a major cornerstone of therapy for T2D as a result of its positive effects on glycemic control, blood pressure, weight loss and cardiovascular risk as well as other measures of health. However, studies show that a majority of people with T2D do not exercise regularly. The reasons given as to why exercise goals are not met are varied and include physiological, psychological, social, cultural and environmental barriers to exercise. One potential cause of inactivity in people with T2D is impaired cardiorespiratory fitness, even in the absence of clinically evident complications. The exercise impairment, although present in both sexes, is greater in women than men with T2D. Women with T2D also experience greater perceived exertion with exercise than their counterparts without diabetes. These physiological barriers are in addition to constructed societal barriers including cultural expectations of bearing the burden of childrearing for women and in some cultures, having limited access to exercise because of additional cultural expectations. People at risk for and with diabetes more commonly experience unfavorable social determinants of health (SDOH) than people without diabetes, represented by neighborhood deprivation. Neighborhood deprivation measures lack of resources in an area influencing socioeconomic status including many SDOH such as income, housing conditions, living environment, education and employment. Higher indices of neighborhood deprivation have been associated with increased risk of all-cause, cardiovascular and cancer related mortality. Unfavorable SDOH is also associated with obesity and lower levels of physical activity. Ideally regular physical activity should be incorporated into all communities as part of a productive and healthy lifestyle. One potential solution to improve access to physical activity is designing and building environments with increased walkability, greenspace and safe recreational areas. Other potential solutions include the use of continuous glucose monitors as real-time feedback tools aimed to increase motivation for physical activity, counseling aimed at improving self-efficacy towards exercise and even acquiring a dog to increase walking time. In this narrative review, we aim to examine some traditional and novel barriers to exercise, as well as present evidence on novel interventions or solutions to overcome barriers to increase exercise and physical activity in all people with prediabetes and T2D.
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Affiliation(s)
- Samantha C. Thielen
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Jane E. B. Reusch
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Ludeman Family Center for Women’s Health Research, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Division of Endocrinology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Rocky Mountain Regional Department of Veterans Affairs Medical Center (VAMC), Aurora, CO, United States
| | - Judith G. Regensteiner
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Ludeman Family Center for Women’s Health Research, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
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21
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Onyekwere AO, Okobi OE, Ifiora FC, Akinboro MK, Akueme NT, Iroro J, Dan-Eleberi AO, Onyeaka FC, Ghansah AA. Association Between Wearable Device Use and Levels of Physical Activity Among Older Adults in the US: Evidence From the 2019-2020 Health Information National Trends Survey. Cureus 2023; 15:e44289. [PMID: 37779789 PMCID: PMC10533366 DOI: 10.7759/cureus.44289] [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] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To examine the relationship between electronic wearable device (WD) use and physical activity (PA) levels among older adults in the US. Methods Data were pooled from 3310 older adults from the 2019 and 2020 Health Information National Trends Survey. The explanatory variable was WD use, and the outcomes were weekly PA levels, resistance training, and sedentary time. Logistic regression was conducted to investigate the association between WD use and the reported outcome variables. Separate logistic models were also fitted to explore the relationship between WD use and physical activity outcomes among a subgroup of older adults with chronic conditions. Results A total of 14.4% of older adults reported WD use. Older adults who use WD were more likely to meet national guidelines for weekly levels of PA (odds ratio (OR) 1.60, 95% confidence intervals (CI) (1.10, 2.32); p = 0.015) and resistance strength training (OR 1.54, 95% CI (1.14, 2.09); p = 0.005) when compared with their counterparts not using WD. After restricting the analysis to those with chronic conditions only, WD use was only associated with a higher level of weekly strength training (OR 1.68, 95% CI 1.19, 2.38; p = 0.004). Conclusion WD use may be associated with increased physical activity among older adults, including those with chronic health conditions. Further studies are needed to examine the factors influencing the adoption and sustained use of WD in older adults.
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Affiliation(s)
| | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | - Francis C Ifiora
- Pharmacy, University of Texas Health Science Center at Houston, Houston, USA
| | - Micheal K Akinboro
- Epidemiology and Biostatistics, Texas A&M Health School of Public Health, College Station, USA
| | - Ngozi T Akueme
- Dermatology, University of Medical Sciences (UNIMED), Ondo, NGA
| | - Joy Iroro
- Internal Medicine, All Saints University School of Medicine, Roseau, DMA
| | | | - Faith C Onyeaka
- Haematology/Blood Transfusion Science, Madonna University, Calabar, NGA
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Heizmann AN, Chapelle C, Laporte S, Roche F, Hupin D, Le Hello C. Impact of wearable device-based interventions with feedback for increasing daily walking activity and physical capacities in cardiovascular patients: a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2023; 13:e069966. [PMID: 37433730 DOI: 10.1136/bmjopen-2022-069966] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVE To systematically review randomised controlled trials (RCTs) using a wearable physical activity monitoring device as an intervention to increase daily walking activity and improve physical capacities in patients with cardiovascular disease (CVD). DESIGN Systematic review and meta-analysis of RCTs. DATA SOURCES PubMed, Embase and Web of Science from inception to June 2022. ELIGIBILITY CRITERIA Randomised controlled studies including patients with CVD over 18 years of age at the end of a cardiac rehabilitation programme comparing an intervention group using a wearable physical activity monitoring device with feedback with usual care or with a control group receiving no feedback on their physical activity and reporting a change in the daily number of steps and/or a change in the distance covered in the 6-minute walk test (6-MWT) or a change in peak oxygen uptake (V̇O2peak) as endpoints. RESULTS Sixteen RCTs were included. The intervention of wearing a physical activity monitoring device with feedback significantly improved daily number of steps compared with controls (standardised mean difference (SMD) 0.85; 95% CI (0.42; 1.27); p<0.01). The effect was greater when the duration of the intervention was less than 3 months (SMD 1.0; 95% CI (0.18; 1.82); p<0.01) than when the duration of the intervention was 3 months or longer (SMD 0.71; 95% CI (0.27; 1.16); p<0.01), but no significant interaction was found between subgroups (p=0.55). 6-MWT distance and V̇O2peak showed only small effects (SMD 0.34; 95% CI (-0.11; 0.80); p=0.02 and SMD 0.54; 95% CI (0.03; 1.03); p=0.07, respectively). CONCLUSION The use of wearable physical activity monitoring devices appears to help patients with CVD to increase their daily walking activity and thus their physical activity, particularly in the short term. PROSPERO REGISTRATION NUMBER CRD42022300423.
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Affiliation(s)
- Anne-Noëlle Heizmann
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
| | - Céline Chapelle
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Clinical Research Unit, Innovation, Pharmacology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Silvy Laporte
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Clinical Research Unit, Innovation, Pharmacology, Saint-Etienne University Hospital, Saint-Etienne, France
- Campus Health and Innovation, Jean Monnet University, Saint-Etienne, France
| | - Frederic Roche
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Campus Health and Innovation, Jean Monnet University, Saint-Etienne, France
- Department of Physiology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - David Hupin
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Campus Health and Innovation, Jean Monnet University, Saint-Etienne, France
- Department of Physiology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Claire Le Hello
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Campus Health and Innovation, Jean Monnet University, Saint-Etienne, France
- Department of Vascular and Therapeutic Medicine, Saint-Etienne University Hospital, Saint-Etienne, France
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23
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Hydari MZ, Adjerid I, Striegel AD. Health Wearables, Gamification, and Healthful Activity. MANAGEMENT SCIENCE 2023; 69:3920-3938. [PMID: 37547027 PMCID: PMC10403254 DOI: 10.1287/mnsc.2022.4581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Health wearables in combination with gamification enable interventions that have the potential to increase physical activity-a key determinant of health. However, the extant literature does not provide conclusive evidence on the benefits of gamification and there are persistent concerns that competition-based gamification approaches will only benefit those who are highly active at the expense of those who are sedentary. We investigate the effect of Fitbit leaderboards on the number of steps taken by the user. Using a unique dataset of Fitbit wearable users, some of whom participate in a leaderboard, we find that leaderboards lead to a 370 (3.5%) step increase in the users' daily physical activity. However, we find that the benefits of leaderboards are highly heterogeneous. Surprisingly, we find that those who were highly active prior to adoption are hurt by leaderboards and walk 630 fewer steps daily post adoption (a 5% relative decrease). In contrast, those who were sedentary prior to adoption benefited substantially from leaderboards and walked an additional 1,300 steps daily after adoption (a 15% relative increase). We find that these effects emerge because sedentary individuals benefit even when leaderboards are small and when they do not rank first on them. In contrast, highly active individuals are harmed by smaller leaderboards and only see benefit when they rank highly on large leaderboards. We posit that this unexpected divergence in effects could be due to the underappreciated potential of non-competition dynamics (e.g., changes in expectations for exercise) to benefit sedentary users, but harm more active ones.
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24
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Mate KKV, Abou-Sharkh A, Mansoubi M, Alosaimi A, Dawes H, Michael W, Stanwood O, Harding S, Gorenko D, Mayo NE. Evidence for the Efficacy of Commercially Available Wearable Biofeedback Gait Devices: Consumer-Centered Review. JMIR Rehabil Assist Technol 2023; 10:e40680. [PMID: 37074771 PMCID: PMC10157455 DOI: 10.2196/40680] [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: 06/30/2022] [Revised: 12/19/2022] [Accepted: 02/26/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND The number of wearable technological devices or sensors that are commercially available for gait training is increasing. These devices can fill a gap by extending therapy outside the clinical setting. This was shown to be important during the COVID-19 pandemic when people could not access one-on-one treatment. These devices vary widely in terms of mechanisms of therapeutic effect, as well as targeted gait parameters, availability, and strength of the evidence supporting the claims. OBJECTIVE This study aimed to create an inventory of devices targeting improvement in gait pattern and walking behavior and identify the strength of the evidence underlying the claims of effectiveness for devices that are commercially available to the public. METHODS As there is no systematic or reproducible way to identify gait training technologies available to the public, we used a pragmatic, iterative approach using both the gray and published literature. Four approaches were used: simple words, including some suggested by laypersons; devices endorsed by condition-specific organizations or charities; impairment-specific search terms; and systematic reviews. A findable list of technological devices targeting walking was extracted separately by 3 authors. For each device identified, the evidence for efficacy was extracted from material displayed on the websites, and full-text articles were obtained from the scientific databases PubMed, Ovid MEDLINE, Scopus, or Google Scholar. Additional information on the target population, mechanism of feedback, evidence for efficacy or effectiveness, and commercial availability was obtained from the published material or websites. A level of evidence was assigned to each study involving the device using the Oxford Centre for Evidence-Based Medicine classification. We also proposed reporting guidelines for the clinical appraisal of devices targeting movement and mobility. RESULTS The search strategy for this consumer-centered review yielded 17 biofeedback devices that claim to target gait quality improvement through various sensory feedback mechanisms. Of these 17 devices, 11 (65%) are commercially available, and 6 (35%) are at various stages of research and development. Of the 11 commercially available devices, 4 (36%) had findable evidence for efficacy potential supporting the claims. Most of these devices were targeted to people living with Parkinson disease. The reporting of key information about the devices was inconsistent; in addition, there was no summary of research findings in layperson's language. CONCLUSIONS The amount of information that is currently available to the general public to help them make an informed choice is insufficient, and, at times, the information presented is misleading. The evidence supporting the effectiveness does not cover all aspects of technology uptake. Commercially available technologies help to provide continuity of therapy outside the clinical setting, but there is a need to demonstrate effectiveness to support claims made by the technologies.
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Affiliation(s)
- Kedar K V Mate
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Ahmed Abou-Sharkh
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Maedeh Mansoubi
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Aeshah Alosaimi
- King Faisal Specialized Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Helen Dawes
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Wright Michael
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Olivia Stanwood
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Sarah Harding
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Daniel Gorenko
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Nancy E Mayo
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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25
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Kompf J, Whiteley J, Wright J, Brenner P, Camhi S. Resistance Training Behavior Is Enhanced With Digital Behavior Change Coaching: A Randomized Controlled Trial With Novice Adults. J Phys Act Health 2023; 20:531-537. [PMID: 37076244 DOI: 10.1123/jpah.2022-0367] [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: 07/08/2022] [Revised: 12/19/2022] [Accepted: 02/13/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Approximately a third of US adults meet the physical activity guidelines of engaging in resistance training 2 times per week, yet few studies have examined how to increase participation rates. The present randomized control trial compared a remotely delivered coaching intervention with an education only control group. METHODS Eligible participants completed 2 remotely delivered Zoom-based personal training sessions during a 1-week run-in period. Participants randomized to the intervention group received synchronous weekly behavioral video coaching sessions over Zoom, whereas the control group received no further contact. Days of resistance training completed were assessed at baseline (pre), 4 weeks (post), and 8 weeks (follow-up). Linear mixed models were used to examine group differences at each time point and within-group differences over time. RESULTS There were significant between-group differences favoring the intervention, at posttest for both the previous week (b = 0.71, SE = 0.23; P = .002) and the previous 4 weeks (b = 2.54, SE = 0.87; P = .003) but not at the follow-up period for either the last week (b = 0.15, SE = 0.23; P = .520) or the last 4 weeks (b = 0.68, SE = 0.88; P = .443). CONCLUSION The present study showed that by providing participants with equipment, skill, and in the case of the intervention group, a remote coaching intervention, resistance training participation increased.
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Affiliation(s)
- Justin Kompf
- University of Massachusetts Boston, Boston, MA,USA
- Brandeis University, Waltham, MA,USA
| | | | - Julie Wright
- University of Massachusetts Boston, Boston, MA,USA
| | | | - Sarah Camhi
- University of San Francisco, San Francisco, CA,USA
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26
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Murray RM, Smith-Turchyn J, Vani MF, McDonough MH, Fong AJ, Mina DS, Arbour-Nicitopoulos KP, Trinh L, Jones JM, Bender JL, Culos-Reed SN, Tomasone JR, Sabiston CM. Matched and moving: exploring daily social support among women partnered for exercise after a breast cancer diagnosis. Support Care Cancer 2023; 31:258. [PMID: 37043074 PMCID: PMC10091327 DOI: 10.1007/s00520-023-07643-4] [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: 10/28/2022] [Accepted: 02/13/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE Exercise and social support are non-pharmacological strategies that improve health and wellbeing in women treated for breast cancer (WTBC). However, strategies to facilitate support and exercise in WTBC are typically resource intensive. The purpose of this study was to examine whether various forms of social support received from a matched peer were associated with increased exercise among WTBC. METHODS A daily diary study was conducted to examine naturally occurring social support as it relates to daily exercise behavior. Forty-six WTBC were matched (23 pairs) and completed pre-screening survey assessing eligibility and baseline levels of exercise. Participants were given Fitbit devices to track physical activity behavior and completed daily surveys across 3 weeks assessing perceptions of exercise-related social support at fixed times at the end of each day. RESULTS Mixed models accounting for day of study, baseline support, and baseline exercise levels revealed that higher levels of daily exercise-related tangible social support were associated with more daily steps (b = 506, SE = 143) and more light physical activity (LPA) minutes (b = 7.01, SE = 3.15). Informational social support was associated with higher moderate to vigorous physical activity (MVPA) minutes (b = 3.18, SE = 1.60). CONCLUSIONS Overall, peer matching programs aimed at increasing exercise-related social support among WTBC might encourage exercise behaviors, especially among women who share exercise-specific information (e.g., benefits, type, activities).
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Affiliation(s)
- Ross M Murray
- University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | | | - Madison F Vani
- University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | | | | | - Daniel Santa Mina
- University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | | | - Linda Trinh
- University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
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27
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Handler L, Jaloul P, Clancy J, Cuypers B, Muir J, Hemphill J, Janaudis-Ferreira T, Gottesman C, Wickerson L, Lovas M, Cafazzo JA, Mathur S. A Qualitative Study of the Perspectives of Healthcare Professionals on Features of Digital Health Interventions to Support Physical Activity in Solid Organ Transplant Recipients. Prog Transplant 2023; 33:43-49. [PMID: 36537126 PMCID: PMC9968994 DOI: 10.1177/15269248221145039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Digital health interventions may support physical activity among solid organ transplant recipients. These interventions should be designed with users in mind, including healthcare professionals who counsel transplant recipients on physical activity to ensure acceptance and to promote an optimal user experience. The purpose of this study was to explore the perspectives of health care providers on the features of digital health interventions that would be useful in the promotion, implementation, and maintenance of physical activity among solid organ transplant recipients. Methods: This qualitative, cross-sectional study used semistructured interviews that were conducted remotely, via videoconferencing software, with providers who worked with transplant recipients. Interviews were transcribed, and an iterative-inductive, thematic analysis was used to identify common themes. Data were coded using NVivo software. Findings: Thirteen providers participated in this study. Four main themes were identified: (a) physical activity and exercise features (eg, physical activity guidelines, and exercise instructions); (b) credibility; (c) self-management; and (d) user engagement. Potential barriers to using digital health interventions included staffing requirements, professional regulatory issues, cost, perceived low patient motivation to use, and lack of technological literacy or access. Discussion: Digital health interventions were perceived to be a potential adjunct to current physical activity counseling practices, and part of an innovative strategy to address identified barriers to physical activity participation in solid organ transplant recipients.
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Affiliation(s)
- Lauren Handler
- Department of Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Paula Jaloul
- Department of Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Jessica Clancy
- Department of Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Brittany Cuypers
- Department of Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Jayme Muir
- Department of Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Julia Hemphill
- Department of Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Tania Janaudis-Ferreira
- School of Physical & Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Canadian Donation and Transplantation Research Program, University of Alberta, Edmonton, Alberta, Canada.,Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Chaya Gottesman
- Toronto Lung Transplant Program, 33540Toronto General Hospital, 7989University Health Network, Toronto, Ontario, Canada
| | - Lisa Wickerson
- Department of Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada.,Canadian Donation and Transplantation Research Program, University of Alberta, Edmonton, Alberta, Canada.,Toronto Lung Transplant Program, 33540Toronto General Hospital, 7989University Health Network, Toronto, Ontario, Canada
| | - Mike Lovas
- Centre for Global eHealth Innovation, 7989University Health Network, Toronto, Ontario, Canada
| | - Joseph A Cafazzo
- Centre for Global eHealth Innovation, 7989University Health Network, Toronto, Ontario, Canada
| | - Sunita Mathur
- Department of Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada.,Canadian Donation and Transplantation Research Program, University of Alberta, Edmonton, Alberta, Canada.,School of Rehabilitation Therapy, 4257Queen's University, Kingston, Ontario, Canada
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28
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Aerobic exercise improves central blood pressure and blood pressure variability among patients with resistant hypertension: results of the EnRicH trial. Hypertens Res 2023:10.1038/s41440-023-01229-7. [PMID: 36813985 DOI: 10.1038/s41440-023-01229-7] [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: 09/28/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
Central blood pressure (BP) and BP variability are associated with cardiovascular disease risk. However, the influence of exercise on these hemodynamic parameters is unknown among patients with resistant hypertension. The EnRicH (The Exercise Training in the Treatment of Resistant Hypertension) was a prospective, single-blinded randomized clinical trial (NCT03090529). Sixty patients were randomized to a 12-week aerobic exercise program or usual care. The outcome measures include central BP, BP variability, heart rate variability, carotid-femoral pulse wave velocity, and circulating cardiovascular disease risk biomarkers including high-sensitivity C-reactive protein, angiotensin II, superoxide dismutase, interferon gamma, nitric oxide, and endothelial progenitor cells. Central systolic BP decreased by 12.22 mm Hg (95% CI, -1.88 to -22.57, P = 0.022) as did BP variability by 2.85 mm Hg (95% CI, -4.91 to -0.78, P = 0.008), in the exercise (n = 26) compared to the control group (n = 27). Interferon gamma -4.3 pg/mL (95%CI, -7.1 to -1.5, P = 0.003), angiotensin II -157.0 pg/mL (95%CI, -288.1 to -25.9, P = 0.020), and superoxide dismutase 0.4 pg/mL (95%CI, 0.1-0.6, P = 0.009) improved in the exercise compared to the control group. Carotid-femoral pulse wave velocity, heart rate variability, high-sensitivity C-reactive protein, nitric oxide, and endothelial progenitor cells were not different between groups (P > 0.05). In conclusion, a 12-week exercise training program improved central BP and BP variability, and cardiovascular disease risk biomarkers in patients with resistant hypertension. These markers are clinically relevant as they are associated with target organ damage and increased cardiovascular disease risk and mortality.
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29
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Richards VL, Rajendran S, Cook RL, Leeman RF, Wang Y, Prins C, Cook C. Identifying Desired Features That Would Be Acceptable and Helpful in a Wrist-Worn Biosensor-Based Alcohol Intervention: Interview Study Among Adults Who Drink Heavily. J Med Internet Res 2023; 25:e38713. [PMID: 36729576 PMCID: PMC9936368 DOI: 10.2196/38713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/29/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Alcohol misuse is highly prevalent in the United States and results in a huge financial and public health burden. Current alcohol reduction treatments are underused, and there is a critical need for innovation in the field. Transdermal alcohol biosensors measure alcohol use passively and continuously and may be helpful tools in alcohol interventions. To date, however, alcohol biosensors have not been widely used to directly intervene on alcohol use. There is a new wrist-worn biosensor that could be used to help people reduce their drinking, although it is unclear how best to incorporate such a device into an alcohol intervention. OBJECTIVE We aimed to identify desired features that would be acceptable and helpful in a wrist-worn biosensor-based alcohol intervention for adults who drink heavily. METHODS Participants were recruited through an alcohol contingency management study, a contact registry, and participant referral. To qualify, participants had to be aged at least 40 years, report drinking at least twice per week, and indicate interest in reducing their drinking. We conducted a semistructured interview with each participant via Zoom (Zoom Video Communications, Inc). The interview guide addressed general thoughts on the wrist-worn biosensor, how participants thought a wrist-worn biosensor could be used to help people quit or reduce drinking, types of information that participants would want to receive from the biosensor, how they would want to receive this information, and how they thought this information could be used to change their behavior. Interviews were transcribed verbatim and analyzed using thematic analysis. RESULTS The sample comprised 20 adults (mean age 55.1, SD 6.1 years; 11/20, 55%, women; and 17/20, 85%, Black). Of the 20 participants, 9 (45%) had previous experience with the Secure Continuous Remote Alcohol Monitor continuous alcohol monitoring ankle biosensor from participating in an alcohol contingency management study. The desirable features could be grouped into 5 main themes: features that would influence willingness to use the biosensor (it should look attractive and be both comfortable to wear and accessible), personalized messaging (personalized biosensor-based prompts and feedback could be helpful), preference for time wearing the biosensor (for some, just wearing the biosensor could have an intervention effect), sharing data with others (this was appealing to many but not to all), and mental health support (many felt that mental health support could be incorporated into the biosensor). CONCLUSIONS Five main themes that would maximize interest in using a wrist-worn biosensor for alcohol intervention were identified. Taken together, the identified themes could inform the development of a just-in-time adaptive intervention that uses a wrist-worn biosensor to help adults who drink heavily reduce their alcohol use.
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Affiliation(s)
- Veronica L Richards
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, United States
| | - Saahas Rajendran
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Robert L Cook
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Robert F Leeman
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, United States
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Yan Wang
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Cindy Prins
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Christa Cook
- College of Nursing, University of Central Florida, Orlando, FL, United States
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30
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Oh YJ, Hoffmann TJ, Fukuoka Y. A Novel Approach to Assess Weekly Self-efficacy for Meeting Personalized Physical Activity Goals Via a Cellphone: 12-Week Longitudinal Study. JMIR Form Res 2023; 7:e38877. [PMID: 36705945 PMCID: PMC9919464 DOI: 10.2196/38877] [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: 04/19/2022] [Revised: 09/29/2022] [Accepted: 10/27/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Despite the health benefits of engaging in regular physical activity (PA), the majority of American adults do not meet the PA guidelines for aerobic and muscle-strengthening activities. Self-efficacy, the belief that one can execute specific actions, has been suggested to be a strong determinant of PA behaviors. With the increasing availability of digital technologies, collecting longitudinal real-time self-efficacy and PA data has become feasible. However, evidence in longitudinal real-time assessment of self-efficacy in relation to objectively measured PA is scarce. OBJECTIVE This study aimed to examine a novel approach to measure individuals' real-time weekly self-efficacy in response to their personalized PA goals and performance over the 12-week intervention period in community-dwelling women who were not meeting PA guidelines. METHODS In this secondary data analysis, 140 women who received a 12-week PA intervention were asked to report their real-time weekly self-efficacy via a study mobile app. PA (daily step counts) was measured by an accelerometer every day for 12 weeks. Participants rated their self-efficacy on meeting PA goals (ranging from "not confident" to "very confident") at the end of each week via a mobile app. We used a logistic mixed model to examine the association between weekly self-efficacy and weekly step goal success, controlling for age, BMI, self-reported White race, having a college education or higher, being married, and being employed. RESULTS The mean age was 52.7 (SD 11.5, range 25-68) years. Descriptive analyses showed the dynamics of real-time weekly self-efficacy on meeting PA goals and weekly step goal success. The majority (74.4%) of participants reported being confident in the first week, whereas less than half of them (46.4%) reported confidence in the final week of the intervention. Participants who met weekly step goals were 4.41 times more likely to be confident about achieving the following week's step goals than those who did not meet weekly step goals (adjusted odds ratio 4.41; 95% CI 2.59-7.50; P<.001). Additional analysis revealed that participants who were confident about meeting the following week's step goals were 2.07 times more likely to meet their weekly step goals in the following week (adjusted odds ratio 2.07; 95% CI 1.16-3.70; P=.01). The significant bidirectional association between real-time self-efficacy and weekly step goal success was confirmed in a series of sensitivity analyses. CONCLUSIONS This study demonstrates the potential utility of a novel approach to examine self-efficacy in real time for analysis of self-efficacy in conjunction with objectively measured PA. Discovering the dynamic patterns and changes in weekly self-efficacy on meeting PA goals may aid in designing a personalized PA intervention. Evaluation of this novel approach in an RCT is warranted.
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Affiliation(s)
- Yoo Jung Oh
- Department of Communication, University of California, Davis, Davis, CA, United States
| | - Thomas J Hoffmann
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Yoshimi Fukuoka
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, United States
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31
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Vlahu-Gjorgievska E, Burazor A, Win KT, Trajkovik V. mHealth Apps Targeting Obesity and Overweight in Young People: App Review and Analysis. JMIR Mhealth Uhealth 2023; 11:e37716. [PMID: 36656624 PMCID: PMC9896356 DOI: 10.2196/37716] [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: 03/03/2022] [Revised: 08/15/2022] [Accepted: 11/22/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Overweight and obesity have been linked to several serious health problems and medical conditions. With more than a quarter of the young population having weight problems, the impacts of overweight and obesity on this age group are particularly critical. Mobile health (mHealth) apps that support and encourage positive health behaviors have the potential to achieve better health outcomes. These apps represent a unique opportunity for young people (age range 10-24 years), for whom mobile phones are an indispensable part of their everyday living. However, despite the potential of mHealth apps for improved engagement in health interventions, user adherence to these health interventions in the long term is low. OBJECTIVE The aims of this research were to (1) review and analyze mHealth apps targeting obesity and overweight and (2) propose guidelines for the inclusion of user interface design patterns (UIDPs) in the development of mHealth apps for obese young people that maximizes the impact and retention of behavior change techniques (BCTs). METHODS A search for apps was conducted in Google Play Store using the following search string: ["best weight loss app for obese teens 2020"] OR ["obesity applications for teens"] OR ["popular weight loss applications"]. The most popular apps available in both Google Play and Apple App Store that fulfilled the requirements within the inclusion criteria were selected for further analysis. The designs of 17 mHealth apps were analyzed for the inclusion of BCTs supported by various UIDPs. Based on the results of the analysis, BCT-UI design guidelines were developed. The usability of the guidelines was presented using a prototype app. RESULTS The results of our analysis showed that only half of the BCTs are implemented in the reviewed apps, with a subset of those BCTs being supported by UIDPs. Based on these findings, we propose design guidelines that associate the BCTs with UIDPs. The focus of our guidelines is the implementation of BCTs using design patterns that are impactful for the young people demographics. The UIDPs are classified into 6 categories, with each BCT having one or more design patterns appropriate for its implementation. The applicability of the proposed guidelines is presented by mock-ups of the mHealth app "Morphe," intended for young people (age range 10-24 years). The presented use cases showcase the 5 main functionalities of Morphe: learn, challenge, statistics, social interaction, and settings. CONCLUSIONS The app analysis results showed that the implementation of BCTs using UIDPs is underutilized. The purposed guidelines will help developers in designing mHealth apps for young people that are easy to use and support behavior change. Future steps involve the development and deployment of the Morphe app and the validation of its usability and effectiveness.
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Affiliation(s)
- Elena Vlahu-Gjorgievska
- School of Computing and Information Technology, University of Wollongong, Wollongong, Australia
| | - Andrea Burazor
- School of Computing and Information Technology, University of Wollongong, Wollongong, Australia
| | - Khin Than Win
- School of Computing and Information Technology, University of Wollongong, Wollongong, Australia
| | - Vladimir Trajkovik
- Faculty of Computer Science and Engineering, Ss Cyril and Methodius University, Skopje, Republic of North Macedonia
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Chia F, Huang WY, Huang H, Wu CE. Promoting Healthy Behaviors in Older Adults to Optimize Health-Promoting Lifestyle: An Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1628. [PMID: 36674395 PMCID: PMC9866478 DOI: 10.3390/ijerph20021628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/11/2023] [Accepted: 01/14/2023] [Indexed: 06/17/2023]
Abstract
Introduction: Exercise intervention is the easiest and most effective way to promote human health. This study combined technology and exercise to improve the health behavior of the older adults through a physical activity intervention and to enhance a health-promoting lifestyle. Materials and methods: A quasi-experimental research method was used to openly recruit 120 healthy male and female older adults over 65 years old (average age of males: 71.6 ± 1.25 years; average age of females: 72.3 ± 1.28 years), all of whom wore smart bracelets. The participants were monitored by special personnel during the same period of walking every Monday to Friday. All participants recorded their daily steps, distance walked, and calorie consumption data for a period of 8 weeks. Results: After 8 weeks of walking, all participants showed a positive medium−high correlation of various factors between healthy behaviors and the health-promoting lifestyle scales. In the post-tests of each factor of two scales, males had the highest correlation between regular physical activity and physical activity, and females had the highest correlation between regular physical activity and social support. The variabilities in the explanatory power of the health behaviors of males and females on the health-promoting lifestyle were R2 = 70.9% (p < 0.01) and R2 = 74.1% (p < 0.01), indicating that the variables of healthy behaviors have a positive effect on health-promoting lifestyles in male and female older adults. Conclusions: Walking interventions positively affect the health behaviors of older adults and encourage health-promoting lifestyles. The value of this study is in its contribution to health promotion and public health recommendations for older adults.
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Affiliation(s)
- Fan Chia
- Office of Physical Education and Sport, National Chung Hsin University, Taichung 402227, Taiwan
| | - Wei-Yang Huang
- Physical Education Leader, National Taiwan College of Performing Arts, Taipei 11464, Taiwan
| | - Hsuan Huang
- Department of Occupational Therapy, National Cheng Kung University, Tainan 701401, Taiwan
| | - Cheng-En Wu
- Office of Physical Education, Tamkang University, New Taipei City 251301, Taiwan
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Guo Y, Xu Q, Dutt N, Kehoe P, Qu A. Longitudinal changes in objective sleep parameters during pregnancy. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231190952. [PMID: 37650368 PMCID: PMC10475261 DOI: 10.1177/17455057231190952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Sleep disturbances are associated with adverse perinatal outcomes. Thus, it is necessary to understand the continuous patterns of sleep during pregnancy and how moderators such as maternal age and pre-pregnancy body mass index impact sleep. OBJECTIVE This study aimed to examine the continuous changes in sleep parameters objectively (i.e. sleep stages, total sleep time, and awake time) in pregnant women and to describe the impact of maternal age and/or pre-pregnancy body mass index as moderators of these objective sleep parameters. DESIGN This was a longitudinal observational design. METHODS Seventeen women with a singleton pregnancy participated in this study. Mixed model repeated measures were used to describe weekly patterns, while aggregated changes describe these three pregnancy periods (10-19, 20-29, and 30-39 gestational weeks). RESULTS For the weekly patterns, we found significantly decreased deep (1.26 ± 0.18 min/week, p < 0.001), light (0.72 ± 0.37 min/week, p = 0.05), and total sleep time (1.56 ± 0.47 min/week, p < 0.001) as well as increased awake time (1.32 ± 0.34 min/week, p < 0.001). For the aggregated changes, we found similar patterns to weekly changes. Women (⩾30 years) had an even greater decrease in deep sleep (1.50 ± 0.22 min/week, p < 0.001) than those younger (0.84 ± 0.29 min/week, p = 0.04). Women who were both overweight/obese and ⩾30 years experienced an increase in rapid eye movement sleep (0.84 ± 0.31 min/week, p = 0.008), but those of normal weight (<30 years) did not. CONCLUSION This study appears to be the first to describe continuous changes in sleep parameters during pregnancy at home. Our study provides preliminary evidence that sleep parameters could be potential non-invasive physiological markers predicting perinatal outcomes.
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Affiliation(s)
- Yuqing Guo
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, USA
| | - Qi Xu
- Department of Statistics, Donald Bren School of Information & Computer Sciences, University of California, Irvine, Irvine, CA, USA
| | - Nikil Dutt
- Donald Bren School of Information & Computer Sciences, University of California, Irvine, Irvine, CA, USA
| | - Priscilla Kehoe
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, USA
| | - Annie Qu
- Department of Statistics, Donald Bren School of Information & Computer Sciences, University of California, Irvine, Irvine, CA, USA
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Mukherji AB, Lu D, Qin F, Hedlin H, Johannsen NM, Chung S, Kobayashi Y, Haddad F, Lamendola C, Basina M, Talamoa R, Myers J, Palaniappan L. Effectiveness of a Community-Based Structured Physical Activity Program for Adults With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2247858. [PMID: 36542382 PMCID: PMC9857601 DOI: 10.1001/jamanetworkopen.2022.47858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE The efficacy of physical activity interventions among individuals with type 2 diabetes has been established; however, practical approaches to translate and extend these findings into community settings have not been well explored. OBJECTIVE To test the effectiveness of providing varying frequencies of weekly structured exercise sessions to improve diabetes control. DESIGN, SETTING, AND PARTICIPANTS The IMPACT (Initiate and Maintain Physical Activity in Communities Trial) study was a controlled randomized clinical trial (randomization occurred from October 2016 to April 2019) that included a 6-month, structured exercise intervention either once or thrice weekly vs usual care (UC; advice only). The exercise intervention was conducted at community-based fitness centers. Follow-up visits were conducted in a university research clinic. Participants included adults with type 2 diabetes (hemoglobin A1c [HbA1c] 6.5%-13.0%, not taking insulin, and no precluding health issues). Data analysis was performed from January to April 2022. INTERVENTIONS A once-weekly structured exercise group, a thrice-weekly structured exercise group, or UC. MAIN OUTCOMES AND MEASURES The primary outcome was HbA1c at 6 months. RESULTS A total of 357 participants (143 women [40.1%]) with a mean (SD) age of 57.4 (11.1) years were randomized (119 each to the UC, once-weekly exercise, and thrice-weekly exercise groups). There was no significant difference in HbA1c change by study group in the intention-to-treat analysis at 6 months. Specifically, HbA1c changed by -0.23% (95% CI, -0.48% to 0.01%) in the thrice-weekly exercise group and by -0.16% (95% CI, -0.41% to 0.09%) in the once-weekly exercise group. A total of 62 participants (52.1%) in the once-weekly exercise group and 56 participants (47.1%) in the thrice-weekly exercise group were at least 50% adherent to the assigned structured exercise regimen and were included in the per-protocol analysis. Per-protocol analysis showed that HbA1c changed by -0.35% (95% CI, -0.60% to -0.10%; P = .005) at 3 months and by -0.38% (95% CI, -0.65% to -0.12%; P = .005) at 6 months in the thrice-weekly exercise group compared with UC. There was no significant decrease in HbA1c in the once-weekly exercise group. The exercise intervention was effective in improving self-reported minutes of metabolic equivalent tasks per week for participants in the thrice-weekly exercise group (both overall and per protocol). CONCLUSIONS AND RELEVANCE Although the intervention was not effective in the intention-to-treat analysis, participants in the thrice-weekly exercise group who attended at least 50% of the sessions during the 6-month exercise intervention program improved HbA1c levels at 6 months. Future efforts should focus on improving adherence to thrice-weekly structured exercise programs to meet exercise guidelines. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02061579.
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Affiliation(s)
- Aishee B. Mukherji
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
| | - Di Lu
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
| | - FeiFei Qin
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
| | - Haley Hedlin
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
| | - Neil M. Johannsen
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge
| | - Sukyung Chung
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
| | - Yukari Kobayashi
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cardiovascular Institute, Stanford, California
| | - Francois Haddad
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cardiovascular Institute, Stanford, California
| | - Cynthia Lamendola
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
| | - Marina Basina
- Division of Endocrinology, Stanford University School of Medicine, Stanford, California
| | - Ruth Talamoa
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
| | - Jonathan Myers
- Cardiology Division, VA Palo Alto Health Care System, Stanford University, Palo Alto, California
| | - Latha Palaniappan
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
- Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Stanford, California
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Kari T, Makkonen M, Carlsson C. Physical Activity Tracker Application in Promoting Physical Activity Behavior among Older Adults: A 24-month Follow-Up Study. J Aging Health 2022:8982643221135812. [DOI: 10.1177/08982643221135812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives To investigate whether and how PA tracker application use supports PA behavior among older adults during the first 24 months of use. Methods: The changes in PA levels (i.e., time spent in different PA intensities) and between PA categories (i.e., low, moderate, or high based on total PA) were examined between three different time points: before taking the application into use (t0), after 12 months of use (t1), and after 24 months of use (t2). The data was collected by using the International Physical Activity Questionnaire modified for the elderly (IPAQ-E). Results: A statistically significant increase was observed in walking (χ2 (2) = 29.741, p < .001), moderate PA (χ2 (2) = 6.327, p = .042), and total PA levels (χ2 (2) = 11.489, p = .003). The increase was observed between t0 and t1 as well as between t0 and t2. The overall changes between PA categories were statistically significant between t0 and t1 (χ2 (3) = 15.789, p = .001) as well as between t0 and t2 (χ2 (3) = 14.745, p = .002). There were more increasingly active (moved to a higher PA category) than decreasingly active (moved to a lower PA category) participants. Discussion: Overall, the results indicate that PA tracker application use can promote PA behavior among older adults. Stakeholders that work with PA programs and PA promotion, as well as individual users, can utilize digital wellness technologies in supporting PA promotion, especially in exceptional times, like the COVID-19 pandemic, when health care restrictions prevent general gatherings.
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Affiliation(s)
- Tuomas Kari
- Institute for Advanced Management Systems Research, Turku, Finland
- Natural Resources Institute Finland (Luke), Helsinki, Finland
| | - Markus Makkonen
- Institute for Advanced Management Systems Research, Turku, Finland
- University of Jyvaskyla, Faculty of Information Technology, Jyvaskyla, Finland
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Huang WY, Huang H, Wu CE. Physical Activity and Social Support to Promote a Health-Promoting Lifestyle in Older Adults: An Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14382. [PMID: 36361256 PMCID: PMC9658453 DOI: 10.3390/ijerph192114382] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to understand the effect of intervention in the form of physical activity and social support while co-exercising to promote a health-promoting lifestyle in older adults. This study openly recruited 60 healthy male older adults, all of whom wore a wrist-worn Garmin device walker. Experimental group A was monitored by a special person and walked together as a group, experimental group B walked independently outdoors, and the control group went about their daily routine as normal. All participants recorded daily steps and calorie consumption data for eight weeks. The results of the study showed that when walking together in experimental group A, the number of daily walks and calories consumed could be maintained at a high level due to the effect of group and social support. The number of daily walks in experimental group B was inconsistent due to the lack of motivation to walk on their own. The control group consumed the lowest number of calories in their daily routine. The results show that physical activity and social support have positive explanatory power for a health-promoting lifestyle. Finally, physical activity in older adults should be promoted, and social support for interaction with peers can effectively promote a healthy lifestyle and respond to the arrival of the super-aged society in advance.
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Affiliation(s)
- Wei-Yang Huang
- Physical Education, National Taiwan College of Performing Arts, Taipei 11464, Taiwan
| | - Hsuan Huang
- Department of Occupational Therapy, National Cheng Kung University, Tainan 701401, Taiwan
| | - Cheng-En Wu
- Office of Physical Education, Tamkang University, No. 151, Ying-Zhuan Rd., Tamshui, New Taipei City 251301, Taiwan
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Haynes A, Gilchrist H, Oliveira JS, Sherrington C, Tiedemann A. "I wouldn't have joined if it wasn't online": understanding older people's engagement with teleyoga classes for fall prevention. BMC Complement Med Ther 2022; 22:283. [PMID: 36324148 PMCID: PMC9628174 DOI: 10.1186/s12906-022-03756-1] [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: 08/08/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Yoga-based exercise is a promising strategy for promoting healthy ageing, with the potential to reduce falls and increase physical, cognitive and psychological wellbeing. Teleyoga (real-time yoga provided via interactive videoconferencing) can deliver yoga programs at scale, potentially reducing costs, increasing convenience, and reaching people who cannot attend studio-based classes. But better understanding of how older people perceive and engage with teleyoga is needed to optimise its design, implementation and promotion. METHODS This study built on a previous realist process evaluation of the SAGE yoga trial which is testing the effect of a yoga-based exercise program on falls among 700 community-dwelling people aged 60 + years. In this second phase of evaluation we conducted focus groups with participants who had completed the SAGE program online and with the yoga instructors who were delivering it. We also conducted interviews with participants who had withdrawn from the trial. Six program theories developed in the earlier evaluation provided a framework for data analysis, supplemented by inductive coding and an analytical workshop. RESULTS Participants described physical and psychological benefits from the SAGE teleyoga program. While noting that teleyoga cannot facilitate hands-on correction or the same quality of observation or interaction as studio classes, participants were highly appreciative of their yoga instructors' strategies for optimising visibility, instruction, social connection and therapeutic alliance, and for adapting to constrained home environments. Some participants argued that teleyoga was superior to studio classes due to its accessibility and convenience, its lower exposure to potential embarrassment about physical appearance or capabilities, and a reduced sense of peer competition and distraction. Our program theories applied across studio and online modes of delivery. CONCLUSION Teleyoga increases accessibility for people in diverse locations and circumstances; it provides a psychologically safer space which combats self-consciousness and unwanted competitiveness; it may enhance embodiment and mindfulness for some; and it has the potential to be offered relatively cheaply at scale which could support free or reduced price classes for people on low incomes and pensions, thereby encouraging a wider population to engage in yoga for healthy ageing and fall prevention.
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Affiliation(s)
- Abby Haynes
- grid.1013.30000 0004 1936 834XInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Gadigal Country, NSW Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, NSW Australia
| | - Heidi Gilchrist
- grid.1013.30000 0004 1936 834XInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Gadigal Country, NSW Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, NSW Australia
| | - Juliana S Oliveira
- grid.1013.30000 0004 1936 834XInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Gadigal Country, NSW Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, NSW Australia
| | - Catherine Sherrington
- grid.1013.30000 0004 1936 834XInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Gadigal Country, NSW Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, NSW Australia
| | - Anne Tiedemann
- grid.1013.30000 0004 1936 834XInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Gadigal Country, NSW Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, Sydney, NSW Australia
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Hume E, Muse H, Wallace K, Wilkinson M, Heslop Marshall K, Nair A, Clark S, Vogiatzis I. Feasibility and acceptability of a physical activity behavioural modification tele-coaching intervention in lung transplant recipients. Chron Respir Dis 2022; 19:14799731221116588. [PMID: 36306548 PMCID: PMC9619269 DOI: 10.1177/14799731221116588] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite improvements in pulmonary function following lung transplantation (LTx), physical activity levels remain significantly lower than the general population. To date, there is little research investigating interventions to improve daily physical activity in LTx recipients. This study assessed the feasibility and acceptability of a novel, 12-weeks physical activity tele-coaching (TC) intervention in LTx recipients. METHODS Lung transplant recipients within 2 months of hospital discharge were recruited and randomised (1:1) to TC or usual care (UC). TC consists of a pedometer and smartphone app, allowing transmission of activity data to a platform that provides feedback, activity goals, education, and contact with the researcher as required. Recruitment and retention, occurrence of adverse events, intervention acceptability and usage were used to assess feasibility. RESULTS Key criteria for progressing to a larger study were met. Of the 15 patients eligible, 14 were recruited and randomised to TC or UC and 12 completed (67% male; mean ± SD age; 58 ± 7 years; COPD n = 4, ILD n = 6, CF n = 1, PH n = 1): TC (n = 7) and UC (n = 5). TC was well accepted by patients, with 86% indicating that they enjoyed taking part. Usage of the pedometer was excellent, with all patients wearing it for over 90% of days and rating the pedometer and telephone contact as the most vital aspects. There were no adverse events related to the intervention. After 12 weeks, only TC displayed improvements in accelerometry steps/day (by 3475 ± 3422; p = .036) and movement intensity (by 153 ± 166 VMU; p = .019), whereas both TC and UC groups exhibited clinically important changes in physical SF-36 scores (by 11 ± 14 and 7 ± 9 points, respectively). CONCLUSION TC appears to be a feasible, safe, and well-accepted intervention in LTx.
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Affiliation(s)
- Emily Hume
- Department of Sport, Exercise and Rehabilitation, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK,Emily HumeDepartment of Sport, Exercise and Rehabilitation, Faculty of Health and Life sciences, Northumbria University, Northumberland Building, Newcastle upon Tyne NE1 8ST, UK.
| | - Hazel Muse
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Kirstie Wallace
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Mick Wilkinson
- Department of Sport, Exercise and Rehabilitation, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | | | - Arun Nair
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Stephen Clark
- Department of Sport, Exercise and Rehabilitation, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK,The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Zanaboni P, Manskow US, Sagelv EH, Morseth B, Edvardsen AE, Aamot IL, Nes BM, Hastings B, Gagnon MP, Antypas K. Digital interventions to promote physical activity among inactive adults: A study protocol for a hybrid type I effectiveness-implementation randomized controlled trial. Front Public Health 2022; 10:925484. [PMID: 36339169 PMCID: PMC9634084 DOI: 10.3389/fpubh.2022.925484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/07/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Physical inactivity is the fourth leading risk factor for global mortality, and inactive adults have a higher risk to develop lifestyle diseases. To date, there is preliminary evidence of the efficacy of fitness technologies and other digital interventions for physical activity (PA) promotion. Intervention studies are needed to test the effectiveness and implementation of innovative PA promotion strategies. Methods and analysis The ONWARDS study is a hybrid type I effectiveness-implementation randomized control trial aiming at an inactive and presumably high-risk population living in Northern Norway. One hundred and eighty participants will be assigned to 3 groups in a 1:1:1 ratio and participate for 18 months. Participants in group A will be provided an activity tracker with the personalized metric Personal Activity Intelligence (PAI). Participants in group B will be provided with both an activity tracker with the personalized metric PAI and access to online training videos (Les Mills+) to perform home-based training. Participants in group C will be provided an activity tracker with the personalized metric PAI, home-based online training and additional peer support via social media. The primary objective is to test which combination of interventions is more effective in increasing PA levels and sustaining long-term exercise adherence. Secondary objectives include: proportion of participants reaching PA recommendations; exercise adherence; physical fitness; cardiovascular risk; quality of life; perceived competence for exercise; self-efficacy; social support; usability; users' perspectives on implementation outcomes (adoption, acceptability, adherence, sustainability). The study design will allow testing the effectiveness of the interventions while gathering information on implementation in a real-world situation. Discussion This study can contribute to reduce disparities in PA levels among inactive adults by promoting PA and long-term adherence. Increased PA might, in turn, result in better prevention of lifestyle diseases. Digital interventions delivered at home can become an alternative to training facilities, making PA accessible and feasible for inactive populations and overcoming known barriers to PA. If effective, such interventions could potentially be offered through national health portals to citizens who do not meet the minimum recommendations on PA or prescribed by general practitioners or specialists. Trial registration https://clinicaltrials.gov/ct2/show/NCT04526444, Registered 23 April 2021, identifier: NCT04526444.
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Affiliation(s)
- Paolo Zanaboni
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway,*Correspondence: Paolo Zanaboni
| | - Unn Sollid Manskow
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Edvard Hamnvik Sagelv
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway,School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Inger-Lise Aamot
- Norwegian National Advisory Unit on Exercise Training as Medicine for Cardiopulmonary Condition, St. Olavs Hospital, Trondheim, Norway,K.G. Jebsen Center for Exercise in Medicine - CERG, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjarne Martens Nes
- K.G. Jebsen Center for Exercise in Medicine - CERG, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | - Konstantinos Antypas
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway,SINTEF Digital, Oslo, Norway
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Grimshaw SL, Taylor NF, Conyers R, Shields N. Promoting positive physical activity behaviors for children and adolescents undergoing acute cancer treatment: Development of the CanMOVE intervention using the Behavior Change Wheel. Front Pediatr 2022; 10:980890. [PMID: 36313891 PMCID: PMC9607881 DOI: 10.3389/fped.2022.980890] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Increasing participation in physical activity has the potential to improve outcomes for children and adolescents with cancer during treatment and into survivorship. The aim of this study is to outline the theoretical process behind development of CanMOVE, a behavior change intervention designed to increase physical activity for children and adolescents with cancer. Study design This study followed a theoretical design process consistent with the Behavior Change Wheel to inform the design of a complex intervention. Materials and methods The three stages of the Behavior Change Wheel intervention design process include: (1) understanding physical activity behavior within the pediatric cancer setting, (2) identifying potential intervention functions, and (3) identifying appropriate behavior change and implementation strategies. Qualitative and behavior change literature relevant to the pediatric cancer treatment setting were used to inform each stage. Results An individualized and flexible approach to physical activity promotion that considers intrinsic factors specific to the child/adolescent and their environment is required. Fifteen behavioral change strategies were identified to form the intervention components of CanMOVE. Implementation strategies were identified to build motivation, opportunity and capacity toward increasing physical activity behaviors. Key intervention components of CanMOVE include standardized assessment and monitoring (physical activity, physical function, and health-related quality of life), provision of an activity monitor to both child/adolescent and parent, and one-on-one capacity building sessions with a healthcare professional. Capacity building sessions include education, goal setting, an active supervised physical activity session, barrier identification and problem solving, and action planning. Conclusion CanMOVE is a novel approach to physical activity promotion in the pediatric cancer treatment setting. The use of a theoretical intervention design process will aid evaluation and replication of CanMOVE when it is assessed for feasibility in a clinical setting. The design process utilized here can be used as a guide for future intervention development.
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Affiliation(s)
- Sarah L. Grimshaw
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Nicholas F. Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Rachel Conyers
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Nora Shields
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
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41
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Vieira WDO, Ostolin TLVDP, Simões MDSMP, Proença NL, Dourado VZ. Profile of adults users of smartphone applications for monitoring the level of physical activity and associated factors: A cross-sectional study. Front Public Health 2022; 10:966470. [PMID: 36203689 PMCID: PMC9530973 DOI: 10.3389/fpubh.2022.966470] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023] Open
Abstract
Background There are currently more than 200 million smartphones in Brazil. The potential of mobile technologies for favorable changes in health behavior such as physical activity has been previously described in the literature. Results of surveys in developed countries indicate that applications (APPs) are developed for people who are better educated, younger, and with higher incomes compared to non-users. However, the profile of users in developing countries like Brazil is not well-known. Understanding the profile of APP users might ease the development turned to physically inactive people and those at higher cardiovascular risk. Furthermore, the physiological and functional factors associated with the use of such APP are unknown. Objectives To characterize the profile of APP users to monitor the physical activity level (PAL) and assess the demographic, socioeconomic, clinical, physiological, and functional characteristics associated with the use of smartphone APPs to monitor physical activity in Brazilian adults. Methods We assessed 176 asymptomatic men and 178 women (43 ± 12 years; 27 ± 5 kg/m2). We initially asked participants about their current use of a smartphone APP containing PAL monitoring functionality, such as exercise session logs and/or step counts. In a cross-sectional design, we investigated schooling, socioeconomic status (Critério Brasil), and classic self-reported cardiovascular risk factors. We evaluated several physiological and functional variables such as maximum O2 consumption on a treadmill (VO2 max), blood pressure, body composition (bioelectrical impedance), handgrip strength, and isokinetic muscle strength of the dominant lower limb. Participants used a triaxial accelerometer for 7 days to quantify daily physical activity. We also assessed health-related quality of life (WHOQOL BREF), perceived stress (PSS14 Scale), and the built environment (NEWS Scale). We compared continuous variables using the Student's t-test and categorical variables using the χ2 test, between APP users and non-users. After univariate analysis, we included the main variables associated with the use of APP in a multiple logistic regression model. Results One hundred and two participants (28.3%), unrelated to gender, reported using a smartphone APP for physical activity at the time of assessment. Except for perceived stress and the built environment that were not associated with the use of APP, users of APP were younger and had higher education, lower cardiovascular risk, better socioeconomic status, a better quality of life, better cardiorespiratory function, better body composition, greater physical fitness and more moderate to vigorous physical activity in daily life. The results of the multiple logistic regression showed that age, hypertension, VO2 max, socioeconomic status (Critério Brasil), and quality of life (WHOQOL BREF total score) were the variables most significantly associated with the use of the APP. Conclusions Our results indicate that smartphone APPs to monitor physical activity are developed for younger adults with better socioeconomic status, lower cardiovascular risk, higher quality of life, and greater cardiorespiratory fitness. Greater efforts are needed to develop a science-based APP for people who most need this technology, enabling greater potential to prevent undesirable health outcomes in asymptomatic adults.
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Affiliation(s)
- Wesley de Oliveira Vieira
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Thatiane Lopes Valentim di Paschoale Ostolin
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Maria do Socorro Morais Pereira Simões
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Neli Leite Proença
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Victor Zuniga Dourado
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- Lown Scholars Program, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Trukeschitz B, Eisenberg S, Schneider C, Schneider U. Exploring the effectiveness of a fitness-app prototype for home care service users in Austria and Italy. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2884-e2895. [PMID: 35098601 PMCID: PMC9546286 DOI: 10.1111/hsc.13733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/23/2021] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
An infinite number of fitness apps are available on various app stores. However, hardly any of them are fitted to the needs and requirements of care-dependent people. This paper investigates the effectiveness of a customised fitness-app prototype for increasing physical activity in home care service users. Home care service users from Austria and Italy were randomly assigned to two groups. In total, 216 participants were involved in the field trial, 104 received a tablet with the fitness app and an activity tracker (treatment group), 112 did not (control group). Regularity of physical activity, frequency of fitness exercises and walking behaviour were self-reported by participants at baseline, after 4 months and after 8 months. In addition, the frequency of using the prototype was assessed based on the fitness app's logged usage data. We estimated multilevel mixed-effects ordered logistic models to examine the effects of the intervention. After 4 months, the intervention increased the home care users' probability of agreeing strongly with being physically active on a regular basis by 28 percentage points (p < 0.001; 95% CI: 0.20, 0.36) and their probability of reporting to exercise more than once a week by 45 percentage points (p < 0.001; 95% CI: 0.32, 0.57). Walking behaviour was not affected on group-level but improved for frequent users of the activity tracker. Frequent and regular users of the fitness app benefited most and effects persisted until the end of the 8 months controlled trial. Tailoring a fitness-app prototype to the needs of care-dependent people has the potential to support people with functional limitations to engage in a more active lifestyle. Future research is encouraged to seek further insights into how new technologies can support physical activities in people with long-term care needs.
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Affiliation(s)
- Birgit Trukeschitz
- Research Institute for Economics of AgingWU Vienna University of Economics and BusinessViennaAustria
| | - Siegfried Eisenberg
- Research Institute for Economics of AgingWU Vienna University of Economics and BusinessViennaAustria
| | - Cornelia Schneider
- Institute of Computer ScienceUniversity of Applied Sciences Wiener NeustadtWiener NeustadtAustria
| | - Ulrike Schneider
- Research Institute for Economics of AgingWU Vienna University of Economics and BusinessViennaAustria
- Institute for Social Policy and Research Institute for Economics of AgingWU Vienna University of Economics and BusinessViennaAustria
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43
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Çevik H, Sevilmiş A. The effects of sense of community on perceived value, consumer satisfaction and future intention in the low-cost fitness clubs. MANAGING SPORT AND LEISURE 2022. [DOI: 10.1080/23750472.2022.2115393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Hüseyin Çevik
- Faculty of Sport Sciences, Department of Recreation, Eskişehir Technical University, Eskişehir, Turkey
| | - Ali Sevilmiş
- Faculty of Sport Sciences, Department of Sports Management, Karamanoğlu Mehmetbey University, Karaman, Turkey
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Sporrel K, Wang S, Ettema DDF, Nibbeling N, Krose BJA, Deutekom M, de Boer RDD, Simons M. Just-in-Time Prompts for Running, Walking, and Performing Strength Exercises in the Built Environment: 4-Week Randomized Feasibility Study. JMIR Form Res 2022; 6:e35268. [PMID: 35916693 PMCID: PMC9379785 DOI: 10.2196/35268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/11/2022] [Accepted: 03/25/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND App-based mobile health exercise interventions can motivate individuals to engage in more physical activity (PA). According to the Fogg Behavior Model, it is important that the individual receive prompts at the right time to be successfully persuaded into PA. These are referred to as just-in-time (JIT) interventions. The Playful Active Urban Living (PAUL) app is among the first to include 2 types of JIT prompts: JIT adaptive reminder messages to initiate a run or walk and JIT strength exercise prompts during a walk or run (containing location-based instruction videos). This paper reports on the feasibility of the PAUL app and its JIT prompts. OBJECTIVE The main objective of this study was to examine user experience, app engagement, and users' perceptions and opinions regarding the PAUL app and its JIT prompts and to explore changes in the PA behavior, intrinsic motivation, and the perceived capability of the PA behavior of the participants. METHODS In total, 2 versions of the closed-beta version of the PAUL app were evaluated: a basic version (Basic PAUL) and a JIT adaptive version (Smart PAUL). Both apps send JIT exercise prompts, but the versions differ in that the Smart PAUL app sends JIT adaptive reminder messages to initiate running or walking behavior, whereas the Basic PAUL app sends reminder messages at randomized times. A total of 23 participants were randomized into 1 of the 2 intervention arms. PA behavior (accelerometer-measured), intrinsic motivation, and the perceived capability of PA behavior were measured before and after the intervention. After the intervention, participants were also asked to complete a questionnaire on user experience, and they were invited for an exit interview to assess user perceptions and opinions of the app in depth. RESULTS No differences in PA behavior were observed (Z=-1.433; P=.08), but intrinsic motivation for running and walking and for performing strength exercises significantly increased (Z=-3.342; P<.001 and Z=-1.821; P=.04, respectively). Furthermore, participants increased their perceived capability to perform strength exercises (Z=2.231; P=.01) but not to walk or run (Z=-1.221; P=.12). The interviews indicated that the participants were enthusiastic about the strength exercise prompts. These were perceived as personal, fun, and relevant to their health. The reminders were perceived as important initiators for PA, but participants from both app groups explained that the reminder messages were often not sent at times they could exercise. Although the participants were enthusiastic about the functionalities of the app, technical issues resulted in a low user experience. CONCLUSIONS The preliminary findings suggest that the PAUL apps are promising and innovative interventions for promoting PA. Users perceived the strength exercise prompts as a valuable addition to exercise apps. However, to be a feasible intervention, the app must be more stable.
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Affiliation(s)
- Karlijn Sporrel
- Human Geography and Spatial Planning, Utrecht University, Utrecht, Netherlands
| | - Shihan Wang
- Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
- Informatics Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Dick D F Ettema
- Human Geography and Spatial Planning, Utrecht University, Utrecht, Netherlands
| | - Nicky Nibbeling
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Ben J A Krose
- Informatics Institute, University of Amsterdam, Amsterdam, Netherlands
- Department of Software Engineering, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | - Marije Deutekom
- Department of Health, Sports and Welfare, Inholland University, Haarlem, Netherlands
| | - Rémi D D de Boer
- Department of Software Engineering, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | - Monique Simons
- Consumption and Healthy Lifestyles group, Wageningen University & Research, Wageningen, Wageningen, Netherlands
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Arredondo EM, Haughton J, Ayala GX, Slymen D, Sallis JF, Perez LG, Serrano N, Ryan S, Valdivia R, Lopez NV, Elder JP. Two-year outcomes of Faith in Action/Fe en Acción: a randomized controlled trial of physical activity promotion in Latinas. Int J Behav Nutr Phys Act 2022; 19:97. [PMID: 35907867 PMCID: PMC9338625 DOI: 10.1186/s12966-022-01329-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Latina women are less likely to report engaging in leisure-time physical activity (PA) than non-Latina white women. This study evaluated the 24-month impact of a faith-based PA intervention targeting Latinas. Methods The study is a cluster randomized controlled trial of a PA intervention or cancer screening comparison condition, with churches as the randomization unit. A total of 436 Latinas (aged 18-65 years) from 16 churches who engaged in low levels of self-report and accelerometer-based PA were enrolled. The experimental condition was a 24-month PA intervention, with in-person classes, social support, and environmental changes, led by community health workers (i.e., promotoras). At baseline, 12-, and 24 months, we assessed changes in accelerometer-based and self-reported moderate to vigorous physical activity (MVPA; primary outcomes). Secondary outcomes were light intensity activity, sedentary time, body mass index (BMI), and waist circumference. Results After adjusting for sociodemographic factors, a mixed effects analysis found significant increases in self-reported leisure time MVPA (p < 0.005) and marginal increases in accelerometer-assessed MVPA (p < 0.08) 24 months post-baseline in the intervention compared to the attention-control condition. Data showed significant associations between PA class attendance and engaging in MVPA as assessed by self-report and accelerometry. No significant changes were found for light activity, sedentary time, BMI, or waist circumference. Conclusions Participants who attended the PA classes at least once a month engaged in significantly higher MVPA compared to those who did not. Maximizing engagement and maintenance strategies to enhance PA maintenance could contribute to important long-term health benefits. Trial registration NCT01776632, Registered March 18, 2011. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01329-6.
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Affiliation(s)
- Elva M Arredondo
- Department of Psychology, San Diego State University and the Institute for Behavioral and Community Health, 9245 Sky Park Ct, San Diego, CA, 92123, USA.
| | - Jessica Haughton
- Institute for Behavioral and Community Health, San Diego State University, San Diego, USA
| | - Guadalupe X Ayala
- School of Public Health, San Diego State University and the Institute for Behavioral and Community Health, San Diego, USA
| | - Donald Slymen
- School of Public Health, San Diego State University, San Diego, USA
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, USA.,Australian Catholic University, Melbourne, Australia
| | - Lilian G Perez
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, USA
| | - Natalicio Serrano
- School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Sherry Ryan
- School of Public Affairs, San Diego State University, San Diego, USA
| | | | - Nanette V Lopez
- Health Sciences, Northern Arizona University, Flagstaff, USA
| | - John P Elder
- School of Public Health, San Diego State University, San Diego, USA
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Peng X, Menhas R, Dai J, Younas M. The COVID-19 Pandemic and Overall Wellbeing: Mediating Role of Virtual Reality Fitness for Physical-Psychological Health and Physical Activity. Psychol Res Behav Manag 2022; 15:1741-1756. [PMID: 35860203 PMCID: PMC9289576 DOI: 10.2147/prbm.s369020] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/05/2022] [Indexed: 12/11/2022] Open
Abstract
Background Virtual reality applications are made for various objectives such as business, entertainment, education, and healthcare. Anxiety, phobias, distress, disordered eating, drug addiction, panic disorder, post-traumatic stress disorder, schizophrenia, bipolar disorder, psychosis, depression, and autism spectrum disorders may benefit from virtual reality-based approaches. The 2019 coronavirus (COVID-19) pandemic has impacted the way we live, enjoy, study, sport, and socialize significantly. Virtual reality fitness technology gained much attention during the COVID-19 preventive measures time. Objective The present study explores the role of virtual reality fitness in improving overall wellbeing during the COVID-19 pandemic home isolation period in terms of physical-psychological health and physical activity. Methods A total of 2300 individuals were recruited using the snowball sampling technique to participate in the study. The primary data were collected using an anonymous web-based survey. SPSS-23 and Smart-PLS 3.2.9 software were used to analyze the data. Results The direct path coefficient analysis of the study constructs show that virtual reality fitness has (preventive measures -> virtual reality fitness -> overall wellbeing, preventive measures -> virtual reality fitness -> physical exercise, and preventive measures -> virtual reality fitness -> physical health) profound effects on the research participants’ mental and physical wellbeing of the study participants while indirect mediation analysis shows that virtual reality fitness has (preventive measures -> virtual reality fitness ->overall wellbeing, preventive measures -> virtual reality fitness -> physical exercise, preventive measures -> virtual reality fitness ->physical health) significant impacts. Conclusion Our study results concluded that house exercises through virtual reality fitness are a good substitute for public gyms and private group fitness programs during the first pandemic wave for physical-psychological and overall wellbeing. Virtual reality fitness technology can alleviate many of the challenges brought on by the epidemic, resulting in increased utilization.
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Affiliation(s)
- Xiang Peng
- College of Physical Education, Hunan City University, Yiyang, People's Republic of China.,College of Physical Education and Sports, Soochow University, Suzhou, People's Republic of China
| | - Rashid Menhas
- Research Center of Sports Social Sciences, College of Physical Education and Sports, Soochow University, Suzhou, People's Republic of China
| | - Jianhui Dai
- College of Physical Education and Sports, Soochow University, Suzhou, People's Republic of China
| | - Muhammad Younas
- School of Education, Soochow University, Suzhou, People's Republic of China
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Dynamic Physical Activity Recommendation Delivered through a Mobile Fitness App: A Deep Learning Approach. AXIOMS 2022. [DOI: 10.3390/axioms11070346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Regular physical activity has a positive impact on our physical and mental health. Adhering to a fixed physical activity regimen is essential for good health and mental wellbeing. Today, fitness trackers and smartphone applications are used to promote physical activity. These applications use step counts recorded by accelerometers to estimate physical activity. In this research, we performed a two-level clustering on a dataset based on individuals’ physical and physiological features, as well as past daily activity patterns. The proposed model exploits the user data with partial or complete features. To include the user with partial features, we trained the proposed model with the data of users who possess exclusive features. Additionally, we classified the users into several clusters to produce more accurate results for the users. This enables the proposed system to provide data-driven and personalized activity planning recommendations every day. A personalized physical activity plan is generated on the basis of hourly patterns for users according to their adherence and past recommended activity plans. Customization of activity plans can be achieved according to the user’s historical activity habits and current activity objective, as well as the likelihood of sticking to the plan. The proposed physical activity recommendation system was evaluated in real time, and the results demonstrated the improved performance over existing baselines.
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Klingenberg A, Purrucker V, Schuler W, Ganapathy N, Spicher N, Deserno TM. Human activity recognition from textile electrocardiograms. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:3434-3437. [PMID: 36086499 DOI: 10.1109/embc48229.2022.9871210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Textile sensors for physiological signals bear the potential of unobtrusive and continuous application in daily life. Recently, textile electrocardiography (ECG) sensors became available which are of particular interest for physical activity monitoring due to the high effect of exercise on the heart rate. In this work, we evaluate the effectiveness of a single-lead ECG signal acquired using a non-medical-grade ECG shirt for human activity recognition (HAR). Healthy volunteers (N=10) wore the shirt during four different activities (sleeping, sitting, walking, running) in an uncontrolled environment and ECG data (256 Hz, 12 Bit) was stored, manually checked, and unusable segments (e.g. no sensor contact) were removed, resulting in a total of 228 hours of recording. Signals were split in short segments of different duration (10, 30, 60s), transformed using the Short-time Fourier Transform (STFT) to a spectrogram image and fed into a state-of-the-art convolutional neural network (CNN). The best configuration results in an F'l-Score of 73% and an accuracy of 77% on the test set. Results with leave-one-subject-out cross-validation show F'l-Scores ranging from 41 % to 80%. Thus, a single-lead, wearable-generated ECG has an informative value for HAR to a certain extent. In future work, we aim at using more sensors of the smart shirt and sensor fusion.
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Barriers and enablers to physical activity in people with venous leg ulcers: A systematic review of qualitative studies. Int J Nurs Stud 2022; 135:104329. [DOI: 10.1016/j.ijnurstu.2022.104329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/16/2022] [Accepted: 07/17/2022] [Indexed: 11/15/2022]
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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: 10] [Impact Index Per Article: 5.0] [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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