Perceived Changes in General Well-being: Findings from the 'MOVEdiabetes' Physical Activity Randomized Control Trial

The effect of lifestyle interventions on depressive symptom severity in individuals with type-2 diabetes: A meta-analysis of randomized controlled trials

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a severe metabolic condition which is commonly comorbid with depression. Lifestyle factors are involved in the pathophysiology of both conditions; however, the role of lifestyle interventions remains unclear.

OBJECTIVE

The objective of this study is to systematically review the literature on randomized controlled trials evaluating the effect of lifestyle interventions on depressive scores in patients with T2DM.

METHODS

A systematic search was conducted in computerized databases before October 2022. A random-effects model was used to investigate the effect of lifestyle interventions on depression scores and meta-regression was conducted to assess the influence of age and disease onset.

RESULTS

Six trials met the eligibility criteria for inclusion. A statistically significant reduction in depression scores was found for groups receiving lifestyle interventions compared to controls (SMD = -0.49 [95%CI -0.89 to -0.08]; p = 0.0269]). Interventions increased in efficacy with the age of the participants but no significant correlation was found with years since disease onset. Participants in a control group receiving a less intense lifestyle intervention demonstrated improved depression scores when compared to those who received standard care or no intervention at all. Trial design and outcome measurement tools were heterogeneous between studies and limited data on antidepressant use was available which may introduce bias into the results.

CONCLUSION

Lifestyle interventions were effective at improving depressive symptom severity in patients with T2DM.

The relationship between home-based physical activity and general well-being among Chinese university students during the COVID-19 pandemic: the mediation effect of self-esteem

This study aimed to investigate the mediating effect of self-esteem on the relationship between home-based physical activity and the general well-being of university students. A web-based questionnaire survey was conducted on 311 Chinese university students using the Physical Activity Rating Scale, Rosenberg Self-Esteem Scale, and General Well-Being Scale. The influence of home-based physical activity on self-esteem and general well-being in Chinese university students was explored using a one-way ANOVA analysis of variance. The mediating model was tested with regression analysis to determine the mediating effects of self-esteem between home-based physical activity and general well-being among Chinese university students during COVID-19. The amount of home-based physical activity had a significant effect on the general well-being (F = 3.46, P < 0.05) and self-esteem (F = 6.99, P < 0.01) of university students. The study found that self-esteem had a full mediation (T = 4.445, P < 0.001) between medium and large amounts of home-based physical activity and general well-being among university students, accounting for 32.5% of the total effect. The study concluded that self-esteem mediated the relationship between home-based physical activity and general well-being in university students during the COVID-19 pandemic. The findings in this study highlight the importance of home-based physical activity in increasing the general well-being of university students during the pandemic.

Psychometric Properties of the Falls Efficacy Scale-International, Cut-off Points, and Validating its Short Version Among Iranian Older People

Objectives

Older people have a fear of falling, which is far more difficult than falling itself. We measured the extent of this feeling using a short and valid Falls Efficacy Scale-International (FES-I) 7-item questionnaire for the aging community in Iran.

Methods

The present psychometric work deals with outlining the validation and translation of FES-I (short version) among 9117 Persian-speaking elderly people with a mean age of 70.2±8.3 years (54.1% female and 45.9% male) in July 2021. Investigations were performed on confirmatory factor analysis, exploratory factor analysis, internal consistency, and construct validity along with test-retest reliability, receiver operating characteristic analysis, inter-rater, and convergent validity.

Results

72.4% of the subjects were living alone, 92.9% required support in activities of daily living, and 93.0% experienced falling in the past two years. A one-factor solution was assigned by exploratory factor analysis for FES-I. Thus, this model was proved by the confirmatory factor analysis with valid fit indices. Based on Cronbach's alpha, intra-cluster correlation coefficient, and McDonald's omega (≥ 0.80), internal consistency was confirmed. The exact cut-off value was represented by the receiver operating characteristic analysis for male/female and between with/without fear of falling among older samples with higher measures of specificity and sensitivity. Moreover, a significant effect of age, aging in place, loneliness, hospitalization rate, frailty, and sense of anxiety (effect size ≥ 0.80, p ≤ 0.05) on fear of falls was detected using analysis of variance.

Conclusions

The psychometric properties of the original scale were preserved by the Persian version of FES-I seven items as a self-reported measure of fear of falling. It could be assuredly a measure in both community and clinical settings. The possible uses and limitations of the Iranian FES-I were also discussed.

Relationships among changes in physical activity, quality of life, and obesity-Status following a behavioral intervention for rural Appalachian adults

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Increasing weekly strength training was associated with reduced unhealthy days.

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No other physical activity and health-related quality of life (HRQoL) changes were linked.

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Baseline obesity did not moderate physical activity and HRQoL change relationships.

Improved health-related quality of life (HRQoL) is one benefit of physical activity. Yet, there is limited intervention research exploring (1) whether changes in physical activity influence changes in HRQoL among community-based populations and (2) if baseline obesity status influences the relationships. This exploratory analysis used secondary data from rural Appalachian adults who completed the MoveMore arm of a larger randomized control trial (n = 105, M_age = 41.8, 82 % female, 96 % White, M_income= $25,911). Specifically, this study examined associations among changes in physical activity and HRQOL and whether baseline obesity status moderated changes. Three HRQoL variables (self-rated health status, total unhealthy days, days poor health impacted activities) and two physical activity variables [weekly moderate-vigorous physical activity (MVPA) minutes, weekly strength training minutes] were collected at baseline and 6-months. Regression models, adjusted for age, gender, race, income, education, assessed associations between physical activity and HRQoL change variables. Moderation analyses explored the influence of baseline obesity status on these relationships. Participants reported significant improvements in self-rated health status (P = 0.001), weekly MVPA minutes (P = 0.008), and weekly strength training minutes (P < 0.001). Increasing weekly strength training minutes was associated with fewer days poor health impacted activities (B = -0.040, P = 0.013). Weekly minutes of MVPA was not associated with HRQoL variables. Baseline obesity status did not moderate relationships. Findings suggest increasing weekly strength training may reduce days poor health impacted activities and that relationships among changes in physical activity and HRQoL were not impacted by baseline obesity. Findings have implications for promoting strength activities in community-based physical activity interventions for rural populations.