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Bergen T, Kim AHM, Mizdrak A, Signal L, Kira G, Richards J. Determinants of Future Physical Activity Participation in New Zealand Adolescents across Sociodemographic Groups: A Descriptive Study. Int J Environ Res Public Health 2023; 20:6001. [PMID: 37297605 PMCID: PMC10252680 DOI: 10.3390/ijerph20116001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
This cross-sectional study aimed to explore various determinants of future physical activity (PA) participation in adolescents across sociodemographic groups. Sociodemographic characteristics (age, gender, ethnicity, deprivation status, physical disability status) were assessed in a national sample (n = 6906) of adolescents (12-17 years old) between 2017 and 2020 in New Zealand. The determinants of future PA participation chosen for analysis included current indicators of PA participation (i.e., total time, number of types, number of settings). We also examined widely recognised modifiable intrapersonal (i.e., physical literacy) and interpersonal (i.e., social support) determinants of current and future PA behaviour, along with indicators of PA availability issues. Older adolescents scored worse across all determinants of future PA than younger adolescents, with a key transition point appearing at 14-15 years of age. Māori and Pacific ethnicities scored best across each determinant category on average, with Asian populations scoring the worst. Gender diverse adolescents scored substantially worse than male and female adolescents across every determinant. Physically disabled adolescents scored worse than non-disabled across all determinants. Adolescents from medium and high deprivation neighbourhoods scored similarly across most determinants of future PA participation and both tended to score worse than people from low deprivation neighbourhoods. A particular focus on the improvement of future PA determinants is warranted within adolescents who are older, Asian, gender diverse, physically disabled, and from medium to high deprivation neighbourhoods. Future investigation should prioritise the longitudinal tracking of PA behaviours over time and develop interventions that affect multiple future PA determinants across a range of sociodemographic backgrounds.
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Affiliation(s)
- Tom Bergen
- Department of Public Health, University of Otago, Wellington 6242, New Zealand; (A.M.); (L.S.)
- Sport New Zealand Ihi Aotearoa, Wellington 6011, New Zealand;
| | - Alice Hyun Min Kim
- Biostatistics Group, Dean’s Department, University of Otago, Wellington 6242, New Zealand;
| | - Anja Mizdrak
- Department of Public Health, University of Otago, Wellington 6242, New Zealand; (A.M.); (L.S.)
| | - Louise Signal
- Department of Public Health, University of Otago, Wellington 6242, New Zealand; (A.M.); (L.S.)
| | - Geoff Kira
- Te Hau Kori, Faculty of Health, Victoria University of Wellington Te Herenga Waka, Wellington 6012, New Zealand;
| | - Justin Richards
- Sport New Zealand Ihi Aotearoa, Wellington 6011, New Zealand;
- Te Hau Kori, Faculty of Health, Victoria University of Wellington Te Herenga Waka, Wellington 6012, New Zealand;
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Wilson OW, Ikeda E, Hinckson E, Mandic S, Richards J, Duncan S, Kira G, Maddison R, Meredith-Jones K, Chisholm L, Williams L, Smith M. Results from Aotearoa New Zealand's 2022 Report Card on Physical Activity for Children and Youth: A call to address inequities in health-promoting activities. J Exerc Sci Fit 2022; 21:58-66. [DOI: 10.1016/j.jesf.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/02/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022] Open
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Rush E, Came H, Souter-Brown G, Kira G. Global food security, self-sufficiency and the cost of bread to Aotearoa. N Z Med J 2022; 135:108-110. [PMID: 36137772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Elaine Rush
- School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland New Zealand; Riddet Institute, Centre of Research Excellence in Food Science, Palmerston North, New Zealand
| | - Heather Came
- Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland New Zealand
| | - Gayle Souter-Brown
- Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland New Zealand
| | - Geoff Kira
- School of Health Science, Massey University, Palmerston North, New Zealand
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Glover M, Kira A, McRobbie H, Kruger R, Funaki-Tahifote M, Stephen J, Breier BH, Kira G. Outcomes of a culturally informed weight-loss competition for New Zealand Indigenous and Pacific peoples: a quasi-experimental trial. BMC Nutr 2021; 7:52. [PMID: 34503549 PMCID: PMC8431855 DOI: 10.1186/s40795-021-00457-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 07/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Reducing obesity prevalence among marginalised subgroups with disproportionately high obesity rates is challenging. Given the promise of incentives and group-based programmes we trialled a culturally tailored, team-based weight-loss competition with New Zealand Māori (Indigenous) and Pacific Island people. Methods A quasi-experimental 12-months trial was designed. The intervention consisted of three six-months competitions, each with seven teams of seven members. Eligible participants were aged 16 years and older, with a BMI ≥30 kg/m2 and being at risk of or already diagnosed with type-2 diabetes or cardiovascular disease. Height, weight and waist circumference were measured at baseline, 6 and 12 months. Results Recruitment of a control group (n = 29) versus the intervention (n = 132) was poor and retention rates were low (52 and 27% of intervention participants were followed-up at six and 12 months, respectively). Thus, analysis of the primary outcome of individual percentage weight loss was restricted to the 6-months follow-up data. Although not significant, the intervention group appeared to lose more weight than the control group, in both the intention to treat and complete-case analyses. Conclusions The intervention promoted some behaviour change in eating behaviours, and a resulting trend toward a reduction in waist circumference. Trial registration ACTRN12617000871347 Registered 15/6/2017 Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00457-9.
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Affiliation(s)
- Marewa Glover
- School of Health Sciences, College of Health, Massey University, Auckland, New Zealand.
| | | | - Hayden McRobbie
- Lakes District Health Board, New Zealand and National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Rozanne Kruger
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | | | - Jane Stephen
- School of Health Sciences, College of Health, Massey University, Auckland, New Zealand
| | - Bernhard H Breier
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Geoff Kira
- School of Health Sciences, College of Health, Massey University, Auckland, New Zealand
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Starck CS, Blumfield M, Keighley T, Marshall S, Petocz P, Inan-Eroglu E, Abbott K, Cassettari T, Ali A, Wham C, Kruger R, Kira G, Fayet-Moore F. Nutrient Dense, Low-Cost Foods Can Improve the Affordability and Quality of the New Zealand Diet-A Substitution Modeling Study. Int J Environ Res Public Health 2021; 18:7950. [PMID: 34360243 PMCID: PMC8345759 DOI: 10.3390/ijerph18157950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 12/16/2022]
Abstract
The high prevalence of non-communicable disease in New Zealand (NZ) is driven in part by unhealthy diet selections, with food costs contributing to an increased risk for vulnerable population groups. This study aimed to: (i) identify the nutrient density-to-cost ratio of NZ foods; (ii) model the impact of substituting foods with a lower nutrient density-to-cost ratio with those with a higher nutrient density-to-cost ratio on diet quality and affordability in representative NZ population samples for low and medium socioeconomic status (SES) households by ethnicity; and (iii) evaluate food processing level. Foods were categorized, coded for processing level and discretionary status, analyzed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods were 56% unprocessed (vegetables, fruit, porridge, pasta, rice, nuts/seeds), 31% ultra-processed (vegetable dishes, fortified bread, breakfast cereals unfortified <15 g sugars/100 g and fortified 15-30 g sugars/100 g), 6% processed (fruit juice), and 6% culinary processed (oils). Using substitution modeling, diet quality improved by 59% and 71% for adults and children, respectively, and affordability increased by 20-24%, depending on ethnicity and SES. The NZ diet can be made healthier and more affordable when nutritious, low-cost foods are selected. Processing levels in the healthier, modeled diet suggest that some non-discretionary ultra-processed foods may provide a valuable source of low-cost nutrition for food insecure populations.
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Affiliation(s)
- Carlene S. Starck
- Department of Translational Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (C.S.S.); (T.C.)
- Riddet Institute, Massey University, Palmerston North 4474, New Zealand
| | - Michelle Blumfield
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
| | - Tim Keighley
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
| | - Skye Marshall
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Peter Petocz
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
| | - Elif Inan-Eroglu
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2000, Australia
| | - Kylie Abbott
- Nutrition Research Australia, Sydney, NSW 2000, Australia;
| | - Tim Cassettari
- Department of Translational Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (C.S.S.); (T.C.)
| | - Ajmol Ali
- School of Sport, Exercise and Nutrition, College of Health, Massey University, North Shore City, Auckland 0745, New Zealand; (A.A.); (C.W.); (R.K.)
| | - Carol Wham
- School of Sport, Exercise and Nutrition, College of Health, Massey University, North Shore City, Auckland 0745, New Zealand; (A.A.); (C.W.); (R.K.)
| | - Rozanne Kruger
- School of Sport, Exercise and Nutrition, College of Health, Massey University, North Shore City, Auckland 0745, New Zealand; (A.A.); (C.W.); (R.K.)
| | - Geoff Kira
- School of Health Sciences, College of Health, Massey University, Palmerston North 4474, New Zealand;
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Kira G, Kira A, Pokaia V. Access and consumption of fruit and vegetables for people living in a deprived neighborhood in New Zealand: a cross-sectional study. Journal of Hunger & Environmental Nutrition 2021. [DOI: 10.1080/19320248.2021.1901820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Geoff Kira
- Senior Lecturer, School of Health Science, Massey University, Palmerston North, New Zealand
| | - Anette Kira
- Senior Research Fellow, Manawatū, Palmerston North, New Zealand
| | - Venessa Pokaia
- Social Worker, Te Wakahuia Manawatū Trust, Palmerston North, New Zealand
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Glover M, Kira A, Kira G, McRobbie H, Breier BH, Kruger R, Stephen J, Funaki-Tahifote M. An innovative team-based weightloss competition to reduce cardiovascular and diabetes risk among Māori and Pacific people: rationale and method for the study and its evaluation. BMC Nutr 2017; 3:78. [PMID: 32153855 PMCID: PMC7050897 DOI: 10.1186/s40795-017-0199-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/03/2017] [Indexed: 11/18/2022] Open
Abstract
Background Obesity rates for New Zealand (NZ) Pacific and Māori (NZ indigenous people) are among the highest in the world. Long-term results of weight management programmes for adults have been modest but primarily focused on individuals. This paper describes the rationale and methodology for a trial of a culturally tailored team-based weightloss competition conducted online with community level support. Methods/Design A quasi-experimental design was used to compare an intervention and control group. Three six-month competitions with seven teams of seven Māori or Pacific people (N = 147) were run. Eligible participants were: Māori or Pacific, 16 years of age and above, obese (BMI ≥30 kg/m2) and either at risk of or already diagnosed with type 2 diabetes (HbA1c >50 mmol/mol) or cardiovascular disease. The intervention facilitated group use of an internet-based competition offering financial incentives, education and support. The primary outcome was percentage of individual weight lost at 12-months. Secondary outcomes were percentage reduced total cholesterol and glycated haemoglobin (HbA1c). Data collected at baseline, 6-months and 12-months included: height, body weight, blood lipids and HbA1c, eating and dieting habits, family support, food access, alcohol use, nutrition literacy, activity levels, perceptions of weight, stress and sleep, and, perceived contagion effect. Process evaluation tasks will inform acceptability. Discussion An attractive, easy to understand weight change programme that effectively reduces disease risk among Māori and Pacific is desperately needed. Web-based delivered support and information to largely self-directed teams could also ease exponential rises in costs to the health system. Trial registration Trial Id: ACTRN12617000871347.
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Affiliation(s)
- Marewa Glover
- 1School of Health Sciences, College of Health, Massey University, Albany Highway, Albany, Auckland, 0632 New Zealand
| | | | - Geoff Kira
- 1School of Health Sciences, College of Health, Massey University, Albany Highway, Albany, Auckland, 0632 New Zealand
| | | | - Bernhard H Breier
- 4School of Sport, Exercise and Nutrition, College of Health, Massey University, Private Bag 102904, North Shore, Auckland, 0745 New Zealand
| | - Rozanne Kruger
- 4School of Sport, Exercise and Nutrition, College of Health, Massey University, Private Bag 102904, North Shore, Auckland, 0745 New Zealand
| | - Jane Stephen
- 1School of Health Sciences, College of Health, Massey University, Albany Highway, Albany, Auckland, 0632 New Zealand
| | - Mafi Funaki-Tahifote
- Pacific Heartbeat, Heart Foundation, PO Box 17-160, Greenlane, Auckland, 1546 New Zealand
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Kira G, Doolan-Noble F, Humphreys G, Williams G, O'Shaughnessy H, Devlin G. A national survey of cardiac rehabilitation services in New Zealand: 2015. N Z Med J 2016; 129:50-58. [PMID: 27355168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIMS Guidelines for cardiac rehabilitation (CR) programmes inform best practice. In Aotearoa NewZealand, little information exists about the structure and services provided by CR programmes and there is a poor understanding of how existing CR programmes are delivered with respect to evidence-based national guidelines. METHODS All 46 CR providers in New Zealand were invited to participate in a national survey in 2015. The survey sought information on the following: unit structure; referral processes; patient assessment; audit (including quality assurance activity); Phase 2 CR content; and support for special populations. Simple descriptive analysis of the responses was conducted, involving forming counts and percentages. RESULTS Thirty-six distinct units completed the survey and 94% provided Phase 2. Assessment tools, Phase 2 educational components, and the methods of providing the exercise component varied. Most units audited their services, 25% audited their programme six-monthly or more frequently. Just over half of the units (56%) reported key performance indicators. CONCLUSIONS The survey identified variations in delivery and content of CR in New Zealand, with poor understanding of the impact on patient outcomes. This is likely due to the absence of standardised audit practices and routine collection of key performance indicators on a national basis.
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Affiliation(s)
- Geoff Kira
- Research Centre for Māori Health and Development, Massey University, Massey University Private Bag 11222, Palmerston North 4442, Aotearoa New Zealand.
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Kira G, Maddison R, Hull M, Blunden S, Olds T. Sleep education improves the sleep duration of adolescents: a randomized controlled pilot study. J Clin Sleep Med 2014; 10:787-92. [PMID: 25024657 DOI: 10.5664/jcsm.3874] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To determine the feasibility and pilot a sleep education program in New Zealand high school students. METHODS A parallel, two-arm randomized controlled pilot trial was conducted. High school students (13 to 16 years) were randomly allocated to either a classroom-based sleep education program intervention (n = 15) or to a usual curriculum control group (n = 14). The sleep education program involved four 50-minute classroom-based education sessions with interactive groups. Students completed a 7-day sleep diary, a sleep questionnaire (including sleep hygiene, knowledge and problems) at baseline, post-intervention (4 weeks) and 10 weeks follow-up. RESULTS An overall treatment effect was observed for weekend sleep duration (F 1,24 = 5.21, p = 0.03). Participants in the intervention group slept longer during weekend nights at 5 weeks (1:37 h:min, p = 0.01) and 10 weeks: (1:32 h:min, p = 0.03) compared to those in the control group. No differences were found between groups for sleep duration on weekday nights. No significant differences were observed between groups for any of the secondary outcomes (sleep hygiene, sleep problems, or sleep knowledge). CONCLUSIONS A sleep education program appears to increase weekend sleep duration in the short term. Although this program was feasible, most schools are under time and resource pressure, thus alternative methods of delivery should be assessed for feasibility and efficacy. Larger trials of longer duration are needed to confirm these findings and determine the sustained effect of sleep education on sleep behavior and its impact on health and psychosocial outcomes. COMMENTARY A commentary on this article appears in this issue on page 793.
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Affiliation(s)
- Geoff Kira
- School of Sport and Exercise, College of Sciences, Massey University, Palmerston North, New Zealand
| | - Ralph Maddison
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Michelle Hull
- Mental Health Foundation of New Zealand, Auckland, New Zealand
| | | | - Timothy Olds
- Health and Use of Time (HUT) Group, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
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Stoner L, Shultz SP, Lambrick DM, Krebs J, Weatherall M, Palmer BR, Lane AM, Kira G, Witter T, Williams MA. The Combating Obesity in Māori and Pasifika Adolescent School-Children Study: COMPASS Methodology and Study Protocol. Int J Prev Med 2013; 4:565-79. [PMID: 23930168 PMCID: PMC3733188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 03/03/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Lifestyle modifications including, physical activity can reduce obesity-related morbidity and subsequent cardiovascular disease in youth. This study will investigate the efficacy of a culturally-sensitive, non-contact, boxing-orientated training program on obesity and related cardio-metabolic conditions in Māori and Pasifika adolescents. Details of the methodological aspects of recruitment, inclusion criteria, randomization, cultural sensitivity, intervention program, assessments, process evaluation, and statistical analyses are described. METHODS This study will be a community based, New Zealand, randomized control trial (RCT). Male and female obese (body mass index >95(th) percentile) Māori and Pasifika adolescents aged 14-16 years will be recruited and the sample size will be confirmed through a feasibility study. Combating Obesity in Māori and Pasifika Adolescent School-children Study (COMPASS) is a 6-month, theory-based program, conducted 3-times/week in a culturally appropriate setting. Each session includes 40 min boxing-orientated training and 30 min resistance training. Assessments will be made at baseline, 3-months, 6-months, 12-months, and 24-months. Main outcomes include abdominal obesity, endothelial function, and insulin resistance. Other outcomes include arterial stiffness, lipid profile, inflammatory biomarkers, well-being, and aerobic fitness. Control measures include physical activity, sleep behavior, and dietary intake. RESULTS As a protocol paper there are no specific results to present, our purpose is to share our RCT design with the scientific community. CONCLUSIONS COMPASS will be used to provide direction for exercise prescription policy in at-risk Māori and Pasifika adolescents.
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Affiliation(s)
- Lee Stoner
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - Sarah P. Shultz
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | | | - Jeremy Krebs
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Mark Weatherall
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Barry R. Palmer
- Institute of Food Nutrition and Human Health, Massey University, New Zealand
| | - Andrew M. Lane
- School of Sport, Performing Arts and Leisure, Wolverhampton University, United Kingdom
| | - Geoff Kira
- School of Sport and Exercise, Massey University, Palmerston North, New Zealand
| | - Trevor Witter
- School of Sport and Exercise, Massey University, Wellington, New Zealand
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Pfaeffli L, Maddison R, Whittaker R, Stewart R, Kerr A, Jiang Y, Kira G, Carter K, Dalleck L. A mHealth cardiac rehabilitation exercise intervention: findings from content development studies. BMC Cardiovasc Disord 2012; 12:36. [PMID: 22646848 PMCID: PMC3442998 DOI: 10.1186/1471-2261-12-36] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 05/30/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Involving stakeholders and consumers throughout the content and study design ensures interventions are engaging and relevant for end-users. The aim of this paper is to present the content development process for a mHealth (mobile phone and internet-based) cardiac rehabilitation (CR) exercise intervention. METHODS An innovative mHealth intervention was developed with patient input using the following steps: conceptualization, formative research, pre-testing, and pilot testing. Conceptualization, including theoretical and technical aspects, was undertaken by experts. For the formative component, focus groups and interviews with cardiac patients were conducted to discuss their perceptions of a mHealth CR program. A general inductive thematic approach identified common themes. A preliminary library of text and video messages were then developed. Participants were recruited from CR education sessions to pre-test and provide feedback on the content using an online survey. Common responses were extracted and compiled. An iterative process was used to refine content prior to pilot testing and conduct of a randomized controlled trial. RESULTS 38 CR patients and 3 CR nurses participated in the formative research and 20 CR patients participated in the content pre-testing. Participants perceived the mHealth program as an effective approach to inform and motivate patients to exercise. For the qualitative study, 100% (n = 41) of participants thought it to be a good idea, and 11% of participants felt it might not be useful for them, but would be for others. Of the 20 participants who completed the online survey, 17 out of 20 (85%) stated they would sign up to a program where they could receive information by video messages on a website, and 12 out of 20 (60%) showed interest in a texting program. Some older CR patients viewed technology as a potential barrier as they were unfamiliar with text messaging or did not have mobile phones. Steps to instruct participants to receive texts and view the website were written into the study protocol. Suggestions to improve videos and wording of texts were fed back to the content development team and refined. CONCLUSIONS Most participants thought a mHealth exercise program was an effective way to deliver exercise-based CR. The results were used to develop an innovative multimedia exercise intervention. A randomized controlled trial is currently underway. TRIAL REGISTRATION ACTRN12611000117910.
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Affiliation(s)
- Leila Pfaeffli
- Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand
| | - Ralph Maddison
- Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand
| | - Ralph Stewart
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Andrew Kerr
- Department of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand
| | - Geoff Kira
- Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand
| | - Karen Carter
- Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand
| | - Lance Dalleck
- Department of Sport and Exercise Science, University of Auckland, Auckland, New Zealand
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