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Tan X, Xie H, Wang D. Nutrition and Physical Activity Counseling by General Practitioners in China. Risk Manag Healthc Policy 2023; 16:2151-2162. [PMID: 37868022 PMCID: PMC10588712 DOI: 10.2147/rmhp.s427481] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction To reduce unhealthy lifestyles in China, it is critical to implement effective strategies. Counseling provided by physicians is important for assisting patients in improving their lifestyles, and general practitioners (GPs) are the main providers of lifestyle counseling to patients. However, few studies have focused on the lifestyle counseling practices by GPs in China, particularly in regard to nutrition and physical activity. Objective The aims of this study are: (i) to examine the current practice of Chinese GPs in counseling patients regarding nutrition and physical activity; (ii) to understand the common barriers to such counseling by Chinese GPs; and (iii) to study the association between GPs' personal lifestyle choices and their practices in lifestyle counseling. Methods A cross-sectional, self-reported online questionnaire was conducted among GPs in Hunan province, China. A total of 198 GPs completed the questionnaire. Results The majority of GPs provide nutrition and physical activity counseling to less than 40% of their patients, spending less than three minutes per counseling session. The main reported barriers to counseling on nutrition and physical activity are inadequate time and a lack of knowledge or experience. GPs primarily acquire knowledge through medical books and journals, followed by science popularization. Furthermore, GPs who maintain healthier lifestyle habits, possess a better understanding of lifestyle guidelines, conduct longer office visits, and exhibit higher self-efficacy are more likely to provide counseling to patients. Conclusion This study highlights the need for improvement in nutrition and physical activity counseling among Chinese GPs. GPs' personal nutrition and physical activity habits may measurably influence their counseling practice. We recommend that GPs themselves adopt healthier lifestyle habits to potentially improve their counseling practice. Moreover, proactive measures should be taken to assist GPs in overcoming barriers encountered with lifestyle counseling.
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Affiliation(s)
- Xian Tan
- Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
- Institute for Future Sciences, University of South China, Changsha, Hunan, People's Republic of China
| | - Hebin Xie
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People's Republic of China
| | - Danling Wang
- Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
- Institute for Future Sciences, University of South China, Changsha, Hunan, People's Republic of China
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People's Republic of China
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Cody R, Beck J, Brand S, Donath L, Faude O, Hatzinger M, Imboden C, Kreppke JN, Lang UE, Ludyga S, Mans S, Mikoteit T, Oswald A, Schweinfurth N, Zahner L, Gerber M. Short-term outcomes of physical activity counseling in in-patients with Major Depressive Disorder: Results from the PACINPAT randomized controlled trial. Front Psychiatry 2023; 13:1045158. [PMID: 36741581 PMCID: PMC9889670 DOI: 10.3389/fpsyt.2022.1045158] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction A physical activity counseling intervention based on a motivation-volition model was developed and delivered to in-patients with Major Depressive Disorders with the aim of increasing lifestyle physical activity. The aim of this study is to evaluate the short-term outcomes of this intervention. Methods A multi-center randomized controlled trial was conducted in four Swiss psychiatric clinics. Adults who were initially insufficiently physically active and were diagnosed with Major Depressive Disorder according to ICD-10 were recruited. The sample consisted of 113 participants in the intervention group (M age = 42 years, 56% women) and 107 in the control group (M age = 40 years, 49% women). Motivation and volition determinants of physical activity were assessed with questionnaires. Implicit attitudes were assessed with an Implicit Association Test. Physical activity was self-reported and measured with hip-worn accelerometers over 7 consecutive days starting on the day following the data collection. Results According to accelerometer measures, step count decreased on average 1,323 steps less per day (95% CI = -2,215 to -431, p < 0.01) over time in the intervention group compared to the control group. A trend was recognized indicating that moderate-to-vigorous physical activity decreased on average 8.37 min less per day (95% CI = -16.98 to 0.23, p < 0.06) over time in the intervention group compared to the control group. The initial phase of the intervention does not seem to have affected motivational and volitional determinants of and implicit attitudes toward physical activity. Conclusion Physical activity counseling may be considered an important factor in the transition from in-patient treatment. Methods to optimize the intervention during this period could be further explored to fulfill the potential of this opportunity. Clinical trial registration https://www.isrctn.com/ISRCTN10469580, identifier ISRCTN10469580.
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Affiliation(s)
- Robyn Cody
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Serge Brand
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Adult Psychiatric Clinics Universitäre Psychiatrische Klinik für Erwachsene (UPKE), University of Basel, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
- Substance Use Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | | | - Jan-Niklas Kreppke
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Undine E. Lang
- Adult Psychiatric Clinics Universitäre Psychiatrische Klinik für Erwachsene (UPKE), University of Basel, Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Münchenbuchsee, Switzerland
| | | | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | - Nina Schweinfurth
- Adult Psychiatric Clinics Universitäre Psychiatrische Klinik für Erwachsene (UPKE), University of Basel, Basel, Switzerland
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Blais A, Longmuir PE, Lougheed J. Pedometer Efficacy for Clinical Care in Pediatric Cardiology. J Phys Act Health 2023;:1-5. [PMID: 36848901 DOI: 10.1123/jpah.2022-0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 11/16/2022] [Accepted: 01/11/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Physical activity is essential to the long-term health of children living with cardiac disease. The simplicity and cost of pedometers make them an attractive alternative to accelerometers for monitoring the physical activity behaviors of these children. This study compared measures obtained from commercial-grade pedometers and accelerometers. METHODS Pediatric cardiology outpatients (n = 41, mean age = 8.4 [3.7] y, 61% female) wore a pedometer and accelerometer daily for 1 week. Step counts and minutes of moderate to vigorous physical activity were compared between devices, accounting for age group, sex, and diagnostic severity, using univariate analysis of variance. RESULTS While pedometer data were significantly correlated with accelerometers (r > .74, P < .001), measurements obtained were significantly different between devices. Overall, pedometers overestimated physical activity data. The overestimation of moderate to vigorous physical activity was significantly less among adolescents than younger age groups (P < .01, ηp2=.38). For step counts, there was a significant age by sex interaction observed where preschool and adolescent males tended to have greater differences between accelerometer and step count data than females (P < .01, ηp2=.33). Differences between devices were not associated with severity of diagnosis. CONCLUSIONS The distribution of pedometers in a pediatric outpatient clinic was feasible, yet the data collected significantly overestimated physical activity, especially among younger children. Practitioners who want to introduce objective measurements as part of their physical activity counseling practice should use pedometers to monitor individual changes in physical activity and consider patient age before administering these devices for clinical care.
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AlMarzooqi MA, Saller F. Physical Activity Counseling in Saudi Arabia: A Systematic Review of Content, Outcomes, and Barriers. Int J Environ Res Public Health 2022; 19:16350. [PMID: 36498424 PMCID: PMC9735878 DOI: 10.3390/ijerph192316350] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES This study aimed to map the characteristics and the predominant components of clinical physical activity (PA) counseling in Saudi Arabia for adult patients and outline evidence of outcomes and prevalent barriers to its implementation. METHODS We conducted a systematic literature search of four online databases: Web of Science, PubMed, ScienceDirect, and The Cochrane Library. Each study was assessed and evaluated using the Mixed Methods Appraisal Tool (MMAT) for methodological quality. RESULTS A total of 120 studies were screened, and 47 studies were sought for retrieval. In total, 25 articles were eligible and were subjected to extensive review. After a detailed evaluation, only nine studies met the inclusion criteria. All included were quantitative studies that compiled descriptive and numerical data on physical activity counseling. Four studies described PA counseling information in Saudi Arabia or prescription as lifestyle modification and program structure. The programs used various techniques to motivate patients to adhere to PA protocols. In general, practitioners indicated a high perceived competence in helping patients meet PA guidelines. The most frequently stated barrier was a lack of time for PA discussions with patients, followed by a lack of training in PA counseling, and a lack of patient compliance. Significant improvements in clinical parameters and smoking, food, and exercise habits were detected in experimental trials with respective intervention programs. CONCLUSION This review provides preliminary insights into the delivered intervention and standard care content, its outcomes, and clinicians' perceived competence and barriers regarding current PA counseling approaches in Saudi Arabia. Despite the small number of studies included, this review contributes to the limited understanding of current PA counseling practices in Saudi Arabia and serves as an informational source for clinicians and policymakers and a starting point for further research.
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Affiliation(s)
- Mezna A. AlMarzooqi
- Department of Community Health Sciences, College of Applied Medical Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Franziska Saller
- Department of Project Management, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
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Shimo K, Hasegawa M, Mizutani S, Hasegawa T, Ushida T. Effects of a 12-week workplace counseling program on physical activity and low back pain: A pilot randomized controlled study. J Back Musculoskelet Rehabil 2021; 34:845-852. [PMID: 33935064 DOI: 10.3233/bmr-200178] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Physical activity (PA) is essential in the management and rehabilitation of low back pain (LBP). However, it is not clear that PA interventions in the workplace can improve LBP. OBJECTIVE This study aimed to investigate the effects of workplace counseling on PA and LBP among workers. METHODS We recruited 37 people with 12 weeks of LBP who worked in a manufacturing company in Aichi, Japan. Participants were randomly assigned to the intervention (n= 20) or control group (n= 17). All participants of both groups were affixed with waist-worn accelerometers to monitor PA. The intervention group also received a program of face-to-face counseling with a physical therapist or nurse once a week for 12 weeks to reassure and encourage participants to maintain a high level of PA. PA and LBP severity were assessed at baseline, 3 and 6 months. RESULTS PA was significantly higher in the intervention group than in the control group at 3 and 6 months. In the intervention group, PA significantly increased at 3 and 6 months from baseline, and LBP severity at 6 months improved significantly from baseline. CONCLUSIONS Our data suggest that workplace PA intervention can increase PA and improve LBP among workers.
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Affiliation(s)
- Kazuhiro Shimo
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Yazako, Nagakute, Aichi, Japan.,Multidisciplinary Pain Center, Aichi Medical University, Yazako, Nagakute, Aichi, Japan.,Faculty of Rehabilitation, Kobe Gakuin University, Ikawadani-cho, Nishi-ku, Kobe, Hyogo, Japan
| | - Mami Hasegawa
- School of Nursing, Aichi Medical University, Yazako, Nagakute, Aichi, Japan
| | - Seiko Mizutani
- School of Nursing, Aichi Medical University, Yazako, Nagakute, Aichi, Japan.,Faculty of Nursing, Nihon Fukushi University, Ota-machi, Toukai, Aichi, Japan
| | - Tomomi Hasegawa
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Yazako, Nagakute, Aichi, Japan
| | - Takahiro Ushida
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Yazako, Nagakute, Aichi, Japan.,Multidisciplinary Pain Center, Aichi Medical University, Yazako, Nagakute, Aichi, Japan
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Asiamah N, Adu-Gyamfi K, Frimpong FKS, Avor WMK. Development of a Scale Measuring Nurses' Physical Activity Counseling in a Primary Care Facility: Implications for Healthcare Quality. Hosp Top 2021; 99:119-129. [PMID: 33459201 DOI: 10.1080/00185868.2020.1871575] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study constructed a scale for measuring nurses' physical activity (PA) counseling in healthcare from the points of view of regular patients. Confirmatory factor analysis produced a two-factor solution with 7 items. The first factor extracted was "follow-up", which accounted for a variance of 44.5% out of a total variance of 64.8% and comprises 4 items. The second factor, "PA recommendation", accounted for a variance of 20.3% and comprises 3 items. The final scale had a good internal consistency (Cronbach's α = 0.75; factor loading ≥0.50) as well as satisfactory validity indicators.
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Affiliation(s)
- Nestor Asiamah
- Department of Clinical Research, Africa Centre for Epidemiology, Accra North, Ghana
| | - Kwame Adu-Gyamfi
- Department of Hospitality Management, Niagara College, Ontario, Canada
| | | | - Wisdom Mensah Kwasi Avor
- Department of Nursing, University of Health and Allied Sciences, PMB 31, Ho, Volta Region, Ghana
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Issakainen M, Schwab U, Lamminpää R. Qualitative study on public health nurses' experience and assessment of nutritional and physical activity counseling of women with gestational diabetes. Eur J Midwifery 2020; 4:37. [PMID: 33537638 PMCID: PMC7839090 DOI: 10.18332/ejm/127123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/12/2020] [Revised: 07/30/2020] [Accepted: 09/01/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The number of pregnant women with gestational diabetes mellitus (GDM) has increased worldwide. GDM is a known risk factor for pregnant mothers and their fetuses that may increase various complications and health concerns. Nutrition and physical activity (PA) counseling during pregnancy can be crucial in supporting pregnant women to adopt healthier lifestyle practices and reducing these risks. This study describes public health nurses’ (PHNs) experiences of nutrition and PA counseling and their assessments on how to develop the counseling for pregnant women with GDM. METHODS This is a descriptive qualitative study containing theme-interviews of 11 PHNs working in an antenatal maternity care setting. The data were analyzed using inductive content analysis. RESULTS Five main themes were identified related to PHNs’ experiences and assessment of nutrition and PA counseling for pregnant women with GDM: competency of nutrition and PA counseling, challenges of counseling, positive experiences of counseling, printed material, and counseling practices. PHNs considered nutrition and PA counseling both challenging and rewarding. There was lack of knowledge and skills to provide proper counseling and adequate material to support versatile counseling. CONCLUSIONS Material related to nutrition and PA counseling should be updated and standardized. PHNs need further training to improve knowledge in the area of diet and exercise.
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Affiliation(s)
| | - Ursula Schwab
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Reeta Lamminpää
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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8
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Füzéki E, Weber T, Groneberg DA, Banzer W. Physical Activity Counseling in Primary Care in Germany-An Integrative Review. Int J Environ Res Public Health 2020; 17:E5625. [PMID: 32759872 PMCID: PMC7432844 DOI: 10.3390/ijerph17155625] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 06/29/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/16/2022]
Abstract
Physical activity counseling in primary health care is regarded as a useful complementary preventive and therapeutic measure and is advocated by leading public health institutions. This integrative review summarizes the available data on physical activity counseling in primary care in Germany. A systematic literature search in various databases (peer reviewed and grey literature) was carried out for quantitative and qualitative studies on physical activity counseling and use of "Exercise on Prescription". The 25 studies included show a very high methodological diversity and, in some cases, considerable risks of bias, with limited comparability across studies. Counseling was provided in all studies by physicians. They report frequent physical activity counseling, which is partly confirmed and partly refuted by patient data. The use of "Exercise on Prescription" is at a very low level. Information on the frequency of physical activity counseling in Germany varies depending on data source and is sometimes contradictory. Our review provides a synthesis of various perspectives on routine physical activity counseling in primary care in Germany. Future studies using standardized and validated instruments in representative samples are needed to further knowledge on counseling and to be able to establish trends in prevalence. Strengthening the topics of physical activity and health and physical activity counseling in medical curriculum is strongly recommended.
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Affiliation(s)
- Eszter Füzéki
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, 60590 Frankfurt, Germany; (T.W.); (D.A.G.); (W.B.)
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Riegel GR, Martins GB, Schmidt AG, Rodrigues MP, Nunes GS, Correa V, Fuchs SC, Fuchs FD, Ribeiro PA, Moreira LB. Self-reported adherence to physical activity recommendations compared to the IPAQ interview in patients with hypertension. Patient Prefer Adherence 2019; 13:209-214. [PMID: 30774316 PMCID: PMC6350830 DOI: 10.2147/ppa.s185519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Physical activity (PA) is recommended as adjuvant therapy to control blood pressure (BP). The effectiveness of simple recommendations is not clear. We aimed to assess the agreement between self-report of adherence to PA in clinical routine and International Physical Activity Questionnaire (IPAQ) interview and its association with BP control. METHODS A cross-sectional study was conducted with hypertensive outpatients. Adherence to recommendation to PA was assessed by the physician and IPAQ interview. A cutoff of 150 minutes/week was used to classify active or nonactive patients. High sitting time was considered >4 hours/day. A total of 127 individuals (SBP 144.9±24.4 mmHg/DBP 82.0±12.8 mmHg) were included. RESULTS A total of 69 subjects (54.3%) reported to be active to their physician, whereas 81 (63.8%) were classified as active by IPAQ (6.3% active in leisure time PA). Kappa test was 0.22 (95% CI, 0.06-0.37). The rate of BP control was 45.7%. There was no association with the reported PA assessed by both methods nor with sitting time. Our results demonstrated poor agreement between self-report adherence and IPAQ interview, and neither evaluation was associated with BP control. CONCLUSION Our findings underpin evidences that a simple PA recommendation has low association with BP control in clinical settings.
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Affiliation(s)
- Glaube R Riegel
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Giulia B Martins
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Afonso G Schmidt
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Marcela P Rodrigues
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Gerson S Nunes
- Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Vicente Correa
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Sandra C Fuchs
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Flavio D Fuchs
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Paula Ab Ribeiro
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Cardiology Division, University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada,
| | - Leila B Moreira
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Pharmacology Department, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Richardson CR, Goodrich DE, Larkin AR, Ronis D, Holleman RG, Damschroder LJ, Lowery JC. A Comparative Effectiveness Trial of Three Walking Self-monitoring Strategies. Transl J Am Coll Sports Med 2017; 1:133-142. [PMID: 28529971 PMCID: PMC5435380 DOI: 10.1249/tjx.0000000000000017] [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] [Indexed: 11/21/2022]
Abstract
Walking programs improve health outcomes in adults at risk for cardiovascular disease (CVD), and self-monitoring strategies can improve adherence to such programs. The objective of this study was to determine whether a 6-month Internet-based walking program using Web-enhanced pedometers results in more weight loss than walking programs based on time or simple pedometer step count goals in adults with or at risk for CVD. This was a multisite, randomized controlled trial of 255 male veterans who were ambulatory, insufficiently active, and with body mass index (BMI) ≥28, and who reported CVD risk factors ≥1 risk factors. Participants were randomized to one of three self-monitoring strategies to increase walking: 1) time-based walking goals; 2) simple pedometer-based walking goals; and 3) Web-enhanced pedometer feedback goals with Internet-mediated feedback. All participants also attended five individual weight loss sessions with a dietitian. The main outcome measure was change in weight at 6 months (kg), and the secondary outcomes were change in accelerometer-measured physical activity (min) and change in health-related quality of life at 6 months. The 255 participants had a mean age of 56.3 yr (SD = 10.0), BMI = 36.3 (SD = 5.3), with a mean value of 5.2 (SD = 2.3) medical comorbidities. Dropouts were distributed evenly across the three groups, and 72% of participants completed the program. At 6 months, participants in the Web-enhanced pedometer arm lost significantly more weight (−1.9 kg, 95% CI, −2.7 to −1.1) than those in the time-based group (−0.7 kg, 95% CI, −1.5 to 0.0; P = 0.04) and simple pedometer group (−0.6 kg, 95% CI, −1.4 to 0.2; P = 0.02). In conclusion, Internet-enhanced pedometers result in greater weight loss in veterans than in walking programs using time-based walking goals or simple pedometers.
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Affiliation(s)
- Caroline R Richardson
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI.,The Department of Family Medicine, University of Michigan Health System, Ann Arbor, MI
| | - David E Goodrich
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Angela R Larkin
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - David Ronis
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Robert G Holleman
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Laura J Damschroder
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Julie C Lowery
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
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