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McVay MA, Carrera Seoane M, Rajoria M, Dye M, Marshall N, Muenyi S, Alkanderi A, Scotti KB, Ruiz J, Voils CI, Ross KM. A low-burden, self-weighing intervention to prevent weight gain in adults with obesity who do not enroll in comprehensive treatment. Obes Sci Pract 2024; 10:e745. [PMID: 38510333 PMCID: PMC10951869 DOI: 10.1002/osp4.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/13/2024] [Accepted: 03/03/2024] [Indexed: 03/22/2024] Open
Abstract
Background For individuals who are eligible but unlikely to join comprehensive weight loss programs, a low burden self-weighing intervention may be a more acceptable approach to weight management. Methods This was a single-arm feasibility trial of a 12-month self-weighing intervention. Participants were healthcare patients with a BMI ≥25 kg/m2 with a weight-related comorbidity or a BMI >30 kg/m2 who reported lack of interest in joining a comprehensive weight loss program, or did not enroll in a comprehensive program after being provided program information. In the self-weighing intervention, participants were asked to weigh themselves daily on a cellular connected scale and were sent text messages every other week with tailored weight change feedback, including messages encouraging use of comprehensive programs if weight gain occurred. Results Of 86 eligible patients, 39 enrolled (45.3%) in the self-weighing intervention. Self-weighing occurred on average 4.6 days/week (SD = 1.4). At 12 months, 12 participants (30.8%) lost ≥3% baseline weight, 11 (28.2%) experienced weight stability (±3% baseline), 6 (15.4%) gained ≥3% of baseline weight, and 10 (25.6%) did not have available weight data to evaluate. Three participants reported joining a weight loss program during the intervention (7.7%). Participants reported high intervention satisfaction in quantitative ratings (4.1 of 5), and qualitative interviews identified areas of satisfaction (e.g., timing and content of text messages) and areas for improvement (e.g., increasing personalization of text messages). Conclusion A low-burden self-weighing intervention can reach adults with overweight/obesity who would be unlikely to engage in comprehensive weight loss programs; the efficacy of this intervention for preventing weight gain should be further evaluated in a randomized trial.
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Affiliation(s)
- Megan A. McVay
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
- Center for Integrative Cardiovascular and Metabolic DiseaseUniversity of FloridaGainesvilleFloridaUSA
| | - Montserrat Carrera Seoane
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
| | | | - Marissa Dye
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
| | - Natalie Marshall
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
| | - Sofia Muenyi
- Department of Community Health and Family MedicineCollege of Medicine‐JacksonvilleUniversity of FloridaJacksonvilleFloridaUSA
| | - Anas Alkanderi
- Department of Epidemiology & Community HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Kellie B. Scotti
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
| | - Jaime Ruiz
- Department of Computer & Information Science & EngineeringCollege of EngineeringUniversity of FloridaGainesvilleFloridaUSA
| | - Corrine I. Voils
- William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
- Department of SurgerySchool of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - Kathryn M. Ross
- Center for Integrative Cardiovascular and Metabolic DiseaseUniversity of FloridaGainesvilleFloridaUSA
- Department of Clinical & Health PsychologyCollege of Public Health & Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
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Tcymbal A, Messing S, Mait R, Perez RG, Akter T, Rakovac I, Gelius P, Abu-Omar K. Validity, reliability, and readability of single-item and short physical activity questionnaires for use in surveillance: A systematic review. PLoS One 2024; 19:e0300003. [PMID: 38470871 PMCID: PMC10931432 DOI: 10.1371/journal.pone.0300003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Accurate and fast measurement of physical activity is important for surveillance. Even though many physical activity questionnaires (PAQ) are currently used in research, it is unclear which of them is the most reliable, valid, and easy to use. This systematic review aimed to identify existing brief PAQs, describe and compare their measurement properties, and assess their level of readability. METHODS We performed a systematic review based on the PRISMA statement. Literature searches were conducted in six scientific databases. Articles were included if they evaluated validity and/or reliability of brief (i.e., with a maximum of three questions) physical activity or exercise questionnaires intended for healthy adults. Due to the heterogeneity of studies, data were summarized narratively. The level of readability was calculated according to the Flesch-Kincaid formula. RESULTS In total, 35 articles published in English or Spanish were included, evaluating 32 distinct brief PAQs. The studies indicated moderate to good levels of reliability for the PAQs. However, the majority of results showed weak validity when validated against device-based measurements and demonstrated weak to moderate validity when validated against other PAQs. Most of the assessed PAQs met the criterion of being "short," allowing respondents to complete them in less than one minute either by themselves or with an interviewer. However, only 17 questionnaires had a readability level that indicates that the PAQ is easy to understand for the majority of the population. CONCLUSIONS This review identified a variety of brief PAQs, but most of them were evaluated in only a single study. Validity and reliability of short and long questionnaires are found to be at a comparable level, short PAQs can be recommended for use in surveillance systems. However, the methods used to assess measurement properties varied widely across studies, limiting the comparability between different PAQs and making it challenging to identify a single tool as the most suitable. None of the evaluated brief PAQs allowed for the measurement of whether a person fulfills current WHO physical activity guidelines. Future development or adaptation of PAQs should prioritize readability as an important factor to enhance their usability.
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Affiliation(s)
- Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Rachel Mait
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Roberto Galindo Perez
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Taiyeba Akter
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ivo Rakovac
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Peter Gelius
- Institute of Sport Sciences, Université de Lausanne, Lausanne, Switzerland
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Dysart A, Harden SM. Effects of Temperature and Tempo: Evaluating How Much Time in a Typical Community-Based Yoga Class Is Moderate-Intensity Aerobic Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2349. [PMID: 36767717 PMCID: PMC9915918 DOI: 10.3390/ijerph20032349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
The 2nd edition of the Physical Activity Guidelines for Americans (PAG) recommends, in part, 150 min of moderate-intensity aerobic physical activity. The PAG states that yoga may be able to help meet the guidelines for moderate-intensity aerobic exercise for adults and older adults. Our study aims to objectively measure the proportion of time participants' activity that is categorized as moderate-intensity aerobic activity based on heart rate data and to subjectively measure rate of perceived exertion (RPE). Participants completed the Stanford Leisure-Time Activity Categorical item to establish baseline PAG aerobic activity compliance. Participants then completed four separate 1-h yoga sessions at different tempos (cadence) and temperatures while wearing heart rate monitors. During and directly after the session they also marked their RPE on a modified 10-point scale. All participants reached moderate-intensity aerobic activity for at least some portion of a yoga session based on heart rate monitor data and RPE. The average duration of moderate intensity was 32.75% of the class across all four class types, with no significant differences by condition. Age was a significant factor in time spent in moderate-to-vigorous physical activity for only the thermo-neutral Hatha classes (p = 0.010). Tempo, temperature, and baseline activity levels were not significant factors in time spent in moderate-to-vigorous intensity physical activity based on Pearson Correlation and the Kruskal-Wallis test. Hatha and Vinyasa yoga classes, at room or hot temperatures, can be used to meet a portion of the PAG moderate-intensity activity recommendations.
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Exploring the relationship between regular physical activity and the 24-hour glucose cycle in gestational glucose intolerance and gestational diabetes mellitus. Am J Obstet Gynecol 2023; 228:100-102. [PMID: 36088987 DOI: 10.1016/j.ajog.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 01/26/2023]
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Dysart A, Harden SM. Mindfulness and Understanding of Self-Care for Leaders of Extension: Promoting Well-Being for Health Educators and Their Clients. Front Public Health 2022; 10:862366. [PMID: 35646779 PMCID: PMC9136216 DOI: 10.3389/fpubh.2022.862366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/22/2022] [Indexed: 11/26/2022] Open
Abstract
Background Mindfulness and self-care, practiced through a variety of methods like meditation and exercise, can improve overall sense of holistic well-being (i.e., flourishing). Increasing mindfulness and self-care may lead to increased flourishing and job satisfaction among the nation-wide Cooperative Extension system delivery personnel (agents) through a theory-based online program and an extended experiential program. Methods Cooperative Extension agents from two states were invited to participate in MUSCLE via statewide listservs. Participants were invited to attend sessions and complete competency checks and between-session assignments each week. The study was conducted using Zoom. Pre- and post- program surveys included validated scales for flourishing and physical activity status. Due to high demand for mindfulness programing during the onset of the COVID-19 pandemic, experiential “Mindful Meet-up” 30-minute sessions were held on Zoom. Dissemination and implementation of the two differing interventions (i.e., MUSCLE and Mindful Meet-ups) were examined. Results MUSCLE (more intensive program with assignments and competency checks) had lower reach, and did not show statistically increased flourishing or physical activity. Mindful Meet-ups had higher attendance and proportional reach during the beginning of the pandemic, but no practical measure of flourishing or physical activity behaviors. Unsolicited qualitative feedback was encouraging because the interventions were well-received and participants felt as though they were more mindful. Conclusions While agents anecdotally reported personal improvements, capturing data on outcomes was challenging. Complementing outcome data with implementation and dissemination outcomes allowed for a richer picture to inform intervention decision-making (i.e., offering the same or new programming depending on participant needs).
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Zoellner JM, Porter KJ, You W, Reid AL, Frederick C, Hilgart M, Brock DJP, Tate DF, Ritterband LM. Study protocol for iSIPsmarter: A randomized-controlled trial to evaluate the efficacy, reach, and engagement of a technology-based behavioral intervention to reduce sugary beverages among rural Appalachian adults. Contemp Clin Trials 2021; 110:106566. [PMID: 34492306 PMCID: PMC8595813 DOI: 10.1016/j.cct.2021.106566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 01/09/2023]
Abstract
Sugar-sweetened beverage (SSB) consumption is disproportionately high among rural Appalachian adults, with intakes double the national average and nearly four times the recommended amount. This trial targets this major dietary risk factor and addresses notable gaps in the rural digital health intervention literature. iSIPsmarter is a technology-based behavior and health literacy intervention aimed at improving SSB behaviors. It is comprised of six Internet-delivered, interactive Cores delivered weekly, an integrated short message service (SMS) strategy to engage users in tracking and reporting SSB behaviors, and a cellular-enabled scale for in-home weighing. iSIPsmarter is adapted from an evidence-based intervention and is grounded by the Theory of Planned Behavior and health literacy, numeracy, and media literacy concepts. The RCT is guided by the RE-AIM framework and targets 244 rural Appalachian adults. The goal is to examine the efficacy of iSIPsmarter to reduce SSB in a two-group design [iSIPsmarter vs. static Participant Education website] with four assessment points. Changes in secondary outcomes (e.g., diet quality, weight, quality of life) and maintenance of outcomes will also be evaluated. Additional secondary aims are to examine reach and representativeness, patterns of user engagement, and cost. Two tertiary aims are exploratory mediation analyses and a systems-level, participatory evaluation to understand context for future organizational-level adoption of iSIPsmarter. The long-term goal is to sustain an effective, scalable, and high reach behavioral intervention to reduce SSB-related health inequities and related chronic conditions (i.e., obesity, diabetes, some obesity-related cancers, heart disease, hypertension, dental decay) in rural Appalachia and beyond. ClinicalTrial registry: NCT05030753.
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Affiliation(s)
- Jamie M Zoellner
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA.
| | - Kathleen J Porter
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Wen You
- University of Virginia, School of Medicine, Department of Public Health Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
| | - Annie L Reid
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Christina Frederick
- University of Virginia, School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
| | - Michelle Hilgart
- University of Virginia, School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
| | - Donna-Jean P Brock
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Deborah F Tate
- University of North Carolina, Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, NC 27599, USA
| | - Lee M Ritterband
- University of Virginia, School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
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Ehrlich SF, Maples JM, Barroso CS, Brown KC, Bassett DR, Zite NB, Fortner KB. Using a consumer-based wearable activity tracker for physical activity goal setting and measuring steps in pregnant women with gestational diabetes mellitus: exploring acceptance and validity. BMC Pregnancy Childbirth 2021; 21:420. [PMID: 34103002 PMCID: PMC8188700 DOI: 10.1186/s12884-021-03900-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/19/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Activity monitoring devices may be used to facilitate goal-setting, self-monitoring, and feedback towards a step-based physical activity (PA) goal. This study examined the performance of the wrist-worn Fitbit Charge 3™ (FC3) and sought opinions on walking and stepping-in-place from women with gestational diabetes (GDM). METHODS Participants completed six 2-min metronome-assisted over ground bouts that varied by cadence (67, 84, or 100 steps per minute) and mode (walking or stepping-in-place; N = 15), with the sequence randomized. Steps were estimated by FC3 and measured, in duplicate, by direct observation (hand-tally device, criterion). Equivalence testing by the two one-sided tests (TOST) method assessed agreement within ± 15%. Mean absolute percent error (MAPE) of steps were compared to 10%, the accuracy standard of the Consumer Technology Association (CTA)™. A subset (n = 10) completed a timed, 200-m self-paced walk to assess natural walking pace and cadence. All participants completed semi-structured interviews, which were transcribed and analyzed using descriptive and interpretive coding. RESULTS Mean age was 27.0 years (SD 4.2), prepregnancy BMI 29.4 kg/m2 (8.3), and gestational age 32.8 weeks (SD 2.6). The FC3 was equivalent to hand-tally for bouts of metronome-assisted walking and stepping-in-place at 84 and 100 steps per minute (i.e., P < .05), although walking at 100 steps per minute (P = .01) was no longer equivalent upon adjustment for multiple comparisons (i.e., at P < .007). The FC3 was equivalent to hand-tally during the 200-m walk (i.e., P < .001), in which mean pace was 68.2 m per minute (SD 10.7), or 2.5 miles per hour, and mean cadence 108.5 steps per minute (SD 6.5). For walking at 84 and 100 steps per minute, stepping-in-place at 100 steps per minute, and the 200-m walk, MAPE was within 10%, the accuracy standard of the CTA™. Interviews revealed motivation for PA, that stepping-in-place was an acceptable alternative to walking, and competing responsibilities made it difficult to find time for PA. CONCLUSIONS The FC3 appears to be a valid step counter during the third trimester, particularly when walking or stepping-in-place at or close to women's preferred cadence.
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Affiliation(s)
- Samantha F Ehrlich
- Department of Public Health, The University of Tennessee, Knoxville, 390 HPER, 1914 Andy Holt Ave, Knoxville, TN, 37996, USA.
| | - Jill M Maples
- The University of Tennessee, Graduate School of Medicine, 1924 Alcoa Highway, Knoxville, TN, 37920, USA
| | - Cristina S Barroso
- College of Nursing, The University of Tennessee, Knoxville, 1200 Volunteer Blvd, Knoxville, TN, 37996, USA
| | - Kathleen C Brown
- Department of Public Health, The University of Tennessee, Knoxville, 390 HPER, 1914 Andy Holt Ave, Knoxville, TN, 37996, USA
| | - David R Bassett
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, 1914 Andy Holt Ave, Knoxville, TN, 37996, USA
| | - Nikki B Zite
- The University of Tennessee, Graduate School of Medicine, 1924 Alcoa Highway, Knoxville, TN, 37920, USA
| | - Kimberly B Fortner
- The University of Tennessee, Graduate School of Medicine, 1924 Alcoa Highway, Knoxville, TN, 37920, USA
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Physical Function in Midlife and Older Adults From an African American Church-Based Health Screening. Am J Prev Med 2021; 60:845-849. [PMID: 33640231 PMCID: PMC8154656 DOI: 10.1016/j.amepre.2020.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Limitations in physical function are predictive of adverse health outcomes, and screening has been recommended in clinical settings for older adults. Rarely assessed in community-based settings, physical function could provide insight for tailoring health-related community-based programs and raise awareness about this important aspect of health. This cross-sectional study seeks to demonstrate the feasibility of integrating physical function assessments into health screenings in African American churches in Chicago, Illinois, through a large health partnership and to determine the prevalence and correlates of physical function limitations among midlife (aged 40-59 years) and late-life (aged ≥60 years) participants. METHODS Screenings were held in 7 churches in Spring 2018. Physical function was assessed using the Short Physical Performance Battery. Demographics, medical history, health status, and health behaviors were assessed. Age-stratified logistic regression identified independent associations with physical function limitations (Score ≤9) among midlife and late-life participants (data were analyzed in 2018-2019). RESULTS Among 731 participants (median age=57 [IQR=51-65] years, 58% women, 97% African American), 25% of midlife and 56% of late-life participants had physical function limitations. For midlife participants, fair/poor health (OR=1.83, 95% CI=1.10, 3.05), stroke/neurologic conditions (OR=2.42, 95% CI=1.07, 5.46), and arthritis (OR=2.25, 95% CI=1.32, 3.81) were associated with higher odds of limitations. Fair/poor health (OR=1.97, 95% CI=1.11, 3.50) and stroke/neurologic conditions (OR=7.85, 95% CI=2.22, 27.74) were related to limitations among late-life participants. CONCLUSIONS Physical function screening was successfully implemented into this large-scale church-based health screening program. Physical function limitations were prevalent, particularly at midlife; this information will be used to guide future programs.
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Vogel EA, Zhang JS, Peng K, Heaney CA, Lu Y, Lounsbury D, Hsing AW, Prochaska JJ. Physical activity and stress management during COVID-19: a longitudinal survey study. Psychol Health 2021; 37:51-61. [DOI: 10.1080/08870446.2020.1869740] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Erin A. Vogel
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Janice S. Zhang
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Katy Peng
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Catherine A. Heaney
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Ying Lu
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford University, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford University, Stanford, CA, USA
- Stanford Cancer Institute, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - David Lounsbury
- Department of Epidemiology and Population Health, Albert Einstein Medical College, The Bronx, NY, USA
| | - Ann W. Hsing
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford University, Stanford, CA, USA
- Stanford Cancer Institute, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - Judith J. Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
- Stanford Cancer Institute, Stanford School of Medicine, Stanford University, Stanford, CA, USA
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Walters R, Leslie SJ, Sixsmith J, Gorely T. Health Literacy for Cardiac Rehabilitation: An Examination of Associated Illness Perceptions, Self-Efficacy, Motivation and Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228641. [PMID: 33233804 PMCID: PMC7699978 DOI: 10.3390/ijerph17228641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022]
Abstract
Following a diagnosis of cardiovascular disease there is a need for patients to self-manage. Health literacy has been shown to be lower in patients with cardiovascular disease, yet research into health literacy in this population is limited. This study used the Health Literacy Questionnaire (HLQ) to examine the health literacy and associated health, health behaviours and psychological profiles of cardiac rehabilitation patients from a remote and rural regional programme in the Scottish Highlands. Consecutive patients referred to the service in a calendar year were sent a cross-sectional questionnaire by post. Hierarchical cluster analysis grouped respondents based on their health literacy profile, and nonparametric methods were used to analyse differences between clusters on the other measures. A total of 282 participants responded (45.7%). Respondents were older (median: 71 years) and more likely to be from more affluent areas. Five health literacy clusters emerged with different profiles of health, physical activity, self-efficacy, motivation and illness perceptions. There was no difference in relation to cardiac rehabilitation attendance by health literacy cluster, but those with lower health literacy were less likely to be aware of the referral. Patterns of health literacy are associated with health, health behaviours and some psychological constructs. Knowledge of distinct cluster characteristics may help services better target interventions.
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Affiliation(s)
- Ronie Walters
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, UK; (S.J.L.); (T.G.)
- Correspondence:
| | - Stephen J. Leslie
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, UK; (S.J.L.); (T.G.)
- Cardiac Department, Raigmore Hospital, Inverness IV2 3UJ, UK
| | - Jane Sixsmith
- Health Promotion Research Centre, National University of Ireland Galway, H91 TK33 Galway, Ireland;
| | - Trish Gorely
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, UK; (S.J.L.); (T.G.)
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Rovniak LS, Adams MA, Sciamanna CN, Kong L, Sullivan N, Costalas S, Bopp M, Kuzmik A. Effects of Bluetooth-Enabled Desk Ellipticals on Office Work Performance: Rationale, Design, and Protocol for a Randomized Trial With Overweight and Obese Adults. JMIR Res Protoc 2020; 9:e16275. [PMID: 31934871 PMCID: PMC6996735 DOI: 10.2196/16275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/22/2019] [Accepted: 10/26/2019] [Indexed: 11/28/2022] Open
Abstract
Background Workplaces that provide opportunities for physical activity without requiring extra time for activity could help counteract the obesity epidemic. Desk ellipticals can contribute to activity-supportive workplace environments; however, the feasibility of engaging employees in pedaling ellipticals during simultaneous office work has not been well evaluated. Objective We aim to present the rationale and methods from an ongoing randomized trial with overweight and obese employees that will evaluate (1) the effects of pedaling a compact desk elliptical on work performance and (2) the influence of different incentive types and schedules on desk pedaling quantity. Methods Overweight and obese medical center employees are being recruited in dyads for a 2 (gift card type: healthier food vs Amazon) by 3 (gift card schedule: immediate incentive contingent on individual pedaling quantity; immediate incentive partially contingent on dyads’ joint pedaling quantity; and delayed noncontingent pedaling incentive) cluster randomized within-subjects factorial trial. All participants receive a Bluetooth-enabled desk elliptical for 4 weeks and access to a mobile app that provides real-time pedaling feedback. The primary aims are to assess (1) change in employee work performance from pre- to postelliptical installation via employee and supervisor ratings and (2) effects of gift card type and schedule on quantity of objectively measured desk pedaling completed. Results Data collection is ongoing. We expect to complete main outcome analyses in 2020. Conclusions This trial represents one of the earliest attempts to assess the effects of desk pedaling and pedaling-incentive types in real-world offices. It could help bridge the research-to-practice gap by providing evidence on whether desk pedaling can be sustained without compromising work performance. International Registered Report Identifier (IRRID) DERR1-10.2196/16275
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Affiliation(s)
- Liza S Rovniak
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Marc A Adams
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Christopher N Sciamanna
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Lan Kong
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Nicole Sullivan
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Sara Costalas
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, State College, PA, United States
| | - Ashley Kuzmik
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
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Brown SD, Hedderson MM, Ehrlich SF, Galarce MN, Tsai AL, Quesenberry CP, Ferrara A. Gestational weight gain and optimal wellness (GLOW): rationale and methods for a randomized controlled trial of a lifestyle intervention among pregnant women with overweight or obesity. BMC Pregnancy Childbirth 2019; 19:145. [PMID: 31039753 PMCID: PMC6492416 DOI: 10.1186/s12884-019-2293-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/12/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Excess gestational weight gain (GWG) is common among women with overweight or obesity, increasing their risks for pregnancy complications, delivering a large infant, and postpartum weight retention. To date, only intensive interventions have had success and few interventions have been designed for implementation in healthcare settings. METHODS We describe the development, rationale, and methods of GLOW (GestationaL Weight Gain and Optimal Wellness), a randomized controlled trial evaluating the efficacy of a lifestyle intervention to prevent excess GWG among racially/ethnically diverse women with overweight or obesity in an integrated healthcare delivery system. Participants in Kaiser Permanente Northern California will be randomized, within 2 weeks of completing a study baseline clinic visit at 10 weeks' gestation, to either usual medical care or a multi-component pregnancy lifestyle intervention adapted from the Diabetes Prevention Program (target N = 400). Informed by focus groups with patients and designed to be feasible in a clinical setting, the intervention will include 13 weekly individual sessions (11 delivered by telephone) focused on behavior change for weight management, healthy eating, physical activity, and stress management. Outcomes will be assessed in women and their infants from randomization to 12 months postpartum. The primary outcome is GWG. Secondary outcomes include changes in diet and physical activity during pregnancy and infant birthweight. Exploratory outcomes include cardiometabolic profile assessed via pregnancy blood samples and cord blood samples; and postpartum weight retention and infant anthropometrics up to 12 months of age. The trial includes systematic approaches to enhance intervention fidelity, intervention adherence, and participant retention in trial assessments. DISCUSSION GLOW is among few trials targeting excess GWG among diverse women with overweight or obesity in a healthcare setting, with long-term maternal and infant outcomes assessed up to 12 months after delivery. This evaluation of a multi-component intervention is designed to produce generalizable results to inform potential adoption of the intervention in clinical settings. TRIAL REGISTRATION ClinicalTrials.gov ( NCT02130232 ): submitted April 30, 2014; posted May 5, 2014.
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Affiliation(s)
- Susan D. Brown
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612 USA
| | - Monique M. Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612 USA
| | - Samantha F. Ehrlich
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612 USA
- The University of Tennessee, Knoxville, TN USA
| | - Maren N. Galarce
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612 USA
| | - Ai-Lin Tsai
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612 USA
| | | | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612 USA
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Tucker WJ, Rosenberry R, Trojacek D, Chamseddine HH, Arena-Marshall CA, Zhu Y, Wang J, Kellawan JM, Haykowsky MJ, Tian F, Nelson MD. Studies into the determinants of skeletal muscle oxygen consumption: novel insight from near-infrared diffuse correlation spectroscopy. J Physiol 2019; 597:2887-2901. [PMID: 30982990 DOI: 10.1113/jp277580] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/10/2019] [Indexed: 12/12/2022] Open
Abstract
KEY POINTS Diffuse correlation spectroscopy (DCS) is emerging as a powerful tool to assess skeletal muscle perfusion. Near-infrared spectroscopy (NIRS) is an established technique for characterizing the transport and utilization of oxygen through the microcirculation. Here we compared a combined NIRS-DCS system with conventional measures of oxygen delivery and utilization during handgrip exercise. The data show good concurrent validity between convective oxygen delivery and DCS-derived blood flow index, as well as between oxygen extraction at the conduit and microvascular level. We then manipulated forearm arterial perfusion pressure by adjusting the position of the exercising arm relative to the position of the heart. The data show that microvascular perfusion can be uncoupled from convective oxygen delivery, and that tissue saturation seemingly compensates to maintain skeletal muscle oxygen consumption. Taken together, these data support a novel role for NIRS-DCS in understanding the determinants of muscle oxygen consumption at the microvascular level. ABSTRACT Diffuse correlation spectroscopy (DCS) is emerging as a powerful tool to assess skeletal muscle perfusion. Combining DCS with near-infrared spectroscopy (NIRS) introduces exciting possibilities for understanding the determinants of muscle oxygen consumption; however, no investigation has directly compared NIRS-DCS to conventional measures of oxygen delivery and utilization in an exercising limb. To address this knowledge gap, nine healthy males performed rhythmic handgrip exercise with simultaneous measurements by NIRS-DCS, Doppler blood flow and venous oxygen content. The two approaches showed good concurrent validity, with directionally similar responses between: (a) Doppler-derived forearm blood flow and DCS-derived blood flow index (BFI), and (b) venous oxygen saturation and NIRS-derived tissue saturation. To explore the utility of combined NIRS-DCS across the physiological spectrum, we manipulated forearm arterial perfusion pressure by altering the arm position above or below the level of the heart. As expected, Doppler-derived skeletal muscle blood flow increased with exercise in both arm positions, but with markedly different magnitudes (below: +424.3 ± 41.4 ml/min, above: +306 ± 12.0 ml/min, P = 0.002). In contrast, DCS-derived microvascular BFI increased to a similar extent with exercise, regardless of arm position (P = 0.65). Importantly, however, the time to reach BFI steady state was markedly slower with the arm above the heart, supporting the experimental design. Notably, we observed faster tissue desaturation at the onset of exercise with the arm above the heart, resulting in similar muscle oxygen consumption profiles throughout exercise. Taken together, these data support a novel role for NIRS-DCS in understanding the determinants of skeletal muscle oxygen utilization non-invasively and throughout exercise.
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Affiliation(s)
- Wesley J Tucker
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA.,College of Nursing, University of Texas at Arlington, Arlington, TX, USA
| | - Ryan Rosenberry
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | - Darian Trojacek
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | - Houda H Chamseddine
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | | | - Ye Zhu
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Jing Wang
- College of Nursing, University of Texas at Arlington, Arlington, TX, USA
| | - J Mikhail Kellawan
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Mark J Haykowsky
- College of Nursing, University of Texas at Arlington, Arlington, TX, USA
| | - Fenghua Tian
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Michael D Nelson
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA.,Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
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