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Mo PKH, Xie L, Fong VWI, Sum RKW, Leung EFL, Wong SWS, Kwok TCY, Lau JTF. Efficacy of a theory-based and setting-based intervention in promoting strength training among older adults in Hong Kong: A clustered randomized controlled trial. Appl Psychol Health Well Being 2024. [PMID: 38757468 DOI: 10.1111/aphw.12548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/11/2024] [Indexed: 05/18/2024]
Abstract
The present study aimed to examine the efficacy of an intervention, based on the Health Belief Model (HBM) and social support, in promoting strength training (ST) among older adults. A two-arm clustered randomized controlled trial (RCT) was conducted among 235 older adults from eight elderly centers in Hong Kong. The intervention group engaged in a 6-month intervention comprising ST sessions, exercise consultations, social gatherings, and a buddy program, while the control group participated in social gatherings. Assessments were conducted at baseline (Month 0), post-intervention (Month 6), and 3-month follow-up (Month 9), with primary outcome being the prevalence of meeting the American College of Sports Medicine (ACSM) recommendations of ST. Results showed that the intervention group reported significantly higher prevalence of meeting ACSM recommendations for ST at both post-intervention and follow-up. Linear mixed models showed significant interaction effect between condition and time on perceived susceptibility of sarcopenia and muscle strength and significant condition effect on self-efficacy for ST, perceived severity of sarcopenia, perceived barriers of ST, and intention to perform ST. Findings suggest that the intervention, guided by HBM and social support, improves older adults' ST participation, muscle strength, perceptions on sarcopenia, and self-efficacy for ST, which offers great potential for broader application in other settings.
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Affiliation(s)
- Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Hong Kong, China
| | - Luyao Xie
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Hong Kong, China
| | - Vivian W I Fong
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Hong Kong, China
| | - Raymond K W Sum
- Department of Sport Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Elean F L Leung
- Physical Education Unit, The Chinese University of Hong Kong, Hong Kong, China
| | - Sam W S Wong
- Physical Fitness Association of Hong Kong, Hong Kong, China
| | - Timothy C Y Kwok
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- Public Mental Health Center, School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
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2
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Manche S, Probst Y. Exploring the socio-ecological factors impacting lifestyle management of multiple sclerosis: A scoping review. Mult Scler Relat Disord 2023; 79:104958. [PMID: 37708822 DOI: 10.1016/j.msard.2023.104958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/01/2023] [Accepted: 08/20/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic, autoimmune, neurodegenerative disorder affecting over 2.9 million people worldwide. First line care revolves around disease modifying therapy and supporting people living with MS to manage their disease. Early management often sees lifestyle modification as people living with MS try to gain a sense of control. Lifestyle management is an evolving area of care with variable strength of evidence for different lifestyle factors. OBJECTIVE To explore factors that impact on the self-management of MS with a socio-ecological focus. METHODS A scoping review following the Joanna Briggs Institute guidelines for a systematic search was conducted across six databases with 9241 articles identified and 51 included in the review. The results were analysed in conjunction with the socio-ecological model considering the categories: individual, interpersonal, organisational, community, and public policy. RESULTS A map of health behaviour (lifestyle) factors extending across all levels of the socio-ecological model revealed a complex web of pathways to behavioural patterns impacting MS self-management. Factors followed a cascading effect towards either of two key principles: (1) self-identity or (2) accessibility. These principles in-turn impact on an individual's self-efficacy, and hence, effectiveness of MS self-management strategies. CONCLUSIONS MS care is highly individualised to the personal context and circumstances of the individual, with consideration towards suitable management strategies required. Healthcare professionals must consider these lifestyle influences and coordinate an approach to assisting people living with MS to self-manage their disease in relation to their personal circumstances. Person-centred care addressing both barriers and motivators to health behaviour changes is key to effective MS self-management.
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Affiliation(s)
- Sarah Manche
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
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3
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Karloh M, Matias TS, de Oliveira JM, de Lima FF, Araújo Pinheiro DH, Barbosa GB, Furlanetto KC, Carvalho CRF. Breaking barriers to rehabilitation: the role of behavior change theories in overcoming the challenge of exercise-related behavior change. Braz J Phys Ther 2023; 27:100574. [PMID: 38056192 PMCID: PMC10749239 DOI: 10.1016/j.bjpt.2023.100574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Promoting exercise-related behavior change in rehabilitation is a challenge. The lack of integration between rehabilitation program prescriptions, behavior change interventions, and behavioral change theories is profound. Using behavior change theories properly is crucial for better adherence and promoting positive outcomes. Therefore, it is essential to bring theories that support the understanding of exercise-related behavioral change to the attention of rehabilitation practitioners. OBJECTIVE This masterclass article aims to provide the theoretical background of theories and strategies for exercise behavior change within the physical therapy context based on acknowledged behavioral change theoretical models. METHODS This is a narrative review that examines six behavior theories; five of them well-established, and a new (and promising) theory that has exhibited the most favorable outcomes in rehabilitation settings. The development process for this masterclass included conversations between authors, reviewing behavior theories, summarizing and discussing the theories' concepts and strategies for physical therapy. RESULTS The included theories were self-determination theory, social-cognitive theory, the transtheoretical model, the theory of planned behavior, the health belief model, and the unifying theory of physical activity. Each theory offers a unique perspective on exercise behavior change within rehabilitation, exploring constructs such as motivation, self-efficacy, stages of change, behavioral intention, perceived threat, and the core elements of physical activity expression. CONCLUSION These theoretical models provide a foundation for understanding and developing strategies for promoting exercise behavior change in rehabilitation. Knowing and using these theories is important for respecting the patient's individuality.
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Affiliation(s)
- Manuela Karloh
- Center for Assistance, Teaching and Research in Pulmonary Rehabilitation (NuReab). Center for Health Sciences and Sport (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil; Graduate Program in Physical Therapy, Center for Health Sciences and Sport (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil.
| | - Thiago Sousa Matias
- Department of Physical Education, School of Sports, Graduate Program in Physical Education, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Graduate Program in Public Health, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Joice Mara de Oliveira
- Laboratory of Research in Respiratory Physical Therapy (LFIP), Department of Physical Therapy, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil; Graduate Program in Rehabilitation Sciences, Universidade Pitágoras-Unopar (UNOPAR), Londrina, PR, Brazil
| | - Fabiano Francisco de Lima
- Physical Therapy Department, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | - Graziele Besen Barbosa
- Center for Assistance, Teaching and Research in Pulmonary Rehabilitation (NuReab). Center for Health Sciences and Sport (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil; Graduate Program in Physical Therapy, Center for Health Sciences and Sport (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil
| | - Karina Couto Furlanetto
- Laboratory of Research in Respiratory Physical Therapy (LFIP), Department of Physical Therapy, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil; Graduate Program in Rehabilitation Sciences, Universidade Pitágoras-Unopar (UNOPAR), Londrina, PR, Brazil
| | - Celso R F Carvalho
- Physical Therapy Department, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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Robert MK, Hales Reynolds MA, Eisenberg M, Rocha A. Exploring an 8-Week Online Adaptive Yoga Program for Multiple Sclerosis: A Pilot Study. Holist Nurs Pract 2023; 37:62-70. [PMID: 36790420 DOI: 10.1097/hnp.0000000000000568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
This pretest-posttest, descriptive pilot study examined the feasibility and perceived impact of an 8-week online adaptive yoga program on patients diagnosed with multiple sclerosis. The program incorporated yoga poses, breathing practices, and relaxation techniques. Participants rated their perceived and actual symptom severity, overall quality of life, and perception of program impact, and contributed open-ended narrative comments about the program. All participants reported an overall perceived benefit from study participation and expressed enjoyment in interacting with other patients with multiple sclerosis. The program was found to be safe and rewarding for all participants.
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Affiliation(s)
- Mindy K Robert
- Annie Taylor Dee School of Nursing, Weber State University, Ogden, Utah (Drs Robert, Hales Reynolds, and Rocha); and Yoga Moves MS, Franklin, Michigan (Ms Eisenberg)
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Thapaliya R, Leshner G, Sharma Ghimire P, Bhochhibhoya A. An extension of the extended parallel process model to promote heart-healthy exercise behavior: An experimental study. Health Promot Perspect 2022; 12:358-366. [PMID: 36852202 PMCID: PMC9958240 DOI: 10.34172/hpp.2022.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/07/2022] [Indexed: 02/22/2023] Open
Abstract
Background: The prevalence of heart disease has increased and is a leading cause of death in the U.S. Despite the importance of physical activity, only one-third of adults in the United States meet the amount of physical activity recommended by the Centers for Disease Control and Prevention (CDC). The purpose of this study was to extend the extended parallel process model (EPPM) by adding a 'barrier' (a construct from Health Belief Model) and exploring the roles of threat, efficacy, and barrier on participants' self-efficacy, attitudes, and intentions toward exercise. Methods: A between-subject experimental design was conducted online in 2018 in the U.S. A total of 446 participants were recruited from the Amazon Mechanical Turk age 18 or above. The participants were first provided with stimuli messages about physical activity behaviors. Then participants' responses to self-efficacy, intention, and attitudes toward exercise were assessed. Results: The results found an interaction between efficacy and barrier to participants' attitudes toward exercise [F(1,435)=4.35, P=0.038, η2 part=0.01]. The results also showed that there was a statistically significant effect of barriers on participants' self-efficacy regarding exercise behavior [F(1,442)=4.21, P=0.04, η2 part=0.009]. However, three-way interactions of threat, efficacy, and barrier were not found in attitudes or intentions to exercise. Conclusion: The findings suggested that addressing an individual's perceived barrier regarding a health behavior may lead to an increase in self-confidence ensuing in higher physical activity. Future studies should further explore how addressing barriers may influence other health behaviors to design unique and effective health messages.
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Affiliation(s)
- Rashmi Thapaliya
- School of Communication and Journalism, Eastern Illinois University, IL, USA
| | - Glenn Leshner
- Gaylord College of Journalism & Mass Communication, University of Oklahoma, Oklahoma, USA
| | | | - Amir Bhochhibhoya
- School of Health and Human Performance, Kean University, New Jersey, USA,Corresponding Author: Amir Bhochhibhoya,
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Chu HY, Huang HC, Huang CY, Chu CC, Su CT, Tsai IL, Hu HLS, Guo SL. A predictive model for identifying low medication adherence among older adults with hypertension: A classification and regression tree model. Geriatr Nurs 2021; 42:1309-1315. [PMID: 34560525 DOI: 10.1016/j.gerinurse.2021.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 11/28/2022]
Abstract
Various individual characteristics may affect medication adherence; however, few studies have investigated the effect of interrelationships among these various individual characteristics on medication adherence. This cross-sectional study explored the interrelationships among risk factors for medication adherence and established a predictive model of low medication adherence among older adults with hypertension. Convenience sampling was used to recruit 300 older adults with hypertension. The following parameters were recorded: demographic and disease characteristics, health beliefs, self-efficacy, social support, and medication adherence of antihypertensive drugs. Classification and regression tree (CART) analysis was performed to develop a predictive model of low medication adherence. The CART model revealed that health belief, disease duration, self-efficacy, and social support interacted to contribute to various pathways of low medication adherence. The predicted accuracy of the model was validated with a low misclassification rate of 26%. The proposed classification model can help identify risk cases with low medication adherence. Suitable health education programs based on these risk factors to manage and improve medication adherence for older adults with hypertension could be considered.
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Affiliation(s)
- Han-Yu Chu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chun-Yao Huang
- Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ching-Chi Chu
- Department of Cardiology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Chien-Tien Su
- Department of Family Medicine, Taipei Medical University Hospital, Taipei Taiwan; School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - I-Lin Tsai
- Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Huey-Lan Sophia Hu
- School of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Liu Guo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.
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Habibi H, Sedighi B, Jahani Y, Hasani M, Iranpour A. Self-Care Practices and Related Factors in Patients with Multiple Sclerosis (MS) Based on the Health Belief Model. J Caring Sci 2021; 10:77-83. [PMID: 34222116 PMCID: PMC8242295 DOI: 10.34172/jcs.2021.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 01/26/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction: Self-care programs can raise health in patients with Multiple Sclerosis (MS). This study aimed to identify the self-care behaviors and determinants in patients with MS according to the Health Belief Model (HBM). Methods: In this cross-sectional study, we included 280 MS patients through convenience sampling method. The collection tool was a self-administered questionnaire based on HBM. The participants were the members of MS society in Kerman, Iran. The data were analyzed using descriptive statistics, path analysis, and multivariable linear regression in SPSS software Version 22. Results: The mean (SD) score for self-care practices was 2.86 (0.64), and medication adherence was the most conducted practice. The perceived benefits and cues to action exerted positive influence on self-care practices. The most frequent symptoms experienced by the participants were fatigue (82.5%), visual impairment (76.4%), headaches (72.1%), and muscle weakness (71.4%). The most important cues to action for self-care behavior were the physician (77%), media (52%), and other MS patients (32%). Conclusion: The quality of life (QOL) of MS patients is heavily influenced by self-care behaviors. In this study, only about half of the patients accomplished self-care behaviors, which seems to be insufficient. Since the perceived benefits and cues to action are the main predictors of self-care practices, intervention based on these two constructs can be utilized to promote self-care programs and QOL in MS patients. Health-care providers should pay more attention to these factors for promoting self-care behaviors.
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Affiliation(s)
- Hajar Habibi
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnaz Sedighi
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Marziyeh Hasani
- Department of Health Education and Promotion, School of Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abedin Iranpour
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Huang J, Zou Y, Huang W, Zhou Y, Lin S, Chen J, Lan Y. Factors associated with physical activity in elderly nursing home residents: a path analysis. BMC Geriatr 2020; 20:274. [PMID: 32758265 PMCID: PMC7406386 DOI: 10.1186/s12877-020-01676-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 07/27/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Physical activity (PA) is low among elderly residents in nursing homes in China. We aimed to determine the factors that influence PA among elderly nursing home residents and their direct or indirect effects on PA levels. METHODS The PA levels of the participants were measured using the International Physical Activity Questionnaire, and their health beliefs were assessed using a self-developed 18-item questionnaire titled the 'Health Beliefs of Nursing Home Residents Regarding Physical Activity' in accordance with Health Belief Model (HBM) constructs. The correlations between HBM constructs and PA levels were analyzed and a regression-based path analysis was conducted to examine the relationships between HBM constructs and PA levels. RESULTS A total of 180 residents with a mean age of 82.5 years (standard deviation = 5.76) were recruited. Linear regression analysis revealed that self-efficacy (p < 0.001), perceived severity (p < 0.01), and cues to action (p < 0.01) were associated with the level of PA among nursing home residents. In the conceptual path model, self-efficacy, perceived severity, and cues to action had positive direct effects on the PA level, while perceived benefits and perceived barriers had indirect effects on the PA level. CONCLUSION The residents' self-efficacy, perceived severity, and cues to action were found to be important factors that can affect the design and implementation of educational programs for PA. A better understanding of such associations may help healthcare providers design informed educational interventions to increase PA levels among nursing home residents.
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Affiliation(s)
- Jingxin Huang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Youqing Zou
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Wentao Huang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Ye Zhou
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shanshan Lin
- Faculty of Health, University of Technology, Sydney, Australia
- School of Cultures and Languages, University of Sydney, Sydney, Australia
| | - Jiaojiao Chen
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Yutao Lan
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China.
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9
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Price J, Barrett-Bernstein M, Wurz A, Karvinen KH, Brunet J. Health beliefs and engagement in moderate-to-vigorous-intensity physical activity among cancer survivors: a cross-sectional study. Support Care Cancer 2020; 29:477-484. [PMID: 32399724 DOI: 10.1007/s00520-020-05515-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/05/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Moderate-to-vigorous-intensity physical activity (PA) can alleviate many adverse side effects and symptoms caused by cancer treatments; yet, most cancer survivors are insufficiently active. Evidence shows that theory-based PA behavior change interventions are more effective than non-theory-based interventions; thus, it is necessary to ascertain modifiable theoretical factors associated with moderate-to-vigorous-intensity PA among cancer survivors. Drawing on the health belief model (HBM), the associations between moderate-to-vigorous-intensity PA and (1) perceived susceptibility to cancer recurrence and health problems, (2) perceived severity of cancer recurrence and health problems, (3) perceived benefits of PA for reducing risk of cancer recurrence and health problems, (4) perceived barriers to PA, and (5) PA barrier self-efficacy among cancer survivors were examined. METHODS A total of 123 adult cancer survivors (Mage = 50.1 ± 15.5 years; 82.9% female) completed an online self-report survey assessing sociodemographic and medical characteristics, moderate-to-vigorous-intensity PA, and the HBM constructs. Data were analyzed descriptively and using hierarchical linear regression analysis. RESULTS After adjusting for age, sex, body mass index, time since cancer diagnosis, and treatments received, the HBM constructs collectively explained 29% of the variance in moderate-to-vigorous-intensity PA. Perceived benefits of PA (β = .20, 95% CI [1.81, 11.67], p = .007) and PA barrier self-efficacy (β = .42, 95% CI [0.26, 0.53], p < .001) were significantly associated with moderate-to-vigorous-intensity PA. CONCLUSION Raising awareness of the benefits of PA for reducing risk of cancer recurrence and health problems and strengthening self-efficacy to overcome PA barriers may help to promote cancer survivors' attainment of moderate-to-vigorous-intensity PA guidelines.
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Affiliation(s)
- Jenson Price
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, Ontario, K1N 6N5, Canada
| | - Meagan Barrett-Bernstein
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, Ontario, K1N 6N5, Canada
| | - Amanda Wurz
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kristina H Karvinen
- Schulich School of Education - Physical and Health Education, Nipissing University, North Bay, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, Ontario, K1N 6N5, Canada.
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McCartan CJ, Yap J, Firth J, Stubbs B, Tully MA, Best P, Webb P, White C, Gilbody S, Churchill R, Breedvelt JJF, Davidson G. Factors that influence participation in physical activity for people with bipolar disorder: a synthesis of qualitative evidence. Hippokratia 2020. [DOI: 10.1002/14651858.cd013557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Claire J McCartan
- Queen's University Belfast; Centre for Evidence & Social Innovation, School of Social Sciences, Education & Social Work; 6 College Park Belfast Northern Ireland UK BT7 1LP
| | - Jade Yap
- Mental Health Foundation; London UK
| | - Joseph Firth
- University of Manchester; Division of Psychology & Mental Health; Manchester UK
| | - Brendon Stubbs
- Kings College London; Institute of Psychiatry, Psychology and Neuroscience; London UK
| | - Mark A Tully
- Ulster University; Institute of Mental Health Sciences, School of Health Sciences; Shore Road Newtownabbey Northern Ireland UK BT37 0QB
| | - Paul Best
- Queen's University Belfast; Centre for Evidence & Social Innovation, School of Social Sciences, Education & Social Work; 6 College Park Belfast Northern Ireland UK BT7 1LP
| | | | | | - Simon Gilbody
- University of York; Mental Health and Addiction Research Group, Department of Health Sciences; Seebohm Rowntree Building York UK YO10 5DD
| | - Rachel Churchill
- University of York; Centre for Reviews and Dissemination; Heslington York UK YO10 5DD
- University of York; Cochrane Common Mental Disorders; York - None - UK Y010 5DD
| | | | - Gavin Davidson
- Queen's University Belfast; Centre for Evidence & Social Innovation, School of Social Sciences, Education & Social Work; 6 College Park Belfast Northern Ireland UK BT7 1LP
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McCartan CJ, Yap J, Firth J, Stubbs B, Tully MA, Best P, Webb P, White C, Gilbody S, Churchill R, Breedvelt JJF, Davidson G. Factors that influence participation in physical activity for anxiety or depression: a synthesis of qualitative evidence. Cochrane Database Syst Rev 2020; 2020:CD013547. [PMCID: PMC7059896 DOI: 10.1002/14651858.cd013547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
This is a protocol for a Cochrane Review (Qualitative). The objectives are as follows: Main objective: To identify the factors that create barriers or facilitate physical activity for people with a diagnosis of anxiety or depression from the perspectives of service users, carers, service providers and practitioners to help inform the design and implementation of interventions that promote physical activity. The overall aim of this review is to identify, appraise, and synthesise qualitative research evidence on the barriers and facilitators to engaging in physical activity in general lifestyle settings or as part of an intervention designed to increase physical activity for people with anxiety and depression. This will allow us to identify factors that create barriers and facilitators of physical activity in this population to inform the development, design, and implementation of future interventions. We will also integrate the findings from the QES with the two associated effectiveness reviews (Cooney 2014 ; Larun 2006 ). We will communicate our findings to public health commissioners and other stakeholders.
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Affiliation(s)
- Claire J McCartan
- Queen's University BelfastCentre for Evidence & Social Innovation, School of Social Sciences, Education & Social Work6 College ParkBelfastNorthern IrelandUKBT7 1LP
| | - Jade Yap
- Mental Health FoundationLondonUK
| | - Joseph Firth
- University of ManchesterDivision of Psychology & Mental HealthManchesterUK
| | - Brendon Stubbs
- Kings College LondonInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
| | - Mark A Tully
- Ulster UniversityInstitute of Mental Health Sciences, School of Health SciencesShore RoadNewtownabbeyNorthern IrelandUKBT37 0QB
| | - Paul Best
- Queen's University BelfastCentre for Evidence & Social Innovation, School of Social Sciences, Education & Social Work6 College ParkBelfastNorthern IrelandUKBT7 1LP
| | | | | | - Simon Gilbody
- University of YorkMental Health and Addiction Research Group, Department of Health SciencesSeebohm Rowntree BuildingYorkUKYO10 5DD
| | - Rachel Churchill
- University of YorkCentre for Reviews and DisseminationHeslingtonYorkUKYO10 5DD
- University of YorkCochrane Common Mental DisordersYork‐ None ‐UKY010 5DD
| | | | - Gavin Davidson
- Queen's University BelfastCentre for Evidence & Social Innovation, School of Social Sciences, Education & Social Work6 College ParkBelfastNorthern IrelandUKBT7 1LP
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Hamana K, Quinn L, Gambling T, Busse M. An exploration of physical activity experiences throughout the Huntington's disease journey: supporting development of theoretically underpinned complex interventions. Disabil Rehabil 2019; 43:1565-1575. [PMID: 31588808 DOI: 10.1080/09638288.2019.1671501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Huntington's disease is an autosomal dominant neurodegenerative disease. Progressive physical, behavioural and cognitive impairments cause loss of independent function. Physical activity interventions are important components of comprehensive intervention strategies and may help alter the functional decline trajectory. Qualitative research has an important role to play in developing theoretically sound, well-defined physical activity interventions in Huntington's disease. MATERIALS AND METHODS Eight focus groups were conducted with people with prodromal to late stage Huntington's disease, caregivers (family members/formal), and healthcare professionals. An analytical coding framework was developed from the data and Levanthal's self-regulation model to assist analysis. RESULTS AND CONCLUSIONS Key themes were identified: evolving representations of Huntington's disease and physical activity; varying social environment of the person with Huntington's disease and the impact on physical activity; achieving physical activity participation while coping with the nuances of Huntington's disease. Levanthal's model facilitated understanding of physical activity experiences, however with progression, self-regulation of activities needs to become more collaborative with caregivers. A modified self-regulation model specific to physical activity in Huntington's disease is presented. Using a novel approach to generate new understanding of physical activity across the Huntington's disease lifespan facilitated development of an original and significant theoretical foundation to underpin development of a range of much needed physical activity and exercise interventions in Huntington's disease.Implications for rehabilitationSocial and familial context of individuals with HD is a key consideration for health care professionals supporting physical activity participation.Strategies such as using physical activity as a way of achieving control and adjusting expectations can help people with HD to continue to be active.People with HD adapt physical activity from high level to more functional activities with symptom progression.
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Affiliation(s)
- Katy Hamana
- School of Healthcare Sciences, Cardiff University, Cardiff, Wales
| | - Lori Quinn
- Teachers College, Columbia University, New York, NY, USA
| | - Tina Gambling
- School of Healthcare Sciences, Cardiff University, Cardiff, Wales
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, Wales
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Kim Y. The effects of a physical inactivity-related health risk message intervention on changes in risk perceptions and physical activity in middle-aged women. J Women Aging 2019; 32:546-562. [PMID: 31038394 DOI: 10.1080/08952841.2019.1607678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The study investigated the effects of the physical inactivity-related health risk message intervention on changes in risk perception for diseases. Forty-one women participated in the 16-week intervention. During this period, the study participants' physical activity, risk perceptions, and objective risk factors were measured. Results indicated that the intervention had a significant effect on improving perceived health risk of heart disease and obesity. Moreover, changes in perceived risk showed significant effect on changes in physical activity over the 16-week intervention. The study provided both theoretical and practical implications for perceived health risk as a predictor of physical activity.
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Affiliation(s)
- Youngho Kim
- Department of Sport Science, Seoul National University of Science and Technology , Seoul, Korea
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Chen SH, Chen SC, Lai YP, Chen PH, Huang TY, Lin CC, Yeh KY. Correlates Between Health Beliefs and Health-Promoting Lifestyle Profiles in the Development of Metabolic Syndrome in Taiwan. Asia Pac J Public Health 2018; 31:30-38. [PMID: 30525917 DOI: 10.1177/1010539518816245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Differences in sociodemographic variables, health beliefs, and a healthy lifestyle all contribute to the varied prevalence of metabolic syndrome (MetS). We investigated the associations among MetS-related risk factors and performed a cross-sectional study, recruiting 1741 Taiwanese residents aged ≥30 years, between August 2014 and August 2015. Data were obtained on sociodemographic factors, health beliefs, and health-promoting lifestyle profiles using questionnaires. Multivariate analysis revealed that age ≥65 years (odds ratio [OR] = 2.17), low educational level (OR = 1.46), body mass index ≥24 kg/m2 (OR = 9.00), more health responsibility (OR = 1.08), and less exercise (OR = 0.924) were independent risk factors for MetS development. A correlation existed between health beliefs and health-promoting lifestyle profiles, suggesting that the establishment of an effective health-promoting program should consider participants' health beliefs.
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Affiliation(s)
- Sue-Hsien Chen
- 1 Chang Gung Memorial Hospital, Keelung.,2 Chang Gung University, Taoyuan.,3 Chang Gung University of Science and Technology, Taoyuan
| | - Shu-Ching Chen
- 4 National Taiwan University Hospital, Taipei.,5 National Taiwan University, Taipei
| | - Yo-Ping Lai
- 4 National Taiwan University Hospital, Taipei
| | | | | | | | - Kun-Yun Yeh
- 1 Chang Gung Memorial Hospital, Keelung.,2 Chang Gung University, Taoyuan
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Ellis R, Kosma M, Agnew S, Bauer JJ. Do temporal scores of motivational constructs correspond with physical activity levels? Disabil Health J 2018; 12:51-57. [PMID: 30297230 DOI: 10.1016/j.dhjo.2018.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Adults with physical disabilities typically engage in low levels of physical activity (PA), thus a better understanding of how motivational factors and behavior vary over time and in relation to disability type and severity is needed. OBJECTIVE/HYPOTHESIS To examine temporal changes in theory of planned behavior (TPB) constructs and PA by disability type (multiple sclerosis vs. spinal cord injury) and severity (mild, moderate, and severe). METHODS Participants were 77 adults with physical disabilities who completed a web-based survey that assessed the TPB constructs and PA participation. The survey was completed once every four months for a total of three time points. Two-way repeated measures ANOVAs were used to examine if the TPB constructs and PA changed over time and in relation to disability type and severity. RESULTS There was only one significant between-subjects effect for PA by disability severity, F (2, 68) = 5.94, p = .004, η2 = 15%. People with mild disabilities exhibited higher mean PA participation over the three time periods (M = 21.06 ± 11.49 MET-hrs/day) than those with moderate disabilities (M = 11.27 ± 9.3 MET-hrs/day) and severe disabilities (M = 13.43 ± 14.74 MET-hrs/day). CONCLUSIONS Although participants possessed positive PA motivational factors that remained stable over time, their PA participation was low and differed as a function of disability severity. Therefore, PA interventions should be tailored such that individuals with severe disabilities receive the greatest amount of exercise prescription consultations and supervision compared to those with more moderate and mild disabilities.
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Affiliation(s)
- Rebecca Ellis
- Department of Kinesiology & Health, Georgia State University, PO Box 3975, Atlanta, GA, 30302, USA.
| | - Maria Kosma
- School of Kinesiology, Louisiana State University, 112 Long Fieldhouse, Baton Rouge, LA, 70803, USA.
| | - Sarah Agnew
- Department of Kinesiology & Health, Georgia State University, PO Box 3975, Atlanta, GA, 30302, USA.
| | - Jeremy J Bauer
- Bauer Forensics, 3301 Clay Street, Apt. 602, San Francisco, CA, 94118, USA.
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16
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Kasser SL, Kosma M. Social Cognitive Factors, Physical Activity, and Mobility Impairment in Adults with Multiple Sclerosis. Behav Med 2018; 44:306-313. [PMID: 28862920 DOI: 10.1080/08964289.2017.1368441] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Among those with multiple sclerosis (MS), mobility impairment is common and significantly affects independent functioning and quality of life. The purpose of the study was to examine the role of physical activity in mobility impairment in individuals with MS and explore the social cognitive factors of social support, outcome expectations, and self-efficacy that facilitate physical activity among those with the disease. A sample of 319 individuals with MS were assessed on the following: family and friend social support, self-efficacy, and physical and social outcome expectations. Self-reported physical activity, perceived ambulation disability, balance confidence, and fall history were also measured. The structural model fit the data (χ2 (29) = 24.49, p = 0.70; Root Mean Square Error of Approximation < 0.01; Comparative Fit Index = 1.0; Normed Fit Index = 0.96; Goodness of Fit Index = 0.98; Standardized Root Mean Square Residual = 0.03). The primary findings of the study revealed that physical activity was strongly linked to mobility impairment (path coefficient, -0.43), such that increasing levels of physical activity were associated with less mobility impairment. The most important predictors of health-promoting levels of physical activity were self-efficacy (path coefficient, 0.48) and social support (path coefficient, 0.38), with support from friends being a stronger indicator of social support than support from family. It may be prudent to design interventions aimed at increasing physical activity, especially in regard to helping individuals become more efficacious and building larger social networks, as this may serve to forestall advancing mobility impairment in those with MS.
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Affiliation(s)
- Susan L Kasser
- a From the Department of Rehabilitation and Movement Science , University of Vermont , Burlington , VT
| | - Maria Kosma
- b School of Kinesiology , Louisiana State University , Baton Rouge , LA
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Casey B, Coote S, Shirazipour C, Hannigan A, Motl R, Martin Ginis K, Latimer-Cheung A. Modifiable Psychosocial Constructs Associated With Physical Activity Participation in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2017; 98:1453-1475. [DOI: 10.1016/j.apmr.2017.01.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/09/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
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Ketelhut NB, Kindred JH, Pimentel RE, Hess AM, Tracy BL, Reiser RF, Rudroff T. Functional factors that are important correlates to physical activity in people with multiple sclerosis: a pilot study. Disabil Rehabil 2017; 40:2416-2423. [DOI: 10.1080/09638288.2017.1336647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nathaniel B Ketelhut
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - John H Kindred
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Richard E Pimentel
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Ann M Hess
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Brian L Tracy
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Raoul F Reiser
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Thorsten Rudroff
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
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Ploughman M. Breaking down the barriers to physical activity among people with multiple sclerosis – a narrative review. PHYSICAL THERAPY REVIEWS 2017. [DOI: 10.1080/10833196.2017.1315212] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michelle Ploughman
- Recovery & Performance Laboratory, Faculty of Medicine, Memorial University, L.A. Miller Centre , St. John's NL, Canada
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Câmara NAAC, Gondim APS. Factors associated with adherence to immunomodulator treatment in people with multiple sclerosis. BRAZ J PHARM SCI 2017. [DOI: 10.1590/s2175-97902017000116132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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21
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Meaning of Self in Multiple Sclerosis: Implications for Treatment and Rehabilitation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 958:43-55. [DOI: 10.1007/978-3-319-47861-6_4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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22
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Stoutenberg M, Sogor A, Arheart K, Cutrono SE, Kornfeld J. A Wellness Program for Cancer Survivors and Caregivers: Developing an Integrative Pilot Program with Exercise, Nutrition, and Complementary Medicine. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:47-54. [PMID: 25663357 DOI: 10.1007/s13187-014-0785-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Integrative Wellness Program (IWP) at the University of Miami Sylvester Comprehensive Cancer Center (SCCC) sought to provide integrative wellness education to cancer patients, survivors, and caregivers by offering instruction in exercise, nutrition, and complementary and alternative medicine. The objective of this study was to assess the impact of the IWP on the overall wellness of the individuals participating in the program. Three different 10-week versions of the IWP were conducted over a 1-year period. Each session focused on a different wellness topic presented through interactive lectures and applied activities. A series of self-report questionnaires were administered at baseline and again at the completion of the program to assess improvements in physical activity levels, dietary habits, sleep hygiene, and quality of life. Participants were generally older, Caucasian, female, had higher levels of education, and still currently receiving treatment. Significant changes were observed in two measures: Starting the Conversation (-2.0 ± 2.40, p = .037) and the Sticking To It subscale of the Self-Efficacy and Eating Habits Survey (1.7 ± 1.22, p = .0013). A trend for improvement in the Reducing Fat subscale of the Self-Efficacy Eating Habits (0.44 ± 0.60, p = .056) was also observed. Participant satisfaction surveys indicated high levels of satisfaction and applicability of the material presented. The significant improvements detected related to dietary habits, combined with the responses from the participant satisfaction surveys, suggest that the IWP was well received and can positively impact the overall wellness of cancer patients, survivors, and their caregivers.
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Affiliation(s)
- Mark Stoutenberg
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA.
| | - Alyssa Sogor
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
| | - Kris Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
| | - Stacy E Cutrono
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Julie Kornfeld
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
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Streber R, Peters S, Pfeifer K. Systematic Review of Correlates and Determinants of Physical Activity in Persons With Multiple Sclerosis. Arch Phys Med Rehabil 2016; 97:633-645.e29. [PMID: 26751247 DOI: 10.1016/j.apmr.2015.11.020] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/16/2015] [Accepted: 11/20/2015] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To review the current evidence regarding correlates and determinants of physical activity (PA) in persons with multiple sclerosis (pwMS). DATA SOURCES PubMed and Scopus (1980 to January 2015) and reference lists of eligible studies. STUDY SELECTION Eligible studies include adults with multiple sclerosis; have a cross-sectional or prospective observational design; or examine the effect of a theory-based intervention trial on PA, including a mediation analysis. Eligible studies also apply a quantitative assessment of PA and correlates or proposed mediators and are published in English or German language. DATA EXTRACTION Two reviewers independently evaluated the risk of bias, extracted data, and categorized variables according to the International Classification of Functioning, Disability and Health. DATA SYNTHESIS Consistency and the direction of associations were evaluated with a semiquantitative approach. Fifty-six publications with data from observational studies and 2 interventional studies provided evidence for 86 different variables. Consistent correlates of PA were the disability level, walking limitations in particular, PA-related self-efficacy, self-regulation constructs, employment status, and educational level. One interventional study provided evidence for a causal relation between self-regulation and PA. However, 59 of the 86 investigated variables in observational studies are based on 1 or 2 study findings, and most results stem from cross-sectional designs. CONCLUSIONS Beside the importance of the general disability level and walking limitations, the results highlight the importance of personal factors (eg, PA-related self-efficacy, self-regulatory constructs, sociodemographic factors). Limitations and implications of the current review are discussed. Research that is more rigorous is needed to better understand what affects PA in pwMS.
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Affiliation(s)
- René Streber
- Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan Peters
- Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Klaus Pfeifer
- Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
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Ploughman M, Harris C, Wallack EM, Drodge O, Beaulieu S, Mayo N. Predictors of exercise participation in ambulatory and non-ambulatory older people with multiple sclerosis. PeerJ 2015; 3:e1158. [PMID: 26339540 PMCID: PMC4558079 DOI: 10.7717/peerj.1158] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 07/15/2015] [Indexed: 11/20/2022] Open
Abstract
Background. Exercise at moderate intensity may confer neuroprotective benefits in multiple sclerosis (MS), however it has been reported that people with MS (PwMS) exercise less than national guideline recommendations. We aimed to determine predictors of moderate to vigorous exercise among a sample of older Canadians with MS who were divided into ambulatory (less disabled) and non-ambulatory (more disabled) groups. Methods. We analysed data collected as part of a national survey of health, lifestyle and aging with MS. Participants (n = 743) were Canadians over 55 years of age with MS for 20 or more years. We identified 'a priori' variables (demographic, personal, socioeconomic, physical health, exercise history and health care support) that may predict exercise at moderate to vigorous intensity (>6.75 metabolic equivalent hours/week). Predictive variables were entered into stepwise logistic regression until best fit was achieved. Results. There was no difference in explanatory models between ambulatory and non-ambulatory groups. The model predicting exercise included the ability to walk independently (OR 1.90, 95% CI [1.24-2.91]); low disability (OR 1.50, 95% CI [1.34-1.68] for each 10 point difference in Barthel Index score), perseverance (OR 1.17, 95% CI [1.08-1.26] for each additional point on the scale of 0-14), less fatigue (OR 2.01, 95% CI [1.32-3.07] for those in the lowest quartile), fewer years since MS diagnosis (OR 1.58, 95% CI [1.11-2.23] below the median of 23 years) and fewer cardiovascular comorbidities (OR 1.55 95% CI [1.02-2.35] one or no comorbidities). It was also notable that the factors, age, gender, social support, health care support and financial status were not predictive of exercise. Conclusions. This is the first examination of exercise and exercise predictors among older, more disabled PwMS. Disability is a major predictor of exercise participation (at moderate to vigorous levels) in both ambulatory and non-ambulatory groups suggesting that more exercise options must be developed for people with greater disability. Perseverance, fatigue, and cardiovascular comorbidities are predictors that are modifiable and potential targets for exercise adherence interventions.
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Affiliation(s)
- Michelle Ploughman
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University , St. John's, NL , Canada
| | - Chelsea Harris
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University , St. John's, NL , Canada
| | - Elizabeth M Wallack
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University , St. John's, NL , Canada
| | - Olivia Drodge
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University , St. John's, NL , Canada
| | | | - Nancy Mayo
- Department of Clinical Epidemiology, McGill University , Montreal, QC , Canada
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Does Self-Efficacy Affect Cognitive Performance in Persons with Clinically Isolated Syndrome and Early Relapsing Remitting Multiple Sclerosis? Mult Scler Int 2015; 2015:960282. [PMID: 26064686 PMCID: PMC4429205 DOI: 10.1155/2015/960282] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 04/15/2015] [Indexed: 11/28/2022] Open
Abstract
In persons with multiple sclerosis (MS) a lowered self-efficacy negatively affects physical activities. Against this background we studied the relationship between self-efficacy and cognitive performance in the early stages of MS. Thirty-three patients with Clinically Isolated Syndrome (CIS) and early Relapsing Remitting MS (eRRMS) were assessed for self-efficacy (MSSES-18), cognition (CDR System), fatigue (MFIS-5), depressive symptoms (BDI), disease impact (MSIS-29), and disability (EDSS). Correlative analyses were performed between self-efficacy and cognitive scores, and stepwise regression analyses identified predictors of cognition and self-efficacy. Good correlations existed between total self-efficacy and Power of Attention (r= 0.65; P< 0.001), Reaction Time Variability (r= 0.57; P< 0.001), and Speed of Memory (r= 0.53; P< 0.01), and between control self-efficacy and Reaction Time Variability (r= 0.55; P< 0.01). Total self-efficacy predicted 40% of Power of Attention, 34% of Reaction Time Variability, and 40% of Speed of Memory variabilities. Disease impact predicted 65% of total self-efficacy and 58% of control self-efficacy variabilities. The findings may suggest that in persons with CIS and eRRMS self-efficacy may positively affect cognitive performance and that prevention of disease activity may preserve self-efficacy.
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Rahmati-Najarkolaei F, Tavafian SS, Gholami Fesharaki M, Jafari MR. Factors predicting nutrition and physical activity behaviors due to cardiovascular disease in tehran university students: application of health belief model. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e18879. [PMID: 26019896 PMCID: PMC4441786 DOI: 10.5812/ircmj.18879] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/07/2014] [Accepted: 08/25/2014] [Indexed: 11/16/2022]
Abstract
Background: Disease preventing methods focus mostly on lifestyle factors such as physical activity, healthy diet and not smoking. Previous studies verified using theory and models to change unhealthy behaviors, so that health belief model (HBM) is a useful framework for describing the healthy nutrition behavior. Objectives: This study aimed to predict factors related to unhealthy nutrition and inactive life in students of Tehran University, Tehran, Iran based on the Health Belief Model (HBM). Patients and Methods: In this cross sectional study, proportional quota sampling from three different educational levels was conducted from October to December 2012. A self-administered validated instrument based on the Health Belief Model (HBM) with 69 items and four sections was used to collect data. In this study through using linear and logistic regression, the effect of body mass index, age, gender, marriage, self-efficacy, cues to action, knowledge, perceived severity, susceptibility, benefits and barriers on nutrition and physical activity behavior were assessed. SPSS version 18 was used to analyze data. Results: Totally, 368 students including 318 female students (86.4%) and 50 male students (13.6%) with a mean age of 24.9 years (SD = 4.55) took part in the study. Among all independent variables, gender (P < 0.001), knowledge (P = 0.023) and perceived barriers (P = 0.004) predicted nutrition behavior. In case of physical activity, knowledge (P = 0.011), perceived severity (P = 0.009), perceived barriers (P = 0.019) and self-efficacy (P = 0.033) had significance association with physical activity behavior. Conclusions: This study indicated that health belief model contrasts could predict the risky behavior of university students due to heart disease. However, more researches are needed to verify the predictors of high risky behaviors in students.
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Affiliation(s)
| | - Sedigheh Sadat Tavafian
- Department of Health Educations, Faculty of Medical Sciences, Tarbiat Modaress University, Tehran, IR Iran
- Corresponding Author: Sedigheh Sadat Tavafian, Department of Health Educations, Faculty of Medical Sciences, Tarbiat Modaress University, Tehran, IR Iran. Tel: +98-2182884547, Fax: +98-2182884555, E-mail:
| | | | - Mohammad Reza Jafari
- Department Of Psychology,College of Humanitiec saveh Science and Research Branch Islamic Azad University Saveh, IR Iran
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Hughes AJ, Beier M, Hartoonian N, Turner AP, Amtmann D, Ehde DM. Self-efficacy as a longitudinal predictor of perceived cognitive impairment in individuals with multiple sclerosis. Arch Phys Med Rehabil 2015; 96:913-9. [PMID: 25597915 DOI: 10.1016/j.apmr.2015.01.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/06/2015] [Accepted: 01/06/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine whether self-efficacy longitudinally predicts 2 types of perceived cognitive impairment (PCI) in multiple sclerosis (MS): general cognitive functioning and executive functioning; and secondarily to assess whether self-efficacy mediates the relationships between depression, fatigue, and PCI. DESIGN Longitudinal analysis of self-report survey data collected over 3 years. Hierarchical regression analyses examined the relationship between self-efficacy and PCI, adjusting for depression and fatigue. Additional analyses tested self-efficacy as a mediator between depression, fatigue, and PCI. SETTING Community. PARTICIPANTS Community-dwelling individuals with MS (N=233; age range, 22-83y) were recruited from a larger longitudinal survey study of individuals with MS (N=562). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Primary outcome measures were the Applied Cognition-General Concerns and the Applied Cognition-Executive Function domains of the Quality of Life in Neurological Disorders (NeuroQoL) measures. RESULTS Self-efficacy was significantly correlated with PCI at baseline (r=.40-.53) and 3 years later (r=.36-.44). In multivariate regression analyses, self-efficacy was a significant longitudinal predictor of PCI, both for general cognitive functioning (β=.20, P<.01) and executive functioning (β=.16, P<.05). Self-efficacy partially mediated the relationships between depression, fatigue, and PCI. CONCLUSIONS Self-efficacy may influence how individuals with MS perceive their cognitive functioning over time. Interventions that target self-efficacy, particularly early in the disease course, may lead to improvements in PCI, as well as improvements in fatigue and depression.
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Affiliation(s)
- Abbey J Hughes
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA.
| | - Meghan Beier
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Narineh Hartoonian
- Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Aaron P Turner
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
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Ploughman M, Beaulieu S, Harris C, Hogan S, Manning OJ, Alderdice PW, Fisk JD, Sadovnick AD, O'Connor P, Morrow SA, Metz LM, Smyth P, Mayo N, Marrie RA, Knox KB, Stefanelli M, Godwin M. The Canadian survey of health, lifestyle and ageing with multiple sclerosis: methodology and initial results. BMJ Open 2014; 4:e005718. [PMID: 25011993 PMCID: PMC4120418 DOI: 10.1136/bmjopen-2014-005718] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE People with multiple sclerosis (MS) are living longer so strategies to enhance long-term health are garnering more interest. We aimed to create a profile of ageing with MS in Canada by recruiting 1250 (5% of the Canadian population above 55 years with MS) participants and focusing data collection on health and lifestyle factors, disability, participation and quality of life to determine factors associated with healthy ageing. DESIGN National multicentre postal survey. SETTING Recruitment from Canadian MS clinics, MS Society of Canada chapters and newspaper advertisements. PARTICIPANTS People aged 55 years or older with MS symptoms more than 20 years. OUTCOME MEASURES Validated outcome measures and custom-designed questions examining MS disease characteristics, living situation, disability, comorbid conditions, fatigue, health behaviours, mental health, social support, impact of MS and others. RESULTS Of the 921 surveys, 743 were returned (80.7% response rate). Participants (mean age 64.6±6.2 years) reported living with MS symptoms for an average of 32.9±9.5 years and 28.6% were either wheelchair users or bedridden. There was only 5.4% missing data and 709 respondents provided optional qualitative information. According to data derived from the 2012 Canadian Community Health Survey of Canadians above 55 years of age, older people with MS from this survey sample are about eight times less likely to be employed full-time. Older people with MS were less likely to engage in regular physical activity (26.7%) compared with typical older Canadians (45.2%). However, they were more likely to abstain from alcohol and smoking. CONCLUSIONS Despite barriers to participation, we were able to recruit and gather detailed responses (with good data quality) from a large proportion of older Canadians with MS. The data suggest that this sample of older people with MS is less likely to be employed, are less active and more disabled than other older Canadians.
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Affiliation(s)
- Michelle Ploughman
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Serge Beaulieu
- Eastern Health Authority, St. John's, Newfoundland, Canada
| | - Chelsea Harris
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Stephen Hogan
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Olivia J Manning
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Penelope W Alderdice
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - John D Fisk
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - A Dessa Sadovnick
- Department of Medical Genetics and Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul O'Connor
- Department of Neurology, St. Michaels Regional Hospital, Toronto, Ontario, Canada
| | | | - Luanne M Metz
- Department of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Penelope Smyth
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Nancy Mayo
- Department of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Katherine B Knox
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Mark Stefanelli
- Department of Neurology, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Marshall Godwin
- Primary Health Care Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
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