Correlates of accelerometry non-adherence in an economically disadvantaged minority urban adult population

Wireless physical activity monitor use among adults living with HIV in a community-based exercise intervention study: a quantitative, longitudinal, observational study

OBJECTIVES

Our aim was to examine wireless physical activity monitor (WPAM) use and its associations with contextual factors (age, highest education level, social support and mental health) among adults living with HIV engaged in a community-based exercise (CBE) intervention.

DESIGN

Quantitative, longitudinal, observational study.

SETTING

Toronto YMCA, Ontario, Canada.

PARTICIPANTS

Eighty adults living with HIV who initiated the CBE intervention.

INTERVENTION

Participants received a WPAM to track physical activity during a 25-week CBE intervention involving thrice-weekly exercise, supervised weekly (phase 1) and a 32-week follow-up involving thrice-weekly exercise with no supervision (phase 2), completed in December 2018.

OUTCOME MEASURES

Uptake was measured as participants who consented to WPAM use at initation of the intervention. Usage was defined as the proportion of days each participant had greater than 0 steps out of the total number of days in the study. We measured contextual factors using a baseline demographic questionnaire (age, highest education level), and median scores from the bimonthly administered Medical Outcomes Study-Social Support Scale and Patient Health Questionnaire (mental health), where higher scores indicated greater social support and mental health concerns, respectively. We calculated Spearman correlations between WPAM usage and contextual factors.

RESULTS

Seventy-six of 80 participants (95%) consented to WPAM use. In phase 1, 66% of participants (n=76) and in phase 2, 61% of participants (n=64) used the WPAM at least 1 day. In phase 1, median WPAM usage was 50% (25th, 75th percentile: 0%, 87%; n=76) of days enrolled and in phase 2, 23% (0%, 76%; n=64) of days. Correlation coefficients with WPAM usage ranged from weak for age (ρ=0.26) and mental health scores (ρ=-0.25) to no correlation (highest education level, social support).

CONCLUSIONS

Most adults living with HIV consented to WPAM use, however, usage declined over time from phase 1 to phase 2. Future implementation of WPAMs should consider factors to promote sustained usage by adults living with HIV.

TRIAL REGISTRATION NUMBER

NCT02794415.

The Challenge of Incomplete Data in Accelerometer Studies: Characteristics of Nonparticipation and Noncompliance in a Nationwide Sample of Adolescents and Young Adults in Germany

BACKGROUND

Incomplete data due to nonparticipation and noncompliance with the study protocol can bias the results of studies. We investigated how a nationwide accelerometer sample of adolescents and young adults is affected by such incomplete data.

METHODS

We analyzed cross-sectional data from 6465 participants (11-31 y old) who participated in a national health survey in Germany (KiGGS Wave 2; 2014-2017). The data included information about the participation in the measurement of physical activity using accelerometers, compliance with the wear-time protocol, and sociodemographic and health-related variables. Multivariable regression analyses were conducted to detect factors associated with incomplete data.

RESULTS

Of the total sample, 78.0% participated in the accelerometer part of the study, and 83.5% of the participants with data available complied with the wear-time protocol. In 11- to 17-year-olds, the likelihood of having incomplete accelerometer data was higher in boys, older adolescents, adolescents with a lower sociodemographic status, adolescents with overweight, adolescents not participating in organized sport, adolescents not speaking only German at home, current smokers, and adolescents having a higher soft drink consumption. In 18- to 31-year-olds, the likelihood of having incomplete accelerometer data was higher in men, adults with a lower educational level, adults not speaking only German at home, and adults who smoke.

CONCLUSIONS

Our results suggest that accelerometer samples are biased such that participants with more beneficial health behaviors provide complete accelerometer data more often. This knowledge should be used to design effective recruitment strategies and should be considered when interpreting results of accelerometer studies.

Objective Measures of Physical Activity in Rural Communities: Factors Associated With a Valid Wear and Lessons Learned

BACKGROUND

Compared with urban/suburban counterparts, rural communities experience lower rates of physical activity (PA) and higher rates of chronic disease. Promoting PA is important for disease prevention but requires reliable and valid measurement of PA. However, little is known about effectively collecting objective PA data in rural communities. Using data from a cluster randomized trial (Heartland Moves), which aims to increase PA in rural Missouri, this study explored factors associated with successful objective PA data collection and presents lessons learned.

METHODS

Baseline survey and accelerometry data were collected through Heartland Moves (n = 368) from August 2019 to February 2021, in southeast Missouri. Chi-square and logistic regression analyses were used to explore factors (demographics, subjective PA, and SMS reminders) associated with valid wear of PA devices.

RESULTS

Overall, 77% had valid wears. Participants who were not married (odds ratio [OR] 0.48, 95% confidence interval [CI], 0.30-0.79) and those living alone (OR 0.49, 95% CI, 0.30-0.81) were less likely to have valid wears. Participants who met PA guidelines (OR 1.69, 95% CI, 1.03-2.75) or received SMS reminders (OR 3.25; 95% CI, 1.97-5.38) were more likely to have valid wears.

CONCLUSIONS

Results are supported by lessons learned, including importance of communication (SMS reminders), accessing hard-to-reach groups (living alone), and need to adapt during data collection.

Recruitment and Retention Strategies for Community-Based Longitudinal Studies in Diverse Urban Neighborhoods

Longitudinal, natural experiments provide an ideal evaluation approach to better understand the impact of built environment interventions on community health outcomes, particularly health disparities. As there are many participant engagement challenges inherent in the design of large-scale community-based studies, adaptive and iterative participant engagement strategies are critical. This paper shares practical lessons learned from the Physical Activity and Redesigned Community Spaces (PARCS) study, which is an evaluation of the impact of a citywide park renovation initiative on physical activity, psychosocial health, and community well-being. The PARCS study, although ongoing, has developed several approaches to improve participant engagement: building trust with communities, adapting the study protocol to meet participants' needs and to reflect their capacity for participation, operational flexibility, and developing tracking systems. These strategies may help researchers anticipate and respond to participant engagement challenges in community-based studies, particularly in low-income communities of color.