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Mavragani A, Woodworth A, Mehrabadi MA. The Relationship Between Exercise Habits and Stress Among Individuals With Access to Internet-Connected Home Fitness Equipment: Single-Group Prospective Analysis. JMIR Form Res 2023; 7:e41877. [PMID: 36719817 PMCID: PMC9947760 DOI: 10.2196/41877] [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: 08/12/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Physical activity (PA) confers numerous benefits to health and health care costs, yet most adults are not meeting recommended PA guidelines. Stress may be a factor that influences PA behavior. Research investigating the impact of stress on PA has yielded inconsistent findings. Most studies find that stress negatively impacts PA, but there is some evidence that habitual exercising buffers this association. OBJECTIVE This study aims to examine the relationship between stress and exercise habits among habitual exercisers with internet-connected home fitness equipment (Peloton Bike) during the COVID-19 lockdown. METHODS Participants were recruited through Facebook (N=146) and asked to complete an internet-based survey that assessed COVID-19-related stressors, perceived stress associated with those stressors, and general perceived stress. Self-reported exercise was assessed on the survey using the Godin Leisure-time Exercise Questionnaire (GLTEQ). Participants were also asked for consent to access their Peloton usage data through the Peloton platform. From their usage data, the frequency and duration of cycling classes was calculated for 4 weeks prior to and 12 weeks following the survey. Hierarchical regression equations tested the association between stress reported on the survey and subsequent exercise participation. Exercise participation was quantified both as the frequency and duration of Peloton cycling over the 12 weeks following the survey and as self-reported moderate to vigorous activity on a second survey completed by a subset of participants 12 weeks after the initial survey. RESULTS There were 146 participants in our Peloton analysis sample and 66 in the self-reported exercise analysis. Peloton user data showed that study participants cycled frequently (mean 5.9 times per week) in the month prior to the initial survey, and that presurvey Peloton use was a strong predictor of exercise frequency (R2=0.57; F2,143=95.27; P<.001) and duration (R2=0.58; F2,143=102.58; P<.001) for the 12 subsequent weeks. Self-reported overall exercise likewise showed that this sample was very active, with an average of more than 8 times per week of moderate to vigorous exercise at the initial survey. Self-reported exercise on the initial survey was a strong predictor of self-reported exercise 12 weeks later (R2=0.31; F1,64=29.03; P<.001). Perceived stress did not impact Peloton cycling duration or frequency (P=.81 and .76, respectively) or self-reported exercise (P=.28). CONCLUSIONS The results suggest that stress did not negatively impact exercise participation among habitually active adults with access to internet-connected home fitness equipment. Habitual exercise may buffer the impact of stress on participation in regular moderate to vigorous activity. Future research should examine the role that the availability of home-based internet-connected exercise equipment may play in this buffering.
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Affiliation(s)
| | - Amanda Woodworth
- Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, United States
| | - Milad Asgari Mehrabadi
- Department of Electrical Engineering and Computer Science, University of California, Irvine, Irvine, CA, United States
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Morales-Palomo F, Moreno-Cabañas A, Alvarez-Jimenez L, Ortega JF, Mora-Rodriguez R. Effect of Yearly Exercise on Medication Expense and Benefit-Cost Ratio in Individuals with Metabolic Syndrome: A Randomized Clinical Trial. Med Sci Sports Exerc 2023; 55:158-166. [PMID: 36171184 DOI: 10.1249/mss.0000000000003053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Lifestyle modification through incorporation of exercise training could improve metabolic syndrome (MetS) clinical components (hypertension, dyslipidemia, hyperglycemia, and visceral abdominal obesity). We aimed to assess if long-term exercise training could restrain the increased pharmacological cost of the clinical management of the MetS. METHODS Medicine cost during a 5-yr-long randomized controlled exercise intervention trial was analyzed. After a per-protocol analysis, a group of 64 individuals 53 ± 2 yr old, with overweight (body mass index, 33.4 ± 0.9 kg·m -2 ) and MetS (3.6 ± 0.2 factors) were randomized to a training (4 months·yr -1 for 5 yr; EXERCISE, n = 25) or to a control group (CONTROL, n = 26). Subjects were studied on three occasions during the 5-yr follow-up. Participants continued their routine medication managed by their general practitioner. The main outcome is the 5-yr evolution of medication cost to treat MetS (hyperglycemia, hypertension, and hyperlipidemia). A secondary outcome is the benefit-cost ratio of the exercise intervention. RESULTS In CONTROL, medicine cost increased 160% from baseline ( P < 0.001), whereas in EXERCISE, it remained unchanged (33%; P = 0.25). After the 5-yr follow-up, medicine use was 60% and medicine cost 74% higher in CONTROL than EXERCISE ( P < 0.05 in both cases). However, MetS z score was similarly reduced over time in both groups ( P = 0.244 for group-time interaction). The number of prescribed medications increased after 5 yr in CONTROL (89%; P < 0.001), whereas it remained stable with yearly training (17%; P = 0.72 in EXERCISE). Ten-year atherosclerotic cardiovascular disease risk estimation increased only in CONTROL (15%; P = 0.05 for group-time interaction). The benefit in medicine savings (€153 per year and patient) triplicated the estimated cost (€50.8 per year and patient) of the exercise intervention. CONCLUSIONS A 5-yr-long supervised exercise training program in middle-age individuals with MetS prevents the need for increasing medicine use. The savings in pharmacological therapy outweighs the estimated costs of implementing the exercise program.
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Affiliation(s)
- Felix Morales-Palomo
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, SPAIN
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Associations Between Physical Activity Vital Sign in Patients and Health Care Utilization in a Health Care System, 2018-2020. J Phys Act Health 2023; 20:28-34. [PMID: 36493760 DOI: 10.1123/jpah.2022-0266] [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: 05/17/2022] [Revised: 09/29/2022] [Accepted: 10/12/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Physical inactivity is a risk factor for many chronic conditions. This retrospective cohort study examined associations between physical activity (PA) with health care utilization (HU). METHODS A PA vital sign was recorded in clinics from January 2018 to December 2020. Patients were categorized as inactive, insufficiently active, or sufficiently active by US PA aerobic guidelines. Associations between PA vital sign and visits (inpatient admissions, emergency department, urgent care, and primary care) were estimated using population average regression by visit type. RESULTS 23,721 patients had at least one PA vital sign recorded, with a mean age of 47.3 years and mean body mass index (BMI) of 28; 52% were female and 63% were White. Sufficiently active patients were younger, male, White, and had lower BMI than insufficiently active patients. Achieving 150 minutes per week of moderate to vigorous PA per 1000 patient years was associated with 34 fewer emergency department visits (P < .001), 19 fewer inpatient admissions (P < .001), and 38 fewer primary care visits (P < .001) compared with inactive patients. Stronger associations between lower PA and higher HU were present among those who were older or had a higher comorbidity. BMI, sex, ethnicity, and race did not modify the association between PA and HU. CONCLUSIONS Meeting aerobic guidelines was associated with reduced HU for inpatient, primary care, and emergency department visits.
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Schneider M, Woodworth A, Arumalla S, Gowder C, Hernandez J, Kim A, Moorthy B. Development of a tool for quantifying need-supportive coaching in technology-mediated exercise classes. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 64:102321. [PMID: 37665807 DOI: 10.1016/j.psychsport.2022.102321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/15/2022] [Accepted: 10/13/2022] [Indexed: 09/06/2023]
Abstract
Technology-mediated interventions to promote physical activity are growing in popularity and appear to be effective for supporting continued adherence for some people. Some of this efficacy may be related to the cultivation of motivation that is self-determined (i.e., autonomous), which is posited to arise from the satisfaction of three basic psychological needs: competence, relatedness, and autonomy. We developed an observational coding tool for quantifying the frequency of needs-supportive and needs-indifferent coaching during technology-mediated exercise classes. The Peloton Instructor Needs-Supportive Coaching (PINC) tool shows evidence of reliability (average kappa = .91). We also demonstrated the utility of the PINC for characterizing needs-supportive coaching profiles across 4 different types of classes (Beginner, Power Zone, Groove, and High-Intensity Interval Training) and the construct validity of the PINC with respect to examining the relationship of needs-supportive coaching to intrinsic motivation. The PINC offers a useful tool with which future studies could evaluate whether and how instructor coaching impacts self-determined motivation to exercise within a technology-mediated context.
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Affiliation(s)
- Margaret Schneider
- Department of Population Health and Disease Prevention, University of California, Irvine, USA.
| | - Amanda Woodworth
- Institute for Clinical and Translational Science, University of California, Irvine, USA
| | - Sathvika Arumalla
- Department of Population Health and Disease Prevention, University of California, Irvine, USA
| | - Conor Gowder
- School of Social Ecology, University of California, Irvine, USA
| | - Julissa Hernandez
- Department of Population Health and Disease Prevention, University of California, Irvine, USA
| | - Ashley Kim
- Department of Population Health and Disease Prevention, University of California, Irvine, USA
| | - Brinthy Moorthy
- Department of Cognitive Sciences, University of California, Irvine, USA
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Perrier F, Ghiasvand R, Lergenmuller S, Robsahm TE, Green AC, Borch KB, Sandanger TM, Weiderpass E, Rueegg CS, Veierød MB. Life-Course Trajectories of Physical Activity and Melanoma Risk in a Large Cohort of Norwegian Women. Clin Epidemiol 2022; 14:1571-1584. [PMID: 36578536 PMCID: PMC9791937 DOI: 10.2147/clep.s382454] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose Physical activity (PA) is a cornerstone in disease prevention and varies throughout life. A pooled analysis of cohort studies and a meta-analysis of cohort studies found positive associations between PA and melanoma risk. However, previous studies focused on PA at specific ages and often lacked information on ultraviolet radiation (UVR) exposure. Using the population-based Norwegian Women and Cancer (NOWAC) cohort, including information on PA and UVR exposure, we estimated life-course PA trajectories from adolescence to adulthood and their associations with melanoma. Methods Total PA across different domains (recreation, occupation, transport, household) was reported for ages 14 and 30 years, and when responding to the questionnaire (31-76 years) using a 10-point scale, validated to rank PA levels in Norwegian females. We estimated life-course PA trajectories using a latent class mixed model in 152,248 women divided into three subcohorts depending on age at questionnaire completion: 31-39 (n = 27,098), 40-49 (n = 52,515) and ≥50 years (n = 72,635). The unique 11-digit identity number of Norwegian citizens was used to link NOWAC to the Cancer Registry of Norway for information on cancer diagnoses, emigration and death. Associations between PA trajectories and melanoma risk were estimated in each subcohort using multivariable Cox regression. Results Five classes of individual life-course PA trajectories were identified in subcohort 31-39 years (low, moderate, high, decreasing, increasing PA) and four in subcohorts 40-49 and ≥50 years (low, moderate, high, decreasing PA). No significant association was found between life-course PA trajectories and melanoma risk in any subcohort. Hazard ratios (95% confidence intervals) for the high versus moderate trajectory were 0.92 (0.66-1.29), 1.15 (0.97-1.37) and 0.90 (0.78-1.05) for subcohorts 31-39, 40-49 and ≥50 years, respectively. Conclusion Our results do not support a positive association between PA and melanoma risk found in previous studies, which is important for public health guidelines promoting regular PA.
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Affiliation(s)
- Flavie Perrier
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Reza Ghiasvand
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Simon Lergenmuller
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trude E Robsahm
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Cancer Research UK Manchester and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Kristin B Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Shin C, Oh KM, Lee M, An K, Sim J. A Technology-Enhanced Physical Activity Intervention: A Feasibility Study. Clin Nurs Res 2022; 31:1219-1224. [PMID: 35686393 DOI: 10.1177/10547738221102272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Using a single-group, pre-posttest design, we evaluated feasibility and acceptability of a technology-enhanced physical activity intervention in 43 midlife (aged 35-64) first-generation Korean American adults who were physically inactive. The intervention consisted of bi-weekly education sessions for 4 weeks, monthly small group walks for the following 8 weeks, and weekly reminder text messages during the entire intervention period. A 100% retention rate, 93% adherence, and 88.4% satisfaction supported the feasibility and acceptability of the intervention. Paired t-tests revealed the intervention was successful and effective as demonstrating a significant increase in self-efficacy and moderate physical activity and improved cardiometabolic health. This easy and motivation enhancing intervention has a wide potential applicability for other ethnic groups. Further intervention research is suggested in a large sample, multisite, for a longer-term with a randomized controlled trial design, which may lead us to narrow the gap in physical activity engagement and cardiometabolic health disparities.
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Affiliation(s)
| | | | - Moonju Lee
- University of Texas Health Science Center at San Antonio, USA
| | - Kyungeh An
- University of Texas Health Science Center at San Antonio, USA
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Comparison of Health Care Expenditures Among U.S. Older Adults With Pain Who Reported Frequent Exercise Versus Nonfrequent Exercise. J Aging Phys Act 2021; 30:824-832. [PMID: 34942593 DOI: 10.1123/japa.2021-0301] [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: 08/02/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022]
Abstract
This cross-sectional study included a nationally representative sample of U.S. adults aged ≥50 years with self-reported pain in the past 4 weeks from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression analyses accounted for the complex survey design and assessed differences in several types of annual health care expenditures between individuals who reported frequent exercise (≥30 min of moderate-vigorous intensity physical activity ≥5 times per week) and those who did not. Approximately 23,940,144 of 56,979,267 older U.S. adults with pain reported frequent exercise. In adjusted analyses, individuals who reported frequent exercise had 15% lower annual prescription medication expenditures compared with those who did not report frequent exercise (p = .007). There were no statistical differences between frequent exercise status for other health care expenditure types (p > .05). In conclusion, adjusted annual prescription medication expenditures were 15% lower among older U.S. adults with pain who reported frequent exercise versus those who did not.
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Coughlan D. Physical activity and the insurance industry. BMJ Open Sport Exerc Med 2021. [DOI: 10.1136/bmjsem-2021-001151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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