Effects of social network incentives and financial incentives on physical activity and social capital among older women: a randomized controlled trial

Social capital and physical activity: a literature review up to March 2024

Background

Social capital, as a multidimensional social science concept, plays a crucial role in promoting physical activity. Despite numerous studies exploring the relationship between social capital and physical activity, there is still a lack of systematic understanding of how different dimensions of social capital influence physical activity levels. This study aims to systematically review the literature up to 2024 on the relationship between social capital and physical activity, uncover the role of social capital in promoting physical activity, and identify its multidimensional impacts.

Methods

We used a combination of search terms including "social capital" and "physical activity" to search the Web of Science, PubMed, Scopus, SportDiscus, and PsychINFO databases for English literature published up to March 1, 2024.

Results

We identified 2,021 unique articles and reviewed 115 studies that met our inclusion criteria. These studies evaluated various dimensions of social capital, with key dimensions including social participation (34%), social networks (30%), social cohesion (30%), social trust (29%), overall social network (26%), social support (19%), safety (19%), norms of reciprocity (13%), social control (10%), satisfaction with the environment (8%), collective efficacy (4%), norms for physical activity (3%), and voting (1%). In studies exploring the relationship between social capital and physical activity, the majority of positive results in the hypothesized direction were observed in dimensions such as social cohesion, trust, participation, reciprocity, satisfaction with the environment, and overall social networks. In contrast, dimensions such as voting, collective efficacy, safety, control, and physical activity norms predominantly showed null or negative results. The results for social support were mixed, displaying positive, negative, and null outcomes, while findings for social networks were also predominantly mixed.

Conclusion

This study reveals the significant role of social capital in promoting physical activity, particularly in the dimensions of social cohesion, social trust, social participation, norms of reciprocity, satisfaction with environment, and overall social network. When designing public health interventions in the future, it is crucial to tailor strategies to different populations and contexts to better leverage social capital in promoting physical activity.

Effects of group communication norms on daily steps in a team-based financial incentive mobile phone intervention in Shanghai, China

BACKGROUND

Mobile technology offers great potential for physical activity promotion, especially by facilitating online communication, however, the impact of group communication norms on intervention effectiveness remains unclear. This study aimed to evaluate the effect on daily steps of a team-based social norms-related intervention using a mobile application.

METHODS

The 13-week quasi-experimental study was conducted in Shanghai, China, from September to November 2019, involving 2,985 employees from 32 worksites. For the intervention group (n = 2,049), participants set a goal of 10,000 steps per day. The teams and individual members would receive points for meeting the daily goal, contributing to team-based rankings and financial rewards for the teams and their members. In addition, the intervention teams created dedicated WeChat groups to facilitate communication, which were also used to collect group chat messages. The communication type in these groups was classified into four types: (1) nudging - encouraging team members to be more active, (2) sharing - exchanging the completion of daily step goals, (3) feedback - providing responses or suggestions to team members, and (4) other -diverse topics that could not be classified otherwise. The control group only tracked their steps online.

RESULTS

The weekly average steps of the intervention group increased by 2,523 steps, while the control group increased by 470 steps. In the first 3 weeks of follow-up, the frequency of nudging of 7-18 times/week had a positive cumulative effect on the step counts. Sharing more than 3 times/week had a positive cumulative effect. Over 6 and 13 weeks of follow-up, nudging 19 times/week or more had a positive cumulative effect while sharing and feedback at any frequency negatively affected average weekly steps.

CONCLUSIONS

Communication types within a team affected team-based step counts in a financial incentive intervention. The team-level social norms related to communications might have different cumulative effects on team-level physical activity. 'nudging' messages had a significant association with the change in individual-level step counts in the medium or long term.

TRIAL REGISTRATION

Pilot Project of the application of walking incentive technology in occupational groups, 2019, ChiCTR1900023813. Registered 13 June 2019,  https://www.chictr.org.cn/showproj.html?proj=39858 .

Knowledge, attitude, and practice regarding Sarcopenia in maintenance hemodialysis patients in Northeastern China

Sarcopenia is a severe complication affecting patients receiving hemodialysis (HD) treatment over an extended period of time. This cross-sectional study assessed knowledge, attitude, and practice (KAP) towards sarcopenia among maintenance HD patients in Northeastern China between 13 December 2023 and 13 January 2024. A total of 752 questionnaires were collected. Multivariate logistic regression showed that completed high school or vocational secondary school, college or bachelor's degree, and maintenance HD lasting ≥ 11 years were independently associated with proactive practice. The Structural equation modeling (SEM) showed that knowledge directly affected attitude and practice. Moreover, attitude directly affects practice. Maintenance HD patients showed inadequate knowledge, positive attitude, and proactive practice towards sarcopenia. Healthcare providers should focus on educational campaigns to increase patient awareness of sarcopenia, its risk factors, and preventive measures.

Effects of small community walking intervention on physical activity, well-being, and social capital among older patients with cardiovascular disease in the maintenance phase: a randomized controlled trial

[Purpose] Older patients with cardiovascular disease should increase their physical activity and prioritize positive psychological and social approaches in the maintenance phase of their cardiac rehabilitation. This study aimed to clarify the effect of small community walking on physical activity, well-being, and social capital in older patients with cardiovascular disease in the maintenance phase. [Participants and Methods] We conducted a multicenter study in Kumamoto, Japan. We randomly divided 55 patients with cardiovascular disease into two groups: small community walking and walking alone. For three months, a registered cardiac rehabilitation instructor provided walking guidance to both groups using a wearable device. We measured physical activity, social capital, and subjective happiness before and after the intervention. [Results] Results revealed a statistically significant main effect of time on physical activity and social participation. In the subjective happiness scale, there was an association between group and time. [Conclusion] Our results suggest that walking guidance using a wearable device was beneficial in improving overall physical activity, regardless of whether the individual did small community walking or walking alone. Furthermore, small community walking intervention may effectively enhance well-being. The relationship between physical activity and social participation needs to be further investigated.

Psychosocial Determinants of Knee Osteoarthritis Progression: Results from the Promoting Independence in Our Seniors with Arthritis Study

BACKGROUND

Knee osteoarthritis (OA) is a common cause of physical disability among older adults. While established risk factors for knee OA include age and increased body weight, few studies have examined psychosocial risk factors or progression of knee OA.

METHODS

The Promoting Independence in our Seniors with Arthritis study recruited participants aged 65 years and over from orthopedic outpatients and community engagement events. Participants were invited to annual visits during which knee OA symptoms were assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOS), social network using the 6-item Lubben Social Network Scale and anxiety and depression using the Hospital Anxiety and Depression scale. Knee OA worsening was defined by a 5% reduction in mean KOOS scores at the last visit compared to the first visit.

RESULTS

Data were available from 148 participants, mean age 66.2±6.5 years and 74.1% female, of whom 28 (18.9%) experienced OA worsening over a median follow-up period of 29 months. Univariate analyses revealed that age, sex, height, grip strength, and social network were associated with OA worsening. Social network remained statistically significantly associated with OA worsening after adjustment for age and sex difference (odds ratio=0.924; 95% confidence interval, 0.857-0.997). The relationship between social network and OA worsening were attenuated by both depression and handgrip strength at baseline.

CONCLUSION

Psychological status and muscle strength may be modifiable risk factors for social network which may in turn prevent knee OA worsening and should be targeted in future intervention studies.

How effective is the health promotion policy in Sichuan, China: based on the PMC-Index model and field evaluation

BACKGROUND

Many countries around the world highlight the health in all policies (HiAP). However, most of the related research focused on the influential factors and implementation strategies, with less concern on the evaluation of HiAP. In response to HiAP's call, the Chinese government has proposed health promotion policies (HPPs) in counties or districts, the evaluation of HPPs in sample counties or districts of Sichuan province in China is an essential basis for optimizing policy content, improving policy implementation, and ensuring health promotion's continuous and efficient operation.

METHODS

This paper established an evaluation system for HPPs based on the PMC-Index model and then quantitatively analyzed 37 representative HPPs from the pilot areas in Sichuan province. In addition, a team of experts conducted a field assessment.

RESULTS

The results showed that the average PMC index of 37 HPPs was 7.091, and correlation analysis showed that there was a significant correlation between the PMC index and expert score.

CONCLUSIONS

This study indicates that the overall consistency of HPPs was good and proves a connection between the formulation and implementation of HPPs.

Effect of psychosocial motivations and technology on physical activity behaviours among community older men and women

BACKGROUND

Implementation of physical activity strategies in older populations may be influenced by underlying psychosocial and gender-based factors to physical activity. We explored associations between these factors and physical activity behaviors and technology among older men and women.

METHODS

Community older adults underwent echocardiography and interviewer administered questionnaires that collected physical activity habits, self-motivation, self-empowerment and smartphone usage patterns associated with physical activity. Aerobic capacity was denoted by VO₂max (High VO₂ was defined as VO₂ > 35 (ml/kg/min) for men or VO₂ > 27 (ml/kg/min) for women).

RESULTS

Among 180 participants (mean age 77 (71-80) years; 43% females), 101 (56.1%) had a low VO₂max. Barriers to activity were lack of time (27.8%), tiredness (26.7%), affordability (12.8%) and pain while exercising (12.2%). Compared to participants with high VO₂max, those with low VO₂max were less likely to report feeling good post-exercise (70.3% vs 86.1%, adjusted p = 0.041) and express barriers to exercise (72.3% vs 88.6%, adjusted p = 0.017). Compared to men, women were more likely to express motivation for exercise if they were guided by an instructor (20.5% vs 1.96%, adjusted p = 0.027), less likely to prefer control over exercise type and difficulty (57.7% vs 82.4%, adjusted p = 0.001), express interest in smartphone apps (7.84% vs 24.4%, adjusted p = 0.01) and participate in apps-guided exercise (10.3% vs 29.4%, adjusted p = 0.001). Major factors that motivated the use of smartphone applications to manage individual health were financial incentives (23.9%) and guidance on exercise routines (21.1%) while the reveal of personal information was a major deterrent (28.3%).

CONCLUSIONS

We observed differences in physical activity motivation, empowerment and technology use based on gender and functional status. Tailoring physical activity strategies, including digital health strategies, that target psychosocial and gender-based factors may improve activity participation in older adults.

Comparing the effects of text messaging and mobile social networking on physical activity and anthropometric indices of middle-aged women: a randomized controlled trial

BACKGROUND

Physical inactivity is a global health problem which is more prevalent among women. Among different age groups, middle-aged women are more vulnerable to physical inactivity as one of consequences of menopause. This study aimed to compare the effect of text messaging and that of mobile social networking on the improvement of physical activity and anthropometric indices of middle-aged women in Iran.

METHODS

This was a randomized controlled trial in which 110 overweight or obese women who were physically inactive were recruited and allocated into two groups of text messaging (n = 55) or mobile social networking (n = 55). Women in both groups received information regarding the necessity, benefits, and barriers of physical activity and how to overcome these barriers for 12 weeks. The International Physical Activity Questionnaire (IPAQ), and a demographic questionnaire were used to collect data. Anthropometric indices including weight, height, waist circumference, hip circumference, waist/hip ratio, and body fat percentage were measured at baseline, as well as 4, 8, and 12 weeks after intervention. Data were analyzed using independent t-test, Chi-square, and repeated measure test.

RESULTS

In the mobile social networking group, most women had moderate physical activity after 12 weeks (P < 0.05). The mean physical activity and energy expenditure were significantly higher in the mobile social group than those in the text messaging. In the 12th week of intervention, there was a significant reduction in the weight and BMI of the participants in the mobile social networking group compared to the text messaging group (P < 0.05). The waist and hip circumferences of women in the mobile social networking group reduced significantly after 12 weeks of intervention in comparison to the text messaging group (P = 0.001). The two groups did not show any significant difference regarding waist/hip ratio. While the body fat percentage was reduced in the mobile social networking group in the 4th, 8th, and 12th week of intervention, the differences between the two groups was not significant.

CONCLUSION

Both text messaging and mobile social networking were effective in promoting physical activity and reducing anthropometric indices except for waist/hip ratio and body fat percentages, but the effect of mobile social networking was more pronounced. Thus, mobile social networking is recommended for promoting physical activity among middle-aged women.