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Sönmez Sari E, Kitiş Y. The effect of nurse-led motivational interviewing based on the trans-theoretical model on promoting physical activity in healthy older adults: A randomized controlled trial. Int J Nurs Pract 2024; 30:e13252. [PMID: 38450865 DOI: 10.1111/ijn.13252] [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: 11/08/2022] [Revised: 01/26/2024] [Accepted: 02/15/2024] [Indexed: 03/08/2024]
Abstract
AIM The aim of this study was to evaluate the effect of motivational interviewing based on the trans-theoretical model promoting physical activity in older adults. METHODS A randomized controlled trial study was conducted with 117 older adults (intervention group: 58, and control group: 59) between April and November 2019. The data were collected via a questionnaire, trans-theoretical model scales, the Physical Activity Scale for the Elderly, the Katz Activities of Daily Living scale and a pedometer. The 24-week intervention consisted of regular motivational interviewing. The control group received usual care at the family health centre. RESULTS Following the intervention, the Intervention Group showed significant improvements Exercise Processes of Change Scale, Exercise Self-Efficacy Scale and Perceived Benefits of the Decisional Balance Scale for Exercise. There was a significant difference between the groups in terms of stages of change. In the Intervention Group, 81.5% were in the contemplation stage in the pre-test, while in the post-test, 70.4% had transitioned to the action stage. In contrast, in the control group, 62.5% were in the contemplation stage initially, but in the post-test, only 9.3% had reached the action stage. The mean number of step counts increased significantly in favour of the Intervention Group, as did the Physical Activity Scale for the Elderly total score. CONCLUSION The trial indicated that after the trans-theoretical model-based motivational interviewing, the stages of change among the older adults improved, as did their exercise behaviours. It is recommended that the trans-theoretical model and motivational interviewing be used by nurses to improve healthy lifestyle stage behaviours in older adults.
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Affiliation(s)
- Ebru Sönmez Sari
- Nursing Department, Bayburt University Health Sciences Faculty, Bayburt, Turkiye
| | - Yeter Kitiş
- Nursing Department, Gazi University Nursing Faculty, Ankara, Turkiye
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Okube OT, Kimani ST. Effectiveness of Trans-Theoretical Model-Based Health Education Intervention in the Promotion of Lifestyle Changes among Adults with Metabolic Syndrome: A Randomized Controlled Trial. SAGE Open Nurs 2024; 10:23779608241251658. [PMID: 38737629 PMCID: PMC11084986 DOI: 10.1177/23779608241251658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/30/2024] [Accepted: 04/13/2024] [Indexed: 05/14/2024] Open
Abstract
Background Evidence revealed that, 60% of deaths in the underdeveloped nations are linked to adoption of unhealthy lifestyles. The Trans-theoretical Model (TTM) has been considered a useful interventional approach in smoking cessation, drug addiction and weight control. However, its effectiveness in improving changes in dietary pattern, physical activity and alcohol consumption has not been reported. Purpose The study aimed at evaluating the effectiveness of the TTM-based health education intervention in the promotion of lifestyle changes among adults with metabolic syndrome. Methods This was an experimental design where 352 participants with metabolic syndrome were allocated to intervention and control groups. The participants were randomly assigned to receive either standard CVD care or a TTM stage-based lifestyle modification intervention for 12-months. Lifestyle patterns were assessed at baseline and endpoint. The mean difference of the subtotal TTM concept scores between pre and post intervention was evaluated using paired t-test. The chi-square test of independence was used to detect between group differences in the categorical data. Results Most of the participants were in the pre-action stage of change for their dietary intake patterns and physical activity habits at the baseline assessment with no difference between the groups. The intervention group's total level of change toward adopting a healthy lifestyle was markedly (p < 0.001) improved than the control group at the endpoint. The mean scores for the intervention group's stage of change, self-efficacy, and pros and cons of decisional balance all improved significantly (p < 0.001) from the baseline. The mean scores for the control group's pros and cons of decisional balance and stage of change also considerably (p < 0.05) improved from baseline to the endpoint. Conclusion The TTM- based health education intervention was effective in improving the participants' lifestyles that includes diet and physical activity. Health care providers, particularly nurses should implement TTM staged-matched educational intervention for individuals who are at risk for cardiovascular diseases.
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Affiliation(s)
- Okubatsion Tekeste Okube
- School of Nursing, The Catholic University of Eastern Africa, Nairobi, Kenya
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
| | - Samuel T. Kimani
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
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Wingood M, Bean JF, Linsky AM. Incorporating Physical Activity Assessments and Behavior Change Techniques Into Geriatrics. Arch Rehabil Res Clin Transl 2023; 5:100293. [PMID: 38163022 PMCID: PMC10757171 DOI: 10.1016/j.arrct.2023.100293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Ninety-one percent of adults 65 years and older do not perform the recommended levels of physical activity (PA), resulting in increased risk of disability, morbidity, and mortality. Despite knowing the benefits of PA and acknowledging the importance of assessing and addressing inadequate PA levels, 50%-75% of health care providers do not incorporate behavior change techniques into clinical practice. This clinical gap can be explained by a lack of knowledge or confidence in (1) assessing PA levels; (2) addressing inadequate PA levels; and (3) justifying the time needed to use these techniques in clinical practice. In this special communication, we address this gap by providing a 3-step theoretical-based clinical decision pathway that guides health care providers on how to identify older adults with inadequate PA levels, determine readiness to increase PA, and empower patents to develop an action plan that will increase their PA levels. We also provide a conceptual model that supports the use of techniques that assess and address inadequate PA by tying PA to the Age-Friendly Health System's 4Ms (ie, What Matters to the older adult, Mentation, Mobility, and Medications).
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Affiliation(s)
- Mariana Wingood
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC
- Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Jonathan F. Bean
- New England Geriatric Education and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, MA
- Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
- Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA
| | - Amy M. Linsky
- Section of General Internal Medicine, Veterans Affairs Boston Healthcare System, Boston, MA
- Center for Healthcare Organization and Implementation Research, Veterans Affairs Boston Healthcare System, Boston, MA
- Section of General Internal Medicine, Boston University School of Medicine, Boston, MA
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Happe L, Sgraja M, Hein A, Quinten V, Diekmann R. Usability and feasibility of a tablet-based e-coach for older adults in rehabilitation units to improve nutrition and physical activity: a prospective pilot study. BMC Geriatr 2023; 23:578. [PMID: 37726662 PMCID: PMC10507984 DOI: 10.1186/s12877-023-04204-6] [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: 11/24/2022] [Accepted: 07/29/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND For older adults (≥ 70 years), it is often challenging to maintain new nutrition and physical activity behaviours learned in rehabilitation. To minimize the risk of negative health consequences when returning home, an e-coach can be helpful. Aligning the program with an established concept such as the Transtheoretical Model of Behaviour Change (TTM) and guidance from healthcare professionals can optimize behaviour change. OBJECTIVE This prospective single-arm pilot study aimed to assess the usability and feasibility of a nutrition and mobility e-coach for older adults during and after rehabilitation for a period of 9 weeks. In addition, we examined the change in the TTM phase as an indicator of the participant's readiness to change or the changes made. METHODS Older adults (≥ 70 years) with nutrition deficits and/ or mobility limitations were recruited in a rehabilitation centre. Participants' phases of behaviour change in the TTM were identified by comparing current nutrition and physical activity habits via self-report with age-specific nutrition and physical activity recommendations. They received a tablet with the e-coach containing educational and interactive elements on the topics of nutrition and physical activity in older age. Participants used the e-coach and received support from healthcare professionals. The TTM phases were assessed at five times; the e-coach content was adjusted accordingly. Usability was assessed using the System Usability Scale (SUS, Score range: 0-100). Timestamps were used to evaluate how frequently participants used the e-coach: high (≥ 67% of the days), medium (66 - 33% of the days), and low (< 33% of the days). RESULTS Approximately 140 patients were approached and n = 30 recruited. Complete data sets of n = 21 persons were analysed (38% female, mean age 79.0 ± 6.0 years). The SUS was 78.6 points, 11 participants (42%) were classified as high users, 6 (39%) as medium users and 4 (19%) as low users. After nine weeks, 15 participants (71%) achieved the physical activity recommendations (baseline: 33%, n = 7). Nutrition recommendations were achieved by 14 participants (66%) after nine weeks (baseline: 24%, n = 5). CONCLUSION The e-coach seems to be usable and feasible for older adults. We identified some optimization potentials for our application that can be transferred to the development of comparable e-health interventions for vulnerable older adults.
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Affiliation(s)
- Lisa Happe
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany.
| | - Marie Sgraja
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany
| | - Andreas Hein
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany
| | - Vincent Quinten
- Department of Health Services Research, Junior research group "nutrition and physical function in older adults", Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany
| | - Rebecca Diekmann
- Department of Health Services Research, Junior research group "nutrition and physical function in older adults", Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany
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Wingood M, Irwin KE, Bamonti PM, Criss MG, Harris R, Phillips E, Vincenzo JL, Chui KK. Examining physical activity participation barriers among adults 50 years and older: a scoping review protocol. PHYSICAL THERAPY REVIEWS 2022; 27:320-323. [PMID: 37920547 PMCID: PMC10621112 DOI: 10.1080/10833196.2022.2087311] [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: 12/31/2021] [Revised: 04/25/2022] [Accepted: 06/04/2022] [Indexed: 10/18/2022]
Abstract
Background Despite the benefits of physical activity (PA), 61% of adults 50 years and older do not meet the recommended levels of PA. One method of increasing PA participation is assessing and addressing PA participation barriers. Currently, no guidance on methodologies for assessing PA participation barriers exist. Objective The primary objective of this scoping review is to map the methodologies used to examine potential PA participation barriers faced by community-dwelling adults 50 years and older. A secondary objective is to evaluate the clinimetric properties of these methodologies. Methods This scoping review protocol is registered with Open Science Framework (https://osf.io/wd2hx). A systematic search of the following databases will be performed: PubMed, PsycINFO, CINAHL, Web of Science, and PEDro. Included studies will 1) present either a) data on development or clinimetric properties of PA participation barrier tool (s); or b) relative risk or odds ratios of PA participation barrier(s); 2) compare PA participation barriers or PA participation barrier tool(s) to either subjective or objective measures of PA; and 3) comprise of community-dwelling participants with a mean age of 50 years and older. A two-phase blinded independent screening process will be conducted to select the included publications. Data will be extracted using a standardized form and cross-checked by the first author. A narrative summary will accompany the results presented in tables and figures. Conclusion This scoping review will provide a comprehensive understanding of current literature and gaps related to PA participation barrier methodologies used with adults 50 years and older.
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Affiliation(s)
- Mariana Wingood
- New England Geriatric Education and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, MA
- Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
| | - Kent E. Irwin
- Department of Physical Therapy, Midwestern University, Downers Grove, IL
| | - Patricia M. Bamonti
- Research & Development, VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | | | - Rebekah Harris
- New England Geriatric Education and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, MA
- Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
| | | | | | - Kevin K. Chui
- Department of Physical Therapy, Radford University, Roanoke, VA
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Jiménez-Zazo F, Navarrete-Villanueva D, Gómez-Cabello A, Romero-Blanco C, Cabanillas E, Pérez-Gómez J, Calonge-Pascual S, Ara I, Vicente-Rodríguez G, Aznar S. Psychosocial factors related to physical activity in frail and prefrail elderly people. BMC Geriatr 2022; 22:407. [PMID: 35534808 PMCID: PMC9082848 DOI: 10.1186/s12877-022-03042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increased physical activity (PA) is a very important factor in a healthy aging lifestyle. Psychosocial factors have also a main role in the initiation and maintenance of this behavior, but nowadays its implications for frailty elderly people are unknown, therefore, the aim of this study was to identify the psychosociological variables of behavior change that influence the practice of (PA) in frail and prefrail elderly. METHODS A total of 103 frail and pre-frail elderly people (72 females) participated in this cross-sectional study, on the framework of the EXERNET-Elder3.0 project. Age ranged from 68-94 years (mean = 80.4 ± 5.9 years). Individualized face-to-face interviews according to the constructs of the Transtheoretical Model of Change (TTM) [(decisional balance (DB) and self-efficacy (SE)], social support (SS) (family and friends) and outcome expectations (OE) were administered to all participants. RESULTS Significant differences were found in DB, perceived benefits (PBn), SE, family-related SS and OE as a function of stages of change (SoC) (p < 0.005), but no significant were found in perceived barriers (PBrr) (p = 0.259) and friends-related SS (p = 0.068). According to the Scheffé post-hoc test, those in advanced SoC (Action-Maintenance), scored higher than those in lower SoC (Precontemplation-Contemplation and Preparation). CONCLUSION The scores obtained from the study variables differed according to the SoC, supporting the external validity for the use of the TTM in frailty elderly. Further research is needed to determine the impact of PBrr and friends-related SS on this people, as well as to identify the validity of this model in the long-term in this population.
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Affiliation(s)
- Fabio Jiménez-Zazo
- PAFS Research Group, Faculty of Sports Sciencies, University of Castilla-La Mancha, 45071, Toledo, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009, Zaragoza, Spain
| | - David Navarrete-Villanueva
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009, Zaragoza, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009, Zaragoza, Spain
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009, Zaragoza, Spain
- Faculty of Health, Department of Physiatry and Nursing, University of Zaragoza, 50009, Zaragoza, Spain
| | - Alba Gómez-Cabello
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009, Zaragoza, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009, Zaragoza, Spain
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009, Zaragoza, Spain
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009, Zaragoza, Spain
- Defense University Center, 50090, Zaragoza, Spain
- Biomedical Research Net in Physiopatology, Obesity and Nutricition (CIBERObn), 28029, Madrid, Spain
| | - Cristina Romero-Blanco
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009, Zaragoza, Spain
- PAFS Research Group, Faculty of Nursing, University of Castilla-La Mancha, 13071, Ciudad Real, Spain
| | - Esther Cabanillas
- PAFS Research Group, Faculty of Sports Sciencies, University of Castilla-La Mancha, 45071, Toledo, Spain
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009, Zaragoza, Spain
| | - Jorge Pérez-Gómez
- HEME Research Group, Faculty of Sports Sciencies, 10003, Cáceres, Spain
| | - Sergio Calonge-Pascual
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009, Zaragoza, Spain
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Polytechnic University of Madrid, 28040, Madrid, Spain
| | - Ignacio Ara
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009, Zaragoza, Spain
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071, Toledo, Spain
- Biomedical Research Networking Center On Frailty and Healthy Aging (CIBERFES), 28029, Madrid, Spain
| | - Germán Vicente-Rodríguez
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009, Zaragoza, Spain
- Agrifood Research and Technology Centre of Aragón -IA2-, CITA-Universidad de Zaragoza, 50009, Zaragoza, Spain
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009, Zaragoza, Spain
- Biomedical Research Net in Physiopatology, Obesity and Nutricition (CIBERObn), 28029, Madrid, Spain
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciencies, University of Castilla-La Mancha, 45071, Toledo, Spain.
- Exercise and Health in Special Population Spanish Research Net (EXERNET), 50009, Zaragoza, Spain.
- Biomedical Research Networking Center On Frailty and Healthy Aging (CIBERFES), 28029, Madrid, Spain.
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Effects of Brain Breaks Video Intervention of Decisional Balance among Malaysians with Type 2 Diabetes Mellitus: A Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178972. [PMID: 34501562 PMCID: PMC8430718 DOI: 10.3390/ijerph18178972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022]
Abstract
Brain Breaks® are structured physical activity (PA) web-based videos designed to promote an interest in learning and health promotion. The objective of this study was to examine its effects on decision balance (DB) which consists of the perceived benefits (Pros) and perceived barriers (Cons) of exercise in people with type 2 diabetes mellitus (T2DM). A randomised controlled trial was conducted among people with T2DM at Hospital Universiti Sains Malaysia. The intervention group received Brain Breaks videos for a period of four months. The intervention and control groups completed the validated Malay version of DB questionnaire for five times, at pre-intervention, the first month, the second month, the third month, and post-intervention. Multivariate Repeated Measures Analysis of Variance was performed for data analysis. A total of 70 participants were included (male = 39; female = 31) with a mean age of 57.6 years (SD = 8.5). The intervention group showed a significant change in the Pros and Cons factors of DB scores over time. The intervention group showed significantly higher scores for the Pros (p-value < 0.001) and lower scores for the Cons (p-value = 0.008) factors than the control group. In conclusion, the Brain Breaks video is an effective intervention to improve decisional balance in patients with T2DM to help them in deciding on behaviour change to be more physically active.
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Moore A, Yee E, Willis BW, Prost EL, Gray AD, Mann JB. A Community-based Boxing Program is Associated with Improved Balance in Individuals with Parkinson's Disease. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:876-884. [PMID: 35096235 PMCID: PMC8758155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In alignment with efforts to mitigate the negative health consequences of Parkinson's Disease (PD), the purpose of this investigation was to examine if participation in a community-based boxing program (CBP) was associated with improvements in balance and fall risk reduction among individuals with PD. In this retrospective cross-sectional study, de-identified data from 12 individuals with PD participating in a CBP was examined. Participants included those with a Hoehn and Yahr stage between 1 and 3, averaging 2.8 ± 0.8 CBP sessions per week for 6.1 ± 0.8 months between testing. Baseline and re-evaluation testing included the Fullerton Advanced Balance (FAB) Scale and Timed Up and Go (TUG) to quantify balance and fall risk. Sessions were 90-minutes in length involving a warm-up, boxing drills, strength and endurance exercises, and cool down. Sessions included multiple bouts of 30-60 second high-intensity exercise intervals (RPE between 15/20 to 17/20). Paired t-tests were used to determine if differences existed between the FAB and TUG from baseline to re-evaluation, with statistical significance accepted at p < 0.05 and > 0.8 interpreted as a large effect using Cohen's d. Results indicated a statistically significant increase and large effect in FAB performance, with a mean increase in score above previously reported minimal detectable change (MDC). While participation in CBP was associated with a statistically significant improvement and medium effect in the TUG, this did not demonstrate a population specific MDC. This study found that participation in a CBP was associated with improved balance among clients with PD.
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Affiliation(s)
- Abbie Moore
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Enoch Yee
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Brad W Willis
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Evan L Prost
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Aaron D Gray
- Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA
| | - J Bryan Mann
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
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Szabo-Reed AN, Donnelly JE. Cognitive Training: Associations and Implications for Weight Management and Translational Research. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021; 6. [PMID: 34017915 DOI: 10.1249/tjx.0000000000000151] [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] [Indexed: 11/21/2022]
Abstract
Behavioral weight loss programs combining energy restriction and increased physical activity (PA) are generally successful in producing clinically significant weight loss (≥5%) over 3-6 mos. However, weight maintenance (≥ 2 yrs.) continues to be problematic, due in part to an inability of individuals to continue adherence to diet and PA recommendations. It is hypothesized that neurocognitive processes, specifically executive functions (EFs, i.e., inhibition, working memory, mental flexibility), underlie self-regulation, self-efficacy, and are essential for the adoption and maintenance of health behaviors. Behavioral weight loss programs generally attempt to improve self-regulation; however, these skills are difficult to implement long-term. Strengthening EFs through cognitive training may improve weight maintenance by improving self-efficacy and self-regulation, resulting in improved program attendance and improved adherence to dietary and PA recommendations. Although randomized trials have not been conducted to specifically evaluate this hypothesis, results from the available literature suggest the potential for cognitive training to improve weight maintenance.
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Affiliation(s)
- Amanda N Szabo-Reed
- Department of Weight Management, Division of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
| | - Joseph E Donnelly
- Department of Weight Management, Division of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
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Jiménez-Zazo F, Romero-Blanco C, Castro-Lemus N, Dorado-Suárez A, Aznar S. Transtheoretical Model for Physical Activity in Older Adults: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249262. [PMID: 33322327 PMCID: PMC7763623 DOI: 10.3390/ijerph17249262] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 12/11/2022]
Abstract
Healthy aging makes the practice of physical activity (PA) a necessity. However, PA guidelines achievement in older adults is scarce. The use of behavioral theories such as Transtheoretical Model (TTM), helps in older adults PA promotion. The aim of this review was to identify the use of TTM for PA in older adults (>60 years). PubMed, SPORTdiscus, and Medline databases were used to conduct the search. All steps of the process followed the recommendations of the PRISMA flow-diagram. We identified eight studies: Six were descriptive cross-sectional studies, one prospective-cohort study and one with a quasi-experimental design. Only two papers evaluated the four behavior change dimensions within the same study, three evaluated the processes of change and the decisional balance, four evaluated the exercise self-efficacy and all assessed the stages of change for PA behavior. From this review, we can conclude that TTM is a useful and suitable behavior model in creating, developing, and evaluating interventions with the aim of acquiring and improving PA habits in the older adults. However, there is paucity of research in this area, and more studies including the four behavioral change dimensions are needed to analyze the effect of TTM on the promotion of PA in the older adults.
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Affiliation(s)
- Fabio Jiménez-Zazo
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (F.J.-Z.); (A.D.-S.)
| | - Cristina Romero-Blanco
- PAFS Research Group, Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Nuria Castro-Lemus
- FENIX Research Group, Faculty of Sports Sciences, University of Sevilla, 41004 Sevilla, Spain;
| | - Alberto Dorado-Suárez
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (F.J.-Z.); (A.D.-S.)
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (F.J.-Z.); (A.D.-S.)
- Correspondence:
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Eshah NF, Mosleh SM, Al-Smadi A. The Decisional Balance Toward Health Behaviors Among Patients With Hypertension. Clin Nurs Res 2020; 30:977-984. [PMID: 33131320 DOI: 10.1177/1054773820967548] [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] [Indexed: 11/16/2022]
Abstract
The decisional balance is related to the transtheoretical model, and involves weighting the pros and cons of performing a behavior. The study aimed to assess hypertensive patients' decisional balances about smoking, weight control, and physical exercise. A cross-section descriptive correlation design was used, and 110 patients were recruited using convenience sampling in outpatient clinics. The decisional balance was measured using "Decisional Balance Scales," which assess an individual's decisional balance related to smoking, weight control, and physical exercise behaviors. The results predicted that Jordanian hypertensive patients with higher physical exercise decisional balance and higher weight decisional balance had lower smoking decisional behaviors. Nurses can foster health promotion and behavioral change by employing interventions that improve decisional balances. Improving the decisional balance of one behavior would have a positive impact on other behaviors. Thus, designing multidimensional interventions might be effective for modifying different types of health behaviors, and fostering health promotion practices.
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Affiliation(s)
| | - Sultan M Mosleh
- Faculty of Nursing, Mutah University, Jordan, UAE.,Higher colleges of Technology, Fujairah, UAE
| | - Ahmed Al-Smadi
- Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
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Psychometric Properties of the Decisional Balance Scale: A Confirmatory Study on Malaysian University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082748. [PMID: 32316170 PMCID: PMC7215421 DOI: 10.3390/ijerph17082748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/03/2022]
Abstract
Decisional balance (DB) is the perceived positive aspects (advantages) and negative aspects (disadvantages) that are associated with behavioural change. Behavioural change is dependent on an individual’s thoughts after considering the advantages of engaging in exercise. When the benefits exceed the barriers, people are more likely to make changes after cognitively evaluating the functional aspects. The purpose of the present study is to determine the validity and reliability of the DB scale among Malaysian university students using a confirmatory factor analysis (CFA). A cross-sectional study was carried out among students who took part in the co-curricular program. By using the purposive sampling method, students were recruited and given written informed consent forms after acknowledging they understood the purpose of the study. The DB scale, which consists of two factors, namely, advantages and disadvantages, was used as the instrument in the study. The advantages referred to the benefits of participating in exercise, whereas the disadvantages referred to the barriers to exercise. The 10-item, self-administered questionnaires were distributed to participating students. Data were analysed using Mplus 8 for the CFA. A total of 562 students (females = 444, males = 118) with a mean age of 19.81 years (SD = 1.22) participated in the study. Most of the students were engaged in regular physical activity for at least three exercise sessions (mean = 2.62) per week, and the average duration per session was 43 minutes. The hypothesised measurement model of DB did not fit the data well; thus, the measurement model was re-specified. The final measurement model fit the data well (comparative fit index (CFI) = 0.960, Tucker–Lewis index (TLI) = 0.943, standardised root mean square residual (SRMR) = 0.055, root mean square error of approximation (RMSEA) (90% confidence interval (CI)) = 0.061 (0.047, 0.074), RMSEA p-value = 0.096). The composite reliability values of 0.757 for the advantages and 0.792 for the disadvantages were acceptable. The 10-item DB scale with two factors displayed a good model fit for the data with good scale reliability. This could be beneficial for Malaysian undergraduate students in making decisions before engaging in physical activity. The benefits of, and barriers to, exercise could be an important component that affects their decision making.
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Ottoboni G, Gallelli T, Mariani E, Rebecca Soluri V, Nunziata S, Tessari A, Savary JP, Chattat R. Remote home physical training for seniors: guidelines from the AAL-supported MOTION project. Eur J Ageing 2018; 16:25-37. [PMID: 30886558 DOI: 10.1007/s10433-018-0477-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
European population will face an unprecedented aging era in the next years. Albeit aging in itself is a success goal, it may bring with it a general decline and functional limitations. In order to decelerate such decline, one of the most efficient strategies is physical activity. The present paper reports the insight emerging from three focus-group interviews organized at the beginning of the MOTION-Remote Home Physical Training for Seniors project, whose main aim regarded the implementation of an ICT system capable of offering home-based gym sessions to healthy seniors. The sixteen interview participants (11 females and 5 males, averaged age 72.3) provided several indications, which were grouped into the following themes: (1) ICT technical characteristics; (2) Platform accessibility; (3) Physical program features; (4) Psychological factors. At the end of the thematic analysis, results suggest that theoretical frameworks mainly focusing on ICT issues might be insufficient to endorse the successful development and maintenance of ICT systems such as MOTION, which challenges seniors to accept ICT while staying committed to the physical exercise program .
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Affiliation(s)
- Giovanni Ottoboni
- 1Department of Psychology, University of Bologna, Viale Berti Pichat, 5, 42127 Bologna, Italy
| | | | - Elena Mariani
- 1Department of Psychology, University of Bologna, Viale Berti Pichat, 5, 42127 Bologna, Italy
| | | | | | | | | | - Rabih Chattat
- 1Department of Psychology, University of Bologna, Viale Berti Pichat, 5, 42127 Bologna, Italy
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