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Lee S, Quinn L, Fritschi C, Fink AM, Park C, Reutrakul S, Collins EG. Physical Activity After Heart Surgery: Associations With Psychosocial and Sleep Factors. West J Nurs Res 2024; 46:333-343. [PMID: 38533821 DOI: 10.1177/01939459241240432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Heart surgery is an effective intervention for managing heart disease, the leading cause of death globally. After surgery, physical activity is key to improving patients' quality of life and decreasing mortality, but patients are frequently physically inactive after heart surgery. OBJECTIVE This cross-sectional pilot study aimed to examine how psychosocial and sleep factors influenced physical activity in patients after heart surgery. The mediating role of sleep factors between psychosocial factors and physical activity was also examined. METHODS Thirty-three patients who had undergone heart surgery were recruited. Psychosocial and sleep factors and physical activity were measured using an online survey and a wrist-worn ActiGraph for 7 days and nights. RESULTS The participants had heart surgery an average of about 7 years previously. They exceeded the recommended 150 minutes per week of moderate-intensity physical activity for Americans; however, 64% of them showed poor sleep quality (Pittsburgh Sleep Quality Index >5). Higher anxiety and depressive symptoms, lower self-efficacy, and greater sleep disturbances were associated with lower physical activity. Moreover, self-efficacy, sleep duration, sleep disturbance, sleep efficiency, and wake after sleep onset were predictors for physical activity. No mediating role of sleep factors was observed between psychosocial factors and physical activity. CONCLUSIONS Psychosocial and sleep factors should be considered when developing and implementing physical activity strategies for patients after heart surgery. Researchers should examine the relationships among the study variables with larger samples of postsurgical cardiac patients during different periods after heart surgery.
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Affiliation(s)
- Sueyeon Lee
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA
| | - Lauretta Quinn
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Cynthia Fritschi
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Anne M Fink
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Chang Park
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Sirimon Reutrakul
- Department of Medicine, University of Illinois Chicago, Chicago, IL, USA
| | - Eileen G Collins
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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Abstract
This study examined the impact of group composition of a 6-week group-based employee Fitbit intervention on daily physical activity steps. Group composition comprised heterogenous and homogeneous groupings based on variations in baseline high, medium, and low steppers. The intervention included weekly step leaderboard information, motivational and informative messages, and the ability to participate in group step challenges. Repeated measures analysis of variance (ANOVA) examined differences in change of steps across time, step-level groups (low, medium, and high), and group composition (low/high, similar, and mixed), and replicated with a subgroup of participants who participated in group step challenges. While group and step level did not emerge as significant interactions in the overall sample, when focused within the group step challenge subsample, relationships among time, the group composition, and participant step-level categories emerged. Overall, the greatest increases in steps occurred at the mid-point time period, among lower steppers, and within the low/high comparison group. This study provides evidence of the importance of group composition in physical activity interventions as well as the fidelity of intervention design in facilitating group comparisons.
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Brennan C, O’Donoghue G, Keogh A, Rhodes RE, Matthews J. "It's what mothers do." A qualitative exploration of mothers' experiences of supporting their daughter to be physically active. PLoS One 2024; 19:e0299260. [PMID: 38558034 PMCID: PMC10984520 DOI: 10.1371/journal.pone.0299260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/07/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE Girls are more at risk than boys of the non-communicable diseases associated with insufficient levels of physical activity (PA), therefore it is important to explore the reasons why girls maintain or cease to be physically active. Maternal support plays an important role in girl's PA, yet the factors influencing mothers' support of their PA have received limited exploration. In response, the aim of this study was to explore, mothers' experiences of supporting their daughters to be physically active and their perceptions of the factors that might influence these experiences. METHOD Semi-structured interviews were conducted with a purposive sample of mothers (n = 29) of girls (Mean age = 10.9 years; SD = 0.6). Reflexive Thematic Analysis was used to analyse the data, with themes mapped to the relevant domains of the Theoretical Domains Framework. RESULTS Themes highlighted how mothers described providing PA support as an inherent part of their parental role and how their role was influenced by their own PA identity. Mothers recognised that the type and amount of support they provided was impacted by the community setting in which they lived. Mothers acknowledged how the role of others (e.g., partners, grandparents, peers) added a layer of complexity to supporting their daughters to be active. CONCLUSION This study advances our understanding of maternal PA support behaviours recognising the complex interplay of individual, social and environmental factors. Additionally, the use of the Theoretical Domains Framework presents an in-depth behavioural diagnosis which can be used to inform future theory-based interventions to promote parent support of children's PA.
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Affiliation(s)
- Carol Brennan
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Grainne O’Donoghue
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Alison Keogh
- School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Ryan E. Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, Canada
| | - James Matthews
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
- Institute of Sport and Health, University College Dublin, Dublin, Ireland
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Regan-Moriarty J, Hardcastle S, McCallion M, Youell A, Collery A, McCarren A, Moyna N, Kehoe B. 'The illness isn't the end of the road'-Patient perspectives on the initiation of and early participation in a multi-disease, community-based exercise programme. PLoS One 2024; 19:e0291700. [PMID: 38551937 PMCID: PMC10980187 DOI: 10.1371/journal.pone.0291700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/14/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Exercise is the cornerstone of cardiac rehabilitation (CR). Hospital-based CR exercise programmes are a routine part of clinical care and are typically 6-12 weeks in duration. Following completion, physical activity levels of patients decline. Multi-disease, community-based exercise programmes (MCEP) are an efficient model that could play an important role in the long-term maintenance of positive health behaviours in individuals with cardiovascular disease (CVD) following their medically supervised programme. AIM To explore patients experiences of the initiation and early participation in a MCEP programme and the dimensions that facilitate and hinder physical activity engagement. METHODS Individuals with established CVD who had completed hospital-based CR were referred to a MCEP. The programme consisted of twice weekly group exercise classes supervised by clinical exercise professionals. Those that completed (n = 31) an initial 10 weeks of the programme were invited to attend a focus group to discuss their experience. Focus groups were transcribed and analysed using reflexive thematic analysis. RESULTS Twenty-four (63% male, 65.5±6.12yrs) patients attended one of four focus groups. The main themes identified were 'Moving from fear to confidence', 'Drivers of engagement,' and 'Challenges to keeping it (exercise) up'. CONCLUSION Participation in a MCEP by individuals with CVD could be viewed as a double-edged sword. Whilst the programme clearly provided an important transition from the clinical to the community setting, there were signs it may breed dependency and not effectively promote independent exercise. Another novel finding was the use of social comparison that provided favourable valuations of performance and increased exercise confidence.
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Affiliation(s)
- Joanne Regan-Moriarty
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| | - Sarah Hardcastle
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, United Kingdom
| | - Maire McCallion
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| | - Azura Youell
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| | | | - Andrew McCarren
- School of Computing, Dublin City University, Dublin, Ireland
| | - Niall Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Brona Kehoe
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
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Lee S, Lahoda K, Myers ND, Horowitz A, Chiu K, Begdache L, Einav E. Physical activity self-efficacy online intervention for adults with obesity: protocol for a feasibility study. Pilot Feasibility Stud 2024; 10:40. [PMID: 38409075 PMCID: PMC10895849 DOI: 10.1186/s40814-024-01468-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Even without weight loss, adults with obesity can greatly benefit from regular physical activity. The Physical Activity Self-efficacy (PAS) intervention is an online behavioral intervention newly developed to promote physical activity in adults with obesity by providing capability-enhancing learning opportunities. The objective of this manuscript is to describe the protocol for a feasibility study designed to investigate the feasibility and acceptability of implementing the PAS online intervention for adults with obesity recruited from a local weight management center in the United States of America (USA). METHODS The study design is a prospective, double-blind, parallel-group individual randomized pilot trial. Thirty participants will be randomly assigned to the PAS group or usual care group to achieve a 1:1 group assignment. Recruitment of participants is scheduled to begin on 1 March 2024 at a local weight management center within a private healthcare system in the USA. There are six eligibility criteria for participation in this study (e.g., a body mass index ≥ 25.00 kg/m2). Eligibility verification and data collection will be conducted online. Three waves of data collection will take up to 14 weeks depending on participants' progress in the study. The primary feasibility outcomes in the study will be: (a) participation rate, (b) engagement behavior, and (c) a preliminary effect size estimate for the effect of the PAS intervention on physical activity. Instruments designed to measure demographic information, anthropometric characteristics, self-efficacy, and acceptability will be included in the survey battery. A research-grade accelerometer will be used to measure free-living physical activity objectively. Data will be analyzed using descriptive statistics and inferential statistical models under an intention-to-treat approach. DISCUSSION Results are intended to inform the preparation of a future definitive randomized controlled trial. TRIAL REGISTRATION ClinicalTrials.gov, NCT05935111, registered 7 July 2023.
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Affiliation(s)
- Seungmin Lee
- Division of Health and Wellness Studies, Binghamton University, Binghamton, USA.
| | - Kevin Lahoda
- Department of Art, Architecture and Design, Lehigh University, Bethlehem, USA
| | - Nicholas D Myers
- Department of Kinesiology, Michigan State University, East Lansing, USA
| | - Andrew Horowitz
- Department of Theatre, Binghamton University, Binghamton, USA
| | - Kenneth Chiu
- Department of Computer Science, Binghamton University, Binghamton, USA
| | - Lina Begdache
- Division of Health and Wellness Studies, Binghamton University, Binghamton, USA
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Swink LA, Mealer ML, Miller MJ, Anderson CB, Cook PF, Stevens-Lapsley JE, Christiansen CL. Telehealth Walking Self-Management for Individuals With Amputation: A Qualitative Study of Therapist Perspectives on Adoption. Phys Ther 2024; 104:pzad155. [PMID: 37944092 PMCID: PMC10902556 DOI: 10.1093/ptj/pzad155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 09/01/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE The aim of this study was to understand therapist-identified factors influencing clinical adoption of a telehealth walking self-management intervention for individuals with lower limb amputation. METHODS Semi-structured focus groups were completed with actively practicing physical and occupational therapists treating populations that are medically complex. A qualitative explorative design was employed with conventional content analysis and iterative independent parallel coding using 2 analysts. Themes and subthemes were generated with a consensus building process identifying patterns and collapsing codes to represent participant perspectives. RESULTS Thematic saturation was met after 5 focus groups (24 therapists). Therapists were on average 34 years old and predominantly female (n = 19; 79%) physical therapists (n = 17; 71%). Three primary facilitator and barrier themes were identified for intervention adoption: system, therapist, and person. System considerations included telehealth support and interprofessional care coordination. Therapist facilitators included self-management programming that overlapped with standard of care and personalization methods. However, limited behavioral theory training was a therapist level barrier. Finally, person factors such as patient activation could influence both positively and negatively. Person facilitators included social support and barriers included the complex health condition. CONCLUSION System, therapist, and person facilitators and barriers must be considered to maximize the adoption of similar telehealth walking self-management interventions and prior to larger scale implementation of the current intervention for individuals with lower limb amputation. IMPACT A telehealth walking self-management intervention has potential impact for individuals with lower limb amputation and must be considered in terms of optimizing system, therapist, and person level facilitators and barriers to implementation.
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Affiliation(s)
- Laura A Swink
- Geriatric Research Education and Clinical Center (GRECC), VA Eastern Colorado Healthcare System, Aurora, Colorado, USA
- Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado, USA
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
| | - Meredith L Mealer
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Aurora, Colorado, USA
| | - Matthew J Miller
- School of Medicine, University of California, San Francisco, California, USA
| | - Chelsey B Anderson
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital, Cincinnati, Ohio, USA
| | - Paul F Cook
- College of Nursing, University of Colorado, Aurora, Colorado, USA
| | - Jennifer E Stevens-Lapsley
- Geriatric Research Education and Clinical Center (GRECC), VA Eastern Colorado Healthcare System, Aurora, Colorado, USA
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
| | - Cory L Christiansen
- Geriatric Research Education and Clinical Center (GRECC), VA Eastern Colorado Healthcare System, Aurora, Colorado, USA
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
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Kekäläinen T, Pulkka AT, Kyröläinen H, Ojanen T, Helén J, Pihlainen K, Heikkinen R, Vaara JP. Exercise self-efficacy remains unaltered during military service. Front Psychol 2024; 15:1307979. [PMID: 38348257 PMCID: PMC10859872 DOI: 10.3389/fpsyg.2024.1307979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024] Open
Abstract
Background Exercise self-efficacy is a crucial aspect of adopting and maintaining a physically active lifestyle. Regular physical activity may enhance exercise self-efficacy. This study aimed to investigate the baseline associations of physical fitness, physical activity, and body composition with exercise self-efficacy and the effects of military service on exercise self-efficacy. Methods: The sample consisted of healthy young Finnish conscripts (n = 243) undergoing military service. The participants were divided into two groups: an intervention group undergoing a high-intensity functional training program (n = 113) and a control group undergoing traditional physical training within their military service (n = 130). Exercise self-efficacy (adoption and barrier) and aerobic and muscular fitness were measured thrice (baseline, month 3, and month 5). Self-reported leisure-time physical activity and measured fat percentage were collected at baseline. Results Adoption and barrier exercise self-efficacy correlated positively with aerobic and muscular fitness and leisure time physical activity (r = 0.33-0.59, p < 0.001), and barrier self-efficacy negatively with fat percentage (r = -0.15, p < 0.05) at baseline. No changes in adoption (time p = 0.912) and barrier self-efficacy (time p = 0.441) occurred during the military service. There were no differences between groups in these changes (group × time interaction p = 0.643 for adoption self-efficacy and p = 0.872 for barrier self-efficacy). Change in muscular fitness correlated positively with change in barrier self-efficacy in the high-intensity functional training group (r = 0.35, p < 0.05). Conclusions: Exercise self-efficacy is positively associated with physical fitness and physical activity among young males. However, military service, whether it involves high-intensity functional physical training or more diverse traditional physical training, does not improve exercise self-efficacy.
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Affiliation(s)
- Tiia Kekäläinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Antti-Tuomas Pulkka
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | - Heikki Kyröläinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | - Tommi Ojanen
- Human Performance Division, Finnish Defence Research Agency, Tuusula, Finland
| | - Joonas Helén
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | - Kai Pihlainen
- Training Division, Defence Command, Finnish Defence Forces, Helsinki, Finland
| | - Risto Heikkinen
- Statistical Analysis Services, Analyysitoimisto Statisti Oy, Jyväskylä, Finland
| | - Jani P. Vaara
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
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Fitter NT, Mohan M, Preston RC, Johnson MJ, Kuchenbecker KJ. How should robots exercise with people? Robot-mediated exergames win with music, social analogues, and gameplay clarity. Front Robot AI 2024; 10:1155837. [PMID: 38283804 PMCID: PMC10813396 DOI: 10.3389/frobt.2023.1155837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 11/08/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction: The modern worldwide trend toward sedentary behavior comes with significant health risks. An accompanying wave of health technologies has tried to encourage physical activity, but these approaches often yield limited use and retention. Due to their unique ability to serve as both a health-promoting technology and a social peer, we propose robots as a game-changing solution for encouraging physical activity. Methods: This article analyzes the eight exergames we previously created for the Rethink Baxter Research Robot in terms of four key components that are grounded in the video-game literature: repetition, pattern matching, music, and social design. We use these four game facets to assess gameplay data from 40 adult users who each experienced the games in balanced random order. Results: In agreement with prior research, our results show that relevant musical cultural references, recognizable social analogues, and gameplay clarity are good strategies for taking an otherwise highly repetitive physical activity and making it engaging and popular among users. Discussion: Others who study socially assistive robots and rehabilitation robotics can benefit from this work by considering the presented design attributes to generate future hypotheses and by using our eight open-source games to pursue follow-up work on social-physical exercise with robots.
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Affiliation(s)
- Naomi T. Fitter
- Collaborative Robotics and Intelligent Systems (CoRIS) Institute, Oregon State University, Corvallis, OR, United States
| | - Mayumi Mohan
- Haptic Intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart, Germany
| | - Rhian C. Preston
- Collaborative Robotics and Intelligent Systems (CoRIS) Institute, Oregon State University, Corvallis, OR, United States
| | - Michelle J. Johnson
- Rehabilitation Robotics Lab, Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA, United States
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Symons M, Vandebosch H, Poels K. Boosts for walking: how humorous messages increase brisk walking among cognitively fatigued individuals. BMC Public Health 2024; 24:128. [PMID: 38195517 PMCID: PMC10775479 DOI: 10.1186/s12889-023-17464-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND A well-studied internal barrier to regular physical activity, and more specifically brisk walking, is cognitive fatigue. However, thus far little research examined how cognitively fatigued individuals can be motivated to exercise, more specifically to engage in brisk walking. This study investigates whether humorous intervention messages might be an effective strategy to motivate cognitively fatigued individuals to brisk walk, and through which underlying processes. METHODS An online experiment was performed in which variation in cognitive fatigue was induced through mental arithmetic questions. Afterwards, participants (n = 250) recruited through Prolific, randomly received either humorous or non-humorous intervention messages related to brisk walking. Potential mediators of the relations between physical activity, humour and cognitive fatigue were measured, were self-efficacy, self-control, and motivation. RESULTS First, regression analyses confirmed that cognitive fatigue negatively influences brisk walking intentions and that the perceived humour of the intervention messages moderated this relationship. Second, results showed that self-control and self-efficacy are mediators explaining the relationship between cognitive fatigue and brisk walking intentions. Lastly, this study found that perceived humour of the intervention messages moderated the relationship between cognitive fatigue and self-control, indicating that perceptions of self-control were positively changed after receiving messages that were perceived as humorous compared to messages that were not perceived as humorous, subsequently increasing brisk walking intentions. CONCLUSIONS This study is the first to unravel the underlying relationship between humorous intervention messages and brisk walking intentions through positive changes in perceptions of self-control within a cognitively fatigued sample. Results of this study suggest that existing smartphone applications monitoring and promoting brisk walking should integrate tailored message strategies within their cues to brisk walk by implementing humour as a strategy to motivate users when they are cognitively fatigued.
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Affiliation(s)
- Michelle Symons
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium.
| | - Heidi Vandebosch
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Karolien Poels
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
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Knudsen SDP, Roland CB, Alomairah SA, Jessen AD, Maindal HT, Bendix JM, Clausen TD, Løkkegaard E, Stallknecht B, Molsted S. The effect of exercise training and motivational counselling on physical activity behaviour and psychosocial factors in pregnant women: secondary analyses of the FitMum randomised controlled trial investigating prenatal physical activity. BMC Public Health 2024; 24:92. [PMID: 38178045 PMCID: PMC10768443 DOI: 10.1186/s12889-023-17525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND A physically active lifestyle is beneficial during pregnancy. However, little is known about physical activity (PA) behaviour and psychosocial factors in women during and after pregnancy. This study examined exercise behavioural regulation, exercise self-efficacy, health-related quality of life, sickness absence and musculoskeletal pain in pregnant women offered either structured supervised exercise training, motivational counselling on PA, or standard prenatal care in the FitMum randomised controlled trial. METHODS Two hundred and eighteen healthy inactive pregnant women were randomised to structured supervised exercise training (n = 87), motivational counselling on PA (n = 86) or standard prenatal care (n = 45). The women answered the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2), the Pregnancy Exercise Self-Efficacy Scale (P-ESES-DK) and the Short Form 36 Health Survey Questionnaire (SF-36) at baseline (gestational age (GA) of max 15 weeks), GA 28 and 34 weeks, and one year after delivery. Sickness absence and low back and/or pelvic girdle pain were likewise reported in questionnaires at baseline and GA 28 weeks. RESULTS Participants offered structured supervised exercise training or motivational counselling on PA had higher autonomous motivation for exercise during pregnancy compared with participants receiving standard prenatal care (e.g., difference in intrinsic regulation at GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 0.39 [0.16; 0.64], p < 0.001). Participants offered structured supervised exercise training also had higher exercise self-efficacy during pregnancy (e.g., GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 6.97 [2.05; 12.02], p = 0.005). All participants reported high exercise self-efficacy at baseline and medium exercise self-efficacy during pregnancy and one year after delivery. No differences were found between groups in health-related quality of life, sickness absence or low back and/or pelvic girdle pain during pregnancy. No group differences were found one year after delivery. CONCLUSION Structured supervised exercise training and motivational counselling on PA had important effects on autonomous exercise motivation during pregnancy. Exercise self-efficacy was also increased with structured supervised exercise training compared to standard prenatal care. No group differences in health-related quality of life, sickness absence, or pain were found during and after pregnancy. No effects were found one year post-delivery after intervention cessation. TRIAL REGISTRATION The study was approved by the Danish National Committee on Health Research Ethics (#H-18011067) and the Danish Data Protection Agency (#P-2019-512). The study adheres to the principles of the Helsinki declaration. Written informed consent was obtained at inclusion.
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Affiliation(s)
- Signe de Place Knudsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.
| | - Caroline Borup Roland
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Saud Abdulaziz Alomairah
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Public Health Department, Saudi Electronic University, College of Health Sciences, Riyadh, Saudi Arabia
| | - Anne Dsane Jessen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Jane M Bendix
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Research, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Tine D Clausen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ellen Løkkegaard
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Newsome A, Gilliard T, Phillips A, Dedrick R. Understanding the perceptions of sedentary college students' engagement in physical activity: application of the theory of planned behavior. J Am Coll Health 2023; 71:2813-2822. [PMID: 34788584 DOI: 10.1080/07448481.2021.1998069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 08/30/2021] [Accepted: 10/17/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To understand salient beliefs related to physical activity (PA) in sedentary college students. PARTICIPANTS Thirty-seven students from a large research university participating in a larger research project were subsequently invited to participate in small focus groups. METHODS Using the Theory of Planned Behavior as a framework, semi-structured focus groups were conducted to understand the perceptions of using mobile technology as a tool to increase PA. RESULTS A grounded theory approach revealed that students generally had positive attitudes about PA and relied heavily on social support as a facilitator of PA behavior change. The structured exercise program delivered via the mobile app increased perceived behavioral control. Other key findings include academic barriers, desire to avoid chronic disease, and inconsistent efficacy of the mobile application among this population. CONCLUSIONS Interventions designed to increase PA in this population should focus on structured activity, increased self-monitoring, positive outcome expectancies, and social support.
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Affiliation(s)
- A'Naja Newsome
- College of Education, University of South Florida, Tampa, Florida, USA
| | - Tiffany Gilliard
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Amelia Phillips
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Robert Dedrick
- College of Education, University of South Florida, Tampa, Florida, USA
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Maes I, Mertens L, Poppe L, Vetrovsky T, Crombez G, De Backere F, Brondeel R, Van Dyck D. Within-Person Associations of Accelerometer-Assessed Physical Activity With Time-Varying Determinants in Older Adults: Time-Based Ecological Momentary Assessment Study. JMIR Aging 2023; 6:e44425. [PMID: 37995131 DOI: 10.2196/44425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/02/2023] [Accepted: 10/10/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Despite the availability of physical activity (PA) interventions, many older adults are still not active enough. This might be partially explained by the often-limited effects of PA interventions. In general, health behavior change interventions often do not focus on contextual and time-varying determinants, which may limit their effectiveness. However, before the dynamic tailoring of interventions can be developed, one should know which time-dependent determinants are associated with PA and how strong these associations are. OBJECTIVE The aim of this study was to examine within-person associations between multiple determinants of the capability, opportunity, motivation, and behavior framework assessed using Ecological Momentary Assessment (EMA) and accelerometer-assessed light PA, moderate to vigorous PA, and total PA performed at 15, 30, 60, and 120 minutes after the EMA trigger. METHODS Observational data were collected from 64 healthy older adults (36/64, 56% men; mean age 72.1, SD 5.6 y). Participants were asked to answer a time-based EMA questionnaire 6 times per day that assessed emotions (ie, relaxation, satisfaction, irritation, and feeling down), the physical complaint fatigue, intention, intention, and self-efficacy. An Axivity AX3 was wrist worn to capture the participants' PA. Multilevel regression analyses in R were performed to examine these within-person associations. RESULTS Irritation, feeling down, intention, and self-efficacy were positively associated with subsequent light PA or moderate to vigorous PA at 15, 30, 60, or 120 minutes after the trigger, whereas relaxation, satisfaction, and fatigue were negatively associated. CONCLUSIONS Multiple associations were observed in this study. This knowledge in combination with the time dependency of the determinants is valuable information for future interventions so that suggestions to be active can be provided when the older adult is most receptive.
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Affiliation(s)
- Iris Maes
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Lieze Mertens
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Louise Poppe
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Fund for Scientific Research Flanders, Brussels, Belgium
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Femke De Backere
- Department of Information Technology, Ghent University, Ghent, Belgium
| | - Ruben Brondeel
- Department of Epidemiology of Infectious Diseases, Belgian Institute for Health (Sciensano), Brussels, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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Zhou Y, Gao W, Gao S, Guo X, Liu M, Cao C. Pain Catastrophizing, Kinesiophobia and Exercise Adherence in Patients After Total Knee Arthroplasty: The Mediating Role of Exercise Self-Efficacy. J Pain Res 2023; 16:3993-4004. [PMID: 38026453 PMCID: PMC10676101 DOI: 10.2147/jpr.s432106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose To examine whether exercise self-efficacy mediates the contributions of pain catastrophizing and kinesiophobia to exercise adherence in patients after total knee arthroplasty. Patients and Methods A cross-sectional study design was conducted. A total 211 post-total knee arthroplasty patients were recruited from three orthopedics units of a tertiary hospital in China. Participants were invited to complete questionnaires on pain catastrophizing, kinesiophobia, exercise self-efficacy, and exercise adherence. Mplus 8.3 software was used to construct mediation models. Results Pain catastrophizing and kinesiophobia were negatively correlated with exercise adherence (r = -0.509, r = -0.605, p < 0.001 respectively), while exercise self-efficacy were positively associated with exercise adherence (r = 0.799, p < 0.001). The results found exercise self-efficacy mediated the correlations of pain catastrophizing and kinesiophobia with exercise adherence after adjusting for demographic and clinical covariates. Pain catastrophizing indirectly affected patients' exercise adherence through its effect on exercise efficacy (indirect effect: -0.412), while Kinesiophobia is directly associated with exercise adherence and also indirectly through exercise self-efficacy (direct effect: -0.184, indirect effect: -0.415). Conclusion Patients after total knee arthroplasty who have high levels of psychological distress (pain catastrophizing and kinesiophobia) are vulnerable to be non-adherent to exercise behaviors. Exercise self-efficacy explains the effects of pain catastrophizing and kinesiophobia on exercise adherence and may be a key target for measures to improve exercise behaviors in patients after total knee arthroplasty.
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Affiliation(s)
- Yi Zhou
- School of Nursing, Langfang Health Vocational College, Langfang, Hebei, People’s Republic of China
| | - Weina Gao
- Department of Orthopedics, Baoding No.1 Central Hospital, Baoding, Hebei, People’s Republic of China
| | - Shumin Gao
- Department of Orthopedics, Baoding No.1 Central Hospital, Baoding, Hebei, People’s Republic of China
| | - Xutong Guo
- Department of Orthopedics, Baoding No.1 Central Hospital, Baoding, Hebei, People’s Republic of China
| | - Meng Liu
- Department of Orthopedics, Baoding No.1 Central Hospital, Baoding, Hebei, People’s Republic of China
| | - Congjie Cao
- School of Nursing, Langfang Health Vocational College, Langfang, Hebei, People’s Republic of China
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Bentlage E, Nyamadi JJ, Dubbeldam R. The Importance of Activating Factors in Physical Activity Interventions for Older Adults Using Information and Communication Technologies: Systematic Review. JMIR Mhealth Uhealth 2023; 11:e42968. [PMID: 37933182 PMCID: PMC10644949 DOI: 10.2196/42968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/14/2023] [Accepted: 08/04/2023] [Indexed: 11/08/2023] Open
Abstract
Background In an aging population, it is important to activate older adults in taking care of their own health. Increasing physical activity is one way to avoid or lessen age-related physical and mental impairments. Interest in the use of information and communication technology (ICT) tools to promote physical activity among older adults is growing considerably. Such tools are suitable for communicating activation factors-skills, knowledge, and motivation-by integrating a variety of behavior change techniques (BCTs) to enhance physical activity. Although activation factors have been incorporated into physical activity interventions using ICT, little is known about the actual integration methods used in such interventions or about the effects of activation factors on influencing behavior change. Objective The first aim of this study was to identify which of the activation factors were covered in physical activity-promoting ICT interventions for older adults and which BCTs were used to address them. The second objective was to classify the user interaction interfaces and delivery modes that were used to promote these activation factors. Methods The search engines of PubMed, Web of Science, and ScienceDirect were used to search for and identify articles examining the effectiveness of ICT interventions for promoting physical activity in older adults. References and related data were selected, extracted, and reviewed independently by 2 reviewers. The risk of bias was assessed, and any conflict was addressed by a third separate reviewer. Selected articles included older adults aged ≥55 years without pre-existing medical diseases and other physical or mental conditions that could hinder movement. Results In total, 368 records were retrieved, and 13 studies met all inclusion criteria. Articles differed in terms of themes, timescales, user interaction interfaces, and outcome measures; therefore, a quantitative data synthesis was not feasible. Motivation was the most promoted activation factor among all trials (33 times). An app and a smartwatch were used in the majority of intervention groups (7/20, 35%) for tracking physical activity and receiving personalized feedback based on the individual goals. Skills (25 times) and knowledge (17 times) were the next most commonly addressed activation factors. Face-to-face interaction was the most used approach to targeting users' skills, including providing instructions on how to perform a behavior and exchanging knowledge via education on the health consequences of insufficient physical activity. Overall, integrating all 3 activation factors and using multiple user interaction interfaces with a variety of delivery modes proved the most effective in improving physical activity. Conclusions This study highlights commonly used BCTs and preferred modes of their delivery. So far, only a limited number of available BCTs (21/99, 21%) have been integrated. Considering their effectiveness, a larger variety of BCTs that address skills, knowledge, and motivation should be exploited in future ICT interventions.
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Affiliation(s)
- Ellen Bentlage
- Department of Movement Science, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - John Jnr Nyamadi
- Department of Movement Science, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Rosemary Dubbeldam
- Department of Movement Science, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
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Perry CK, Seguin-Fowler R, Maddock JE, Lenstra N, Dieckmann NF, Currier J, Andreyeva E, Winkle J, Trost SG. Rural libraries implementing walking groups or walking groups plus civic engagement for walkability in rural communities: a comparative effectiveness trial study protocol. BMC Public Health 2023; 23:1895. [PMID: 37784086 PMCID: PMC10544451 DOI: 10.1186/s12889-023-16788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Rural residents generally lack adequate physical activity to benefit health and reduce disparities in chronic diseases, such as cardiovascular disease and certain cancers. The Socioecological Model describes physical activity as involving a dynamic and reciprocal interaction between individual, social, and community factors. Community group-based walking programs and civic engagement interventions aimed at enhancing physical activity have been successful in rural communities but have not targeted all three socioecological levels. Public libraries can act as innovative public health partners in rural communities. However, challenges remain because rural libraries often lack the capacity to implement evidence-based health promotion programming. The goals of this study are (1) build the capacity for rural libraries to implement evidence-based health promotion programs, (2) compare changes in physical activity between a group-based walking program and a combined group-based walking and civic engagement program with rural residents, and (3) conduct an implementation evaluation. METHODS We will conduct a comparative effectiveness study of a group-based walking (standard approach) versus a group-based walking plus civic engagement program (combined approach) aimed at enhancing walkability to increase physical activity among rural adults. Key mediators between the program effects and change in outcomes will also be identified. Finally, we will evaluate program implementation, conduct a cost effectiveness evaluation, and use a positive deviance analysis to understand experiences of high and low changers on key outcomes. Twenty towns will be matched and randomized to one of the two conditions and our aim is to enroll a total of 350-400 rural residents (15-20 per town). Study outcomes will be assessed at baseline, and 6, 12, and 24 months. DISCUSSION This study will build the capacity of rural libraries to implement evidence-based walking programs as well as other health promotion programs in their communities. The study results will answer questions regarding the relative effectiveness and cost effectiveness of two multilevel physical activity interventions targeting rural communities. We will learn what works and how these multilevel interventions can be implemented in rural populations. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05677906.
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Affiliation(s)
- Cynthia K Perry
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA.
| | - Rebecca Seguin-Fowler
- Texas A & M University Institute for Advancing Health through Agriculture, 1500 Research Parkway, Centeq Building B, College Station, TX, 77845, USA
| | - Jay E Maddock
- Texas A & M University School of Public Health, 1266 TAMU, College Station, TX, 77843, USA
| | - Noah Lenstra
- University North Carolina Greensboro School of Education, 1300 Spring Garden St, Greensboro, NC, 27412, USA
| | - Nathan F Dieckmann
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Jessica Currier
- Knight Cancer Institute, Division of Oncological Sciences, Oregon Health & Science University, 2720 S. Moody Ave, Portland, OR, 97201, USA
| | - Elena Andreyeva
- Texas A & M University, 212 Adriance Lab Rd, College Station, TX, 77843, USA
| | - Jim Winkle
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld, 4072, Australia
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17
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Holler P, Carl J, van Poppel MN, Jaunig J. Development of the Perceived Physical Literacy Questionnaire (PPLQ) for the adult population. J Exerc Sci Fit 2023; 21:424-433. [PMID: 38028984 PMCID: PMC10661355 DOI: 10.1016/j.jesf.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 09/15/2023] [Accepted: 09/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background/objective In physical literacy (PL) research, instruments for the adult population covering all relevant domians are currently lacking in German language. Therefore, the Perceived Physical Literacy Questionnaire (PPLQ) was developed as an assessment instrument of PL for the adult population. The purpose of this study is to describe the multistage development process leading to the aim to evaluate the psychometric properties of the PPLQ. Methods Based on established questionnaires (subscales) operationalizing the six defined PL domains (motivation, confidence, physical competence, knowledge, understanding, and physical activity behavior), we generated a large item pool. Exploratory analyses on survey data (n = 506), compelemented through an expert panel, served to identify the best fitting items. Cognitive interviews (n = 7) and a language certification process (level A2) helped to enhance the content validity of the items. Finally, we assessed the hypothesized factor structure of the PPLQ and its convergent validity with the Physical Activity-related Health Competence (PAHCO) questionnaire in a second independent sample. Results Valid data of 417 adults (66% women, 48 ± 16 years) entered the confirmatory factor analysis. We found empirical support for a theory-compatible 24-item version, after reducing complexity (i.e., domain subscales). Additionally, the six domains could be subsumed under an overall factor for PL (χ2247 = 450.70, χ2/df = 1.83, CFIRobust = 0.895, RMSEARobust = 0.074 [CI90 = 0.063-0.085], SRMR = 0.064). Factor loadings, composite reliability, and discriminant validity were sufficient, while acceptable convergent validity was achieved for the total PL score and three domains. Conclusion The 24-item version of the PPLQ is appropriate for assessing PL among adults. However, some items (especially in the knowledge domain) can benefit from refinement in further studies.
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Affiliation(s)
- Peter Holler
- FH JOANNEUM - University of Applied Sciences, Institute of Health and Tourism Management, Kaiser-Franz-Josef-Straße 24, 8344, Bad Gleichenberg, Austria
- Sport Science Laboratory, FH JOANNEUM - University of Applied Sciences, 8344, Bad Gleichenberg, Austria
- University of Graz, Institute of Human Movement Science, Sport and Health, Mozartgasse 14, 8010, Graz, Austria
| | - Johannes Carl
- Friedrich-Alexander University Erlangen-Nürnberg, Department of Sport Science and Sport, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Mireille N.M. van Poppel
- University of Graz, Institute of Human Movement Science, Sport and Health, Mozartgasse 14, 8010, Graz, Austria
| | - Johannes Jaunig
- University of Graz, Institute of Human Movement Science, Sport and Health, Mozartgasse 14, 8010, Graz, Austria
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Yang X, Xiang Z, Zhang J, Song Y, Guo E, Zhang R, Chen X, Chen L, Gao L. Development and feasibility of a theory-guided and evidence-based physical activity intervention in pregnant women with high risk for gestational diabetes mellitus: a pilot clinical trial. BMC Pregnancy Childbirth 2023; 23:678. [PMID: 37726710 PMCID: PMC10510212 DOI: 10.1186/s12884-023-05995-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/13/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Physical activity has been utilized as an effective strategy to prevent gestational diabetes mellitus (GDM). However, most pregnant women with high risk for GDM did not achieve the recommended physical activity level. Furthermore, relevant physical activity protocols have varied without theory-guided and evidence-based tailored to pregnant women with high risk for GDM. This study aimed to develop and pilot test a theory-guided and evidence-based physical activity intervention protocol for pregnant women with high risk for GDM. METHODS The study design was guided by the Medical Research Council Framework for Developing and Evaluating Complex Intervention (the MRC framework). The preliminary protocol for physical activity intervention was developed based on self-efficacy theory, research evidence identified from systematic reviews and clinic trials, stakeholder engagement, context, and economic considerations. The preliminary intervention protocol was validated through a content validity study by an expert panel of 10 experts. A single-blinded randomized controlled trial (RCT) was designed to test the feasibility and acceptability of the intervention. RESULTS The validity of the preliminary intervention protocol was excellent as consensus was achieved. The final 13 sessions of self-efficacy enhancing physical activity intervention protocol were developed, including knowledge education, exercise clinic visits and video, and group discussions with face-to-face and online blended sessions. In the feasibility study, 34 pregnant women with high risk for GDM were randomized for the intervention (n = 17) or the control group (n = 17). The recruitment and retention rates were 82.9% and 58.9%, respectively. Women in the intervention group had a lower incidence of GDM (26.7% vs. 36.5%) than the control group (P >0.05). All participants were satisfied with the intervention and agreed that the intervention was helpful. CONCLUSIONS The developed self-efficacy-enhancing physical activity intervention is a feasible and acceptable intervention for enhancing physical activity among pregnant women with high risk for GDM and is ready to be tested in a more extensive RCT study. TRIAL REGISTRATION The study was registered on 4 February 2022 (ChiCTR2200056355) by the Chinese Clini Trial Registry (CHiCTR).
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Affiliation(s)
- Xiao Yang
- School of Nursing, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080 Guangdong Province P.R. China
| | - Zhixuan Xiang
- School of Nursing, Xiangtan Medicine & Health Vocational College, Xiangtan, China
| | - Ji Zhang
- Zhengzhou Maternal and Child Health Care Hospital, Zhengzhou, China
| | - Yingli Song
- Zhengzhou Maternal and Child Health Care Hospital, Zhengzhou, China
| | - Erfeng Guo
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Ruixing Zhang
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Xin Chen
- School of Nursing, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080 Guangdong Province P.R. China
| | - Lu Chen
- School of Nursing, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080 Guangdong Province P.R. China
| | - Lingling Gao
- School of Nursing, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080 Guangdong Province P.R. China
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Fu ACL, Sanders RH. The Effectiveness of Coaching the Australian Recommended Fundamental Overarm Throwing Skill Criteria for Less-Skilled Adolescents. Res Q Exerc Sport 2023; 94:886-894. [PMID: 35576129 DOI: 10.1080/02701367.2022.2070120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
Purpose: The aim of this study was to investigate the effects of coaching the Australian recommended fundamental overarm throwing skill criteria for less-skilled adolescents on movement competency using three-dimensional (3D) motion analysis. Methods: Less-skilled non-sports-active and skilled sports-active pupils were assigned to FMS Group (n = 97) and Sports Group (n = 129), respectively. Demographic, anthropometric, whole-body kinematic (discrete and time-series angular displacement and angular velocity data), motor coordination (segmental sequencing) and motor performance (maximum ball release speed) were analyzed. Baseline data were compared using independent T-tests and Chi-Square tests; interaction effects were assessed using repeated-measure ANOVAs. Changes in time-series kinematic data were analyzed by comparing the areas enclosed by the 95% confidence intervals. Results:There was merely a modest improvement in motor competency for the less-skilled pupils. The FMS group significantly acquired 13/75 discrete kinematic variables (p < .01) and four movement patterns but not motor coordination (p = .469) and motor performance (p = .756). Prior to the intervention, the pupils acquired 4/7 recommended skill criteria. The descriptions of another three criteria were not appropriate with no improvement in motor coordination and performance. Two new skills were identified and improved after the FMS intervention. Conclusions: The recommended skill criteria for children were not developmentally and age-appropriate for early adolescents. The use of quantitative 3D motion data provided a more precise and developmentally applicable fundamental overarm throwing criteria than content validated skill criteria. The recommended skill criteria should be modified to facilitate teachers and coaches for effective education.
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Schüler J, Stähler J, Wolff W. Mind-over-body beliefs in sport and exercise: A driving force for training volume and performance, but with risks for exercise addiction. Psychol Sport Exerc 2023; 68:102462. [PMID: 37665904 DOI: 10.1016/j.psychsport.2023.102462] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 04/04/2023] [Accepted: 05/05/2023] [Indexed: 09/06/2023]
Abstract
We assume that athletic success is associated with certain beliefs that on the one hand promote performance-enhancing behavior (training volume), but on the other hand can also be detrimental to health (sports addiction). These beliefs are succinctly characterized by the title of the 9-item "Mind-over-Body" scale presented here. They are the three beliefs that 1) athletic performance requires a high level of effort, 2) that willpower plays an important role in athletic success, and 3) that athletic success requires pain tolerance. A total of six web-survey-based studies with a total of 1121 participants (approximately gender parity), including individuals with different levels of athletic performance (no competition; amateur sport; regional, national, or international competition), examined the psychometric network and construct and criterion validity of the MoB scale. Exploratory graph analyses, which included the studies with the largest sample sizes, showed that the three belief components (effort, willpower, pain) form separable communities within the MoB network and that the MoB items form communities distinct from self-control and self-efficacy. Meta-analyzed correlations across all six studies showed low positive correlations with self-control and self-efficacy. In terms of criterion validity, MoB beliefs were positively correlated with training volume and exercise addiction. We discuss MoBs as "on the edge of unhealthy" and place MOBs within a framework of related but distinct concepts.
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Affiliation(s)
| | | | - Wanja Wolff
- University of Konstanz, Germany; University of Bern, Switzerland
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Mullan LJ, Blackburn NE, Gracey J, Dunwoody L, Lorimer J, Semple CJ. Evaluating the effects of lymphoedema management strategies on functional status and health-related quality of life following treatment for head and neck cancer: a systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01453-7. [PMID: 37648875 DOI: 10.1007/s11764-023-01453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Patients living with head and neck lymphoedema (HNL) after completion of head and neck cancer (HNC) often can experience long-term functional challenges and overall poorer health-related quality of life (HRQOL). This systematic review aims to explore components of effective HNL interventions through identification and synthesising literature on existing HNL management interventions. METHODS Five electronic databases (MEDLINE via Ovid and PubMed, CINAHL, CENTRAL, and Scopus) were systematically searched using Medical Subject Headings and free text, as well as citation tracking and Google Scholar for grey literature. RESULTS A total of 1910 studies were screened, with 12 studies meeting the inclusion criteria. Findings indicated vast heterogeneity within HNL interventions. Patients' adherence to intervention strategies was reported as low and partially adhered to, particularly at home. This impacted on function domains and overall HRQOL during the post-treatment HNC phase, as well as further increasing the demands placed on healthcare professionals. CONCLUSIONS Synthesis of the research findings highlighted a need to provide and educate patients with individualised HNL self-management intervention strategies. Promoting adherence was reported as being essential, with self-efficacy and behaviour change techniques being emphasised as a critical element to enhance motivation and therefore effective intervention delivery. Further work is important to address barriers to adherence and promote both motivation and behaviour change, to develop individualised self-management interventions for this cancer population. IMPLICATIONS FOR CANCER SURVIVORS The findings from this systematic review will provide guidance in the development and delivery of individualised self-management HNL interventions for patients who have completed HNC treatment.
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Affiliation(s)
- Lauren J Mullan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK.
| | - Nicole E Blackburn
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Jackie Gracey
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Lynn Dunwoody
- School of Psychology, Faculty of Life and Health Sciences, Ulster University, Londonderry, UK
| | - Jill Lorimer
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Cherith J Semple
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK
- Cancer Services, South Eastern Health and Social Care Trust, Belfast, UK
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Streetman AE, Lister MM, Brown A, Brin HN, Heinrich KM. A Mixed-Methods Study of Women's Empowerment through Physical Activities: Relationships with Self-Efficacy and Physical Activity Levels. J Funct Morphol Kinesiol 2023; 8:118. [PMID: 37606413 PMCID: PMC10443353 DOI: 10.3390/jfmk8030118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023] Open
Abstract
Participation in empowering physical activities may increase self-efficacy and facilitate long-term engagement. This explanatory sequential mixed-methods study examined the relationship between physical activity empowerment, exercise self-efficacy, and engagement. Midwestern women (N = 147) aged 18-65, 90% white, completed an online cross-sectional survey that captured exercise engagement and self-efficacy for exercise. Participants entered up to five types of physical activities and ranked them from most to least empowering. Physical activities were coded by training type for statistical comparisons using independent t-tests. After survey completion, seventeen women completed a 30 min, 8-question semi-structured interview. Women ranked resistance training as the most empowering physical activity type (38%), followed by running (14%). Total and moderate-to-vigorous physical activity and self-efficacy for exercise scores did not vary between women empowered by cardiorespiratory or resistance training (i.e., total physical activity t(136) = 1.13, p = 0.11; moderate-to-vigorous physical activity t(136) = 2.42, p = 0.06; and self-efficacy for exercise t(136) = 0.66, p = 0.07). Themes identified from the interviews included: (1) women's physical activity participation barriers are gender-centric, (2) physical activity participation benefits extend beyond physical health, (3) some exercise types are more empowering than others, and (4) empowerment and enjoyment are closely related. Exploring empowerment in exercise may reveal mechanisms to facilitate exercise self-efficacy and engagement in physical activity.
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Affiliation(s)
- Aspen E. Streetman
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA; (M.M.L.); (A.B.); (H.N.B.)
| | | | | | | | - Katie M. Heinrich
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA; (M.M.L.); (A.B.); (H.N.B.)
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Wilkerson AH, Abutalib N, McFadden NT, Bhochhibhoya S, Dragicevic A, Salous BR, Nahar VK. A Social Cognitive Assessment of Workplace Sedentary Behavior among a Sample of University Employees. Int J Environ Res Public Health 2023; 20:6476. [PMID: 37569017 PMCID: PMC10419213 DOI: 10.3390/ijerph20156476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/07/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
Sedentary behavior (SB) is an important public health concern. Adults working in desk-based occupations spend a considerable proportion of the workday sitting. More information is needed regarding the factors that contribute to occupational SB. The aim of this study was to assess the utility of social cognitive theory (SCT) to explain work-related SB using a quantitative, cross-sectional design by administering an online questionnaire. Participants included 381 full-time employees at a large, public university in the south-central United States. Hierarchical multiple linear regression was used to determine the relationship between SCT constructs and SB. Mean work-related SB was 5.95 (SD = 1.30) h/8 h workday. In model 1, 9.6% of the total variance in SB was accounted for by standing desk ownership and physical activity level (p = 0.001; R2 = 0.096). In model 2, SCT constructs led to a statistically significant R2 increase of 4.9% (p < 0.001), where standing desk ownership, physical activity, and self-efficacy explained 13.3% of the variance in work-related SB. Findings from this study suggest that self-efficacy may be an important factor in explaining variation in occupational SB. Public health researchers and practitioners should consider strategies to address self-efficacy when developing workplace interventions to target occupational SB.
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Affiliation(s)
- Amanda H. Wilkerson
- Department of Health Science, The University of Alabama, Tuscaloosa, AL 35401, USA; (N.A.); (N.T.M.)
| | - Nuha Abutalib
- Department of Health Science, The University of Alabama, Tuscaloosa, AL 35401, USA; (N.A.); (N.T.M.)
| | - Ny’Nika T. McFadden
- Department of Health Science, The University of Alabama, Tuscaloosa, AL 35401, USA; (N.A.); (N.T.M.)
| | - Shristi Bhochhibhoya
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA 30302, USA;
| | - Adriana Dragicevic
- Department of Health and Exercise Science, The University of Oklahoma, Norman, OK 73019, USA; (A.D.); (B.R.S.)
| | - Bushra R. Salous
- Department of Health and Exercise Science, The University of Oklahoma, Norman, OK 73019, USA; (A.D.); (B.R.S.)
| | - Vinayak K. Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA;
- Department of Preventive Medicine, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS 39216, USA
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Heizmann AN, Chapelle C, Laporte S, Roche F, Hupin D, Le Hello C. Impact of wearable device-based interventions with feedback for increasing daily walking activity and physical capacities in cardiovascular patients: a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2023; 13:e069966. [PMID: 37433730 DOI: 10.1136/bmjopen-2022-069966] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVE To systematically review randomised controlled trials (RCTs) using a wearable physical activity monitoring device as an intervention to increase daily walking activity and improve physical capacities in patients with cardiovascular disease (CVD). DESIGN Systematic review and meta-analysis of RCTs. DATA SOURCES PubMed, Embase and Web of Science from inception to June 2022. ELIGIBILITY CRITERIA Randomised controlled studies including patients with CVD over 18 years of age at the end of a cardiac rehabilitation programme comparing an intervention group using a wearable physical activity monitoring device with feedback with usual care or with a control group receiving no feedback on their physical activity and reporting a change in the daily number of steps and/or a change in the distance covered in the 6-minute walk test (6-MWT) or a change in peak oxygen uptake (V̇O2peak) as endpoints. RESULTS Sixteen RCTs were included. The intervention of wearing a physical activity monitoring device with feedback significantly improved daily number of steps compared with controls (standardised mean difference (SMD) 0.85; 95% CI (0.42; 1.27); p<0.01). The effect was greater when the duration of the intervention was less than 3 months (SMD 1.0; 95% CI (0.18; 1.82); p<0.01) than when the duration of the intervention was 3 months or longer (SMD 0.71; 95% CI (0.27; 1.16); p<0.01), but no significant interaction was found between subgroups (p=0.55). 6-MWT distance and V̇O2peak showed only small effects (SMD 0.34; 95% CI (-0.11; 0.80); p=0.02 and SMD 0.54; 95% CI (0.03; 1.03); p=0.07, respectively). CONCLUSION The use of wearable physical activity monitoring devices appears to help patients with CVD to increase their daily walking activity and thus their physical activity, particularly in the short term. PROSPERO REGISTRATION NUMBER CRD42022300423.
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Affiliation(s)
- Anne-Noëlle Heizmann
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
| | - Céline Chapelle
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Clinical Research Unit, Innovation, Pharmacology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Silvy Laporte
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Clinical Research Unit, Innovation, Pharmacology, Saint-Etienne University Hospital, Saint-Etienne, France
- Campus Health and Innovation, Jean Monnet University, Saint-Etienne, France
| | - Frederic Roche
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Campus Health and Innovation, Jean Monnet University, Saint-Etienne, France
- Department of Physiology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - David Hupin
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Campus Health and Innovation, Jean Monnet University, Saint-Etienne, France
- Department of Physiology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Claire Le Hello
- INSERM U1059-SAINBIOSE, Jean Monnet University, Mines Saint-Etienne, Saint-Etienne, France
- Campus Health and Innovation, Jean Monnet University, Saint-Etienne, France
- Department of Vascular and Therapeutic Medicine, Saint-Etienne University Hospital, Saint-Etienne, France
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25
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Vear NK, Goodman W, Rose GL, McCarthy AL. Impact of exercise and/or dietary interventions, and their behaviour change techniques, on quality of life in middle-aged and older women following treatment for cancer: A systematic review. Maturitas 2023; 175:107783. [PMID: 37327577 DOI: 10.1016/j.maturitas.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023]
Abstract
Many middle-aged or older women are treated for cancer and their quality of life can be significantly impaired following treatment. Exercise and dietary interventions could address this. The aim of this review was to determine whether exercise and/or dietary interventions which are scaffolded by behaviour change theories and techniques are associated with improved quality of life in middle-aged and older women following cancer treatment. Secondary outcomes included self-efficacy, distress, waist circumference, and food variety. A search of CINAHL (EBSCOhost), Embase, MEDLINE (EBSCOhost), PsycINFO, PubMed and Scopus databases up to 17th November 2022 was conducted. A narrative summary was provided. Twenty articles discussing 18 independent randomised controlled trials/interventions were included, with a total of 1754 participants. No studies reported the outcomes of distress or food variety. Exercise and/or dietary interventions had mixed effects on quality of life, self-efficacy and waist circumference (positive effect: n = 4/14; n = 3/5; n = 4/7, respectively). Two-thirds of the interventions (exercise-only, n = 2; exercise and diet, n = 2) that demonstrated an improvement in quality-of-life scores were based upon Social Cognitive Theory. All studies that reported improvements in waist circumference employed combined exercise and dietary interventions, with individualised aspects for the dietary components. Exercise and/or dietary interventions could potentially enhance quality of life and self-efficacy, and reduce waist circumference, in middle-aged and older women treated for cancer. Although findings are currently mixed, avenues for the development of interventions include ensuring there is a theoretical underpinning and incorporating more behaviour change techniques in exercise and/or dietary interventions in this population.
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Affiliation(s)
- Natalie K Vear
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia.
| | - William Goodman
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia; Leeds Institute of Health Science, University of Leeds, Clarendon Way, Leeds LS2 9JT, United Kingdom.
| | - Grace L Rose
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia; School of Health, Level 4, T Building, University of the Sunshine Coast, Sippy Downs, Queensland 4556, Australia.
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia; Mater Research Institute, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia.
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26
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Ayre E, Lee JJ, Frie K, Aveyard P, Albury CVA. GP delivered brief weight loss advice: associations between in-consultation behaviour change techniques and patient weight loss in recorded primary care discussions. Health Psychol Behav Med 2023; 11:2213751. [PMID: 37223642 PMCID: PMC10201997 DOI: 10.1080/21642850.2023.2213751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 05/05/2023] [Indexed: 05/25/2023] Open
Abstract
Background Primary care clinicians are encouraged to intervene opportunistically, offering weight-loss advice to people living with obesity. The BWeL trial showed patients receiving brief weight-loss advice from their general practitioner lost weight at one year follow-up. We examined the behaviour change techniques (BCTs) clinicians used to identify which BCTs are associated with this weight loss. Methods We coded 224 audio recorded interventions from the BWeL trial using the behavioural change techniques version one taxonomy (BCTTv1) and the 'refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours' (CALOR-RE taxonomy). Linear and logistic regressions were performed to analyse associations between behaviour change techniques used in these taxonomies and patient weight loss. Results Mean intervention length was 86 s. We identified 28 different BCTs BCTTv1 and 22 from CALOR-RE. No BCTs or BCT domains were associated with mean weight loss at 12 months, loss of 5% bodyweight, or action taken at 3 months. The BCT 'Feedback on outcomes of behaviour (future)' was associated with an increased likelihood that the patient reported taking action to lose weight by 12 months (OR = 6.10, 95%CI = 1.20, 31.0). Conclusion Although we found no evidence to support the use of particular BCTs, our results suggest that it is the brief intervention itself, rather than specific content, which may motivate weight loss. This can support clinicians to confidently intervene without needing complex training. Offering follow-up appointments can support positive changes to health behaviours, even if these are not associated with weight loss.
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Affiliation(s)
- Eleanor Ayre
- Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Joseph J. Lee
- Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kerstin Frie
- Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Paul Aveyard
- Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Chalabaev A, Cheval B, Maltagliati S, Saoudi I, Sniehotta FF. Beyond Individual Cognitions: Time for Intervention Science to Focus on Health Context and Audience. J Phys Act Health 2023; 20:465-470. [PMID: 37076243 DOI: 10.1123/jpah.2023-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 04/21/2023]
Abstract
Intervention science faces a hazardous paradox: on the one hand, vulnerable populations (eg, patients, people from low socioeconomic background, older adults) are those for whom adoption of healthy behaviors is most urgent; on the other hand, behavior change models are less predictive, and interventions less successful, in these populations. This commentary presents 4 reasons that may explain this issue: (1) research mostly focuses on what causes behavior and how to change it, at the expense of investigating among whom and under what conditions models are valid; (2) models put an undue emphasis on individual cognitions; (3) most studies are not conducted on vulnerable populations; and (4) most researchers are from high-income countries. Several avenues are proposed to address this issue: (1) providing a central place to the context and audience in health behavior change modelization, through collaborations with researchers from other disciplines and countries, and with members of the targeted audience; (2) better reporting samples' sociodemographic characteristics and increasing samples' diversity; and (3) using more rigorous and innovative designs (eg, powered randomized controlled trials, N-of-1 trials, intensive longitudinal studies). In conclusion, it becomes urgent to change the way we do research: the social utility and credibility of intervention science depend on it.
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Affiliation(s)
| | - Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Geneva,Switzerland
- Department of Psychology, Switzerland Department of Public Health, Social and Environmental Determinants of Health, Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), University of Geneva, Geneva,Switzerland
| | | | | | - Falko F Sniehotta
- Department of Public Health, Social and Preventive Medicine, CPD, Medical Faculty Mannheim, University of Heidelberg, Mannheim,Germany
- NIHR Policy Research Unit Behavioural Science, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne,United Kingdom
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28
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Amatori S, Ferri Marini C, Gobbi E, Sisti D, Giombini G, Rombaldoni R, Rocchi MBL, Lucertini F, Federici A, Perroni F, Calcagnini G. Short High-Intensity Interval Exercise for Workplace-Based Physical Activity Interventions: A Systematic Review on Feasibility and Effectiveness. Sports Med 2023; 53:887-901. [PMID: 36840913 PMCID: PMC10036456 DOI: 10.1007/s40279-023-01821-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Workplace exercise interventions showed good results, but lack of time was often reported as a barrier to participation. To overcome this problem, several studies attempted to implement short high-intensity interval training (HIT) within the workplace. OBJECTIVES The aim of this systematic review is to explore the feasibility and effectiveness of HIT interventions within the workplace setting. DATA SOURCES A systematic literature search was conducted in PubMed and SPORTDiscus to identify articles related to HIT within the workplace. STUDY ELIGIBILITY CRITERIA Only interventions that consisted of HIT programmes within the workplace and tested at least one physiological, psychological, or work-related outcome were included. RESULTS Seven studies (317 participants) met the inclusion criteria. HIT interventions lasted 6-12 weeks, with a frequency of 2-4 sessions/week and a duration of 8-30 min per session. Feasibility was qualitatively investigated in four studies, with key positive aspects reported for HIT time-appeal, the sense of competence driven by individual intensity, and improved intention to exercise; five studies reported adherence rates > 80%. Small-to-large effect sizes were reported for improvements in cardiorespiratory and muscular fitness. Small-to-medium effect sizes were reported for blood parameters and health-related quality of life. CONCLUSIONS HIT interventions in the workplace showed limited effectiveness in improving health-related outcomes, while promising results regarding feasibility were reported, mainly due to the time-efficiency and the positive post-exercise psychosocial responses. However, further high-quality studies involving more participants are still needed to make firm conclusions on HIT effectiveness and feasibility compared to other types of exercise in this context.
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Affiliation(s)
- Stefano Amatori
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Erica Gobbi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy.
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Germana Giombini
- Department of Economics, Social Science, and Politics, University of Urbino Carlo Bo, Urbino, Italy
| | - Rosalba Rombaldoni
- Department of Economics, Social Science, and Politics, University of Urbino Carlo Bo, Urbino, Italy
| | - Marco B L Rocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Ario Federici
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Fabrizio Perroni
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Giorgio Calcagnini
- Department of Economics, Social Science, and Politics, University of Urbino Carlo Bo, Urbino, Italy
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Manzi C, Adorni R, Giannella VA, Steca P. How to Age More Positively? Analyzing Determinants that Shape Attitudes Towards Aging. J Adult Dev 2023. [DOI: 10.1007/s10804-023-09447-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
AbstractA considerable amount of research has illustrated that negative attitudes toward one’s own aging can directly hinder mental and physical well-being or lead to maladjustment in later stages of life (Swift et al. in Social Issues Policy Rev 11(1):195–231, https://doi.org/10.1111/sipr.12031, 2017). Research so far has focused on the analysis of individual factors related to attitudes toward aging, often related to personality traits. Our study proposes and tests a model of positive contact with aging (PCA). It analyses both individual and social antecedents of attitudes towards one’s own aging, hypothesizing that individual health self-efficacy directly affects attitudes towards one’s own aging and that the quality and quantity of contact with older adults indirectly impacts on attitudes towards one’s own aging through attitudes towards older adults. The model was tested in a wide sample of the Italian population (N = 753) with a varied age range. The PCA model tested showed excellent fit to the data, explaining a moderate amount of variance in attitudes toward one’s own aging (12%). This model promises to offer implications for active policies that can improve attitudes towards one’s own aging, promoting educational strategies to increase intergenerational exchanges and foster health-related self-efficacy.
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Blaschke S, Carl J, Pelster K, Mess F. Promoting physical activity-related health competence to increase leisure-time physical activity and health-related quality of life in German private sector office workers. BMC Public Health 2023; 23:470. [PMID: 36899338 PMCID: PMC10007852 DOI: 10.1186/s12889-023-15391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Office workers (OWs) are at risk of low levels of health-enhancing physical activity (HEPA) and impaired health-related quality of life (HRQOL). Interventions based on physical activity-related health competence (PAHCO) aim to facilitate long-term changes in HEPA and HRQOL. However, these assumptions rely on the changeability and temporal stability of PAHCO and have not been tested empirically. This study therefore aims to test the changeability and temporal stability of PAHCO in OWs within an interventional design and to examine the effect of PAHCO on leisure-time PA and HRQOL. METHODS Three hundred twenty-eight OWs (34% female, 50.4 ± 6.4 years) completed an in-person, three-week workplace health promotion program (WHPP) focusing on PAHCO and HEPA. The primary outcome of PAHCO as well as the secondary outcomes of leisure-time PA and HRQOL were examined at four measurement points over the course of 18 months in a pre-post design by employing linear mixed model regressions. RESULTS PAHCO displayed a substantial increase from the baseline to the time point after completion of the WHPP (β = 0.44, p < 0.001). Furthermore, there was no decrease in PAHCO at the first (p = 0.14) and the second follow-up measurement (p = 0.56) compared with the level at the end of the WHPP. In addition, the PAHCO subscale of PA-specific self-regulation (PASR) had a small to moderate, positive effect on leisure-time PA (β = 0.18, p < 0.001) and HRQOL (β = 0.26, p < 0.001). The subscale of control competence for physical training (CCPT) also had a positive small to moderate effect on HRQOL (β = 0.22, p < 0.001). CONCLUSION The results substantiate PAHCO's theoretical characteristics of changeability and temporal stability, and underline the theoretically postulated effects on leisure-time PA and HRQOL. These findings highlight the potential of PAHCO for intervention development, which can be assumed to foster long-term improvements in HEPA and HRQOL in OWs. TRIAL REGISTRATION The study was retrospectively registered in the German Clinical Trials Register, which is an approved Primary Register in the WHO network, at the 14/10/2022 (DRKS00030514).
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Affiliation(s)
- Simon Blaschke
- Department of Sport and Health Sciences, Associate Professorship of Didactics in Sport and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, 80992, Germany.
| | - Johannes Carl
- Department of Sport Science and Sport, Chair of Exercise and Health, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, Erlangen, 91058, Germany
| | - Klaus Pelster
- Siemens AG, Environmental Protection, Health Management and Safety - Health Management (P&O EHS DE HM), Lyoner Str. 27, Frankfurt am Main, 60528, Germany
| | - Filip Mess
- Department of Sport and Health Sciences, Associate Professorship of Didactics in Sport and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
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Diaz C, Caillaud C, Yacef K. Mining Sensor Data to Assess Changes in Physical Activity Behaviors in Health Interventions: Systematic Review. JMIR Med Inform 2023; 11:e41153. [PMID: 36877559 PMCID: PMC10028506 DOI: 10.2196/41153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Sensors are increasingly used in health interventions to unobtrusively and continuously capture participants' physical activity in free-living conditions. The rich granularity of sensor data offers great potential for analyzing patterns and changes in physical activity behaviors. The use of specialized machine learning and data mining techniques to detect, extract, and analyze these patterns has increased, helping to better understand how participants' physical activity evolves. OBJECTIVE The aim of this systematic review was to identify and present the various data mining techniques employed to analyze changes in physical activity behaviors from sensors-derived data in health education and health promotion intervention studies. We addressed two main research questions: (1) What are the current techniques used for mining physical activity sensor data to detect behavior changes in health education or health promotion contexts? (2) What are the challenges and opportunities in mining physical activity sensor data for detecting physical activity behavior changes? METHODS The systematic review was performed in May 2021 using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We queried the Association for Computing Machinery (ACM), IEEE Xplore, ProQuest, Scopus, Web of Science, Education Resources Information Center (ERIC), and Springer literature databases for peer-reviewed references related to wearable machine learning to detect physical activity changes in health education. A total of 4388 references were initially retrieved from the databases. After removing duplicates and screening titles and abstracts, 285 references were subjected to full-text review, resulting in 19 articles included for analysis. RESULTS All studies used accelerometers, sometimes in combination with another sensor (37%). Data were collected over a period ranging from 4 days to 1 year (median 10 weeks) from a cohort size ranging between 10 and 11615 (median 74). Data preprocessing was mainly carried out using proprietary software, generally resulting in step counts and time spent in physical activity aggregated predominantly at the daily or minute level. The main features used as input for the data mining models were descriptive statistics of the preprocessed data. The most common data mining methods were classifiers, clusters, and decision-making algorithms, and these focused on personalization (58%) and analysis of physical activity behaviors (42%). CONCLUSIONS Mining sensor data offers great opportunities to analyze physical activity behavior changes, build models to better detect and interpret behavior changes, and allow for personalized feedback and support for participants, especially where larger sample sizes and longer recording times are available. Exploring different data aggregation levels can help detect subtle and sustained behavior changes. However, the literature suggests that there is still work remaining to improve the transparency, explicitness, and standardization of the data preprocessing and mining processes to establish best practices and make the detection methods easier to understand, scrutinize, and reproduce.
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Affiliation(s)
- Claudio Diaz
- School of Computer Science, The University of Sydney, Sydney, Australia
| | - Corinne Caillaud
- Charles Perkins Centre, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Kalina Yacef
- School of Computer Science, The University of Sydney, Sydney, Australia
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Arigo D, Gray RC, Dallal DH, Villareale J, Zhu J. Selection of and Response to Physical Activity-Based Social Comparisons in a Digital Environment: Series of Daily Assessment Studies. JMIR Hum Factors 2023; 10:e41239. [PMID: 36848204 PMCID: PMC10012003 DOI: 10.2196/41239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/27/2022] [Accepted: 01/01/2023] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Innovative approaches are needed to understand barriers to and facilitators of physical activity among insufficiently active adults. Although social comparison processes (ie, self-evaluations relative to others) are often used to motivate physical activity in digital environments, user preferences and responses to comparison information are poorly understood. OBJECTIVE We used an iterative approach to better understand users' selection of comparison targets, how they interacted with their selected targets, and how they responded to these targets. METHODS Across 3 studies, different samples of insufficiently active college students used the Fitbit system (Fitbit LLC) to track their steps per day as well as a separate, adaptive web platform each day for 7 to 9 days (N=112). The adaptive platform was designed with different layouts for each study; each allowed participants to select their preferred comparison target from various sets of options, view the desired amount of information about their selected target, and rate their physical activity motivation before and after viewing information about their selected target. Targets were presented as achieving physical activity at various levels below and above their own, which were accessed via the Fitbit system each day. We examined the types of comparison target selections, time spent viewing and number of elements viewed for each type of target, and day-level associations between comparison selections and physical activity outcomes (motivation and behavior). RESULTS Study 1 (n=5) demonstrated that the new web platform could be used as intended and that participants' interactions with the platform (ie, the type of target selected, the time spent viewing the selected target's profile, and the number of profile elements viewed) varied across the days. Studies 2 (n=53) and 3 (n=54) replicated these findings; in both studies, age was positively associated with time spent viewing the selected target's profile and the number of profile elements viewed. Across all studies, upward targets (who had more steps per day than the participant) were selected more often than downward targets (who had fewer steps per day than the participant), although only a subset of either type of target selection was associated with benefits for physical activity motivation or behavior. CONCLUSIONS Capturing physical activity-based social comparison preferences is feasible in an adaptive digital environment, and day-to-day differences in preferences for social comparison targets are associated with day-to-day changes in physical activity motivation and behavior. Findings show that participants only sometimes focus on the comparison opportunities that support their physical activity motivation or behavior, which helps explain previous, equivocal findings regarding the benefits of physical activity-based comparisons. Additional investigation of day-level determinants of comparison selections and responses is needed to fully understand how best to harness comparison processes in digital tools to promote physical activity.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ, United States.,Department of Family Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, United States
| | - Robert C Gray
- Department of Digital Media, Drexel University, Philadelphia, PA, United States
| | - Diane H Dallal
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States.,Weight, Eating, and Lifestyle Science Center, Drexel University, Philadelphia, PA, United States
| | - Jennifer Villareale
- Department of Digital Media, Drexel University, Philadelphia, PA, United States
| | - Jichen Zhu
- Department of Digital Design, IT University of Copenhagen, Copenhagen, Denmark
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Latrille C, Chapel B, Héraud N, Bughin F, Hayot M, Boiché J. An individualized mobile health intervention to promote physical activity in adults with obstructive sleep apnea: An intervention mapping approach. Digit Health 2023; 9:20552076221150744. [PMID: 36776408 PMCID: PMC9909081 DOI: 10.1177/20552076221150744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 12/26/2022] [Indexed: 02/10/2023] Open
Abstract
Objective Combining continuous positive airway pressure with physical activity (PA) might be a promising strategy to treat obstructive sleep apnea (OSA). This article describes how intervention mapping (IM) can guide the development, content, and mechanisms of action of a mobile application to promote PA in adults with OSA. Methods To develop the program, the IM approach was followed. This article presents the first three steps of IM to develop a mixed intervention (with interventionists and a digital application) aiming to: (1) assess patients' health problems and needs in a literature review to determine their expectations and perceived facilitators and barriers to PA behavior change and thus select the determinants of behavior; (2) formulate the expected intervention outcomes and objectives to be met to achieve the overall program goals; and (3) select and implement the behavior change techniques (BCTs) to achieve the change objectives. Results The literature review identified the relevant determinants (e.g., self-efficacy, coping, planning, and habit) of PA behavior using the health action process approach and multiprocess action control. These results were used to specify the program outcomes for PA adapted to physical, psychological, and social parameters. Overall, 11 performance objectives and 30 change objectives were defined. Lastly, BCTs and practical applications were identified. Conclusions The study provides a theoretical and methodological basis for researchers and practitioners given the current paucity of evidence-based PA interventions for adults with OSA. It addresses the lack of BCTs (framing and prompts/cue techniques) and meaningful behavioral determinants (identity and habit) in most interventions.
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Affiliation(s)
- Christophe Latrille
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France,PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France,Christophe Latrille, University of Montpellier, 700 avenue du Pic Saint-Loup, Montpellier 34090, France.
| | - Blandine Chapel
- Montpellier Research of Management MRM, University of Montpellier, Montpellier, France
| | - Nelly Héraud
- Direction de la recherche clinique et de l'innovation en santé, Korian SA, Lodève, France
| | - François Bughin
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Julie Boiché
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France
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Abstract
BACKGROUND Research indicates that perceived behavioral control (PBC) is an important determinant of behavior and that it is composed of perceived capability and opportunity. However, typical measurement of these constructs may be confounded with motivation and outcome expectations. Vignettes presented before questionnaire items may clarify construct meaning leading to precise measurement. PURPOSE The purpose of this study was to develop and validate measures of perceived capability and opportunity that parse these constructs from the influence of motivation and outcome expectations using vignettes. METHODS Study 1 collected feedback from experts (N = 9) about the initial measure. Study 2a explored internal consistency reliability and construct and discriminant validity of the revised measure using two independent samples (N = 683 and N = 727). Finally, using a prospective design, Study 2b (N = 1,410) investigated test-retest reliability, construct and discriminant validity at Time 2, and nomological validity. RESULTS After Study 1, the revised measure was tested in Studies 2a and 2b. Overall, the evidence suggests that the measure is optimal with four items for perceived capability and three for the perceived opportunity. The measure demonstrated strong internal consistency ( > 0.90) and test-retest reliability (intraclass correlation coefficients [ICCs] > .78). The measure also showed construct and discriminant validity by differentiating itself from behavioral intentions (i.e., motivation) and affective attitude (based on expected outcomes) (SRMR = 0.03; RMSEA = 0.06). It also demonstrated evidence of nomological validity as behavior 2 weeks later was predicted. CONCLUSIONS We recommend researchers use this tool in future correlational and intervention studies to parse motivation and outcome expectations from perceived capability and opportunity measurement.
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Affiliation(s)
- Alexander Lithopoulos
- Behavioral Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - David M Williams
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Ryan E Rhodes
- Behavioral Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
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35
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Ma N, Chau JPC, Liang W, Choi KC. A review of the behaviour change techniques used in physical activity promotion or maintenance interventions in pregnant women. Midwifery 2023; 117:103574. [PMID: 36521198 DOI: 10.1016/j.midw.2022.103574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 11/08/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The proportion of women meeting the recommended physical activity requirement is low. Evidence suggests behaviour change techniques (BCTs) can be effective in initiating and maintaining behaviour change and improving physical activity. PURPOSE To synthesise the evidence related to the attributes of BCT-based physical activity interventions targeted at pregnant women. METHODS A systematic search of studies was made. Randomised controlled trials aiming to improve or maintain physical activity in pregnant women were included. Trials were categorised into 'very promising', 'quite promising', or 'non-promising' according to the intervention effectiveness. One-way analysis of variance was used to determine the difference in mean BCTs implemented in promising/ non-promising studies. FINDINGS A total of 18,966 studies were identified and 10 studies were included. 'Problem solving', 'social support (unspecified)', 'graded tasks', 'goal setting (behaviour)', 'instruction on how to perform a behaviour', 'self-monitoring of behaviour', 'demonstration of the behaviour', and 'action planning' were rated as promising BCTs. DISCUSSION Specific types of BCTs might be associated with physical activity promotion or maintenance during pregnancy. More high-quality randomised controlled trials investigating the effectiveness of individual or combinations of BCTs on physical activity in pregnant women are needed.
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Affiliation(s)
- Nan Ma
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Wei Liang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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36
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Encho H, Uchida K, Horibe K, Nakatsuka K, Ono R. Walking and perception of green space among older adults in Japan: subgroup analysis based self-efficacy. Health Promot Int 2023; 38:6974791. [PMID: 36617292 DOI: 10.1093/heapro/daac175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Self-efficacy is the key factor for promoting physical activity. Older adults with low self-efficacy tend to be physical inactive than those with high self-efficacy, and an approach is needed to promote physical activity. Among several approaches, increasing the perception of green space may be an effective approach for low self-efficacy not high self-efficacy, but no study has investigated. This study investigated the association between walking and perception of green space among older adults with high and low self-efficacy, respectively. We conducted a cross-sectional study among 204 community-dwelling older adults (mean age = 78.3 years, 62.3% females). Using the median split, the participants were divided into high and low self-efficacy groups based on the median score of 12. Walking was measured using the International Physical Activity Questionnaire and 'more walking' was defined as ≥150 min of walking time per week. Perception of green space was measured using an 8-item questionnaire. We performed logistic regression analysis to investigate the association between walking and perception of green space adjusted for age, gender, years of education, living with someone and income level. For all participants, 94 participants (46.1%) fell under low self-efficacy. After adjustment, higher perception of green space is associated with more walking among older adults with low self-efficacy [adjusted odds ratio (aOR) = 1.07, 95% confidence interval (CI) = 1.00-1.15], but not among those with high self-efficacy (aOR = 1.09, 95% CI= 0.99-1.20). To increase perception of green space, experts should design/improve green spaces considering beneficiaries' characteristics.
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Affiliation(s)
- Haruhi Encho
- Department of Rehabilitation Sciences, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
| | - Kazuaki Uchida
- Department of Rehabilitation Sciences, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan.,Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kana Horibe
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
| | - Kiyomasa Nakatsuka
- Department of Rehabilitation Sciences, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan
| | - Rei Ono
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo, Japan.,National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
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Mavragani A, Zwanenburg SP, Paton C. Supporting Autonomous Motivation for Physical Activity With Chatbots During the COVID-19 Pandemic: Factorial Experiment. JMIR Form Res 2023; 7:e38500. [PMID: 36512402 PMCID: PMC9879319 DOI: 10.2196/38500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/14/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although physical activity can mitigate disease trajectories and improve and sustain mental health, many people have become less physically active during the COVID-19 pandemic. Personal information technology, such as activity trackers and chatbots, can technically converse with people and possibly enhance their autonomous motivation to engage in physical activity. The literature on behavior change techniques (BCTs) and self-determination theory (SDT) contains promising insights that can be leveraged in the design of these technologies; however, it remains unclear how this can be achieved. OBJECTIVE This study aimed to evaluate the feasibility of a chatbot system that improves the user's autonomous motivation for walking based on BCTs and SDT. First, we aimed to develop and evaluate various versions of a chatbot system based on promising BCTs. Second, we aimed to evaluate whether the use of the system improves the autonomous motivation for walking and the associated factors of need satisfaction. Third, we explored the support for the theoretical mechanism and effectiveness of various BCT implementations. METHODS We developed a chatbot system using the mobile apps Telegram (Telegram Messenger Inc) and Google Fit (Google LLC). We implemented 12 versions of this system, which differed in 3 BCTs: goal setting, experimenting, and action planning. We then conducted a feasibility study with 102 participants who used this system over the course of 3 weeks, by conversing with a chatbot and completing questionnaires, capturing their perceived app support, need satisfaction, physical activity levels, and motivation. RESULTS The use of the chatbot systems was satisfactory, and on average, its users reported increases in autonomous motivation for walking. The dropout rate was low. Although approximately half of the participants indicated that they would have preferred to interact with a human instead of the chatbot, 46.1% (47/102) of the participants stated that the chatbot helped them become more active, and 42.2% (43/102) of the participants decided to continue using the chatbot for an additional week. Furthermore, the majority thought that a more advanced chatbot could be very helpful. The motivation was associated with the satisfaction of the needs of competence and autonomy, and need satisfaction, in turn, was associated with the perceived system support, providing support for SDT underpinnings. However, no substantial differences were found across different BCT implementations. CONCLUSIONS The results provide evidence that chatbot systems are a feasible means to increase autonomous motivation for physical activity. We found support for SDT as a basis for the design, laying a foundation for larger studies to confirm the effectiveness of the selected BCTs within chatbot systems, explore a wider range of BCTs, and help the development of guidelines for the design of interactive technology that helps users achieve long-term health benefits.
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Affiliation(s)
| | | | - Chris Paton
- Department of Information Science, University of Otago, Dunedin, New Zealand.,Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom
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38
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Kushniruk A, Middelweerd A, van Empelen P, Preuhs K, Konijnendijk AAJ, Oude Nijeweme-d'Hollosy W, Schrijver LK, Laverman GD, Vollenbroek-Hutten MMR. A Digital Lifestyle Coach (E-Supporter 1.0) to Support People With Type 2 Diabetes: Participatory Development Study. JMIR Hum Factors 2023; 10:e40017. [PMID: 36633898 PMCID: PMC9947918 DOI: 10.2196/40017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/29/2022] [Accepted: 11/20/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND A healthy lifestyle, including regular physical activity and a healthy diet, is becoming increasingly important in the treatment of chronic diseases. eHealth interventions that incorporate behavior change techniques (BCTs) and dynamic tailoring strategies could effectively support a healthy lifestyle. E-Supporter 1.0 is an eCoach designed to support physical activity and a healthy diet in people with type 2 diabetes (T2D). OBJECTIVE This paper aimed to describe the systematic development of E-Supporter 1.0. METHODS Our systematic design process consisted of 3 phases. The definition phase included the selection of the target group and formulation of intervention objectives, and the identification of behavioral determinants based on which BCTs were selected to apply in the intervention. In the development phase, intervention content was developed by specifying tailoring variables, intervention options, and decision rules. In the last phase, E-Supporter 1.0 integrated in the Diameter app was evaluated using a usability test in 9 people with T2D to assess intervention usage and acceptability. RESULTS The main intervention objectives were to stimulate light to moderate-vigorous physical activities or adherence to the Dutch dietary guidelines in people with T2D. The selection of behavioral determinants was informed by the health action process approach and theories explaining behavior maintenance. BCTs were included to address relevant behavioral determinants (eg, action control, self-efficacy, and coping planning). Development of the intervention resulted in 3 types of intervention options, consisting of motivational messages, behavioral feedback, and tailor-made supportive exercises. On the basis of IF-THEN rules, intervention options could be tailored to, among others, type of behavioral goal and (barriers to) goal achievement. Data on these variables could be collected using app data, activity tracker data, and daily ecological momentary assessments. Usability testing revealed that user experiences were predominantly positive, despite some problems in the fixed delivery of content. CONCLUSIONS The systematic development approach resulted in a theory-based and dynamically tailored eCoach. Future work should focus on expanding intervention content to other chronic diseases and lifestyle behaviors, enhancing the degree of tailoring and evaluating intervention effects on acceptability, use, and cost-effectiveness.
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Affiliation(s)
| | - Anouk Middelweerd
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Pepijn van Empelen
- Department of Child Health, TNO (Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
| | - Katharina Preuhs
- Department of Child Health, TNO (Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
| | | | | | - Laura K Schrijver
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Gozewijn D Laverman
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente, Almelo, Netherlands
| | - Miriam M R Vollenbroek-Hutten
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,Board of Directors, Medisch Spectrum Twente, Enschede, Netherlands
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Peng S, Othman AT, Khairani AZ, zeng G, Xiaogang Z, Fang Y. Effectiveness of pedometer- and accelerometer-based interventions in improving physical activity and health-related outcomes among college students: A systematic review and meta-analysis. Digit Health 2023; 9:20552076231188213. [PMID: 37492032 PMCID: PMC10364418 DOI: 10.1177/20552076231188213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 06/28/2023] [Indexed: 07/27/2023] Open
Abstract
Background Although the pedometer- and accelerometer-based interventions (PABI) have demonstrated efficacy in improving physical activity (PA) and health-related outcomes, the dearth of empirical evidence in college students warrants further investigation. Objective This systematic review and meta-analysis aim to examine the effects of PABI on improving PA and health-related outcomes among college students. Methods PubMed, Web of Science, Embase, Cochrane Library, and PsycINFO were searched for relevant literature from inception to 20 February 2022. Randomized controlled trials (RCTs) conducted among college students with PABI to increase objectively measured PA as the primary outcome were included in this study. Results A total of nine RCTs with 527 participants were included in this study. The combined results showed that PABI significantly improved PA (standardized mean difference = 0.41, 95% confidence interval (CI): 0.08, 0.74, P = 0.016) and significantly contributed to weight loss (mean differences (MD) = -1.56 kg, 95% CI: -2.40 kg, -0.73 kg, P < 0.01), and lower body mass index (MD = -0.33 kg/m2, 95% CI: -0.66 kg/m2, 0.00 kg/m2, P = 0.05) compared to the control group, but no significant effects were observed on improvements of body fat (%) and exercise self-efficacy. Interventions in the group of step, general students, pedometer-based intervention, theory, and developed region were significantly more effective in subgroup analyses. Conclusions PABI was found to be effective in promoting PA and weight loss among college students. Future research is needed to further explore the long-term effects of PABI and the characteristics of multiple intervention models.
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Affiliation(s)
- Sanying Peng
- Department of Physical Education, Hohai University, Nanjing, China
- School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
| | | | | | - Gao zeng
- School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
| | - Zhou Xiaogang
- School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
| | - Yuan Fang
- College of International Languages and Cultures, Hohai University, Nanjing, China
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Mavragani A, Davies A, Mueller J, Cholerton R, Howell A, Evans DG, Howell SJ, French DP, Harvie M. Evaluating the Acceptance and Usability of an App Promoting Weight Gain Prevention and Healthy Behaviors Among Young Women With a Family History of Breast Cancer: Protocol for an Observational Study. JMIR Res Protoc 2022; 11:e41246. [PMID: 36525287 PMCID: PMC9804094 DOI: 10.2196/41246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Breast cancer is the most common form of cancer in women, and around 20% of cases are associated with factors such as adult weight gain, overweight and obesity, and potentially modifiable health behaviors including high alcohol intake, smoking, lack of physical activity, and breastfeeding. Significant weight gain occurs between the ages of 18 and 35 years; hence, this age group could benefit from weight gain prevention interventions. Population studies have reported that women at increased risk of breast cancer account for a disproportionate amount of cases. Thus, there is a particular need to target weight gain prevention and other health behavior interventions for women at increased risk. A literature review identified no evidence-based apps that cover all relevant health behaviors. With patient and participant involvement from the target population, we have developed a new app to promote healthy behaviors among young women at increased risk of breast cancer. Alongside the app, a Facebook group provides peer support, and a virtual welcome event provides an overview of the project and the opportunity to meet the research team and other study participants. The aim of the intervention is to prevent weight gain via changes to eating habits and physical activity levels, and improve other health behaviors associated with breast cancer. The app includes goal setting and self-monitoring of health behaviors and provides education about breast cancer. OBJECTIVE This study aims to assess the acceptability and usability of the app in young women at increased risk of breast cancer, and the feasibility of the study procedures for a future, larger efficacy study. METHODS Young women (n=35, age 18-35 years) at increased risk of breast cancer (>17% lifetime risk) will be recruited via 2 recruitment procedures: mailed invite from the local breast cancer family history, risk and prevention clinic, and advertisements on social media and websites. Participants will have access to the app and the private Facebook group for 2 months. They will complete questionnaires regarding their health behaviors and breast cancer risk belief at the start and end of the study, complete app rating scales in the middle and at the end of the study, and be invited to give feedback on the app during the study period. Approximately 20 participants will have a semistructured interview at the end of the study regarding their views on the app and trial procedures. RESULTS The trial is ongoing, and the publication of results is anticipated in 2023. CONCLUSIONS The trial will provide evidence regarding the acceptability and usability of the newly developed app for young women at increased risk of breast cancer. Feedback obtained will be used to improve the app. The trial will also assess the feasibility of the study procedures and how these can be refined for a future efficacy study. TRIAL REGISTRATION ClinicalTrials.gov NCT05460650; https://clinicaltrials.gov/ct2/show/NCT05460650. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/41246.
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Affiliation(s)
| | - Alan Davies
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, United Kingdom
| | - Julia Mueller
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Rachel Cholerton
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Anthony Howell
- Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom.,The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom.,Manchester Breast Centre, University of Manchester, Manchester, United Kingdom.,Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - D Gareth Evans
- The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom.,Manchester Breast Centre, University of Manchester, Manchester, United Kingdom.,Division of Evolution, Infection and Genomics, University of Manchester, Manchester, United Kingdom
| | - Sacha J Howell
- Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom.,The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom.,Manchester Breast Centre, University of Manchester, Manchester, United Kingdom.,Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - David P French
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Breast Centre, University of Manchester, Manchester, United Kingdom
| | - Michelle Harvie
- Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom.,The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom.,Manchester Breast Centre, University of Manchester, Manchester, United Kingdom
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41
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Rhodes S, Waters D, Brockway B, Skinner M. Exercise and motivational text messaging to support physical activity behaviour change in a population with obstructive sleep apnoea: a feasibility study. J Prim Health Care 2022; 14:318-325. [PMID: 36592765 DOI: 10.1071/hc22033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/17/2022] [Indexed: 01/05/2023] Open
Abstract
Introduction Patients with obstructive sleep apnoea (OSA) commonly present in primary care. Increasing physical activity reduces symptoms and severity of OSA. Low motivation is a barrier to physical activity in adults with OSA. Aim To investigate the feasibility and acceptability of an exercise and personalised text messaging programme to enhance motivation and support physical activity behaviour change in adults with OSA. Methods Participants were recruited from the local Sleep Clinic. Exclusion criteria were unstable angina, and/or poorly controlled hypertension. The intervention comprised three groups, who received either individual exercise prescription, personalised text messages or both over a 24-week period. Participants were allocated to one of the three groups. The primary outcome was feasibility of study design including participant recruitment and retention. Secondary outcomes were a change in 6-min walk distance and exercise self-efficacy over time. Results Thirty participants were recruited, 17 male and 13 female, with a mean age of 54.6 years. The study design appears feasible and the outcome measures used were acceptable to participants. Recruitment and retention rates were lower than anticipated. A trend towards increased functional exercise capacity was identified in all three groups, along with a corresponding increase in exercise self-efficacy over time. Discussion Exercise and personalised text messaging both appear to offer an acceptable and feasible means to increase physical activity in adults with OSA. A larger scale trial may provide justification for physiotherapist input to support patients with OSA to address physical inactivity.
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Affiliation(s)
- Sarah Rhodes
- School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, New Zealand
| | - Debra Waters
- Department of Medicine/School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, New Zealand
| | - Ben Brockway
- Department of Medicine, University of Otago, 201 Great King Street, Dunedin, New Zealand
| | - Margot Skinner
- School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, New Zealand
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Rhodes RE, Sui W, Nuss K, Liu S. Reflecting on physical activity across 2 years of the COVID-19 pandemic: Predictors of intention-behavior profiles. Appl Psychol Health Well Being 2022; 15:757-775. [PMID: 36344248 PMCID: PMC9877947 DOI: 10.1111/aphw.12409] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/30/2022] [Indexed: 11/09/2022]
Abstract
The COVID-19 pandemic has affected how many people engage in regular moderate-to-vigorous intensity physical activity (MVPA). The purpose of this study was to predict current and dynamic (across 2 years of the pandemic) intention and MVPA profiles using the multi-process action control (M-PAC) framework. A representative sample of 977 English-speaking Canadians (18 + years) completed measures of reflective (instrumental attitude, affective attitude, perceived capability, and opportunity), regulatory (planning and self-monitoring), and reflexive (habit and identity) processes, intention, and MVPA. These measures included current assessments and reflections prior to the COVID-19 restrictions. Three current intention-behavior profiles (nonintenders, unsuccessful intenders, and successful intenders) and five dynamic intention-MVPA by prepandemic MVPA profiles (consistent nonintenders, relapsed nonintenders, consistent unsuccessful intenders, relapsed unsuccessful intenders, and consistent successful intenders) emerged from these data, showing few increased MVPA across the pandemic. The current and dynamic profiles were subsequently predicted by changes in specific reflective, regulatory, and reflexive processes across the pandemic; however, only change in identity was the critical predictor of successful MVPA engagement in the dynamic 2-year MVPA profiles. Collectively, the findings support the joint promotion of reflective, regulatory, and reflexive processes in the choice of behavior change techniques to promote postpandemic MVPA intention and behavior.
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Affiliation(s)
- Ryan E. Rhodes
- School of Exercise Science, Physical and Health EducationUniversity of VictoriaVictoriaBritish ColumbiaCanada
| | - Wuyou Sui
- School of Exercise Science, Physical and Health EducationUniversity of VictoriaVictoriaBritish ColumbiaCanada
| | - Kayla Nuss
- School of Exercise Science, Physical and Health EducationUniversity of VictoriaVictoriaBritish ColumbiaCanada
| | - Sam Liu
- School of Exercise Science, Physical and Health EducationUniversity of VictoriaVictoriaBritish ColumbiaCanada
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Shibuta T, Waki K, Miyake K, Igarashi A, Yamamoto-Mitani N, Sankoda A, Takeuchi Y, Sumitani M, Yamauchi T, Nangaku M, Ohe K. Preliminary Efficacy, Feasibility, and Perceived Usefulness of a Smartphone-Based Self-Management System with Personalized Goal Setting and Feedback to Increase Step Count among Workers with High Blood Pressure: Before-After Study (Preprint). JMIR Cardio 2022. [PMID: 37477976 PMCID: PMC10403795 DOI: 10.2196/43940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND High blood pressure (BP) and physical inactivity are the major risk factors for cardiovascular diseases. Mobile health is expected to support patients' self-management for improving cardiovascular health; the development of fully automated systems is necessary to minimize the workloads of health care providers. OBJECTIVE The objective of our study was to evaluate the preliminary efficacy, feasibility, and perceived usefulness of an intervention using a novel smartphone-based self-management system (DialBetes Step) in increasing steps per day among workers with high BP. METHODS On the basis of the Social Cognitive Theory, we developed personalized goal-setting and feedback functions and information delivery functions for increasing step count. Personalized goal setting and feedback consist of 4 components to support users' self-regulation and enhance their self-efficacy: goal setting for daily steps, positive feedback, action planning, and barrier identification and problem-solving. In the goal-setting component, users set their own step goals weekly in gradual increments based on the system's suggestion. We added these fully automated functions to an extant system with the function of self-monitoring daily step count, BP, body weight, blood glucose, exercise, and diet. We conducted a single-arm before-and-after study of workers with high BP who were willing to increase their physical activity. After an educational group session, participants used only the self-monitoring function for 2 weeks (baseline) and all functions of DialBetes Step for 24 weeks. We evaluated changes in steps per day, self-reported frequencies of self-regulation and self-management behavior, self-efficacy, and biomedical characteristics (home BP, BMI, visceral fat area, and glucose and lipid parameters) around week 6 (P1) of using the new functions and at the end of the intervention (P2). Participants rated the usefulness of the system using a paper-based questionnaire. RESULTS We analyzed 30 participants (n=19, 63% male; mean age 52.9, SD 5.3 years); 1 (3%) participant dropped out of the intervention. The median percentage of step measurement was 97%. Compared with baseline (median 10,084 steps per day), steps per day significantly increased at P1 (median +1493 steps per day; P<.001), but the increase attenuated at P2 (median +1056 steps per day; P=.04). Frequencies of self-regulation and self-management behavior increased at P1 and P2. Goal-related self-efficacy tended to increase at P2 (median +5%; P=.05). Home BP substantially decreased only at P2. Of the other biomedical characteristics, BMI decreased significantly at P1 (P<.001) and P2 (P=.001), and high-density lipoprotein cholesterol increased significantly only at P1 (P<.001). DialBetes Step was rated as useful or moderately useful by 97% (28/29) of the participants. CONCLUSIONS DialBetes Step intervention might be a feasible and useful way of increasing workers' step count for a short period and, consequently, improving their BP and BMI; self-efficacy-enhancing techniques of the system should be improved.
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den Daas C, Johnston M, Hubbard G, Dixon D. An experimental COVID-19 messaging study in a representative sample of the Scottish population: Increasing physical distancing intentions through self-efficacy. Br J Health Psychol 2022; 28:439-450. [PMID: 36317412 PMCID: PMC9878139 DOI: 10.1111/bjhp.12632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/01/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Self-efficacy is important for adherence to transmission-reducing behaviours (e.g., physical distancing) as also shown in the CHARIS project. We aimed to show that a theory-based short message can increase physical distancing self-efficacy and intentions to keep physical distance. DESIGN Structured telephone surveys with a randomly selected nationally representative sample of adults in Scotland (N = 497). METHODS Participants were randomly assigned to one of two experimental conditions: message condition (short message to increase self-efficacy via vicarious experiences, verbal persuasion and emotional arousal) or control condition (no message). Followed by measures for self-efficacy and intention for physical distancing on 4-point scales. Adherence to physical distancing was assessed on a 5-point frequency scale (never - always). RESULTS Using mediation analyses with bootstrapping procedures, we first confirmed that self-efficacy was associated indirectly with adherence, via higher intentions in a partial mediation (unstandardized indirect effect .21, 95% CI .18-.25). The message increased self-efficacy; participants receiving the message reported higher self-efficacy (M = 4.23, SD = .80) compared to participants in the control condition (M = 4.08, SD = .77; standardized regression coefficient = .19, p < .05) and self-efficacy affected intention (.48, p < .001). There was a small significant indirect effect of the message on intention via self-efficacy (unstandardized indirect effect .07, CI .01-.14). CONCLUSIONS Increasing self-efficacy for physical distancing with a short message can successfully increase intention to physical distance via increased self-efficacy. As both self-efficacy and intentions are important predictors of adherence to transmission-reducing behaviours short messages have potential to limit the spread of COVID-19.
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Affiliation(s)
- Chantal den Daas
- Health Psychology GroupUniversity of Aberdeen Institute of Applied Health SciencesAberdeenUK
| | - Marie Johnston
- Health Psychology GroupUniversity of Aberdeen Institute of Applied Health SciencesAberdeenUK
| | - Gill Hubbard
- Department of Nursing and MidwiferyUniversity of the Highlands and Islands Institute of Health Research and InnovationInvernessUK
| | - Diane Dixon
- Health Psychology GroupUniversity of Aberdeen Institute of Applied Health SciencesAberdeenUK
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Jakiela JT, Voinier D, Hinman RS, Copson J, Schmitt LA, Leonard TR, Aily JB, Bodt BA, White DK. Comparing an Expanded Versus Brief Telehealth Physical Therapy Intervention for Knee Osteoarthritis: Study Protocol for the Delaware PEAK Randomized Controlled Trial. Phys Ther 2022; 103:6749069. [PMID: 36200390 DOI: 10.1093/ptj/pzac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/15/2022] [Accepted: 09/12/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate whether a remotely delivered physical therapist intervention increases physical activity (PA) over 12 weeks, compared to existing web-based resources, in adults with knee osteoarthritis (OA). METHODS This will be a single-center, randomized controlled trial with 2 parallel arms: (1) the Expanded Intervention (Delaware PEAK [Physical Exercise and Activity for Knee osteoarthritis]), which includes five 45- to 60-minute video conference-based sessions of supervised exercise (strengthening exercises, step goals) that are remotely delivered over 12 weeks by a physical therapist, or (2) the Brief Intervention (control group), a website that includes prerecorded videos directing participants to web-based resources for strengthening, PA, and pain management for knee OA that are freely available online. The trial will enroll 100 participants who meet the National Institute for Health and Care Excellence (NICE) OA clinical criteria (≥45 years old, have activity-related knee pain, have no morning stiffness or it lasts ≤30 minutes), reside in the contiguous US (excluding Alaska and Hawaii), and are seeking to be more physically active. Outcomes include PA (time in moderate-to-vigorous exercise and light exercise, steps/day), sedentary behaviors, treatment beliefs, and self-efficacy for exercise. Our primary outcome is moderate-to-vigorous PA (MVPA). Outcomes will be measured at baseline, 12 weeks, and 24 weeks. IMPACT This protocol focuses on the remote delivery of physical therapy via telehealth to adults with knee OA and comes at a critical time, as the burden of inactivity is of particular concern in this population. If successful, the findings of this work will provide strong support for the broad implementation of Delaware PEAK, highlight the utility of telehealth in physical therapy, and address the critical need to utilize exercise to manage adults with knee OA through physical therapists.
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Affiliation(s)
- Jason T Jakiela
- Department of Physical Therapy, University of Delaware, Newark, Delaware.,Department of Biomechanics and Movement Science, University of Delaware, Newark, Delaware
| | - Dana Voinier
- Department of Physical Therapy, University of Delaware, Newark, Delaware.,Department of Biomechanics and Movement Science, University of Delaware, Newark, Delaware
| | - Rana S Hinman
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Jennifer Copson
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Laura A Schmitt
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Tara R Leonard
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Jéssica B Aily
- Department of Physical Therapy, University of Delaware, Newark, Delaware.,Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Barry A Bodt
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Daniel K White
- Department of Physical Therapy, University of Delaware, Newark, Delaware.,Department of Biomechanics and Movement Science, University of Delaware, Newark, Delaware
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Reid H, Smith R, Williamson W, Baldock J, Caterson J, Kluzek S, Jones N, Copeland R. Use of the behaviour change wheel to improve everyday person-centred conversations on physical activity across healthcare. BMC Public Health 2022; 22:1784. [PMID: 36127688 PMCID: PMC9487060 DOI: 10.1186/s12889-022-14178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/09/2022] [Indexed: 11/12/2022] Open
Abstract
Background An implementation gap exists between the evidence supporting physical activity in the prevention and management of long-term medical conditions and clinical practice. Person-centred conversations, i.e. focussing on the values, preferences and aspirations of each individual, are required from healthcare professionals. However, many currently lack the capability, opportunity, and motivation to have these conversations. This study uses the Behaviour Change Wheel (BCW) to inform the development of practical and educational resources to help bridge this gap. Methods The BCW provides a theoretical approach to enable the systematic development of behaviour change interventions. Authors followed the described eight-step process, considered results from a scoping review, consulted clinical working groups, tested and developed ideas across clinical pathways, and agreed on solutions to each stage by consensus. Results The behavioural diagnosis identified healthcare professionals’ initiation of person-centred conversations on physical activity at all appropriate opportunities in routine medical care as a suitable primary target for interventions. Six intervention functions and five policy categories met the APEASE criteria. We mapped 17 Behavioural Change Techniques onto BCW intervention functions to define intervention strategies. Conclusions This study uses the BCW to outline a coherent approach for intervention development to improve healthcare professionals’ frequency and quality of conversations on physical activity across clinical practice. Time-sensitive and role-specific resources might help healthcare professionals understand the focus of their intervention. Educational resources aimed at healthcare professionals and patients could have mutual benefit, should fit into existing care pathways and support professional development. A trusted information source with single-point access via the internet is likely to improve accessibility. Future evaluation of resources built and coded using this framework is required to establish the effectiveness of this approach and help improve understanding of what works to change conversations around physical activity in clinical practice.
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Affiliation(s)
- Hamish Reid
- Moving Medicine, Faculty of Sport and Exercise Medicine, 6 Hill Square, Edinburgh, UK. .,Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Ralph Smith
- Oxford University Hospital NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK
| | - Wilby Williamson
- School of Medicine, Trinity College Dublin, 152-160 Pearse Street, Dublin, Ireland
| | - James Baldock
- Oxford University Hospital NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK
| | - Jessica Caterson
- Imperial College Healthcare NHS Trust, Praed Street, London, GB, W2 1NY, UK
| | - Stefan Kluzek
- School of Medicine, University of Nottingham, Medical School, Nottingham, NG7 2UH, UK
| | - Natasha Jones
- Moving Medicine, Faculty of Sport and Exercise Medicine, 6 Hill Square, Edinburgh, UK.,Oxford University Hospital NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK
| | - Robert Copeland
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
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Chew HSJ, Rajasegaran NN, Chin YH, Chew WSN, Kim KM. Effectiveness of combined health coaching and self-monitoring apps on weight-related outcomes in people with overweight and obesity: A systematic review and meta-analysis (Preprint). J Med Internet Res 2022; 25:e42432. [PMID: 37071452 PMCID: PMC10155083 DOI: 10.2196/42432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/04/2022] [Accepted: 03/09/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Self-monitoring smartphone apps and health coaching have both individually been shown to improve weight-related outcomes, but their combined effects remain unclear. OBJECTIVE This study aims to examine the effectiveness of combining self-monitoring apps with health coaching on anthropometric, cardiometabolic, and lifestyle outcomes in people with overweight and obesity. METHODS Relevant articles published from inception till June 9, 2022, were searched through 8 databases (Embase, CINAHL, PubMed, PsycINFO, Scopus, The Cochrane Library, and Web of Science). Effect sizes were pooled using random-effects models. Behavioral strategies used were coded using the behavior change techniques taxonomy V1. RESULTS A total of 14 articles were included, representing 2478 participants with a mean age of 39.1 years and a BMI of 31.8 kg/m2. Using combined intervention significantly improved weight loss by 2.15 kg (95% CI -3.17 kg to -1.12 kg; P<.001; I2=60.3%), waist circumference by 2.48 cm (95% CI -3.51 cm to -1.44 cm; P<.001; I2=29%), triglyceride by 0.22 mg/dL (95% CI -0.33 mg/dL to 0.11 mg/dL; P=.008; I2=0%), glycated hemoglobin by 0.12% (95% CI -0.21 to -0.02; P=.03; I2=0%), and total calorie consumption per day by 128.30 kcal (95% CI -182.67 kcal to -73.94 kcal; P=.003; I2=0%) kcal, but not BMI, blood pressure, body fat percentage, cholesterol, and physical activity. Combined interventional effectiveness was superior to receiving usual care and apps for waist circumference but only superior to usual care for weight loss. CONCLUSIONS Combined intervention could improve weight-related outcomes, but more research is needed to examine its added benefits to using an app. TRIAL REGISTRATION PROSPERO CRD42022345133; https://tinyurl.com/2zxfdpay.
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Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nagadarshini Nicole Rajasegaran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - W S Nicholas Chew
- Department of Cardiology, National University Hospital Singapore, Singapore, Singapore
| | - Kyung Mi Kim
- Office of Research, Patient Care Services, Stanford Health Care, Menlo Park, CA, United States
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Ahern L, Timmons PS, Lamb PSE, McCullagh DR. Can behavioural change interventions improve self-efficacy and exercise adherence among people with Parkinson’s? A systematic review protocol. HRB Open Res 2022; 5:15. [PMID: 36101872 PMCID: PMC9440372 DOI: 10.12688/hrbopenres.13474.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 01/17/2023] Open
Abstract
Background
:People with Parkinson’s (PwP) have a higher tendency to adopt sedentary lifestyle behaviours and have lower physical activity levels compared to their healthy peers. Previous research has indicated that personal factors including poor outcome expectation and low self-efficacy are stronger predictors of exercise adherence than disease severity.
: The purpose of this review is to synthesize the best available evidence on interventions that encompass self-management strategies to overcome barriers to exercise and improve self-efficacy and exercise adherence among PwP. Methods
: The following databases will be searched using a comprehensive search strategy: EBSCO, Medline, CINAHL, Web of Science, PubMed, Embase, Scopus, Google Scholar and Cochrane Library from database inception to 2020. Interventional studies including behavioural change interventions will be included in this review. The title, abstract and full-text screening will be conducted by two independent reviewers. The Joanne Briggs Institute Checklist will be used to assess the quality of each included study. Data will be extracted by two independent reviewers. The outcomes of interest will be self-efficacy outcomes and measures of exercise adherence. A systematic narrative synthesis will be conducted using a framework analysis, applying the Theoretical Domains Framework and Behaviour Change Wheel, producing findings focusing on practice-orientated outcomes. Presentation of data will include tables and text summarizing the characteristics and findings of the eligible studies. Data synthesis and statistical analysis will be performed in Review manager 5.3. The quality of evidence will be reviewed using the GRADE criteria. Discussion
: The review will comprehensively synthesize the available evidence on interventions to enhance self-efficacy, improve quality of life, physical function, ultimately improving exercise adherence among PwP and provide invaluable information for healthcare professionals.. This review will make recommendations for appropriate self-management strategies for maximum effect and may have implications for policy and practice regarding enhancing self-efficacy and long-term exercise adherence among PwP.
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Affiliation(s)
- Leanne Ahern
- Department of Physiotherapy, School of Clinical Therapies, University College Cork, Cork, Ireland
| | - Prof Suzanne Timmons
- Centre for Gerontology and Rehabilitation, School of Medicine,, University College Cork, Cork, Ireland
| | | | - Dr Ruth McCullagh
- Department of Physiotherapy, School of Clinical Therapies, University College Cork, Cork, Ireland
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Sharma M. Understanding the impact of social learning forms on environmentally sustainable consumption behavior among school children. IJEM 2022. [DOI: 10.1108/ijem-01-2022-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe learning environment is not a vacuum, but rather is rich in social contexts with innumerable points, interests, and beliefs. This takes one of the concepts of “social learning” which is not just a natural occurring phenomenon but also a way of organizing learning and communities of learners. Social Learning (SL) tends to refer to learning that takes place when divergent interests, norms and values of reality meet in an environment that is conducive to learning. This paper helps to determine the impact of SL forms on environmentally sustainable consumption behavior among school children.Design/methodology/approachAfter conducting an experimental study among school children, data were analyzed using ANOVA. The total sample size was 760.FindingsSL forms as an intervention influence environmentally sustainable consumption behavior (ESCB) among school children. The findings of this paper suggest that SL techniques such as visuals had been able to positively impact the constructs like knowledge, comprehension, and application. This was very much supported by observations of children, interactions with them and the upfront support provided by school and teachers.Research limitations/implicationsBased on the result, the paper identified that although SL forms influence the ESCB, there is a need to identify the most effective SL forms having impact on ESCB.Practical implicationsThis study will help marketers to understand that what type of learning forms can be used to enhance the environmentally sustainable consumption behavior among children.Originality/valueThis paper is completely an original work carried out by the author.
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50
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Knudsen SDP, Alomairah SA, Roland CB, Jessen AD, Hergel IM, Clausen TD, Larsen JE, van Hall G, Jensen AK, Molsted S, Bendix JM, Løkkegaard E, Stallknecht B. Effects of Structured Supervised Exercise Training or Motivational Counseling on Pregnant Women's Physical Activity Level: FitMum - Randomized Controlled Trial. J Med Internet Res 2022; 24:e37699. [PMID: 35857356 PMCID: PMC9350815 DOI: 10.2196/37699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/18/2022] [Accepted: 05/31/2022] [Indexed: 02/06/2023] Open
Abstract
Background Physical activity (PA) during pregnancy is an effective and safe way to improve maternal health in uncomplicated pregnancies. However, compliance with PA recommendations remains low among pregnant women. Objective The purpose of this study was to evaluate the effects of offering structured supervised exercise training (EXE) or motivational counseling on PA (MOT) during pregnancy on moderate-to-vigorous intensity physical activity (MVPA) level. Additionally, complementary measures of PA using the Pregnancy Physical Activity Questionnaire (PPAQ) and gold standard doubly labeled water (DLW) technique were investigated. The hypotheses were that both EXE and MOT would increase MVPA in pregnancy compared with standard care (CON) and that EXE would be more effective than MOT. In addition, the association between MVPA and the number of sessions attended was explored. Methods A randomized controlled trial included 220 healthy, inactive pregnant women with a median gestational age of 12.9 (IQR 9.4-13.9) weeks. A total of 219 women were randomized to CON (45/219), EXE (87/219), or MOT (87/219). The primary outcome was MVPA (minutes per week) from randomization to the 29th gestational week obtained by a wrist-worn commercial activity tracker (Vivosport, Garmin International). PA was measured by the activity tracker throughout pregnancy, PPAQ, and DLW. The primary outcome analysis was performed as an analysis of covariance model adjusting for baseline PA. Results The average MVPA (minutes per week) from randomization to the 29th gestational week was 33 (95% CI 18 to 47) in CON, 50 (95% CI 39 to 60) in EXE, and 40 (95% CI 30 to 51) in MOT. When adjusted for baseline MVPA, participants in EXE performed 20 (95% CI 4 to 36) minutes per week more MVPA than participants in CON (P=.02). MOT was not more effective than CON; EXE and MOT also did not differ. MVPA was positively associated with the number of exercise sessions attended in EXE from randomization to delivery (P=.04). Attendance was higher for online (due to COVID-19 restrictions) compared with physical exercise training (P=.03). Adverse events and serious adverse events did not differ between groups. Conclusions Offering EXE was more effective than CON to increase MVPA among pregnant women, whereas offering MOT was not. MVPA in the intervention groups did not reach the recommended level in pregnancy. Changing the intervention to online due to COVID-19 restrictions did not affect MVPA level but increased exercise participation. Trial Registration ClinicalTrials.gov NCT03679130; https://clinicaltrials.gov/ct2/show/NCT03679130 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2020-043671
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Affiliation(s)
- Signe de Place Knudsen
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Saud Abdulaziz Alomairah
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Caroline Borup Roland
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Dsane Jessen
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ida-Marie Hergel
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark
| | - Tine D Clausen
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Eg Larsen
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Gerrit van Hall
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Clinical Biochemistry, Clinical Metabolomics Core Facility, Rigshospitalet, Copenhagen, Denmark
| | - Andreas Kryger Jensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Research, Copenhagen University Hospital-North Zealand, Hillerod, Denmark
| | - Stig Molsted
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Research, Copenhagen University Hospital-North Zealand, Hillerod, Denmark
| | - Jane M Bendix
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Clinical Research, Copenhagen University Hospital-North Zealand, Hillerod, Denmark
| | - Ellen Løkkegaard
- Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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