Piloting the feasibility and effectiveness of print- and telephone-mediated interventions for promoting the adoption of physical activity in Australian adults

This study examined the feasibility and effectiveness for increasing physical activity of a print-based intervention, and a print- plus telephone-mediated intervention among mid-life and older Australian adults. A randomised controlled trial study design was used. In mid-2002, 66 adults (18 men, 48 women) aged 45-78 years, who identified themselves as under-active, were recruited through advertisements and word-of-mouth at two sites (Melbourne and Brisbane), and randomised to either the print or print-plus-telephone mediated intervention group. Participants in both groups attended an initial briefing session, and over the 12-week intervention period received an instructional newsletter and use of a pedometer (both groups), and individualised telephone calls (print- plus-telephone group only). Self-reported physical activity data were collected at baseline, 12 and 16 weeks. Measures of self-reported global physical activity, moderate-vigorous intensity activity and walking all showed increases between baseline and 12 weeks for both intervention groups. These increases were generally maintained by 16 weeks, although participants in the print-plus-telephone group maintained slightly higher levels of global reported activity and walking (by approximately 30 mins/wk) than those in the print group. These interventions show potential for promoting initial increases in physical activity among mid-life and older Australian adults, and should be evaluated across more extended time periods.

Age-related differences in physical activity levels of young adults

Purpose: To examine age-related differences in the physical activity behaviors of young adults. Methods: We examined rates of participation in vigorous- and moderate-intensity leisure-time activity and walking, as well as an index of physical activity sufficient for health benefits in three Australian cross-sectional samples, for the age ranges of 18-19, 20-24, and 25-29 yr. Data were collected in 1991, 1996, and 1997/8. Results: There was at least a 15% difference in vigorous-intensity leisure-time physical activity from the 18-19 yr to the 25-29 yr age groups, and at least a 10% difference in moderate-intensity leisure-time physical activity. For the index of sufficient activity there was a difference between 9 and 21% across age groups. Differences in rates of walking were less than 8%. For all age groups, males had higher rates of participation for vigorous and moderate-intensity activity than did females, bur females had much higher rates of participation in walking than males. Age-associated differences in activity levels were more apparent for males. Conclusions: Promoting walking and various forms of moderate-intensity physical activities to young adult males, and encouraging young adult females to adopt other forms of moderate-intensity activity to complement walking may help to ameliorate decreases in physical activity over the adult lifespan.

Psychological well-being and perception of disease severity in people with multiple sclerosis, who underwent a program of self-regulation to promote physical activity

Rehabilitation is very important for in the results of treatment in individuals with multiple sclerosis. Rehabilitation processes occur through gradual changes. These changes integrate intrinsic and extrinsic mechanisms of the individual, promoting adaptations to the needs and activities of daily living according to individual goals. Recommendations for exercise in multiple sclerosis: these recommendations apply only to patients with EDSS less than 7; moderate intensity aerobic exercise for a total of 20 to 30 minutes, twice or three times for week; the resistance training with low or moderate intensity is well tolerated by patients with MS; associated with these exercises were recommended flexibility exercises of moderate intensity, as well as strengthening exercises. The aim of this study is to examine the implications of the program of self-regulation in the perception of illness and mental health (psychological well-being domain) in multiple sclerosis patients.

Enhancing physical activity coaching through personalized motivational strategies and self-adaptive goal-setting: development of self-adaptive processes in a monitoring and coaching smartphone application

Dissertação para obtenção do Grau de Mestre em Engenharia Biomédica

Assessment of the Cardiovascular Risk and Physical Activity of Individuals Exercising at a Public Park in the City of São Paulo

OBJECTIVE: Physical exercise helps to prevent cardiovascular disorders. Campaigns promoting exercise have taken many people to the parks of our city. The most appropriate exercise for preventing cardiovascular disorders is the aerobic modality; inappropriate exercise acutely increases cardiovascular risk, especially in individuals at higher risk. Therefore, assessing the cardiovascular risk of these individuals and their physical activities is of practical value. METHODS: In the Parque Fernando Costa, we carried out the project "Exercício e Coração" (Exercise and Heart) involving 226 individuals. Assessment of the cardiovascular risk and of the physical activity practiced by the individuals exercising at that park was performed with a questionnaire and measurement of the following parameters: blood pressure, weight, height, and waist/hip ratio. The individuals were lectured on the benefits provided by exercise and how to correctly exercise. Each participant received a customized exercise prescription. RESULTS: In regard to risk, 43% of the individuals had health problems and 7% of the healthy individuals had symptoms that could be attributed to heart disorders. High blood pressure was observed in a large amount of the population. In regard to the adequacy of the physical activity, the individuals exercised properly. The project was well accepted, because the participants not only appreciated the initiative, but also reported altering their exercise habits after taking part in the project. CONCLUSION: Data obtained in the current study point to the need to be more careful in assessing the health of individuals who exercise at parks, suggesting that city parks should have a sector designated for assessing and guiding physical activity.

Long-term effect of a school-based physical activity program (KISS) on fitness and adiposity in children: a cluster-randomized controlled trial.

BACKGROUND: School-based intervention studies promoting a healthy lifestyle have shown favorable immediate health effects. However, there is a striking paucity on long-term follow-ups. The aim of this study was therefore to assess the 3 yr-follow-up of a cluster-randomized controlled school-based physical activity program over nine month with beneficial immediate effects on body fat, aerobic fitness and physical activity. METHODS AND FINDINGS: Initially, 28 classes from 15 elementary schools in Switzerland were grouped into an intervention (16 classes from 9 schools, n = 297 children) and a control arm (12 classes from 6 schools, n = 205 children) after stratification for grade (1st and 5th graders). Three years after the end of the multi-component physical activity program of nine months including daily physical education (i.e. two additional lessons per week on top of three regular lessons), short physical activity breaks during academic lessons, and daily physical activity homework, 289 (58%) participated in the follow-up. Primary outcome measures included body fat (sum of four skinfolds), aerobic fitness (shuttle run test), physical activity (accelerometry), and quality of life (questionnaires). After adjustment for grade, gender, baseline value and clustering within classes, children in the intervention arm compared with controls had a significantly higher average level of aerobic fitness at follow-up (0.373 z-score units [95%-CI: 0.157 to 0.59, p = 0.001] corresponding to a shift from the 50th to the 65th percentile between baseline and follow-up), while the immediate beneficial effects on the other primary outcomes were not sustained. CONCLUSIONS: Apart from aerobic fitness, beneficial effects seen after one year were not maintained when the intervention was stopped. A continuous intervention seems necessary to maintain overall beneficial health effects as reached at the end of the intervention. TRIAL REGISTRATION: ControlledTrials.com ISRCTN15360785.

Physical activity, bodyweight, health and fear of negative evaluation in primary school children.

Fear of negative evaluation (FNE) is regarded as being the core feature of social anxiety. The present study examined how FNE is associated with physical activity (PA), body mass index (BMI) and perceived physical health (PPH) in children. Data were collected in a sample of 502 primary school children in first and fifth grades taking part in a randomized-controlled trial ("Kinder-Sportstudie KISS") aimed at increasing PA and health. PA was assessed by accelerometry over 7 days, PPH by the Child Health Questionnaire and FNE by the Social Anxiety Scale for Children--Revised. BMI z-scores were calculated based on Swiss norms. Cross-sectional analyses indicated that children high in FNE exercised less, reported lower levels of PPH and had higher BMI z-scores (P<0.01). Using mixed linear models, the school-based PA intervention did not manage to reduce FNE scores. Overweight children demonstrated a greater increase in FNE (P<0.05) indicating that enhanced weight may be a risk factor for FNE. In conclusion, the associations among high FNE, low PA and increased BMI should be considered when promoting an active lifestyle in children.

Physical activity and energy expenditure in rheumatoid arthritis patients and matched controls.

OBJECTIVES: To compare daily energy expenditure between RA patients and matched controls, and to explore the relationship between daily energy expenditure or sedentariness and disease-related scores. METHODS: One hundred and ten patients with RA and 440 age- and sex-matched controls were included in this study. Energy expenditure was assessed using the validated physical activity (PA) frequency questionnaire. Disease-related scores included disease activity (DAS-28), functional status (HAQ), pain visual analogue scale (VAS) and fatigue VAS. Total energy expenditure (TEE) and the amount of energy spent in low- (TEE-low), moderate- (TEE-mod) and high-intensity (TEE-high) PAs were calculated. Sedentariness was defined as expending <10% of TEE in TEE-mod or TEE-high activities. Between-group comparisons were computed using conditional logistic regression. The effect of disease-related scores on TEE was investigated using linear regression. RESULTS: TEE was significantly lower for RA patients compared with controls [2392 kcal/day (95% CI 2295, 2490) and 2494  kcal/day (2446, 2543), respectively, P = 0.003]. A significant difference was found between groups in TEE-mod (P = 0.015), but not TEE-low (P = 0.242) and TEE-high (P = 0.146). All disease-related scores were significantly poorer in sedentary compared with active patients. TEE was inversely associated with age (P < 0.001), DAS-28 (P = 0.032) and fatigue VAS (P = 0.029), but not with HAQ and pain VAS. CONCLUSION: Daily energy expenditure is significantly lower in RA patients compared with matched controls, mainly due to less moderate-intensity PAs performed. Disease activity and fatigue are important contributing factors. These points need to be addressed if promoting PA in RA patients is a health goal. Trial registration. ClinicalTrials.gov, http://clinicaltrials.gov, NCT01228812.

"An on-going individual adjustment" : a qualitative study of midwives' experiences counselling pregnant women on physical activity in Sweden

Background: In Sweden, midwives play prominent supportive role in antenatal care by counselling and promoting healthy lifestyles. This study aimed to explore how Swedish midwives experience the counselling of pregnant women on physical activity, specifically focusing on facilitators and barriers during pregnancy. Also, addressing whether the midwives perceive that their own lifestyle and body shape may influence the content of the counselling they provide. Methods: Eight focus group discussions (FGD) were conducted with 41 midwives working in antenatal care clinics in different parts of Sweden between September 2013 and January 2014. Purposive sampling was applied to ensure a variation in age, work experience, and geographical location. The FGD were digitally recorded, transcribed verbatim, and analyzed using manifest and latent content analysis. Results: The main theme- "An on-going individual adjustment" was built on three categories: "Counselling as a challenge"; "Counselling as walking the thin ice" and "Counselling as an opportunity" reflecting the midwives on-going need to adjust their counselling depending on each woman's specific situation. Furthermore, counselling pregnant women on physical activity was experienced as complex and ambiguous, presenting challenges as well as opportunities. When midwives challenged barriers to physical activity, they risked being rejected by the pregnant women. Despite risking rejection, the midwives tried to promote increased physical activity based on their assessment of individual needs of the pregnant woman. Some participants felt that their own lifestyle and body shape might negatively influence the counselling; however, the majority of participants did not agree with this perspective. Conclusions: Counselling on physical activity during pregnancy may be a challenging task for midwives, characterized by on-going adjustments based on a pregnant woman's individual needs. Midwives strive to find individual solutions to encourage physical activity. However, to improve their counselling, midwives may benefit from further training, also organizational and financial barriers need to be addressed. Such efforts might result in improved opportunities to further support pregnant women's motivation for performance of physical activity.

Cognitively engaging chronic physical activity, but not aerobic exercise, affects executive functions in primary school children: A group-randomized controlled trial

Although the positive effects of different kinds of physical activity (PA) on cognitive functioning have already been demonstrated in a variety of studies, the role of cognitive engagement in promoting children’s executive functions is still unclear. The aim of the present study was therefore to investigate the effects of two qualitatively different chronic PA interventions on executive functions in primary school children. 181 children aged between 10 and 12 years were assigned to either a 6-week physical education program with a high level of physical exertion and high cognitive engagement (team games), a physical education program with high physical exertion but low cognitive engagement (aerobic exercise), or to a physical education program with both low physical exertion and low cognitive engagement (control condition). Executive functions (updating, inhibition, shifting) and aerobic fitness (multistage 20-meter shuttle run test) were measured before and after the respective condition. Results revealed that both interventions (team games and aerobic exercise) have a positive impact on children’s aerobic fitness (4-5 % increase in estimated VO2max). Importantly, an improvement in shifting performance was found only in the team games and not in the aerobic exercise or control condition. Thus, the inclusion of cognitive engagement in PA seems to be the most promising type of chronic intervention to enhance executive functions in children, providing further evidence for the importance of the qualitative aspects of PA.

Physician's adherence to CDC standards for physical activity counseling of older women in a cardiology practice in Texas---An exploratory study

Physical activity is an important health-promoting behavior to prevent and control chronic disease. Interventions to increase physical activity are vitally needed. Women are not meeting the recommended goals for physical activity - a behavior that has been shown to effectively reduce the incidence of chronic disease and the medical costs associated with treating it. Among many factors predicting physical activity and the different forms of interventions that have been applied, physician counseling is one potentially cost-effective approach that may produce at least modest effects on women's behavior. The Centers for Disease Control and Prevention has published standards for physician counseling of patients regarding physical activity. This study used a short questionnaire to assess the degree to which a group practice of cardiology physicians in Texas queried and discussed physical activity recommendations to older women that they treat and whether they are meeting the physical activity counseling goals of the Centers for Disease Control and Prevention. The majority of this group of physicians counseled patients without benefit of exploring patient behavior. Although these physicians "agreed" that physical activity delayed or prevented disease, the outcome suggests that low self-efficacy hampered efforts to counsel older women on this. Physicians' perceptions that counseling may be ineffective could explain the lower rate of physical activity counseling that does not meet the goals of the Centers for Disease Control and Prevention. ^

Examining seasonal variations in physical activity among low-income Hispanic walk-trail users living in the Cameron Park Colonia

This study examines variations in physical activity by season, and within seasons by age and gender among park users living in the Cameron Park Colonia, a low-income Hispanic community along the Texas-Mexico border. This is the first study of its kind to evaluate seasonal variations by physical activity among a Hispanic population. We hypothesized that (1) there are no differences in overall physical activity by season; (2) youth engage in more sport-related physical activity compared to adults, (3) males engage in more physical activity than females, and (4) there are differences in physical activity between walk-trail users compared to non walk-trail users in the park.^ Physical activity behavioral data was collected (males n=2,093; females n=1,014) at two time periods (winter 2007; summer 2007) via direct observations and assessed park use, walking trail use, and physical activity (moderate-to-vigorous physical activity (MVPA) by seasons. Frequencies for physical activities were calculated for gender, age groups, and season. Separate Pearson's chi-square analyses were used to address variations in physical activity, age, gender, intensity level of physical activity by season, between walk-trails users and non walk-trail users.^ People visiting the park engaged in more sedentary behavior in winter than summer and a higher percentage engaged in MVPA in the summer than winter (p<.05). More females engaged in light activity compared to males (p<.05). Walk-trail users consisted mostly of females and engaged in more light activity than non walk-trail users (p<.05) who participated in more MVPA.^ Increasing access to parks and walk-trails may be an intervention strategy to increase physical activity among Hispanics. More research is needed to assess promoting trail use and determining long-term effects on physical activity among minority/ethnic groups at greater risk of a sedentary lifestyle and reasons for trail use and non-use. Future studies should focus on the types of activities Hispanics engage in at different parks particularly between men and women. As a result of this study city officials and planners may use this information to build and design parks that cater to the types of activities that Hispanics engage in and may use to meet physical activity guidelines.^

Effects of a health advocacy program to promote physical activity and nutrition behaviors among adolescents: An evaluation of the Young Leaders for Healthy Change program

Background. This study was designed to evaluate the effects of the Young Leaders for Healthy Change program, an internet-delivered program in the school setting that emphasized health advocacy skills-development, on nutrition and physical activity behaviors among older adolescents (13–18 years). The program consisted of online curricular modules, training modules, social media, peer and parental support, and a community service project. Module content was developed based on Social Cognitive Theory and known determinants of behavior for older adolescents. ^ Methods. Of the 283 students who participated in the fall 2011 YL program, 38 students participated in at least ten of the 12 weeks and were eligible for this study. This study used a single group-only pretest/posttest evaluation design. Participants were 68% female, 58% white/Caucasian, 74% 10th or 11th graders, and 89% mostly A and/or B students. The primary behavioral outcomes for this analysis were participation in 60-minutes of physical activity per day, 20-minutes of vigorous- or moderate- intensity physical activity (MVPA) participation per day, television and computer time, fruit and vegetable (FV) intake, sugar-sweetened beverage intake, and consumption of breakfast, home-cooked meals, and fast food. Other outcomes included knowledge, beliefs, and attitudes related to healthy eating, physical activity, and advocacy skills. ^ Findings. Among the 38 participants, no significant changes in any variables were observed. However, among those who did not previously meet behavioral goals there was an 89% increase in students who participated in more than 20 minutes of MVPA per day and a 58% increase in students who ate home-cooked meals 5–7 days per week. The majority of participants met program goals related to knowledge, beliefs, and attitudes prior to the start of the program. Participants reported either maintaining or improving to the goal at posttest for all items except FV intake knowledge, taste and affordability of healthy foods, interest in teaching others about being healthy, and ease of finding ways to advocate in the community. ^ Conclusions. The results of this evaluation indicated that promoting healthy behaviors requires different strategies than maintaining healthy behaviors among high school students. In the school setting, programs need to target the promotion and maintenance of health behaviors to engage all students who participate in the program as part of a class or club activity. Tailoring the program using screening and modifying strategies to meet the needs of all students may increase the potential reach of the program. The Transtheoretical Model may provide information on how to develop a tailored program. Additional research on how to utilize the constructs of TTM effectively among high school students needs to be conducted. Further evaluation studies should employ a more expansive evaluation to assess the long-term effectiveness of health advocacy programming.^

Relationship Between Workplace Productivity and Physical Activity Among an Employed Healthcare Workforce

Thesis (Master's)--University of Washington, 2016-06

Using the Internet for Physical Activity Promotion in a Regional Community: Feasibility Study Findings

New communication technologies (websites and email) are believed to hold promise for delivering population health interventions. However, studies on internet-delivered physical activity (PA) programs have encountered difficulties in engaging and retaining participants. Recent PA research has focused on peoples’ perceptions of the local environment and how this relates to PA participation. This study investigated the potential of: 1) reaching people living in a regional community via a locally-based Internet Service Provider (ISP), and 2) using data on the local environment to design a PA intervention relevant to the individual. An online survey was conducted via the ISP’s website over 12 days. ISP clients (approximately 9,000) were invited to participate in the survey via electronic newsletter and direct email. Data on motivational readiness and environmental correlates of PA were collected. 820 surveys were completed, of which 797 were valid (response rate = 9%). Participants had a mean BMI 27.6±8.3, were 55% male, 56% aged >45 years, 57% worked fulltime, and 36% were in the early stages of motivational readiness for PA. Most reported positive perceptions of the local environment in terms of aesthetics, convenience, access, traffic and safety. However, over half did not know about or use local PA facilities. Over 70% were somewhat to extremely interested in having access to a PA promotion website. These data suggest that promoting PA via a locally based ISP is feasible and appealing to some people living in a regional community, but also highlight some of the challenges of using this technology to deliver population health interventions.