scholarly journals Physical activity coaching for adults with mobility limitations: protocol for the ComeBACK pragmatic hybrid effectiveness-implementation type 1 randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e034696
Author(s):  
Leanne Hassett ◽  
Anne Tiedemann ◽  
Rana S Hinman ◽  
Maria Crotty ◽  
Tammy Hoffmann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Well Being ◽  
Text Messages ◽  
Waiting List ◽  
Randomised Control Trial ◽  
Control Group ◽  
Mobility Limitations ◽  
Intervention Package ◽  
Motivational Resources

IntroductionMobility limitation is common and often results from neurological and musculoskeletal health conditions, ageing and/or physical inactivity. In consultation with consumers, clinicians and policymakers, we have developed two affordable and scalable intervention packages designed to enhance physical activity for adults with self-reported mobility limitations. Both are based on behaviour change theories and involve tailored advice from physiotherapists.Methods and analysisThis pragmatic hybrid effectiveness-implementation type 1 randomised control trial (n=600) will be undertaken among adults with self-reported mobility limitations. It aims to estimate the effects on physical activity of: (1) an enhanced 6-month intervention package (one face-to-face physiotherapy assessment, tailored physical activity plan, physical activity phone coaching from a physiotherapist, informational/motivational resources and activity monitors) compared with a less intensive 6-month intervention package (single session of tailored phone advice from a physiotherapist, tailored physical activity plan, unidirectional text messages, informational/motivational resources); (2) the enhanced intervention package compared with no intervention (6-month waiting list control group); and (3) the less intensive intervention package compared with no intervention (waiting list control group). The primary outcome will be average steps per day, measured with the StepWatch Activity Monitor over a 1-week period, 6 months after randomisation. Secondary outcomes include other physical activity measures, measures of health and functioning, individualised mobility goal attainment, mental well-being, quality of life, rate of falls, health utilisation and intervention evaluation. The hybrid effectiveness-implementation design (type 1) will be used to enable the collection of secondary implementation outcomes at the same time as the primary effectiveness outcome. An economic analysis will estimate the cost-effectiveness and cost-utility of the interventions compared with no intervention and to each other.Ethics and disseminationEthical approval has been obtained by Sydney Local Health District, Royal Prince Alfred Zone. Dissemination will be via publications, conferences, newsletters, talks and meetings with health managers.Trial registration numberACTRN12618001983291.

Effectiveness of the 5A’s Model for Changing Physical Activity Behaviors in Rural Adults Recruited From Primary Care Clinics

2019 ◽  
Vol 16 (12) ◽  
pp. 1138-1146
Author(s):  
Jill R. Reed ◽  
Paul Estabrooks ◽  
Bunny Pozehl ◽  
Kate Heelan ◽  
Christopher Wichman
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Primary Care Clinic ◽  
Intervention Group ◽  
Well Being ◽  
Text Messages ◽  
Future Research ◽  
Control Group ◽  
Care Clinic ◽  
Rural Adults

Background: Most rural adults do not meet current guidelines for physical activity (PA). A 12-week feasibility study tested the effectiveness of using the 5A’s model for PA counseling on rural adults’ PA behaviors. Methods: Inactive rural adults recruited from a primary care clinic were randomized to an intervention (n = 30) or control (n = 29) group. All subjects wore a Fitbit to track steps and active minutes. The intervention group completed action plans to improve self-regulatory PA strategies and received weekly motivational text messages to improve PA behaviors. Theory of planned behavior constructs and self-regulatory strategies of planning, goal setting, and tracking (steps and active minutes) were measured with both groups. The control group received the Fitbit only. Results: All individuals became more physically active; however, no significant differences between groups in active minutes or steps were found. All subjects, regardless of group, increased steps (P > .05). There were no statistically significant differences between groups on any of the theoretical variables. Conclusions: It is vitally important to continue to find ways to make PA a priority to improve the overall health and well-being of rural adults. Future research warrants adjusting the intervention dose and strategies to increase PA that can be maintained long term.

scholarly journals Effectiveness of Text Messaging as an Incentive to Maintain Physical Activity after Cardiac Rehabilitation: A Randomized Controlled Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6645
Author(s):  
Giulia Foccardi ◽  
Marco Vecchiato ◽  
Daniel Neunhaeuserer ◽  
Michele Mezzaro ◽  
Giulia Quinto ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Exercise Testing ◽  
Text Messages ◽  
Control Group ◽  
Stand Test ◽  
Randomized Controlled ◽  
Sit To Stand ◽  
Significant Difference

Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients’ adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects’ ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ −77.5 (95% CI 104.9, −50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients’ Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.

Efficacy of ‘Foundations’, a Digital Mental Health App to Improve Mental Well-Being, during COVID-19: A Proof-of-Principle Randomised Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Silvina Catuara-Solarz ◽  
Bartlomiej Skorulski ◽  
Inaki Estella ◽  
Claudia Avella-Garcia ◽  
Sarah Shepherd ◽  
...  
Keyword(s):  
Mental Health ◽  
Perceived Stress ◽  
Intervention Group ◽  
Well Being ◽  
Self Report ◽  
World Health ◽  
Randomised Control Trial ◽  
Control Group ◽  
Mental Well Being ◽  
Proof Of Principle

BACKGROUND Against a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being. OBJECTIVE The aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomised control trial that took place during the first wave of the COVID-19 pandemic in the UK. METHODS Adults with mild to severe anxiety and moderate to high levels of perceived stress were randomised to either the intervention or control arm. Participants in the intervention arm were given access to the app, Foundations, for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10]; 7-item Generalised Anxiety Disorder scale [GAD-7]; Office of National Statistics Four Subjective Well-being Questions [ONS-4]; World Health Organisation-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and weeks 2 and 4; and, in addition, on perceived stress weekly (10-item Perceived Stress Score [PSS]). RESULTS 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety (GAD-7 score, delta from baseline to week 2 in the intervention group: -1.35 [SD 4.43]; control group: -0.23 [SD 3.24]; t134= 1.71 , P=.04), resilience (CD-RISC score, delta from baseline to week 2 in the intervention group: 1.79 [± SD 4.08]; control group: -0.31 [± SD 3.16]; t134 -3.37, P<.001), sleep (MISS score, delta from baseline to week 2 in the intervention group: -1.16 [± SD 2.67]; control group: -0.26 [± SD 2.29]; t134= 2.13, P=.01), and mental well-being (WHO-5 score, delta from baseline to week 2 in the intervention group: 1.53 [5.30]; control group: -0.23 [± SD 4.20]; t134= -2.16, P=.02) within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the results did not reach statistical significance relative to the control group (PSS score, delta from baseline to week 2 in the intervention group: -2.94 [± SD 6.84]; control group: -2.05 [± SD 5.34]; t134= 0.84, P=.20). CONCLUSIONS This study provides proof-of-principle that the digital mental health app, Foundations, can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. It therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic.

scholarly journals Long-Term and Transfer Effects of an Action Control Intervention in Overweight Couples: A Randomized Controlled Trial Using Text Messages

2021 ◽  
Vol 12 ◽  
Author(s):  
Corina Berli ◽  
Urte Scholz
Keyword(s):  
Physical Activity ◽  
Physical Fitness ◽  
Text Messaging ◽  
Vigorous Physical Activity ◽  
Action Control ◽  
Text Messages ◽  
Control Group ◽  
Transfer Effects ◽  
Control Intervention

Keeping a physically active lifestyle requires consistent self-regulatory effort such as action control (e.g., continuously monitoring and evaluating a behavior in terms of one’s goals). Involving the romantic partner in interventions might be particularly effective in the long run. The present study examined the long-term and transfer effects of an action control intervention in couples using text messaging for promoting target persons’ and partners’ physical activity, anthropometric measures and physical fitness 6 months post baseline. A total of 121 overweight and obese romantic couples, randomly allocated to an intervention (n = 60; information + action control text messages) or a control group (n = 61; information only) and to participating as target person or partner, completed baseline assessments (T1). 100 couples (82.6%) completed the 6-month follow-up (T3) assessment. Primary outcomes included self-reported moderate-to-vigorous physical activity (MVPA) and objective MVPA and MVPA adherence using triaxial accelerometers across a diary period of 14 days after T3. Secondary outcomes included BMI, waist-to-hip circumference and physical fitness (target persons only) using a submaximal aerobic cycle test. At T3, there were no significant between-group differences between target persons and partners with regard to their objective MVPA, self-reported MVPA, BMI, waist-hip ratio or physical fitness. No significant changes in outcomes were observed from T1 to T3; however, changes in BMI from T1 to T3 between target persons and partners in the intervention group were associated. Overall, the brief 14-days action control intervention was not effective in improving target person’s physical activity, body measures and physical fitness in the long-term. Moreover, no long-term benefits for partners emerged. While brief ecological momentary interventions might be a promising tool for short-term effects, future studies are needed to test features enhancing long-term effectiveness. Associations in romantic partners’ changes suggest that dyadic interventions can be a promising approach, as changes induced in one partner may then transfer over to the other (controlled-trials.com ISRCTN15705531).

An Adaptive, Algorithm-based Text Message Intervention to Promote Health Behavior Adherence in Type 2 Diabetes: Treatment Development and Proof-of-Concept Trial

2021 ◽  
pp. 193229682110650
Author(s):  
Christopher M. Celano ◽  
Christina Massey ◽  
Jessica Long ◽  
Sonia Kim ◽  
Olivia Velasquez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Adaptive Algorithm ◽  
Controlled Trial ◽  
Text Message ◽  
Self Care ◽  
Well Being ◽  
Psychological Outcomes ◽  
Text Messages

Background: Most individuals with type 2 diabetes (T2D) struggle to adhere to one or more health behaviors. Text message interventions (TMIs) have the potential to improve adherence but have had mixed effects on diet and activity in T2D. We developed an eight-week, adaptive, algorithm-driven TMI to promote physical activity, diet, self-care, and well-being. Then, in a single-arm trial, we assessed its feasibility, acceptability, and preliminary efficacy in 15 individuals with T2D and suboptimal adherence. Methods: Participants received daily text messages and were asked to rate the utility of each message (0=not helpful, 10=very helpful). These ratings were used by an algorithm to select subsequent messages based on each participant’s prior ratings. We assessed intervention feasibility by rates of message transmission/response and acceptability through ratings of message utility and burden. Finally, we examined pre-post changes in diabetes self-care, diet, physical activity, and psychological outcomes and calculated effect sizes (Cohen’s d). Results: All text messages were delivered, and participants provided ratings for 79% of messages, above our a priori thresholds for feasibility. Participants rated the individual messages and overall TMI as subjectively useful (utility: 8.1 [SD=2.1] and 7.8 [SD=2.0], respectively) and not burdensome (burden: 0.8 [SD=1.8]). The intervention led to significant, medium- to large-sized improvements in self-care ( d=0.77), diet ( d=0.99), and activity ( d=0.61) but minimal change in psychological outcomes. Conclusions: The TMI was feasible and well-accepted, and it led to promising improvements in adherence-related outcomes. These findings should be confirmed in a larger randomized controlled trial.

A Group-Based Walking Study to Enhance Physical Activity Among Older Adults: The Role of Social Engagement

2020 ◽  
pp. 016402752096361
Author(s):  
Yujun Liu ◽  
Margie E. Lachman
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Social Engagement ◽  
Treatment Condition ◽  
Social Comparisons ◽  
Text Messages ◽  
Control Group ◽  
Group Members

Objectives. The aim of this study was to explore social engagement and social comparisons as mechanisms to increase physical activity among older adults. Methods. Participants (N = 60, mean age = 65.7) were randomly assigned to one of two conditions. Participants in the treatment condition used the application to track their daily walking steps and interact via text messages with their group members for 4 weeks. Participants in the control group used the application only to track their own walking steps. Outcome variables included mean weekly steps, exercise self-efficacy, and social engagement. Results. The results revealed that participants in the experimental condition significantly increased their mean weekly steps and social engagement from the pretest to the posttest whereas the control group did not. These effects were maintained at the 1-month follow up. Discussion. The study expands our understanding of the motivational role of social engagement and social comparison in increasing PA among older adults.

PHARMACEUTICAL CARE OF ADOLESCENTS WITH DIABETES MELLITUS TYPE 1: THE DIADEMA STUDY, A RANDOMIZED CONTROLLED TRIAL

2015 ◽  
Vol 101 (1) ◽  
pp. e1.67-e1
Author(s):  
Emina Obarčanin ◽  
Manfred Krueger ◽  
Petra Mueller ◽  
Verena Nemitz ◽  
Holger Schwender ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pharmaceutical Care ◽  
Intervention Group ◽  
Well Being ◽  
Diabetes Mellitus Type ◽  
Control Group ◽  
Randomized Controlled ◽  
Phone Calls ◽  
The Impact

BackgroundAdolescents with type 1 diabetes mellitus (T1DM) often show low adherence to complex insulin regimens, leading to poor glycemic control. The benefit of pharmaceutical care in adults with diabetes mellitus type 2 (T2DM) has been widely explored; however, evidence in adolescents with T1DM remains scarce.ObjectiveTo evaluate the impact of pharmaceutical care in adolescents with T1DM provided by a multidisciplinary team on multiple important clinical outcomes.SettingAt the outpatient Helios Paediatric Clinic and at the 12 regular community pharmacies of the study patients with 14 pharmacists in the Krefeld area, Germany, and at the University Pediatric Clinic with one pharmacist on-site in Sarajevo, Bosnia-Herzegovina.MethodsA randomized, controlled, prospective, multicenter study in 68 adolescents with T1DM. The intervention group received monthly structured pharmaceutical care delivered by pharmacists plus supplementary phone calls for 6 months. The control group received usual diabetic care. Data were collected at baseline and after 3 and 6 months. In addition, HbA1c was measured after 12 months.Main outcome measures The between-group difference in the change from baseline in glycosylated hemoglobin (HbA1c), the number of severe hypoglycemic events in both groups, and patient well-being in the intervention group.ResultsThe improvement from baseline in HbA1c was significantly greater in the intervention group than in the control group after 6 months (change from baseline −0.54 vs. +0.32%, p=0.0075), even after adjustment for country-specific variables (p=0.0078). However, the effect was more pronounced after only 3 months (−1.09 vs. +0.23%, p=0.00002). There was no significant between-group difference in the number of severe hypoglycemia events. After 6 months, the well-being according to the WHO-5 index in the intervention group increased significantly from 52.8% to 63.3%. After 12 months the mean total HbA1c remained significantly reduced in the intervention compared to the control group (8.6% vs. 9.5%, p=0.0184).ConclusionThe improved outcomes seen in this study provide new evidence that pharmaceutical care adds value to the management of T1DM in adolescents. However, the optimal methods of achieving sustained long-term improvements in this specific patient population require further study.

Cadaveric Renal Transplant Failure: The Short-Term Sequelae

1986 ◽  
Vol 15 (4) ◽  
pp. 357-364 ◽  
Author(s):  
Gary Rodin ◽  
Karen Voshart ◽  
Daniel Cattran ◽  
Phillip Halloran ◽  
Carl Cardella ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Failure Rate ◽  
Psychosocial Functioning ◽  
Graft Failure ◽  
Well Being ◽  
Waiting List ◽  
Short Term ◽  
Cadaveric Transplantation

Quality of life was evaluated in 103 patients initially when each was placed on the waiting list for a cadaveric transplant. Patients who were not transplanted were reassessed six months after being placed on the waiting list. Patients who received a transplant were reassessed six months after the surgery. Cadaveric transplantation was performed in sixty-three patients by the time of follow-up. The mortality rate of 12.7 percent in transplanted patients after six months was more than twice that in patients who remained on the waiting list without a transplant, but this difference was not statistically significant. There was a graft failure rate of 23.6 percent among transplanted patients who survived six months. Graft failures were associated with some deterioration in subsequent physical activity ( F = 5.4, p < 0.03) but not in psychosocial functioning. Successful cadaveric transplants were associated with a marked and significant improvement in psychosocial well-being ( F = 10.5, p < 0.002) after six months even though physical activity did not increase. These findings suggest that 1) a successful cadaveric transplant is associated with an improved quality of life, 2) the graft failure rate of 23 percent with cadaveric transplantation is still appreciable but 3) graft failure is not necessarily associated in the short term with deterioration in psychosocial well-being.

scholarly journals Assessing the level of well-being in individuals practicing sport

2020 ◽  
Vol 24 (2) ◽  
pp. 15-19
Author(s):  
Magdalena Pieniążek ◽  
Grzegorz Mańko ◽  
Angelika Sosulska ◽  
Jarosław Jaszczur-Nowicki ◽  
Irina Lozinska ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Time Pressure ◽  
Training Session ◽  
Well Being ◽  
Positive Influence ◽  
Mental Condition ◽  
Control Group ◽  
Treatment Of Depression ◽  
Study Results

Background and aim: There is an increasing body of evidence that physical exercise may have a positive effect on people’s mental condition and well-being. Numerous study results indicate that physical activity helps in the treatment of depression and anxiety. This allows for a conclusion that sport – to a great extent – influences not only people’s physical aspects, but also their psyche. Sedentary lifestyle, time pressure and stress that accompanies people at an increasingly younger age contribute both to higher incidence of numerous civilisation diseases and to problems with mental health. The purpose of the study was to verify whether individuals practicing sports manifest better well-being than non-training individuals. Methods: A general interview was conducted with 80 students (40 individuals practicing sports and 40 individuals not practicing sports at all), whereupon they were requested to complete the Warwick-Edinburgh Mental Well-being Scale questionnaire. Results: The individuals practicing sport exhibit greater well-being than the subjects from the control group. It was also demonstrated that the males in the study group exhibit greater wellbeing than the females from the same group However, no findings were made that longer duration of a single training session, its frequency or the time when a given person started practicing sport had any influence on his/her well-being. Conclusions: Practicing sports has a positive influence on people’s well-being. Physical activity should be promoted from as early an age as possible to minimise the risk of numerous diseases in the future, including those affecting mental health.

scholarly journals Effects of barefoot walking on the flat foot in school going children: A Randomised control trial

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1805-1812
Author(s):  
Sharath Hullumani V ◽  
Purusotham Chippala
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Well Being ◽  
Randomised Control Trial ◽  
Control Group ◽  
P Value ◽  
Foot And Ankle ◽  
Flat Foot ◽  
Study Results ◽  
Arch Index

Flat foot is also called Plano-valgus foot, and it is a term, that is commonly used in describing flat foot. Some studies have suggested, that certain foot-specific exercises and barefoot weight bear walking can change foot function like flat foot, and also confirm that shoed walking children are more likely to get a flat foot. An Assessor blinded, Randomized controlled trial with thirty-eight children with flat foot aged 6 – 14 years, both male and female were randomised to the control group (n= 19) and intervention group (n=19). The control group had performed barefoot walking for 45 minutes a day for eight weeks, and the intervention group had received foot-specific exercises with barefoot walking for eight weeks. Foot posture was evaluated by the arch index, while the Oxford foot and ankle questionnaire was used to measure the subjective well-being of children. Measurements were taken before and after the eight weeks of intervention. The outcome of the randomised control trial showed that the barefoot walking group faired far better than that which didn't (p-value <0.05). The intervention group outcomes measure Arch Index, and Oxford Foot and Ankle Questionnaire were p-values is <0.05 from seventh and eight weeks. This study results suggest that barefoot walking and specific foot exercises are effective in improving the flat foot in school-going children.

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