Linking Physical Activity to Personal Values: Feasibility and Acceptability Randomized Pilot of a Behavioral Intervention for Older Adults with Osteoarthritis Pain

Abstract Background Osteoarthritis (OA) pain is common and leads to functional impairment for many older adults. Physical activity can improve OA outcomes for older adults, but few are appropriately active. Behavioral interventions can reduce barriers to physical activity. We developed and tested a brief, novel behavioral intervention for older adults combining values to enhance motivation and strategic activity pacing to improve arthritis-related pain and functioning and increase physical activity. Methods A randomized feasibility and acceptability pilot trial compared Engage-PA to treatment as usual plus fitness tracker (TAU+) in N=40 adults age 65+ with OA pain in the knee or hip. Engage-PA involved two 60-minute telephone sessions. All participants wore a fitness tracker to collect daily steps throughout the study and completed baseline and post-treatment assessments of secondary outcomes (arthritis-related pain and physical functioning, physical activity, psychological distress, psychological flexibility, and value-guided action). The impact of COVID-19 on general wellbeing and physical activity was also assessed. Descriptive statistics were conducted for feasibility and acceptability outcomes. Indicators of improvement in secondary outcomes were examined via change scores from baseline to post-treatment and performing independent samples t-tests to assess for between-group differences. Results Feasibility was high; 100% accrual, low (5%) attrition, and 100% completion of study sessions. Acceptability was high, with 89% finding the intervention “mostly” or “very” helpful. Engage-PA participants demonstrated improvements in arthritis pain severity (Mdiff=1.68, p<.05), arthritis-related physical functioning (Mdiff=.875, p=.056), and self-reported activity (Mdiff=.875, p<.05) from baseline to post-treatment as compared to TAU+. Sixty-three percent of participants provided useable objective daily steps data. Other secondary outcome patterns were not interpretable in this small sample. COVID-19 added additional burden to participants, such that 50% were exercising less, 68% were more sedentary, and 72% lost access to spaces and social support to be active. Conclusions Engage-PA is a promising brief, novel behavioral intervention that has potential to support older adults in improving arthritis-related pain and functioning and increasing physical activity. The feasibility and acceptability of the intervention is particularly notable as most participants reported COVID-19 added more barriers to physical activity, and Engage-PA may be appealing in future studies. Trial Registration: clinicaltrials.gov, NCT04490395, registered 7/29/2020, https://clinicaltrials.gov/ct2/show/NCT04490395.

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Lifestyle-integrated functional exercise to prevent falls and promote physical activity: Results from the LiFE-is-LiFE randomized non-inferiority trial

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01190-z ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Carl-Philipp Jansen ◽

Corinna Nerz ◽

Sarah Labudek ◽

Sophie Gottschalk ◽

Franziska Kramer-Gmeiner ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Secondary Outcome ◽

Risk Of Falling ◽

Intention To Treat ◽

Phone Calls ◽

Functional Exercise ◽

Secondary Outcomes ◽

Intervention Costs

Abstract Background The ‘Lifestyle-integrated Functional Exercise’ (LiFE) program successfully reduced risk of falling via improvements in balance and strength, additionally increasing physical activity (PA) in older adults. Generally being delivered in an individual one-to-one format, downsides of LiFE are considerable human resources and costs which hamper large scale implementability. To address this, a group format (gLiFE) was developed and analyzed for its non-inferiority compared to LiFE in reducing activity-adjusted fall incidence and intervention costs. In addition, PA and further secondary outcomes were evaluated. Methods Older adults (70 + years) at risk of falling were included in this multi-center, single-blinded, randomized non-inferiority trial. Balance and strength activities and means to enhance PA were delivered in seven intervention sessions, either in a group (gLiFE) or individually at the participant’s home (LiFE), followed by two “booster” phone calls. Negative binomial regression was used to analyze non-inferiority of gLiFE compared to LiFE at 6-month follow-up; interventions costs were compared descriptively; secondary outcomes were analyzed using generalized linear models. Analyses were carried out per protocol and intention-to-treat. Results Three hundred nine persons were randomized into gLiFE (n = 153) and LiFE (n = 156). Non-inferiority of the incidence rate ratio of gLiFE was inconclusive after 6 months according to per protocol (mean = 1.27; 95% CI: 0.80; 2.03) and intention-to-treat analysis (mean = 1.18; 95% CI: 0.75; 1.84). Intervention costs were lower for gLiFE compared to LiFE (-€121 under study conditions; -€212€ under “real world” assumption). Falls were reduced between baseline and follow-up in both groups (gLiFE: -37%; LiFE: -55%); increases in PA were significantly higher in gLiFE (+ 880 steps; 95% CI 252; 1,509). Differences in other secondary outcomes were insignificant. Conclusions Although non-inferiority of gLiFE was inconclusive, gLiFE constitutes a less costly alternative to LiFE and it comes with a significantly larger enhancement of daily PA. The fact that no significant differences were found in any secondary outcome underlines that gLiFE addresses functional outcomes to a comparable degree as LiFE. Advantages of both formats should be evaluated in the light of individual needs and preferences before recommending either format. Trial registration The study was preregistered under clinicaltrials.gov (identifier: NCT03462654) on March 12th 2018

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Symposium 32: Physical activity across the lifespan: Motives and barriers: Barriers to physical activity participation in older adults: A cross-cultural study

PsycEXTRA Dataset ◽

10.1037/e547922012-064 ◽

2003 ◽

Author(s):

Narender K. Chadha ◽

Gregory S. Kolt

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cultural Study ◽

Cross Cultural ◽

Physical Activity Participation ◽

Activity Participation ◽

Cross Cultural Study ◽

Barriers To Physical Activity

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Efficacy of a computer-tailored web-based physical activity intervention using Fitbits for older adults: a randomised controlled trial protocol

BMJ Open ◽

10.1136/bmjopen-2019-033305 ◽

2019 ◽

Vol 9 (12) ◽

pp. e033305 ◽

Cited By ~ 1

Author(s):

Stephanie Alley ◽

Jannique GZ van Uffelen ◽

Stephanie Schoeppe ◽

Lynne Parkinson ◽

Susan Hunt ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Activity Intervention ◽

Sitting Time ◽

Intervention Fidelity ◽

Web Based ◽

Participant Satisfaction ◽

Website Usability ◽

Secondary Outcomes ◽

Tailored Advice

IntroductionPhysical activity is an integral part of healthy ageing, yet the majority of older adults 65+ years are not sufficiently active. Web-based physical activity interventions hold much promise to reach older adults. Preliminary evidence suggests that web-based interventions with tailored advice and Fitbits may be well suited for older adults.Methods and analysisThis study aims to test the effectiveness of ‘Active for Life’, a 12-week computer-tailored web-based physical activity intervention using Fitbits for older adults. We will recruit 300 participants who will be randomly assigned to one of three trial arms: (1) web-based physical activity intervention with tailored advice only, (2) web-based physical activity intervention with tailored advice and Fitbit or (3) a wait-list control. The primary outcome, objective moderate to vigorous physical activity (MVPA) and secondary outcomes of objective sedentary behaviour, objective sleep, quality of life, social support, physical function and satisfaction with life will be assessed at baseline and week 12. The secondary outcomes of self-reported physical activity, sitting time and sleep will be assessed at baseline, week 6, 12 and 24. Website usability and participant satisfaction will be assessed at week 12 and website usage and intervention fidelity will be assessed from week 1 to 24. Intention-to-treat linear mixed model analyses will be used to test for group (tailoring only, tailoring +Fitbit, control) differences on changes in the main outcome, MVPA and secondary outcomes. Generalised linear models will be used to compare intervention groups (tailoring only, tailoring +Fitbit) on website usability, participant satisfaction, website usage and intervention fidelity.Ethics and disseminationThe study has received ethics approval from the Central Queensland University Human Research Ethics Committee (H16/12-321). Study outcomes will be disseminated through peer-reviewed publications and academic conferences and used to inform improvements and dissemination of a tailored, web-based physical activity intervention for adults 65+ years.Trial registration numberAustralian and New Zealand Clinical Trials Registry Number: ACTRN12618000646246

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Motivators, Facilitators, and Barriers to Physical Activity in Older Adults

Holistic Nursing Practice ◽

10.1097/hnp.0000000000000218 ◽

2017 ◽

Vol 31 (4) ◽

pp. 216-224 ◽

Cited By ~ 6

Author(s):

Wendy Miller ◽

Patrick R. Brown

Keyword(s):

Physical Activity ◽

Older Adults ◽

Facilitators And Barriers ◽

Barriers To Physical Activity

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Using an Adjunctive Treatment to Address Psychological Distress in a National Weight Management Program: Results of an Integrated Pilot Study

Military Medicine ◽

10.1093/milmed/usaa145 ◽

2020 ◽

Vol 185 (9-10) ◽

pp. e1662-e1670

Author(s):

Gina Evans-Hudnall ◽

Mary O Odafe ◽

Adrienne Johnson ◽

Nicholas Armenti ◽

Jennifer O’Neil ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Psychological Distress ◽

Weight Management ◽

Physical Functioning ◽

Psychological Symptoms ◽

Post Treatment ◽

Adjunctive Treatment ◽

Depression Symptom ◽

Depression And Anxiety

Abstract Introduction Obesity is highly comorbid with psychological symptoms in veterans, particularly post-traumatic stress disorder (PTSD), depression, and anxiety. Obese veterans with comorbid psychological symptoms often display suboptimal weight loss and poor physical functioning when participating in weight management programs. The MOVE! program aims to increase healthy eating and physical activity to promote weight loss in obese veterans. Adequately addressing psychological barriers is necessary to maximize outcomes in MOVE! for veterans with PTSD, depression, and anxiety. We examined the preliminary outcomes of administering the Healthy Emotions and Improving Health BehavioR Outcomes (HERO) intervention. HERO is adjunctive cognitive-behavioral therapy to MOVE! that addresses PTSD, depression, and anxiety symptom barriers to engagement in physical activity. Materials and Methods All recruitment and study procedures were approved by the institutional review board and research and development committees of the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston, Texas. Participants gave written informed consent before enrollment. Thirty-four obese veterans with a diagnosis of PTSD, depression, and/or anxiety who were attending MOVE! were assigned to the 8-session HERO group or the usual care (UC) group. Veterans completed assessments of PTSD, depression and anxiety symptoms, physical activity, physical functioning, and weight at baseline, 8 and 16 weeks post treatment. Changes from baseline to 8- and 16-week follow-up on the self-report and clinician-rated measures were assessed, using independent samples t-tests and analyses of covariance. Results At 8 weeks post treatment, participants in the HERO group had significantly higher step counts per day than participants in the UC group. Similarly, at 16 weeks post-treatment, participants in the HERO group continued to experience a significant increase in daily steps taken per day, as well as statistically and clinically significantly lower scores on the depression symptom and PTSD symptom severity. Participants in the HERO group also demonstrated significantly higher scores on the physical functioning inventory than participants in the UC group (44.1 ± 12.1 vs. 35.7 ± 10.7, P = 0.04) at 16 weeks post treatment. Conclusions Findings of this small trial have important implications pending replication in a more rigorously designed large-scale study. Providing an adjunctive treatment to MOVE! that addresses psychological distress has potential benefits for psychological symptom reduction, engagement in healthy dietary habits, and greater physical activity for individuals who traditionally experience barriers to making positive weight management changes.

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AN MHEALTH BEHAVIORAL INTERVENTION FOR PROMOTING PHYSICAL ACTIVITY AND SLEEP IN COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.603 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S169-S169

Author(s):

Junxin Li ◽

Sarah Szanton ◽

Minhui Liu ◽

Nada Lukkahatai ◽

Junxin Li ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sleep Quality ◽

Behavioral Intervention ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Post Intervention ◽

Tnf Α ◽

Community Dwelling Older Adults

Abstract Evidence suggests physical activity (PA) improves sleep in older adults. This study examined the preliminary effect of a personalized mHealth behavioral intervention on PA and sleep in older adults. We conducted a randomized controlled pilot trial in 21 community-dwelling older adults with sleep complaints. The 24-week mHealth behavioral intervention included a 2-hour in person training session, personalized exercise prescription, real time PA self-monitoring, interactive prompts, phone consultation, and weekly financial incentives. PA and sleep were measured objectively using Actiwatch 2.0 and subjectively using questionnaires. Peripheral blood was drawn for measuring Plasma inflammatory biomarkers [interleukin 1β, 6, 8, Tumor Necrosis Factor- alpha (TNF-α), and c-reactive protein (CRP)]. Data were collected at baseline, 8-week, 16-week, and post intervention. Repeated measures ANOVA (time*group) was used to examine differences of PA and sleep across times between the two groups. Majority of participants are women (71.4%) with mean age of 73.7 (SD = 6.9). Repeated measure ANOVA showed significant (p <0.05) improvement of objective and subjective PA, objective nocturnal sleep duration, self-report sleep quality (measured by Pittsburg Sleep Quality Index and Insomnia Severity Index) and decreasing of sedentary time over times in the intervention group (n=11), compared to the control group. The intervention group showed significant reduction of plasma TNF-α and CRP levels at 16-week and post intervention. Interventions combining personalized PA and mHealth strategies may positively affect physical activity and sleep in older adults. A larger study is needed to test the efficacy of this intervention and the mechanisms associated with it.

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A Review of Physical Activity Interventions Delivered via Facebook

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0534 ◽

2017 ◽

Vol 14 (10) ◽

pp. 823-833 ◽

Cited By ~ 9

Author(s):

David A. Ferrer ◽

Rebecca Ellis

Keyword(s):

Physical Activity ◽

Behavior Change ◽

Physical Activity Behavior ◽

Small Sample ◽

Secondary Outcome ◽

Control Group ◽

Delivery Method ◽

Physical Activity Interventions ◽

Activity Behavior ◽

Physical Activity Behavior Change

Background:The use of social networking sites to deliver behavioral interventions is becoming more prevalent. The purpose of this review was to systematically evaluate the published research to determine the effectiveness of Facebook-delivered interventions for promoting physical activity behavior change.Methods:A search of interventions delivered via Facebook (as the primary delivery method or part of a multifaceted intervention) in which physical activity was the primary or secondary outcome resulted in 8 studies for review.Results:Overall, 87.5% of the Facebook interventions reported some type of significant physical activity behavior change (ie, interactions, main effects for time, differences between conditions); however, only 2 of these interventions found this change to be significantly better for the treatment group than the control group.Conclusion:Future researchers are encouraged to test the effectiveness of Facebook-delivered physical activity interventions with additional control groups that receive no aspects of the intervention within experimental study designs, more diverse samples, theory-based content with assessment of mediators of behavior change, direct observations of physical activity, and long-term follow-ups. Although based on a small sample of studies, Facebook appears to be a promising delivery method for physical activity interventions.

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