Behavioral Intervention in the Overweight and ObeseEmployee: The Challenge of Promoting Weight Lossand Physical Activity

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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Pilot Trial of a Social Cognitive Theory-Based Physical Activity Intervention Delivered by Nonsupervised Technology in Persons With Multiple Sclerosis

Journal of Physical Activity and Health ◽

10.1123/jpah.2014-0018 ◽

2015 ◽

Vol 12 (7) ◽

pp. 924-930 ◽

Cited By ~ 17

Author(s):

Yoojin Suh ◽

Robert W. Motl ◽

Connor Olsen ◽

Ina Joshi

Keyword(s):

Physical Activity ◽

Multiple Sclerosis ◽

Social Cognitive Theory ◽

Behavioral Intervention ◽

Social Cognitive ◽

Cognitive Theory ◽

Pilot Trial ◽

Intervention Group ◽

Self Report ◽

Phone Calls

Background:Physical inactivity is prevalent in people with multiple sclerosis (MS) and this highlights the importance of developing behavioral interventions for increasing physical activity (PA) in MS. This pilot trial examined the efficacy of a 6-week, behavioral intervention based on social cognitive theory (SCT) delivered by newsletters and phone calls for increasing PA in persons with MS who were physically inactive and had middle levels of self-efficacy.Methods:The sample included 68 persons with relapsing-remitting MS who were randomly assigned into intervention and control groups. The intervention group received SCT-based information by newsletters and phone calls, whereas the controls received information regarding topics such as stress management over 6 weeks. Participants completed self-report of PA and social cognitive variables.Results:The intervention group had a significant increase in self-reported PA (d = 0.56, P = .02) over the 6 weeks, but the controls had a nonsignificant change (d = –0.13, P = .45). Goal setting was changed in the intervention group (d = 0.68, P ≤ .01) and identified as a significant mediator of change in self-reported PA.Conclusions:This study provides initial evidence for the benefit of a theory-based behavioral intervention for increasing PA in MS.

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Pilot Test of an Acceptance-Based Behavioral Intervention to Promote Physical Activity During Weight Loss Maintenance

Behavioral Medicine ◽

10.1080/08964289.2016.1170663 ◽

2016 ◽

Vol 44 (1) ◽

pp. 77-87 ◽

Cited By ~ 3

Author(s):

Meghan L. Butryn ◽

Stephanie Kerrigan ◽

Danielle Arigo ◽

Greer Raggio ◽

Evan M. Forman

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Behavioral Intervention ◽

Weight Loss Maintenance ◽

Pilot Test

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Dietary patterns in obese pregnant women; influence of a behavioral intervention of diet and physical activity in the UPBEAT randomized controlled trial

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-016-0450-2 ◽

2016 ◽

Vol 13 (1) ◽

Cited By ~ 19

Author(s):

Angela C. Flynn ◽

◽

Paul T. Seed ◽

Nashita Patel ◽

Suzanne Barr ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Pregnant Women ◽

Behavioral Intervention ◽

Dietary Patterns ◽

Controlled Trial ◽

Randomized Controlled ◽

Diet And Physical Activity

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Randomized controlled trial of an e-learning designed behavioral intervention for increasing physical activity behavior in multiple sclerosis

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217317734886 ◽

2017 ◽

Vol 3 (4) ◽

pp. 205521731773488 ◽

Cited By ~ 7

Author(s):

Robert W Motl ◽

Elizabeth A Hubbard ◽

Rachel E Bollaert ◽

Brynn C Adamson ◽

Dominique Kinnett-Hopkins ◽

...

Keyword(s):

Physical Activity ◽

Multiple Sclerosis ◽

Randomized Controlled Trial ◽

Behavioral Intervention ◽

Controlled Trial ◽

Analysis Of Covariance ◽

Learning Approaches ◽

Positive Effects ◽

Randomized Controlled ◽

E Learning

Background Internet-delivered, behavioral interventions represent a cost-effective, broadly disseminable approach for teaching persons with multiple sclerosis (MS) the theory-based skills, techniques, and strategies for changing physical activity. Objectives This pilot, randomized controlled trial examined the efficacy of a newly developed Internet website based on e-learning approaches that delivered a theory-based behavior intervention for increasing physical activity and improving symptoms, walking impairment, and neurological disability. Methods Participants with MS ( N = 47) were randomly assigned into behavioral intervention ( n = 23) or waitlist control ( n = 24) conditions delivered over a six-month period. Outcomes were administered before and after the six-month period using blinded assessors, and data were analyzed using analysis of covariance in SPSS. Results There was a significant, positive intervention effect on self-reported physical activity ( P = 0.05, [Formula: see text] = 0.10), and non-significant improvement in objectively measured physical activity ( P = 0.24, [Formula: see text] = 0.04). There were significant, positive effects of the intervention on overall ( P = 0.018, [Formula: see text] = 0.13) and physical impact of fatigue ( P = 0.003, [Formula: see text] = 0.20), self-reported walking impairment ( P = 0.047, [Formula: see text] = 0.10), and disability status ( P = 0.033, [Formula: see text] = 0.11). There were non-significant improvements in fatigue severity ( P = 0.10, [Formula: see text] = 0.06), depression ( P = 0.10, [Formula: see text] = 0.07) and anxiety ( P = 0.06, [Formula: see text] = 0.09) symptoms, and self-reported disability ( P = 0.10, [Formula: see text] = 0.07). Conclusions We provide evidence for the efficacy of an Internet-based behavioral intervention with content delivered through interactive video courses grounded in e-learning principles for increasing physical activity and possibly improving secondary outcomes of fatigue, depression, anxiety, and walking impairment/disability in persons with MS.

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Does the Effect of a Physical Activity Behavioral Intervention Vary by Characteristics of People with Multiple Sclerosis?

International Journal of MS Care ◽

10.7224/1537-2073.2014-016 ◽

2015 ◽

Vol 17 (2) ◽

pp. 65-72 ◽

Cited By ~ 17

Author(s):

Robert W. Motl ◽

Deirdre Dlugonski ◽

Lara A. Pilutti ◽

Rachel E. Klaren

Keyword(s):

Physical Activity ◽

Multiple Sclerosis ◽

Behavioral Intervention ◽

Behavioral Interventions ◽

Weight Status ◽

Interindividual Variability ◽

Vigorous Physical Activity ◽

Normal Weight ◽

Analysis Of Covariance ◽

Disability Status

Background: Behavioral interventions have significantly increased physical activity in people with multiple sclerosis (MS). Nevertheless, there has been interindividual variability in the pattern and magnitude of change. This study documented the efficacy and variability of a behavioral intervention for changing physical activity and examined the possibility that efficacy varied by the characteristics of individuals with MS. Methods: Eighty-two people with MS were randomly assigned to one of two conditions: behavioral intervention (n = 41) or waitlist control (n = 41). We collected information before the study on MS type, disability status, weight status based on body-mass index, and current medications. Furthermore, all participants completed the Godin Leisure Time Exercise Questionnaire and the abbreviated International Physical Activity Questionnaire and wore an accelerometer for 1 week to measure minutes of moderate-to-vigorous physical activity before and after the 6-month intervention period. Results: Analysis of covariance (ANCOVA) indicated that participants in the behavioral intervention had significantly higher levels of physical activity than control participants after the 6-month period (P < .001). There was substantial interindividual variability in the magnitude of change, and ANCOVA indicated that MS type (relapsing vs. progressive) (P < .01), disability status (mild vs. moderate) (P < .01), and weight status (normal weight vs. overweight/obese) (P < .05) moderated the efficacy of the behavioral intervention. Conclusions: The behavioral intervention was associated with improvements in physical activity, particularly for those with mild disability, relapsing-remitting MS, or normal weight status.

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