The Impact of a Telehealth Intervention on Activity Profiles in Older Adults during the COVID-19 Pandemic: A Pilot Study

Background: Physical inactivity during the COVID-19 pandemic is a public health concern for older adults. Telehealth presents a safe platform for conducting health-related interventions that may have additional benefits such as widespread reach. Our pilot study sought to examine how a telehealth intervention changed activity profiles in older adults during the COVID-19 pandemic. Methods: There were n = 13 adults aged 70.6 ± 4.5 years that participated in a 6 week telehealth intervention during the COVID-19 pandemic. The didactic intervention contents were shared online, and participants worked with trained interviewers over the telephone to discuss physical activity. At baseline and post-intervention, the Multimedia Activity Recall for Children and Adults examined activity profiles, while accelerometry estimated time spent sedentary and in physical activity. Results: Relative to the baseline measures, there was an 88 min/day (95% confidence interval (CI): 39, 137) increase in computer time and 36 min/day (CI: 10, 62) reduction in time spent in active transport at post-intervention. Moderate-to-vigorous physical activity participation also increased by an estimated 2 min/day (CI: −21, 26) and 12 min/week (CI: −154, 180), but this trend was not statistically significant. Conclusion: We recommend that support be provided to older adults transitioning to telehealth, especially as migration to telehealth progresses.

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Abstract P495: Trends in Physical Activity Among US Older Adults With Heart Failure 2007-2016

Circulation ◽

10.1161/circ.141.suppl_1.p495 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Fan Ye ◽

Li Zhou ◽

Joseph Yeboah ◽

Peter H Brubaker ◽

Alain G Bertoni

Keyword(s):

Physical Activity ◽

Heart Failure ◽

Older Adults ◽

Vigorous Physical Activity ◽

Public Health Problem ◽

Moderate Intensity ◽

Recreational Activities ◽

Aerobic Activity ◽

Vigorous Intensity ◽

The Impact

Introduction: Heart failure (HF) is a growing public health problem which is the leading cause of hospitalization. About half of people who develop HF die within 5 years of diagnosis. Recent evidence suggests that physical inactivity may be an important risk for HF. However, the importance of physical activity in the prevention and treatment have not been adequately recognized. Self-reported physical activity can provide insights into the impact of lifestyle behaviors on mortality. The objective of this study was to determine the relationship between physical activity and HF in a nationally representative sample of United States (US) adults. Methods: The 2007-2016 National Health and Nutrition Examination Survey data collection cycles were used for this analysis. Participants aged 65 and older with HF were defined as those who answered “yes” to the question: “Has a doctor or other health professional ever told you that you had congestive HF?” Frequency and duration of self-reported moderate-intensity (“Days moderate recreational activities” and “Minutes moderate recreational activities”) and vigorous-intensity Days vigorous recreational activities” and “Minutes vigorous recreational activities”) physical activity were collected through questionnaires as well in all data cycles. We used 2018 Physical Activity Guidelines for Americans Older Adults, which recommended that most older adults (age≥65 years) participate in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week as our cut-off points for calculating moderate-to-vigorous physical activity. Results: Between 2007-2008 and 2015-2016, the percentage of US adults ≥65 years with HF increased from 2.76% to 3.69% (p=0.04). Although a similar percentage of participants who met the criteria of at least 150 minutes of moderate-intensity activity per week was noted in both groups from 2007 to 2016 (on average, HF: 56.9% vs. HF-free: 56.7%, respectively, p>0.05), more HF-free participants reported at least 75 minutes of vigorous-intensity recreational activities per week compared to HF participants in each calendar year (82.8% vs. 66.7%, 85.0% vs. 70.0%, 83.5% vs. 55.0%, 87.0% vs.75%, 85.2% vs. 63.6%, respectively, p<0.01). Additionally, among those who reported activities, older adults with HF were less than 20 times as likely to report moderate or vigorous recreational activities compared to those without HF. Conclusions: Our findings illustrate lower self-reported physical recreational activities, especially vigorous activities, in older participants who report a diagnosis of HF and more participants without HF report vigorous-intensity recreational activities. Future study should focus on understanding the physical limitations of HF patients, which is paramount in developing cardiac rehabilitation strategies to improve their function capacity.

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Impact of first and second eye cataract surgery on physical activity: a prospective study

BMJ Open ◽

10.1136/bmjopen-2018-024491 ◽

2019 ◽

Vol 9 (3) ◽

pp. e024491 ◽

Cited By ~ 2

Author(s):

Lynn B Meuleners ◽

Ying Ru Feng ◽

Michelle Fraser ◽

Kate Brameld ◽

Kyle Chow

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cataract Surgery ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Vigorous Physical Activity ◽

Moderate Physical Activity ◽

Bilateral Cataract ◽

Eye Surgery ◽

The Impact

ObjectivesTo investigate the impact of first eye and second eye cataract surgery on the level of physical activity undertaken by older adults with bilateral cataract.DesignProspective cohort study.SettingThree public ophthalmology clinics in Western Australia.ParticipantsFifty-five older adults with bilateral cataract aged 55+ years, awaiting first eye cataract surgery.Outcome measuresThe primary outcome measure was participation in moderate leisure-time physical activity. The secondary outcomes were participation in walking, gardening and vigorous leisure-time physical activity. Participants completed a researcher-administered questionnaire, containing the Active Australia Survey and visual tests before first eye cataract surgery, after first eye surgery and after second eye surgery. A Generalised Estimating Equation linear regression model was undertaken to analyse the change in moderate leisure-time physical activity participation before first eye surgery, after first eye surgery and after second eye surgery, after accounting for relevant confounders.ResultsParticipants spent significantly less time per week (20 min) on moderate leisure-time physical activity before first eye cataract surgery compared with after first eye surgery (p=0.04) after accounting for confounders. After second eye cataract surgery, participants spent significantly more time per week (32 min) on moderate physical activity compared with after first eye surgery (p=0.02). There were no significant changes in walking, gardening and vigorous physical activity throughout the cataract surgery process.ConclusionFirst and second eye cataract surgery each independently increased participation in moderate leisure-time physical activity. This provides a rationale for timely first and second eye cataract surgery for bilateral cataract patients, even when they have relatively good vision.

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Process evaluation of HAT TRICK: feasibility, acceptability and opportunities for programme refinement

Health Education Research ◽

10.1093/her/cyaa029 ◽

2020 ◽

Vol 35 (6) ◽

pp. 605-617

Author(s):

Paul Sharp ◽

Joan L Bottorff ◽

John L Oliffe ◽

Kate Hunt ◽

Cristina M Caperchione

Keyword(s):

Physical Activity ◽

Process Evaluation ◽

Social Connectedness ◽

Vigorous Physical Activity ◽

Intervention Programme ◽

Post Intervention ◽

Engagement Strategies ◽

Health Related ◽

Programme Content ◽

Recruitment And Selection

Abstract Preventive lifestyle interventions are needed to address challenges in engaging men in conventional health programmes. This process evaluation examined the feasibility and acceptability of HAT TRICK, a gender-sensitized programme targeting physical activity, healthy eating and social connectedness. A mixed-methods approach was utilized to examine the effectiveness of recruitment and selection processes, facilitators’ experiences and challenges and participant experiences with the programme. Evaluation measures included participant flow data and baseline assessments, facilitator debriefs, a post-intervention process evaluation questionnaire and telephone interviews with a subsample of participants. Participants (n = 62) were overweight (body mass index [BMI] > 25 kg m−2) and inactive (<150 min of moderate to vigorous physical activity [MVPA] per week) men with a mean age 51 ± 10.1 years. Participants reported high levels of satisfaction, acceptability and engagement with the intervention programme, content and resources. Facilitators noted the importance of creating a friendly, non-judgemental environment and observed that intervention content was best received when delivered in an interactive and engaging manner. Future programme refinements should consider strategies for strengthening social support, as well as opportunities for leveraging participants’ interest in other health-related issues (e.g. mental health). Findings yield valuable information about the implementation of gender-sensitized interventions for men and demonstrate the importance of male-specific engagement strategies for reaching and engaging overweight, inactive men.

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The impact of school closures on adolescent health-related outcomes during the COVID-19 pandemic: A natural experiment in South Korea

10.1101/2021.08.12.21261943 ◽

2021 ◽

Author(s):

Hanbin Lee ◽

Buhm Han

Keyword(s):

Physical Activity ◽

Placebo Group ◽

Adolescent Health ◽

Vigorous Physical Activity ◽

School Closure ◽

Total Physical Activity ◽

School Students ◽

Analysis Group ◽

Health Related ◽

The Impact

A large number of countries implemented school closure as a response to the COVID-19 pandemic in 2020. As existing studies mostly rely on retrospective or pre/post comparisons that are prone to unmeasured confounding, the effect of school closure on adolescent health is poorly understood. The South Korean government implemented school closure to prevent the spread of COVID-19. A difference-in-differences comparing changes in health-related outcomes between provinces with differing degrees of school closure was performed. The main analysis group consists of middle school students of age 14 to 16 who were hit hardest where up to 73% of total schooling was taken online in Seoul (the physical attendance was reduced from 170 days to 45 days). For sensitivity analysis, a placebo group of high school students of age 19 who attended all school-days physically was included to detect any violation of our identification strategy. In the main analysis group of boys that experienced reduced physical school-days, both total and vigorous physical activity were reduced (-0.35 [-0.54 -0.17] days/week for vigorous physical activity and -0.38 [-0.61 -0.16] days/week for total physical activity) while such effect was absent in the placebo group of boys that actually did not experience school closure (-0.08 [-0.49 0.32] days/week for vigorous PA and -0.16 [-0.67 0.34] days/week for total PA). In girls, vigorous physical activity decreased (-0.22 [-0.40 -0.04] days/week) but the total physical activity was nearly constant (0.03 [-0.18 0.25] days/week). Other outcomes were largely unchanged.

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Preschoolers’ health-related quality of life following the implementation of a childcare physical activity intervention

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2017-0396 ◽

2018 ◽

Vol 43 (5) ◽

pp. 453-459 ◽

Cited By ~ 3

Author(s):

Stephanie Truelove ◽

Andrew M. Johnson ◽

Leigh M. Vanderloo ◽

Molly Driediger ◽

Shauna M. Burke ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Controlled Trial ◽

Health Related Quality ◽

Post Intervention ◽

Related Quality ◽

Health Related ◽

The Impact

Being active offers many physical and emotional benefits contributing to a higher health-related quality of life (HRQoL); however, this relationship remains unexplored among preschoolers (aged 2.5–5 years). This study examined the impact of the Supporting Physical Activity in the Childcare Environment (SPACE), which was an intervention implemented using a cluster randomized controlled trial on preschoolers’ HRQoL. Childcare centres were randomly allocated to the experimental (n = 11) or control (n = 11) conditions, and preschoolers’ HRQoL was measured using the parent-report Pediatric Quality of Life Inventory 4.0 (3 subscales: physical, psychosocial, and total HRQoL) at baseline, post-intervention (i.e., week 8), and 6- and 12-month follow-up. A linear mixed-effects model was used to determine if preschoolers in the experimental condition displayed an increased HRQoL post-intervention and at follow-up compared with preschoolers in the control condition. Preschoolers (n = 234) with HRQoL data at baseline and one additional time-point were retained for analyses. Body mass index was not found to impact significantly on the intervention, and no statistically significant interaction effects were found for any of the 3 HRQoL variables. In conclusion, the SPACE intervention had no impact on preschoolers’ HRQoL. Given the scarcity of research in this population, additional exploration is necessary to better understand the potential impact of physical activity participation on preschoolers’ HRQoL.

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Partnerships for active elementary schools: Physical education outcomes after 4 months of a 2-year pilot study

Health Education Journal ◽

10.1177/0017896917713530 ◽

2017 ◽

Vol 76 (7) ◽

pp. 763-774 ◽

Cited By ~ 1

Author(s):

R. Glenn Weaver ◽

Collin Webster ◽

Catherine Egan ◽

Carolina Campos ◽

Robert D Michael ◽

...

Keyword(s):

Physical Activity ◽

Elementary Schools ◽

Pilot Study ◽

Physical Education ◽

Vigorous Physical Activity ◽

Community Based Participatory Research ◽

Physical Activity Promotion ◽

Activity Promotion ◽

Promotion Strategies ◽

The Impact

Objective: This study assessed the impact of Partnerships for Active Children in Elementary Schools (PACES) on children’s moderate-to-vigorous physical activity (MVPA) during physical education (PE) and teachers’ incorporation of physical activity promotion strategies after one academic semester (i.e. 4 months) of the intervention. Design: Single group pre–post pilot study. Setting: Three elementary schools in one southeastern metropolitan city in the USA. Methods: Using principles of community-based participatory-research, researchers worked with teachers to identify contextually appropriate physical activity promotion strategies aligned with prevailing recommendations, principles and theories. Outcome measures included accelerometer-derived percent of time children ( N = 150) engaged in MVPA. The System for Observing Fitness Instruction Time+ assessed changes in teachers’ incorporation of physical activity promotion strategies. Multi-level mixed-effects linear regression estimated differences over time. Results: MVPA increased for girls (22.7%–26.6%) and boys (33.2%–39.0%). Small-sided games (1.0%–9.0%) and teachers’ verbal promotion of physical activity (6.4%–13.5%) increased while student’s off-task behaviour (6.0%–2.0%) decreased. Lines (20.2%–8.4%) and elimination games (21.6%–13.3%) decreased, but these changes were not statistically significant. Conclusion: PACES shows promise for increasing the percent of time children spend in MVPA during PE but requires further evaluation.

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Partnerships for Active Children in Elementary Schools: Outcomes of a 2-Year Pilot Study to Increase Physical Activity During the School Day

American Journal of Health Promotion ◽

10.1177/0890117117707289 ◽

2017 ◽

Vol 32 (3) ◽

pp. 621-630 ◽

Cited By ~ 8

Author(s):

R. Glenn Weaver ◽

Collin A. Webster ◽

Cate Egan ◽

Carolina M. C. Campos ◽

Robert D. Michael ◽

...

Keyword(s):

Physical Activity ◽

Elementary Schools ◽

Pilot Study ◽

Service Learning ◽

Vigorous Physical Activity ◽

Intervention Group ◽

Control Group ◽

Institute Of Medicine ◽

School Day ◽

The Impact

Purpose: To evaluate the impact of the pilot study Partnerships for Active Children in Elementary Schools on the percentage of children achieving the Institute of Medicine guideline of 30 minutes of moderate-to-vigorous physical activity (MVPA) during the school day. Design: Pre/multiple post-quasi-experimental. Setting: Four elementary schools. Participants: Physical education (n = 3) and classroom teachers (n = 12) and students (n = 229). Intervention: Partnerships for Active Children in Elementary Schools was a multicomponent, theory-driven intervention facilitated through school–university partnerships. Intervention approaches included communities of practice, community-based participatory research, and service learning. Measures: Accelerometer-derived percentage of children accumulating 30 minutes of MVPA during the school day. Analysis: Multilevel mixed-effects regression estimated MVPA differences over time. Results: Compared to control, a 2.4% (95% confidence interval [CI]: −0.0% to 4.8%) and 8.8% (95% CI: −0.3% to 15.4%) increase in the percentage of time girls and boys engaged in MVPA during the school day was observed. The percentage of boys and girls in the intervention group achieving 30 minutes of MVPA/day increased from 57.5% to 70.7% and 35.4% to 56.9%, respectively. Boys and girls in the control group decreased from 61.5% to 56.4% and 52.6% to 41.9%, respectively. However, these changes did not reach statistical significance. Conclusion: Partnerships for Active Children in Elementary Schools demonstrated meaningful impact on children’s MVPA during the school day by increasing boys’ and girls’ MVPA. However, additional strategies may be required to help schools achieve the Institute of Medicine guideline.

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Free-living standing activity as assessed by seismic accelerometers and cognitive function in community-dwelling older adults: The MIND trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glab106 ◽

2021 ◽

Author(s):

Shannon Halloway ◽

Klodian Dhana ◽

Pankaja Desai ◽

Puja Agarwal ◽

Thomas Holland ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cognitive Function ◽

Daily Life ◽

Vigorous Physical Activity ◽

Community Dwelling ◽

Perceptual Speed ◽

Free Living ◽

Activity Intensity ◽

The Impact

Abstract Background Few older adults are able to achieve recommended levels of moderate-vigorous physical activity despite known cognitive benefits. Alternatively, less intense activities such as standing can be easily integrated into daily life. No existing study has examined the impact of free-living standing activity during daily life as measured by a device on cognition in older adults. Our purpose was to examine the association between free-living standing activity and cognitive function in cognitively healthy older adults. Methods Participants were 98 adult participants aged 65 years or older from the ongoing MIND trial (NCT02817074) without diagnoses or symptoms of mild cognitive impairment or dementia. Linear regression analyses tested cross-sectional associations between standing activity (duration and intensity from the MoveMonitor+ accelerometer/gyroscope) and cognition (4 cognitive domains constructed from 12 cognitive performance tests). Results Participants were on average 69.7 years old (SD = 3.7), 69.4% women, and 73.5% had a college degree or higher. Higher mean intensity of standing activity was significantly associated with higher levels of perceptual speed when adjusting for age, gender, and education level. Each log unit increase in standing activity intensity was associated with 0.72 units higher of perceptual speed (p=.023). When we additionally adjusted for cognitive activities and moderate-vigorous physical activity, and then also for body mass index, depressive symptoms, prescription medication use, and device wear time, the positive association remained. Conclusions These findings should be further explored in longitudinal analyses and interventions for cognition that incorporate small changes to free-living activity in addition to promoting moderate-vigorous physical activity.

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Considerations in Processing Accelerometry Data to Explore Physical Activity and Sedentary Time in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2019-0244 ◽

2020 ◽

Vol 28 (4) ◽

pp. 623-633

Author(s):

Claire L. Cleland ◽

Sara Ferguson ◽

Paul McCrorie ◽

Jasper Schipperijn ◽

Geraint Ellis ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Low Frequency ◽

Correlation Coefficients ◽

Population Surveillance ◽

Rank Test ◽

Cut Points ◽

The Impact

Processing decisions for accelerometry data can have important implications for outcome measures, yet little evidence exists exploring these in older adults. The aim of the current study was to investigate the impact of three potentially important criteria on older adults, physical activity, and sedentary time. Participants (n = 222: mean age 71.75 years [SD = 6.58], 57% male) wore ActiGraph GT3X+ for 7 days. Eight data processing combinations from three criteria were explored: low-frequency extension (on/off), nonwear time (90/120 min), and intensity cut points (moderate-to-vigorous physical activity ≥1,041 and >2,000 counts/min). Analyses included Wilcoxon signed-rank test, paired t tests, and correlation coefficients (significance, p < .05). Results for low-frequency extension on 90-min nonwear time and >1,041 counts/min showed significantly higher light and moderate-to-vigorous physical activity and lower sedentary time. Cut points had the greatest impact on physical activity and sedentary time. Processing criteria can significantly impact physical activity and/or sedentary time, potentially leading to data inaccuracies, preventing cross-study comparisons and influencing the accuracy of population surveillance.

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Self-monitoring and reminder text messages to increase physical activity after colorectal cancer (CRC): A pilot randomized controlled trial.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.615 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 615-615

Author(s):

Erin Van Blarigan ◽

Katherine Van Loon ◽

Stacey A. Kenfield ◽

June M. Chan ◽

Emily Mitchell ◽

...

Keyword(s):

Physical Activity ◽

Physical Activity Intervention ◽

Controlled Trial ◽

Vigorous Physical Activity ◽

Text Messages ◽

Post Intervention ◽

Self Monitoring ◽

Significant Difference ◽

Pilot Rct ◽

The Impact

615 Background: Over 1.3 million people in the US are living with CRC. Physical activity is associated with lower risk of CRC mortality. Interventions are needed to increase physical activity after CRC diagnosis. Methods: We conducted a pilot RCT to determine the feasibility (adherence, attrition) and acceptability of a 12-wk intervention using a Fitbit Flex™ and daily text messages to increase physical activity after CRC. Eligible patients had to have colon or rectal cancer of any stage, be disease free or have stable disease, able to speak and read English, and access to Internet and a mobile phone. Individuals with contraindications to moderate-to-vigorous physical activity (MVPA) or exercising ≥30 min ≥5 d/wk were excluded. We explored the impact of the intervention (n = 20) vs. usual care (n = 21) on MVPA via ActiGraph GT3X+ accelerometers pre-/post-intervention. Results: The intervention was feasible and acceptable. On average, participants were 54 y, BMI 28 kg/m2 and enrolled 1.5 y after diagnosis; 59% were women, 73% were White, and 61% were stage III. The intervention arm wore their Fitbits a median of 74 d (89% of study days, IQR: 23-83 d) and responded to 74% (34) of the 46 text messages that asked for a reply (IQR: 28-82%). Older participants were more likely to wear the Fitbit ( r: 0.72; p < 0.001). Married participants were more likely to wear the Fitbit and respond to texts compared to unmarried (96% vs. 32% wear time, p: 0.02 and 85% vs. 46% response rate, p: 0.006). Most patients (88%) reported that the intervention motivated them to exercise and that they were satisfied with their experience. On average, the intervention arm increased MVPA by 14 min/d, while the control arm increased by only 1 min/d, but there was no statistically significant difference in change in MVPA between groups (mean difference comparing change in MVPA in the intervention vs. control: 13 min/d; 95% CI: -14, 40; p: 0.33). Conclusions: A 12-wk physical activity intervention with a Fitbit and text messages is feasible and acceptable among CRC patients after treatment. Larger studies are needed to determine whether the intervention increases physical activity. Clinical trial information: NCT02966054.

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