ORCID Profile
0000-0002-1341-7804
Current Organisations
Flinders University
,
University of South Australia
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Publisher: JMIR Publications Inc.
Date: 21-12-2021
DOI: 10.2196/31737
Abstract: Virtual assistants can be used to deliver innovative health programs that provide appealing, personalized, and convenient health advice and support at scale and low cost. Design characteristics that influence the look and feel of the virtual assistant, such as visual appearance or language features, may significantly influence users’ experience and engagement with the assistant. This scoping review aims to provide an overview of the experimental research examining how design characteristics of virtual health assistants affect user experience, summarize research findings of experimental research examining how design characteristics of virtual health assistants affect user experience, and provide recommendations for the design of virtual health assistants if sufficient evidence exists. We searched 5 electronic databases (Web of Science, MEDLINE, Embase, PsycINFO, and ACM Digital Library) to identify the studies that used an experimental design to compare the effects of design characteristics between 2 or more versions of an interactive virtual health assistant on user experience among adults. Data were synthesized descriptively. Health domains, design characteristics, and outcomes were categorized, and descriptive statistics were used to summarize the body of research. Results for each study were categorized as positive, negative, or no effect, and a matrix of the design characteristics and outcome categories was constructed to summarize the findings. The database searches identified 6879 articles after the removal of duplicates. We included 48 articles representing 45 unique studies in the review. The most common health domains were mental health and physical activity. Studies most commonly examined design characteristics in the categories of visual design or conversational style and relational behavior and assessed outcomes in the categories of personality, satisfaction, relationship, or use intention. Over half of the design characteristics were examined by only 1 study. Results suggest that empathy and relational behavior and self-disclosure are related to more positive user experience. Results also suggest that if a human-like avatar is used, realistic rendering and medical attire may potentially be related to more positive user experience however, more research is needed to confirm this. There is a growing body of scientific evidence examining the impact of virtual health assistants’ design characteristics on user experience. Taken together, data suggest that the look and feel of a virtual health assistant does affect user experience. Virtual health assistants that show empathy, display nonverbal relational behaviors, and disclose personal information about themselves achieve better user experience. At present, the evidence base is broad, and the studies are typically small in scale and highly heterogeneous. Further research, particularly using longitudinal research designs with repeated user interactions, is needed to inform the optimal design of virtual health assistants.
Publisher: Springer Science and Business Media LLC
Date: 06-10-2020
DOI: 10.1186/S12889-020-09563-Y
Abstract: Instagram provides an opportunity to deliver low cost, accessible and appealing physical activity content. This study evaluated the feasibility of delivering an exercise program for young women using Instagram. A single-group pre- and post-intervention trial examined the feasibility and preliminary efficacy of a 12-week Instagram-delivered program with young inactive women ( n = 16 M = 23 years), which prescribed running and body weight exercises to complete three times per week. Daily Instagram posts delivered the exercises, video demonstrations and motivational content. Feasibility was evaluated by examining exposure (Instagram posts viewed per week), engagement (likes, comments and tags on Instagram posts number of exercise sessions completed per week retention, defined as completion of the online survey at weeks 6 and 12), and acceptability [whether the program increased participants’ motivation to exercise (1 = strongly disagree-5 = strongly agree) satisfaction with the program (1 = not satisfied-5 = very satisfied)]. Preliminary efficacy was evaluated by comparing baseline and 12-week self-reported physical activity (IPAQ short-form) and fitness (cardiorespiratory and muscle strength 1 = very poor-5 = very good, International Fitness Scale) using the Exact sign test. On average, participants reported seeing six posts in their Instagram feed per week. Posts received an average of five likes (IQR = 3–6). A total of four comments and one tag were observed across all posts. On average, participants reported completing two exercise sessions per week. Retention was 88% at 6 weeks but dropped to 56% at 12 weeks. Participants reported increased motivation to exercise (Mdn = 4, IQR = 3–4) and were satisfied with the program (Mdn = 4, IQR = 3–4). Only self-reported cardiorespiratory fitness showed a meaningful, though nonsignificant, improvement (MdnΔ = 1, IQR = 0–1, p = .06). Although Instagram has the potential to deliver a low cost, convenient exercise program for young women, additional research is needed to identify methods of improving engagement (interaction with the Instagram content, exercise sessions completed, and retention in the program). Future research could examine the use of behaviour change theory and provide information that enables participants to tailor the exercises to their interests and needs. Additionally, the use of objective assessments of physical activity and fitness among a larger participants s le is needed.
Publisher: Kasetsart University and Development Institute
Date: 2021
Publisher: JMIR Publications Inc.
Date: 19-12-2019
Abstract: oor diet and physical inactivity are leading modifiable causes of death and disease. Advances in artificial intelligence technology present tantalizing opportunities for creating virtual health coaches capable of providing personalized support at scale. his proof of concept study aimed to test the feasibility (recruitment and retention) and preliminary efficacy of physical activity and Mediterranean-style dietary intervention (MedLiPal) delivered via artificially intelligent virtual health coach. his 12-week single-arm pre-post study took place in Adelaide, Australia, from March to August 2019. Participants were inactive community-dwelling adults aged 45 to 75 years, recruited through news stories, social media posts, and flyers. The program included access to an artificially intelligent chatbot, Paola, who guided participants through a computer-based in idualized introductory session, weekly check-ins, and goal setting, and was available 24/7 to answer questions. Participants used a Garmin Vivofit4 tracker to monitor daily steps, a website with educational materials and recipes, and a printed diet and activity log sheet. Primary outcomes included feasibility (based on recruitment and retention) and preliminary efficacy for changing physical activity and diet. Secondary outcomes were body composition (based on height, weight, and waist circumference) and blood pressure. ver 4 weeks, 99 potential participants registered expressions of interest, with 81 of those screened meeting eligibility criteria. Participants completed a mean of 109.8 (95% CI 1.9-217.7) more minutes of physical activity at week 12 compared with baseline. Mediterranean diet scores increased from a mean of 3.8 out of 14 at baseline, to 9.6 at 12 weeks (mean improvement 5.7 points, 95% CI 4.2-7.3). After 12 weeks, participants lost an average 1.3 kg (95% CI –0.1 to –2.5 kg) and 2.1 cm from their waist circumference (95% CI –3.5 to –0.7 cm). There were no significant changes in blood pressure. Feasibility was excellent in terms of recruitment, retention (90% at 12 weeks), and safety (no adverse events). n artificially intelligent virtual assistant-led lifestyle-modification intervention was feasible and achieved measurable improvements in physical activity, diet, and body composition at 12 weeks. Future research examining artificially intelligent interventions at scale, and for other health purposes, is warranted.
Publisher: JMIR Publications Inc.
Date: 09-05-2019
Abstract: he success of a mobile phone app in changing health behavior is thought to be contingent on engagement, commonly operationalized as frequency of use. his subgroup analysis of the 2 intervention arms from a 3-group randomized controlled trial aimed to examine user engagement with a 100-day physical activity intervention delivered via an app. Rates of engagement, associations between user characteristics and engagement, and whether engagement was related to intervention efficacy were examined. ngagement was captured in a real-time log of interactions by users randomized to either a gamified (n=141) or nongamified version of the same app (n=160). Physical activity was assessed via accelerometry and self-report at baseline and 3-month follow-up. Survival analysis was used to assess time to nonuse attrition. Mixed models examined associations between user characteristics and engagement (total app use). Characteristics of super users (top quartile of users) and regular users (lowest 3 quartiles) were compared using italic t /italic tests and a chi-square analysis. Linear mixed models were used to assess whether being a super user was related to change in physical activity over time. ngagement was high. Attrition (30 days of nonuse) occurred in 32% and 39% of the gamified and basic groups, respectively, with no significant between-group differences in time to attrition ( italic P /italic =.17). Users with a body mass index (BMI) in the healthy range had higher total app use (mean 230.5, 95% CI 190.6-270.5 italic F /italic sub /sub =8.67 italic P /italic & .001), compared with users whose BMI was overweight or obese (mean 170.6, 95% CI 139.5-201.6 mean 132.9, 95% CI 104.8-161.0). Older users had higher total app use (mean 200.4, 95% CI 171.9-228.9 italic F /italic sub /sub =6.385 italic P /italic =.01) than younger users (mean 155.6, 95% CI 128.5-182.6). Super users were 4.6 years older (t sub /sub =3.6 italic P /italic & .001) and less likely to have a BMI in the obese range (χ sup /sup sub /sub =15.1 italic P /italic & .001). At the 3-month follow-up, super users were completing 28.2 (95% CI 9.4-46.9) more minutes of objectively measured physical activity than regular users ( italic F /italic sub ,272 /sub =4.76 italic P /italic =.03). otal app use was high across the 100-day intervention period, and the inclusion of gamified features enhanced engagement. Participants who engaged the most saw significantly greater increases to their objectively measured physical activity over time, supporting the theory that intervention exposure is linked to efficacy. Further research is needed to determine whether these findings are replicated in other app-based interventions, including those experimentally evaluating engagement and those conducted in real-world settings.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.AMEPRE.2019.09.009
Abstract: Appealing approaches to increasing physical activity levels are needed. This study evaluated whether a social and gamified smartphone app (Active Team) could be one such approach. A 3-group cluster RCT compared the efficacy of Active Team with a basic self-monitoring app and waitlist control group. Australian adults (N=444, mean age of 41 years, 74% female) were recruited in teams (n=121) and randomly assigned (1:1:1) to the Active Team (n=141, 39 teams), self-monitoring app (n=160, 42 teams), or waitlist group (n=143, 40 teams). Data were collected in 2016-2017, and analysis was conducted in 2018-2019. Active Team is a 100-day app-based, gamified, online social networking physical activity intervention. The primary outcome was change in objective physical activity from baseline to 3-month follow-up. Secondary outcomes included objective physical activity at 9 months and self-reported physical activity, quality of life, depression, anxiety and stress, well-being, and engagement. Mixed models indicated no significant differences in objective physical activity between groups at 3 (F=0.17, p=0.84 Cohen's d=0.03, 95% CI= -0.21, 0.26) or 9 months (F=0.23, p=0.92 d=0.06, 95% CI= -0.17, 0.29) and no significant differences for secondary outcomes of quality of life, depression, anxiety and stress, or well-being. Self-reported moderate-to-vigorous physical activity was significantly higher in the Active Team group at the 9-month follow-up (F=3.05, p=0.02 d=0.50, 95% CI=0.26, 0.73). Engagement was high the Active Team group logged steps on an average of 72 (SD=35) days and used the social and gamified features an average of 89 (SD=118) times. A gamified, online social networking physical activity intervention did not change objective moderate-to-vigorous physical activity, though it did increase self-reported moderate-to-vigorous physical activity and achieve high levels of engagement. Future work is needed to understand if gamification, online social networks, and app-based approaches can be leveraged to achieve positive behavior change. This study is registered at Australian and New Zealand Clinical Trial Registry (protocol: ANZCTR12617000113358).
Publisher: Public Library of Science (PLoS)
Date: 23-12-2019
Publisher: JMIR Publications Inc.
Date: 10-07-2020
DOI: 10.2196/17558
Abstract: Poor diet and physical inactivity are leading modifiable causes of death and disease. Advances in artificial intelligence technology present tantalizing opportunities for creating virtual health coaches capable of providing personalized support at scale. This proof of concept study aimed to test the feasibility (recruitment and retention) and preliminary efficacy of physical activity and Mediterranean-style dietary intervention (MedLiPal) delivered via artificially intelligent virtual health coach. This 12-week single-arm pre-post study took place in Adelaide, Australia, from March to August 2019. Participants were inactive community-dwelling adults aged 45 to 75 years, recruited through news stories, social media posts, and flyers. The program included access to an artificially intelligent chatbot, Paola, who guided participants through a computer-based in idualized introductory session, weekly check-ins, and goal setting, and was available 24/7 to answer questions. Participants used a Garmin Vivofit4 tracker to monitor daily steps, a website with educational materials and recipes, and a printed diet and activity log sheet. Primary outcomes included feasibility (based on recruitment and retention) and preliminary efficacy for changing physical activity and diet. Secondary outcomes were body composition (based on height, weight, and waist circumference) and blood pressure. Over 4 weeks, 99 potential participants registered expressions of interest, with 81 of those screened meeting eligibility criteria. Participants completed a mean of 109.8 (95% CI 1.9-217.7) more minutes of physical activity at week 12 compared with baseline. Mediterranean diet scores increased from a mean of 3.8 out of 14 at baseline, to 9.6 at 12 weeks (mean improvement 5.7 points, 95% CI 4.2-7.3). After 12 weeks, participants lost an average 1.3 kg (95% CI –0.1 to –2.5 kg) and 2.1 cm from their waist circumference (95% CI –3.5 to –0.7 cm). There were no significant changes in blood pressure. Feasibility was excellent in terms of recruitment, retention (90% at 12 weeks), and safety (no adverse events). An artificially intelligent virtual assistant-led lifestyle-modification intervention was feasible and achieved measurable improvements in physical activity, diet, and body composition at 12 weeks. Future research examining artificially intelligent interventions at scale, and for other health purposes, is warranted.
Publisher: Oxford University Press (OUP)
Date: 26-08-2020
Abstract: Remaining engaged with life is a hallmark of aging well and pursuing personally meaningful activities is presumably important for late-life affect. We examined how moment-to-moment variability in meaning and degree of challenge ascribed to daily activities relate to positive and negative affect in very old adults. Possible moderating effects of between-person differences in conscientiousness on meaning-affect associations were also examined. Participants were 73 adults aged 89 years on average from the Australian Daily Life Time-S ling module of the Australian Longitudinal Study of Aging. Participants provided self-report data on activity engagement (meaning and challenge associated with activities) and affect, on 5 occasions per day for a period of 7 consecutive days. Within-person associations of activity meaning with affect varied as a function of within-person challenge ratings. Specifically, gains in positive affect associated with meaningful activity were more strongly evident when activities were regarded as more challenging. In contrast, meaningful activity was associated with higher negative affect when activities were regarded as more challenging and lower negative affect when activities were regarded as less challenging. Conscientiousness did not moderate associations of activity meaning with affect. Our findings shed light on the intricate interplay between maintaining meaningful engagement and daily emotional experiences in very old age. We discuss theoretical and practical implications and consider the role of late-life conscientiousness for self- and emotion regulation.
Publisher: JMIR Publications Inc.
Date: 19-03-2018
DOI: 10.2196/12053
Publisher: Human Kinetics
Date: 02-2020
Abstract: Background : Substantial evidence links activity domains with health and well-being however, research has typically examined time-use behaviors independently, rather than considering daily activity as a 24-hour time-use composition. This study used compositional data analysis to estimate the difference in physical and mental well-being associated with reallocating time between behaviors. Methods : Participants (n = 430 74% female 41 [12] y) wore an accelerometer for 7 days and reported their body mass index health-related quality of life (QoL) and symptoms of depression, anxiety, and stress. Regression models determined whether time-use composition, comprising sleep, sedentary behavior, light physical activity (LPA), and moderate to vigorous physical activity (MVPA), was associated with well-being. Compositional isotemporal substitution models estimated the difference in well-being associated with reallocating time between behaviors. Results : Time-use composition was associated with body mass index and physical health-related QoL. Reallocating time to MVPA from sleep, sedentary behavior, and LPA showed favorable associations with body mass index and physical health-related QoL, whereas reallocations from MVPA to other behaviors showed unfavorable associations. Reallocations from LPA to sedentary behavior were associated with better physical health–related QoL and vice versa. Conclusion : Results reinforce the importance of MVPA for physical health but do not suggest that replacing sedentary behavior with LPA is beneficial for health and well-being.
Publisher: Informa UK Limited
Date: 28-02-2015
DOI: 10.1080/13825585.2014.888392
Abstract: It is well established that fundamental aspects of cognition such as memory and speed of processing tend to decline with age however, there is substantial between-in idual variability in levels of cognitive performance in older adulthood and in rates of change in cognitive abilities over time. Recent years have seen an increasing number of studies concerned with examining personality characteristics as possible predictors of some of this variability in cognitive aging. The purpose of this article is to review the literature, and identify patterns of findings regarding the relationships between personality (focusing on the Big-5) and cognitive ability across nonclinical populations of older adults. Possible mechanisms underlying associations of personality characteristics with cognition are reviewed, and assessed in the context of the current literature. Some relatively consistent relationships are identified, including positive associations between openness and cognitive ability, and associations of conscientiousness with slower rates of cognitive decline. However, the relationships between several personality traits and cognitive abilities in older adults remain unclear. We suggest some approaches to research design and analysis that may help increase our understanding of how personality differences may contribute to cognitive aging.
Publisher: MDPI AG
Date: 12-11-2021
DOI: 10.3390/NU13114040
Abstract: Whilst there is considerable evidence to support the efficacy of physical activity and dietary interventions in disease and death prevention, translation of knowledge into practice remains inadequate. We aimed to examine the uptake, retention, acceptability and effectiveness on physical activity, physical function, sitting time, diet and health outcomes of a Healthy Eating Activity and Lifestyle program (HEALTM) delivered under real-world conditions. The program was delivered to 430 adults living across rural South Australia. Participants of the program attended weekly 2 h healthy lifestyle education and exercise group-based sessions for 8 weeks. A total of 47 programs were delivered in over 15 communities. In total, 548 referrals were received, resulting in 430 participants receiving the intervention (78% uptake). At baseline, 74.6% of participants were female, the mean age of participants was 53.7 years and 11.1% of participants identified as Aboriginal and/or Torres Strait Islander. Follow-up assessments were obtained for 265 participants. Significant improvements were observed for walking, planned physical activity, incidental physical activity, total physical activity, 30 s chair stand, 30 s arm curl, 6 min walk, fruit consumption and vegetable consumption, sitting time and diastolic blood pressure. Positive satisfaction and favourable feedback were reported. The healthy lifestyle program achieved excellent real-world uptake and effectiveness, reasonable intervention attendance and strong program acceptability amongst rural and vulnerable communities.
Publisher: ANU Press
Date: 21-10-2016
Publisher: Springer Science and Business Media LLC
Date: 14-03-2023
DOI: 10.1186/S12966-023-01414-4
Abstract: Weather is a potentially important influence on how time is allocated to sleep, sedentary behaviour and physical activity across the 24-h day. Extremes of weather (very hot, cold, windy or wet) can create undesirable, unsafe outdoor environments for exercise or active transport, impact the comfort of sleeping environments, and increase time indoors. This 13-month prospective cohort study explored associations between weather and 24-h movement behaviour patterns. Three hundred sixty-eight adults (mean age 40.2 years, SD 5.9, 56.8% female) from Adelaide, Australia, wore Fitbit Charge 3 activity trackers 24 h a day for 13 months with minute-by-minute data on sleep, sedentary behaviour, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) collected remotely. Daily weather data included temperature, rainfall, wind, cloud and sunshine. Multi-level mixed-effects linear regression analyses (one model per outcome) were used. Ninety thousand eight hundred one days of data were analysed. Sleep was negatively associated with minimum temperature (-12 min/day change across minimum temperature range of 31.2 °C, p = 0.001). Sedentary behaviour was positively associated with minimum temperature (+ 12 min/day, range = 31.2 oC, p = 0.006) and wind speed (+ 10 min/day, range = 36.7 km/h, p 0.001), and negatively associated with sunshine (-17 min/day, range = 13.9 h, p 0.001). LPA was positively associated with minimum temperature (+ 11 min/day, range = 31.2 °C, p = 0.002), cloud cover (+ 4 min/day, range = 8 eighths, p = 0.008) and sunshine (+ 17 min/day, range = 13.9 h, p 0.001), and negatively associated with wind speed (-8 min/day, range = 36.7 km/h, p 0.001). MVPA was positively associated with sunshine (+ 3 min/day, range = 13.9 h, p 0.001) and negatively associated with minimum temperature (-13 min/day, range = 31.2 oC, p 0.001), rainfall (-3 min/day, range = 33.2 mm, p = 0.006) and wind speed (-4 min/day, range = 36.7 km/h, p 0.001). For maximum temperature, a significant ( p 0.05) curvilinear association was observed with sleep (half-U) and physical activity (inverted-U), where the decrease in sleep duration appeared to slow around 23 °C, LPA peaked at 31 oC and MVPA at 27 °C. Generally, adults tended to be less active and more sedentary during extremes of weather and sleep less as temperatures rise. These findings have the potential to inform the timing and content of positive movement behaviour messaging and interventions. The study was prospectively registered on the Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN12619001430123).
Publisher: Springer Science and Business Media LLC
Date: 03-2023
DOI: 10.1186/S12966-023-01416-2
Abstract: For adults, vacations represent a break from daily responsibilities of work – offering the opportunity to re-distribute time between sleep, sedentary behaviour, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) across the 24-h day. To date, there has been minimal research into how activity behaviour patterns change on vacation, and whether any changes linger after the vacation. This study examined how daily movement behaviours change from before, to during and after vacations, and whether these varied based on the type of vacation and vacation duration. Data collected during the Annual Rhythms In Adults’ lifestyle and health (ARIA) study were used. 308 adults (mean age 40.4 years, SD 5.6) wore Fitbit Charge 3 fitness trackers 24 h a day for 13 months. Minute-by-minute movement behaviour data were aggregated into daily totals. Multi-level mixed-effects linear regressions were used to compare movement behaviours during and post-vacation (4 weeks) to pre-vacation levels (14 days), and to examine the associations with vacation type and duration. Participants took an average of 2.6 (SD = 1.7) vacations of 12 (SD = 14) days’ ( N = 9778 days) duration. The most common vacation type was outdoor recreation (35%) followed by family/social events (31%), rest (17%) and non-leisure (17%). Daily sleep, LPA and MVPA all increased (+ 21 min [95% CI = 19,24] p 0.001, + 3 min [95% CI = 0.4,5] p 0.02, and + 5 min [95% CI = 3,6] p 0.001 respectively) and sedentary behaviour decreased (-29 min [95% CI = -32,-25] p 0.001) during vacation. Post-vacation, sleep remained elevated for two weeks MVPA returned to pre-vacation levels and LPA and sedentary behaviour over-corrected, with LPA significantly lower for 4 weeks, and sedentary behaviour significantly higher for one week. The largest changes were seen for “rest” and “outdoor” vacations. The magnitude of changes was smallest for short vacations ( 3 days). Vacations are associated with favourable changes in daily movement behaviours. These data provide preliminary evidence of the health benefits of vacations. The study was prospectively registered on the Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN12619001430123).
Publisher: Springer Science and Business Media LLC
Date: 02-03-2023
DOI: 10.1186/S12889-023-15232-7
Abstract: Fitspiration is a social media phenomenon purported to inspire viewers to lead healthier lifestyles but can result in negative psychological outcomes such as body dissatisfaction. This study aimed to develop a tool to audit Instagram fitspiration accounts and screen for content that could have potentially negative psychological effects. This study developed and implemented an audit tool to (1) identify credible fitspiration accounts (i.e., accounts that do not portray potentially harmful or unhealthy content) and (2) describe the content of identified accounts. The most recent 15 posts of 100 leading Instagram fitspiration accounts were audited. Accounts were deemed non-credible and were excluded if they contained fewer than four fitness-related posts or portrayed nudity or inappropriate clothing, sexualisation or objectification, extreme body types, “thinspiration”, or negative messages. Many accounts contained fewer than four fitness-related posts (n = 41), sexualisation or objectification (n = 26), nudity or inappropriate clothing (n = 22), and/or extreme body types (n = 15). Three accounts failed on all four criteria, while 13, 10 and 33 failed on three, two, or one criterion, respectively. Therefore, only 41% of accounts were considered credible. Inter-rater reliability (percentage agreement and Brennan and Prediger’s coefficient κ q ) was high (Stage 1: 92% agreement [95% CI 87, 97], κ q 0.84 [95% CI 0.73, 0.95] Stage 2: 93% agreement [95% CI 83, 100], κ q 0.85 [95% CI 0.67, 1.00]). Account holders of credible fitspiration accounts were predominantly female (59%), aged 25–34 (54%), Caucasian (62%), and from the United States (79%). Half held a qualification related to physical activity or physical health (e.g., personal trainer, physiotherapy 54%). Most included accounts included an exercise video (93%) and ex le workout (76%). While many popular Instagram fitspiration accounts offered credible content such as ex le workouts, many accounts contained sexualisation, objectification or promotion of unhealthy or unrealistic body shapes. The audit tool could be used by Instagram users to ensure the accounts they follow do not portray potentially harmful or unhealthy content. Future research could use the audit tool to identify credible fitspiration accounts and examine whether exposure to these accounts positively influences physical activity.
Publisher: Springer Science and Business Media LLC
Date: 10-01-2020
DOI: 10.1186/S12874-020-0896-4
Abstract: This study examined the criterion validity of the online Active Australia Survey, using accelerometry as the criterion, and whether self-report bias was related to level of activity, age, sex, education, body mass index and health-related quality of life. The online Active Australia Survey was validated against the GENEActiv accelerometer as a direct measure of activity. Participants ( n = 344) wore an accelerometer for 7 days, completed the Active Australia Survey, and reported their health and demographic characteristics. A Spearman’s rank coefficient examined the association between minutes of moderate-to-vigorous physical activity recorded on the Active Australia Survey and GENEActiv accelerometer. A Bland-Altman plot illustrated self-report bias (the difference between methods). Linear mixed effects modelling was used to examine whether participant factors predicted self-report bias. The association between moderate-to-vigorous physical activity reported on the online Active Australia Survey and accelerometer was significant ( r s = .27, p .001). Participants reported 4 fewer minutes per day on the Active Australia Survey than was recorded by accelerometry (95% limits of agreement −104 – 96 min) but the difference was not significant ( t (343) = −1.40, p = .16). Self-report bias was negatively associated with minutes of accelerometer-recorded moderate-to-vigorous physical activity and positively associated with mental health-related quality of life. The online Active Australia Survey showed limited criterion validity against accelerometry. Self-report bias was related to activity level and mental health-related quality of life. Caution is recommended when interpreting studies using the online Active Australia Survey.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Oxford University Press (OUP)
Date: 23-01-2021
DOI: 10.1093/TBM/IBAA139
Abstract: Technology-based physical activity programs are a novel solution to the major public health issue of physical inactivity. However, to be successful, there must be a large and population-appropriate uptake, which depends heavily on promotion. This study evaluates the effectiveness of an advertising c aign to disseminate a physical activity smartphone app. The experiment used a 3 × 3 × 3 full-factorial design, examining platforms (Facebook Facebook Messenger Instagram), selling-techniques (hard-sell—sending viewers directly to (a) Apple Store or (b) Google Play, and soft-sell—sending viewers from an ad to a (c) landing-page, then to an app store) and themes (Health and Wellbeing Body and Self-Confidence Social Enjoyment). Outcomes were reach, click-through, and app downloads. Advertisements reached 1,373,273 people, achieving 2,989 clicks and 667 downloads. Instagram and Facebook Messenger had higher reach compared to Facebook (F[2,27] = 27.17, p & .001), whilst Facebook and Facebook Messenger both produced higher click-through (F[2,27] = 8.98, p & .001) and downloads (F[2,27] = 4.649, p = .018). Selling-technique differed, with soft-selling ads producing greater reach (F[2,27] = 4,616.077, p & .001) however, both hard-selling ads (Apple Store and Google Play) had greater click-through (F[2,27] = 10.77, p & .001) and downloads (F[2,27] = 3.791, p & .001). Advertising theme varied, with Social Enjoyment themes producing less click-through (F[2,27] = 5.709, p = .009) and downloads (F[2,27] = 5.480, p = .010). We recommend future studies to consider Facebook and Facebook Messenger, using hard-selling techniques, with themes relating to Health and Wellbeing and Body and Self-Confidence.
Publisher: Oxford University Press (OUP)
Date: 30-09-2017
Publisher: MDPI AG
Date: 07-12-2020
Abstract: Artificial intelligence virtual health assistants are a promising emerging technology. This study is a process evaluation of a 12-week pilot physical activity and diet program delivered by virtual assistant “Paola”. This single-arm repeated measures study (n = 28, aged 45–75 years) was evaluated on technical performance (accuracy of conversational exchanges), engagement (number of weekly check-ins completed), adherence (percentage of step goal and recommended food servings), and user feedback. Paola correctly asked scripted questions and responded to participants during the check-ins 97% and 96% of the time, respectively, but correctly responded to spontaneous exchanges only 21% of the time. Participants completed 63% of weekly check-ins and conducted a total of 3648 exchanges. Mean dietary adherence was 91% and was lowest for discretionary foods, grains, red meat, and vegetables. Participants met their step goal 59% of the time. Participants enjoyed the program and found Paola useful during check-ins but not for spontaneous exchanges. More in-depth knowledge, personalized advice and spontaneity were identified as important improvements. Virtual health assistants should ensure an adequate knowledge base and ability to recognize intents and entities, include personality and spontaneity, and provide ongoing technical troubleshooting of the virtual assistant to ensure the assistant remains effective.
Publisher: Oxford University Press (OUP)
Date: 16-08-2021
DOI: 10.1093/TBM/IBAB101
Abstract: Social media provides a convenient platform for health c aigns. However, practitioners designing such c aigns are faced with a number of decisions regarding advertising formats and appeals. This study set out to compare the effectiveness of two advertising formats (image vs. video) and two advertising appeals (benefits of being active vs. app attributes and features) for promoting a physical-activity smartphone app. The advertising experiment was conducted on Facebook and employed a 2 × 2 full-factorial experimental design, examining two advertising formats: image versus video and two advertising appeals: benefit versus attribute. Outcome measures were advertisement cost (number of viewers reached according to the amount spent) and consumer engagement (rates of advertisement click-through and app downloads). Chi-Square analysis revealed that advertisement cost was found to differ according to the type of advertising format used, with image advertisements achieving a greater audience reach than video advertisements (χ 2(1) = 905.292, p & .001). Consumer engagement also differed according to advertising format and appeal: images achieved high rates of advertisement click-through (2.7% vs. 1.9% χ 2(1) = 196.9, p & .001) and app downloads (0.6% vs. 0.5% χ 2(1) = 4.0, p = .044) compared with videos. Furthermore, benefit appeal advertisements were more effective than attribute appeals, yielding a greater rate of advertisement click-through (2.8% vs. 1.8% χ 2(1) = 282.2, p & .001) and app downloads (0.7% vs. 0.4% χ 2(1) =106.0, p & .001). Overall, image advertisements were seen to be the most cost-effective and engaging. Advertisements employing a benefit appeal achieved greater consumer engagement than and attribute appeal advertisements.
Publisher: JMIR Publications Inc.
Date: 27-11-2019
DOI: 10.2196/14645
Abstract: The success of a mobile phone app in changing health behavior is thought to be contingent on engagement, commonly operationalized as frequency of use. This subgroup analysis of the 2 intervention arms from a 3-group randomized controlled trial aimed to examine user engagement with a 100-day physical activity intervention delivered via an app. Rates of engagement, associations between user characteristics and engagement, and whether engagement was related to intervention efficacy were examined. Engagement was captured in a real-time log of interactions by users randomized to either a gamified (n=141) or nongamified version of the same app (n=160). Physical activity was assessed via accelerometry and self-report at baseline and 3-month follow-up. Survival analysis was used to assess time to nonuse attrition. Mixed models examined associations between user characteristics and engagement (total app use). Characteristics of super users (top quartile of users) and regular users (lowest 3 quartiles) were compared using t tests and a chi-square analysis. Linear mixed models were used to assess whether being a super user was related to change in physical activity over time. Engagement was high. Attrition (30 days of nonuse) occurred in 32% and 39% of the gamified and basic groups, respectively, with no significant between-group differences in time to attrition (P=.17). Users with a body mass index (BMI) in the healthy range had higher total app use (mean 230.5, 95% CI 190.6-270.5 F2=8.67 P .001), compared with users whose BMI was overweight or obese (mean 170.6, 95% CI 139.5-201.6 mean 132.9, 95% CI 104.8-161.0). Older users had higher total app use (mean 200.4, 95% CI 171.9-228.9 F1=6.385 P=.01) than younger users (mean 155.6, 95% CI 128.5-182.6). Super users were 4.6 years older (t297=3.6 P .001) and less likely to have a BMI in the obese range (χ22=15.1 P .001). At the 3-month follow-up, super users were completing 28.2 (95% CI 9.4-46.9) more minutes of objectively measured physical activity than regular users (F1,272=4.76 P=.03). Total app use was high across the 100-day intervention period, and the inclusion of gamified features enhanced engagement. Participants who engaged the most saw significantly greater increases to their objectively measured physical activity over time, supporting the theory that intervention exposure is linked to efficacy. Further research is needed to determine whether these findings are replicated in other app-based interventions, including those experimentally evaluating engagement and those conducted in real-world settings. Australian New Zealand Clinical Trials Registry ACTRN12617000113358 www.anzctr.org.au/ACTRN12617000113358.aspx
Publisher: JMIR Publications Inc.
Date: 28-08-2018
Abstract: martphone apps are a promising tool for delivering accessible and appealing physical activity interventions. Given the large growth of research in this field, there are now enough studies using the “gold standard” of experimental design—the randomized controlled trial design—and employing objective measurements of physical activity, to support a meta-analysis of these scientifically rigorous studies. his systematic review and meta-analysis aimed to determine the effectiveness of smartphone apps for increasing objectively measured physical activity in adults. total of 7 electronic databases (EMBASE, EmCare, MEDLINE, Scopus, Sport Discus, The Cochrane Library, and Web of Science) were searched from 2007 to January 2018. Following the Population, Intervention, Comparator, Outcome and Study Design format, studies were eligible if they were randomized controlled trials involving adults, used a smartphone app as the primary or sole component of the physical activity intervention, used a no- or minimal-intervention control condition, and measured objective physical activity either in the form of moderate-to-vigorous physical activity minutes or steps. Study quality was assessed using a 25-item tool based on the Consolidated Standards of Reporting Trials checklist. A meta-analysis of study effects was conducted using a random effects model approach. Sensitivity analyses were conducted to examine whether intervention effectiveness differed on the basis of intervention length, target behavior (physical activity alone vs physical activity in combination with other health behaviors), or target population (general adult population vs specific health populations). ollowing removal of duplicates, a total of 6170 studies were identified from the original database searches. Of these, 9 studies, involving a total of 1740 participants, met eligibility criteria. Of these, 6 studies could be included in a meta-analysis of the effects of physical activity apps on steps per day. In comparison with the control conditions, smartphone apps produced a nonsignificant (P=.19) increase in participants’ average steps per day, with a mean difference of 476.75 steps per day (95% CI −229.57 to 1183.07) between groups. Sensitivity analyses suggested that physical activity programs with a duration of less than 3 months were more effective than apps evaluated across more than 3 months (P=.01), and that physical activity apps that targeted physical activity in isolation were more effective than apps that targeted physical activity in combination with diet (P=.04). Physical activity app effectiveness did not appear to differ on the basis of target population. his meta-analysis provides modest evidence supporting the effectiveness of smartphone apps to increase physical activity. To date, apps have been most effective in the short term (eg, up to 3 months). Future research is needed to understand the time course of intervention effects and to investigate strategies to sustain intervention effects over time.
Publisher: Public Library of Science (PLoS)
Date: 03-03-2021
DOI: 10.1371/JOURNAL.PONE.0248008
Abstract: The COVID-19 pandemic has dramatically impacted lifestyle behaviour as public health initiatives aim to “flatten the curve”. This study examined changes in activity patterns (physical activity, sedentary time, sleep), recreational physical activities, diet, weight and wellbeing from before to during COVID-19 restrictions in Adelaide, Australia. This study used data from a prospective cohort of Australian adults (parents of primary school-aged children n = 61, 66% female, aged 41±6 years). Participants wore a Fitbit Charge 3 activity monitor and weighed themselves daily using Wi-Fi scales. Activity and weight data were extracted for 14 days before (February 2020) and 14 days during (April 2020) COVID-19 restrictions. Participants reported their recreational physical activity, diet and wellbeing during these periods. Linear mixed effects models were used to examine change over time. Participants slept 27 minutes longer (95% CI 9–51), got up 38 minutes later (95% CI 25–50), and did 50 fewer minutes (95% CI -69–-29) of light physical activity during COVID-19 restrictions. Additionally, participants engaged in more cycling but less swimming, team sports and boating or sailing. Participants consumed a lower percentage of energy from protein (-0.8, 95% CI -1.5–-0.1) and a greater percentage of energy from alcohol (0.9, 95% CI 0.2–1.7). There were no changes in weight or wellbeing. Overall, the effects of COVID-19 restrictions on lifestyle were small however, their impact on health and wellbeing may accumulate over time. Further research examining the effects of ongoing social distancing restrictions are needed as the pandemic continues.
Publisher: Cambridge University Press (CUP)
Date: 24-07-2016
DOI: 10.1017/S1041610215001143
Abstract: Social relationships are multifaceted, and different social network components can operate via different processes to influence well-being. This study examined associations of social network structure and relationship quality (positive and negative social exchanges) with mental health in midlife and older adults. The focus was on both direct associations of network structure and relationship quality with mental health, and whether these social network attributes moderated the association of self-rated health (SRH) with mental health. Analyses were based on survey data provided by 2001 (Mean age = 65, SD = 8.07) midlife and older adults. We used Latent Class Analysis (LCA) to classify participants into network types based on network structure (partner status, network size, contact frequency, and activity engagement), and used continuous measures of positive and negative social exchanges to operationalize relationship quality. Regression analysis was used to test moderation. LCA revealed network types generally consistent with those reported in previous studies. Participants in more erse networks reported better mental health than those categorized into a restricted network type after adjustment for age, sex, education, and employment status. Analysis of moderation indicated that those with poorer SRH were less likely to report poorer mental health if they were classified into more erse networks. A similar moderation effect was also evident for positive exchanges. The findings suggest that both quantity and quality of social relationships can play a role in buffering against the negative implications of physical health decline for mental health.
Publisher: American Medical Association (AMA)
Date: 27-07-2023
DOI: 10.1001/JAMANETWORKOPEN.2023.26038
Abstract: Obesity is a major global health concern. A better understanding of temporal patterns of weight gain will enable the design and implementation of interventions with potential to alter obesity trajectories. To describe changes in daily weight across 12 months among Australian adults. This cohort study conducted between December 1, 2019, and December 31, 2021 in Adelaide, South Australia, involved 375 community-dwelling adults aged 18 to 65 years. Participants wore a fitness tracker and were encouraged to weigh themselves, preferably daily but at least weekly, using a body weight scale. Data were remotely gathered using custom-developed software. Time assessed weekly, seasonally, and at Christmas/New Year and Easter. Data were visually inspected to assess the overall yearly pattern in weight change. Data were detrended (to remove systematic bias from intrain idual gradual increases or decreases in weight) by calculating a line of best fit for each in idual’s annual weight change relative to baseline and subtracting this from each participant’s weight data. Multilevel mixed-effects linear regression analysis was used to compare weight across days of the week and seasons and at Christmas/New Year and Easter. Of 375 participants recruited, 368 (mean [SD] age, 40.2 [5.9] years 209 [56.8%] female mean [SD] baseline weight, 84.0 [20.5] kg) provided at least 7 days of weight data for inclusion in analyses. Across the 12-month period, participants gained a median of 0.26% body weight (218 g) (range, −29.4% to 24.0%). Weight fluctuated by approximately 0.3% (252 g) each week, with Mondays and Tuesdays being the heaviest days of the week. Relative to Monday, participants’ weight gradually decreased from Tuesday, although not significantly so (mean [SE] weight change, 0.01% [0.03%] P = .83), to Friday (mean [SE] weight change, −0.18% [0.03%] P & .001) and increased across the weekend to Monday (mean [SE] weight change for Saturday, −0.16% [0.03%] P & .001 mean [SE] weight change for Sunday, −0.10% [0.03%] P & .001). Participants’ weight increased sharply at Christmas/New Year (mean [SE] increase, 0.65% [0.03%] z score, 25.30 P & .001) and Easter (mean [SE] weight change, 0.29% [0.02%], z score, 11.51 P & .001). Overall, participants were heaviest in summer (significantly heavier than in all other seasons), were lightest in autumn (mean [SE] weight change relative to summer, −0.47% [0.07%] P & .001), regained some weight in winter (mean [SE] weight change relative to summer, −0.23% [0.07%] P = .001), and became lighter in spring (mean [SE] weight change relative to summer, −0.27% [0.07%] P & .001). In this cohort study of Australian adults with weekly and yearly patterns in weight gain observed across 12 months, high-risk times for weight gain were Christmas/New Year, weekends, and winter, suggesting that temporally targeted weight gain prevention interventions may be warranted.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2021
DOI: 10.1186/S12889-020-10100-0
Abstract: Regular engagement in physical activity has well-established physical and psychological health benefits. Despite this, over a quarter of the global adult population is insufficiently physically active. Physical activity interventions grounded in behaviour change theory, such as the social-cognitive theory, are widely considered to be more effective than non-theoretical approaches. Such interventions set out to intervene on the ultimate outcome (physical activity), but also influence intermediate factors (social-cognitive theory constructs) which in turn, are believed to influence physical activity behaviour. The primary aim of the study was to use mediation analysis to examine whether changes in the social-cognitive theory and related constructs, in particular self-efficacy, outcome expectations, intentions, barriers and goal setting, mediated the effects of a smartphone-based social networking physical activity intervention. Mediation analyses were conducted using the PROCESS Macro in SPSS to (i) calculate the regression coefficients for the effect of the independent variable (group allocation) on the hypothesised mediators (social-cognitive theory constructs), (ii) calculate the regression coefficient for the effect of the hypothesised mediators (social-cognitive theory constructs) on the dependent variable (objectively measured physical activity or self-report physical activity), independent of group assignment and (iii) determine the total, direct and indirect intervention effects. Data from 243 participants were included in the mediation analysis. There was no evidence of mediation for change in objectively measured MVPA or self-reported MVPA. There was no conclusive evidence that any of the social-cognitive theory constructs mediated the relationship between an app-based intervention and change in physical activity. Ongoing efforts to develop and understand components that make physical activity app-based interventions effective are recommended. This trial was registered with the Australian and New Zealand Clinical Trial Registry ( ACTRN12617000113358 , date of registration 23 January, 2017).
Publisher: SAGE Publications
Date: 03-2021
Abstract: To evaluate the performance of Facebook advertisements for a physical activity smartphone app at different times of the year. A repeated cross-sectional study examined the cost and engagement levels of advertisements during 3 time points: Post-Easter April-May 2019 , Pre-Summer October 2019 , and New Year January 2020 . Advertisements were delivered on Facebook. The target population was Australian females aged 25-60 years. Cost was evaluated in terms of reach per dollar. Engagement was evaluated in terms of click-through and app downloads per reach. ANOVA and Chi-square were used to assess differences in reach per dollar, click-through, and app downloads per reach between time points. Reach per dollar was highest in Post-Easter, but declined in Pre-Summer and New Year (reach/$ 34.8 vs 31.5 vs 27.5 p = .004). Click-through was highest in New Year followed by Post-Easter, then Pre-Summer (click-through 3.2% vs 1.9% vs 1.2% p .001). New Year and Post-Easter advertisements achieved higher app downloads per reach than Pre-Summer (downloads 0.9% vs 0.7% vs 0.3% p .001). Facebook advertisements were cheaper in the first time-point, and appear to be getting more expensive (i.e. declining reach/$). Advertisements in the New Year achieved the highest click-through and app downloads per reach, suggesting a useful time of year to promote physical activity products.
Publisher: Springer Science and Business Media LLC
Date: 13-07-2021
DOI: 10.1186/S12889-021-11298-3
Abstract: Time spent in daily activities (sleep, sedentary behaviour and physical activity) has important consequences for health and wellbeing. The amount of time spent varies from day to day, yet little is known about the temporal nature of daily activity patterns in adults. The aim of this review is to identify the annual rhythms of daily activity behaviours in healthy adults and explore what temporal factors appear to influence these rhythms. Six online databases were searched for cohort studies exploring within-year temporal patterns (e.g. season effects, vacation, cultural festivals) in sleep, sedentary behaviour or physical activity in healthy 18 to 65-year-old adults. Screening, data extraction, and risk of bias scoring were performed in duplicate. Extracted data was presented as mean daily minutes of each activity type, with transformations performed as needed. Where possible, meta-analyses were performed using random effect models to calculate standardised mean differences (SMD). Of the 7009 articles identified, 17 studies were included. Studies were published between 2003 and 2019, representing 14 countries and 1951 participants, addressing variation in daily activities across season ( n = 11), Ramadan ( n = 4), vacation ( n = 1) and daylight savings time transitions ( n = 1). Meta-analyses suggested evidence of seasonal variation in activity patterns, with sleep highest in autumn (+ 12 min) sedentary behaviour highest in winter (+ 19 min) light physical activity highest in summer (+ 19 min) and moderate-to-vigorous physical activity highest in summer (+ 2 min) when compared to the yearly mean. These trends were significant for light physical activity in winter (SMD = − 0.03, 95% CI − 0.58 to − 0.01, P = 0.04). Sleep appeared 64 min less during, compared to outside Ramadan (non-significant). Narrative analyses for the impact of vacation and daylight savings suggested that light physical activity is higher during vacation and that sleep increases after the spring daylight savings transition, and decreases after the autumn transition. Research into temporal patterns in activity behaviours is scarce. Existing evidence suggests that seasonal changes and periodic changes to usual routine, such as observing religious events, may influence activity behaviours across the year. Further research measuring 24-h time use and exploring a wider variety of temporal factors is needed.
Publisher: Informa UK Limited
Date: 18-10-2019
Publisher: Mary Ann Liebert Inc
Date: 06-2022
Publisher: American Medical Association (AMA)
Date: 22-08-2023
DOI: 10.1001/JAMANETWORKOPEN.2023.30098
Abstract: Little is known about temporal trends in children’s well-being and how the COVID-19 pandemic may have influenced the well-being of young Australians. Certain demographic groups may be more vulnerable to experiencing declines in well-being. To examine well-being trends over 6 consecutive years among South Australian students and explore the influence of sociodemographic characteristics. Longitudinal analyses of annual (2017 to 2022) cross-sectional data of students in grades 4 through 9 (n = 40 392 to 56 897 per year) attending South Australian government schools from the Well-being and Engagement Collection (WEC) census. Calendar year (2017-2022) and sociodemographic characteristics (sex, school grade, parental education, language spoken at home, residential region) from school enrollment records. Students self-reported life satisfaction, optimism, happiness, cognitive engagement, emotional regulation, perseverance, worry, and sadness. Over 6 years (2017 to 2022), a total of 119 033 students (mean [SD] age, 12.1 y 51.4% male) participated in this study. Most well-being measures declined over time, with consistent worsening of well-being from 2020 onward. For ex le, compared with 2017, sadness was 0.26 (95% CI, 0.25-0.27) points higher in 2020 (standardized mean difference [SMD], 0.27) and remained elevated by more than 0.26 points (SMD, 0.27) in 2021 and 2022. At almost every time point, greatest well-being was reported by students of male sex (except cognitive engagement and perseverance), in earlier school grades, with highest parental education, speaking a language other than English at home, and residing in outer regional and remote settings (for satisfaction, optimism, and emotional regulation). Sociodemographic differences in well-being were generally consistent over time however, sex differences widened from 2020 for all indicators except cognitive engagement and perseverance. For ex le, between 2017 and 2022, sadness increased by 0.27 (95% CI, 0.25-0.29) more points among females than males (SMD, 0.28). In this longitudinal analysis of annual census data, there were downward trends in students’ well-being, especially since 2020. The largest sociodemographic disparities were observed for students of female sex, those in later school grades, and those with lowest parental education. Urgent and equitable support for the well-being of all young people, particularly those facing disparity, is imperative.
Publisher: BMJ
Date: 14-06-2021
DOI: 10.1136/THORAXJNL-2021-217271
Abstract: Breathlessness is a major cause of suffering and disability globally. The symptom relates to multiple factors including asthma and lung function, which are influenced by hereditary factors. No study has evaluated potential inheritance of breathlessness itself across generations. We analysed the association between breathlessness in parents and their offspring in the Respiratory Health in Northern Europe, Spain and Australia generation study. Data on parents and offspring aged ≥18 years across 10 study centres in seven countries included demographics, self-reported breathlessness, asthma, depression, smoking, physical activity level, measured Body Mass Index and spirometry. Data were analysed using multivariable logistic regression accounting for clustering within centres and between siblings. A total of 1720 parents (mean age at assessment 36 years, 55% mothers) and 2476 offspring (mean 30 years, 55% daughters) were included. Breathlessness was reported by 809 (32.7%) parents and 363 (14.7%) offspring. Factors independently associated with breathlessness in parents and offspring included obesity, current smoking, asthma, depression, lower lung function and female sex. After adjusting for potential confounders, parents with breathlessness were more likely to have offspring with breathlessness, adjusted OR 1.8 (95% CI 1.1 to 2.9). The association was not modified by sex of the parent or offspring. Parents with breathlessness were more likely to have children who developed breathlessness, after adjusting for asthma, lung function, obesity, smoking, depression and female sex in both generations. The hereditary components of breathlessness need to be further explored.
Publisher: JMIR Publications Inc.
Date: 17-10-2018
Abstract: o date, many online health behavior programs developed by researchers have not been translated at scale. To inform translational efforts, health researchers must work with marketing experts to design cost-effective marketing c aigns. It is important to understand the characteristics of end users of a given health promotion program and identify key market segments. his study aimed to describe the characteristics of the adopters of Active Team, a gamified online social networking physical activity app, and identify potential market segments to inform future research translation efforts. articipants (N=545) were Australian adults aged 18 to 65 years who responded to general advertisements to join a randomized controlled trial (RCT) evaluating the Active Team app. At baseline they provided demographic (age, sex, education, marital status, body mass index, location of residence, and country of birth), behavioral (sleep, assessed by the Pittsburgh Quality Sleep Index) and physical activity (assessed by the Active Australia Survey), psychographic information (health and well-being, assessed by the PERMA [Positive Emotion, Engagement, Relationships, Meaning, Achievement] Profile depression, anxiety and stress, assessed by the Depression, Anxiety, and Stress Scale [DASS-21] and quality of life, assessed by the 12-Item Short Form Health Survey [SF-12]). Descriptive analyses and a k-medoids cluster analysis were performed using the software R 3.3.0 (The R Foundation) to identify key characteristics of the s le. luster analyses revealed four clusters: (1) younger inactive women with poor well-being (218/545), characterized by a higher score on the DASS-21, low mental component summary score on the SF-12, and relatively young age (2) older, active women (153/545), characterized by a lower score on DASS-21, a higher overall score on the SF-12, and relatively older age (3) young, active but stressed men (58/545) with a higher score on DASS-21 and higher activity levels and (4) older, low active and obese men (30/545), characterized by a high body mass index and lower activity levels. nderstanding the characteristics of population segments attracted to a health promotion program will guide the development of cost-effective research translation c aigns. ustralian New Zealand Clinical Trial Registry ACTRN12617000113358 www.anzctr.org .au/Trial/Registration/TrialReview.aspx?id=371463 R2-10.1186/s12889-017-4882-7
Publisher: Springer Science and Business Media LLC
Date: 08-2023
Publisher: Springer Science and Business Media LLC
Date: 21-05-2022
DOI: 10.1186/S12887-022-03322-1
Abstract: Lower socioeconomic status is associated with poorer wellbeing among children. Identifying how children participate in after-school activities and how after-school activities are associated with wellbeing may inform interventions to improve wellbeing among children from low socioeconomic backgrounds. This study explored whether children’s after-school activities varied by socioeconomic status and examined the associations between after-school activities and wellbeing in low socioeconomic status children. This study analysed cross-sectional data from 61,759 school students in years 4 to 9 who completed the 2018 South Australian Wellbeing and Engagement Collection. Students reported the number of days per week they participated in 12 activities (after-school care, homework, music lessons or practice, youth organisations, sports, television, videogames, social media, reading, chores, arts and crafts, and socialising with friends) during the after-school period (3-6 pm) and their wellbeing (happiness, sadness, worry, engagement, perseverance, optimism, emotion regulation, and life satisfaction). Socioeconomic status was measured by parents' highest education level obtained from school enrolment data. Linear multilevel models were used to examine whether frequency of after-school activities varied by socioeconomic status. Multilevel ordered logit models were used to analyse the association between after-school activities and wellbeing amongst participants in the low socioeconomic status category. After-school activities differed according to socioeconomic status high socioeconomic status children did more frequent sport, homework, and reading and low socioeconomic status children did more frequent screen-based activities (TV, videogames and social media). Among children from low socioeconomic status backgrounds, higher wellbeing was associated most consistently with more frequent sports participation, homework, reading and spending time with friends and less frequent videogames, social media and after-school care. Children's wellbeing is positively associated with socioeconomic status. Amongst children from disadvantaged backgrounds, participating in sport, spending time with friends and getting less screen time may be protective for wellbeing. The results suggest that programming targeted at increasing sports participation and reducing screen time amongst children from low socioeconomic status backgrounds may support their wellbeing.
Publisher: Human Kinetics
Date: 10-2023
Abstract: Background : Around 40% of Australian children do not participate in sport. Cost is a major barrier to participation, particularly for children from low socioeconomic backgrounds. This study aimed to evaluate the uptake of a population-level children’s sports subsidy scheme, including sociodemographic differences in uptake. Methods : A state-wide cross-sectional analysis comparing sports voucher claimants (primary school-aged children with a valid Medicare or Australian visa number) from the 2019 financial year with population census data from South Australia. Chi-square was used to examine whether the percentage of eligible children who claimed a voucher differed based on age, sex, socioeconomic status (SES), and geographical remoteness. Subgroup analyses were conducted for the lowest 2 socioeconomic disadvantage deciles, split by gender. Scatterplots were used to compare sports between high and low SES children. Results : A total of 74,668 children claimed sports vouchers (45.5% of eligible children). Children who were relatively younger, female, from low socioeconomic backgrounds, and from major cities were least likely to claim the voucher. The 5 most common sports were Australian rules football (30.2%), netball (13.6%), soccer (13.1%), gymnastics (10.4%), and basketball (5.7%), with the popular sports similar for high and low SES children. Conclusions : Future work is needed to understand how Sports Voucher, and sport participation rates have changed over time, and to improve voucher uptake among girls, city dwellers, and low SES children.
Publisher: JMIR Publications Inc.
Date: 19-05-2020
DOI: 10.2196/16674
Abstract: Wearable trackers for monitoring physical activity (PA) and total sleep time (TST) are increasingly popular. These devices are used not only by consumers to monitor their behavior but also by researchers to track the behavior of large s les and by health professionals to implement interventions aimed at health promotion and to remotely monitor patients. However, high costs and accuracy concerns may be barriers to widespread adoption. This study aimed to investigate the concurrent validity of 6 low-cost activity trackers for measuring steps, moderate-to-vigorous physical activity (MVPA), and TST: Geonaut On Coach, iWown i5 Plus, MyKronoz ZeFit4, Nokia GO, VeryFit 2.0, and Xiaomi MiBand 2. A free-living protocol was used in which 20 adults engaged in their usual daily activities and sleep. For 3 days and 3 nights, they simultaneously wore a low-cost tracker and a high-cost tracker (Fitbit Charge HR) on the nondominant wrist. Participants wore an ActiGraph GT3X+ accelerometer on the hip at daytime and a BodyMedia SenseWear device on the nondominant upper arm at nighttime. Validity was assessed by comparing each tracker with the ActiGraph GT3X+ and BodyMedia SenseWear using mean absolute percentage error scores, correlations, and Bland-Altman plots in IBM SPSS 24.0. Large variations were shown between trackers. Low-cost trackers showed moderate-to-strong correlations (Spearman r=0.53-0.91) and low-to-good agreement (intraclass correlation coefficient [ICC]=0.51-0.90) for measuring steps. Weak-to-moderate correlations (Spearman r=0.24-0.56) and low agreement (ICC=0.18-0.56) were shown for measuring MVPA. For measuring TST, the low-cost trackers showed weak-to-strong correlations (Spearman r=0.04-0.73) and low agreement (ICC=0.05-0.52). The Bland-Altman plot revealed a variation between overcounting and undercounting for measuring steps, MVPA, and TST, depending on the used low-cost tracker. None of the trackers, including Fitbit (a high-cost tracker), showed high validity to measure MVPA. This study was the first to examine the concurrent validity of low-cost trackers. Validity was strongest for the measurement of steps there was evidence of validity for measurement of sleep in some trackers, and validity for measurement of MVPA time was weak throughout all devices. Validity ranged between devices, with Xiaomi having the highest validity for measurement of steps and VeryFit performing relatively strong across both sleep and steps domains. Low-cost trackers hold promise for monitoring and measurement of movement and sleep behaviors, both for consumers and researchers.
Publisher: Human Kinetics
Date: 09-2019
Abstract: Background : Homophily is the tendency to associate with friends similar to ourselves. This study explored the effects of homophily on team formation in a physical activity challenge in which “captains” signed up their Facebook friends to form teams. Methods : This study assessed whether participants (n = 430) were more similar to their teammates than to nonteammates with regard to age, sex, education level, body mass index, self-reported and objectively measured physical activity, and negative emotional states and whether captains were more similar to their own teammates than to nonteammates. Variability indices were calculated for each team, and a hypothetical variability index, representing that which would result from randomly assembled teams, was also calculated. Results : Within-team variability was less than that for random teams for all outcomes except education level and depression, with differences (SDs) ranging from +0.15 (self-reported physical activity) to +0.47 (age) ( P .001 to P = .001). Captains were similar to their teammates except in regard to age, with captains being 2.6 years younger ( P = .003). Conclusions : Results support hypotheses that self-selected teams are likely to contain in iduals with similar characteristics, highlighting potential to leverage team-based health interventions to target specific populations by instructing in iduals with risk characteristics to form teams to help change behavior.
Publisher: American Psychological Association (APA)
Date: 07-2015
DOI: 10.1037/DEV0000023
Abstract: Having a sense of purpose is recognized as an important resource for maintaining health and well-being over the life span. We examined associations of in idual differences in sense of purpose with levels and rates of change in indices of aging well (health, cognition, and depressive symptoms) in a s le of 1,475 older adults (Mage = 77.06 years, SD = 6.27 50% female) assessed on up to 6 occasions over 18 years. We also conducted survival analysis to examine associations of purpose with longevity. We hypothesized that a higher sense of purpose would be associated with better performance on the aging well measures, and that those with a higher sense of purpose would show shallower declines in aging well over time. Results indicated that participants who scored higher on sense of purpose reported lower levels of functional disability, performed better on cognitive tests (episodic memory and speed of processing), and reported better self-rated health and fewer depressive symptoms. Sense of purpose was not associated with in idual differences in rates of change in the aging well indices with the exception of speed of processing, for which a higher sense of purpose was associated with marginally shallower rates of decline. Higher sense of purpose was also associated with increased probability of survival, although this association became weaker over time. The findings support the notion that purposeful living contributes to health and well-being. At the same time, higher sense of purpose may not buffer against more pervasive losses in health that become more common in oldest-old adulthood.
Publisher: JMIR Publications Inc.
Date: 14-10-2019
Abstract: earable trackers for monitoring physical activity (PA) and total sleep time (TST) are increasingly popular. These devices are used not only by consumers to monitor their behavior but also by researchers to track the behavior of large s les and by health professionals to implement interventions aimed at health promotion and to remotely monitor patients. However, high costs and accuracy concerns may be barriers to widespread adoption. his study aimed to investigate the concurrent validity of 6 low-cost activity trackers for measuring steps, moderate-to-vigorous physical activity (MVPA), and TST: Geonaut On Coach, iWown i5 Plus, MyKronoz ZeFit4, Nokia GO, VeryFit 2.0, and Xiaomi MiBand 2. free-living protocol was used in which 20 adults engaged in their usual daily activities and sleep. For 3 days and 3 nights, they simultaneously wore a low-cost tracker and a high-cost tracker (Fitbit Charge HR) on the nondominant wrist. Participants wore an ActiGraph GT3X+ accelerometer on the hip at daytime and a BodyMedia SenseWear device on the nondominant upper arm at nighttime. Validity was assessed by comparing each tracker with the ActiGraph GT3X+ and BodyMedia SenseWear using mean absolute percentage error scores, correlations, and Bland-Altman plots in IBM SPSS 24.0. arge variations were shown between trackers. Low-cost trackers showed moderate-to-strong correlations (Spearman i r /i =0.53-0.91) and low-to-good agreement (intraclass correlation coefficient [ICC]=0.51-0.90) for measuring steps. Weak-to-moderate correlations (Spearman i r /i =0.24-0.56) and low agreement (ICC=0.18-0.56) were shown for measuring MVPA. For measuring TST, the low-cost trackers showed weak-to-strong correlations (Spearman i r /i =0.04-0.73) and low agreement (ICC=0.05-0.52). The Bland-Altman plot revealed a variation between overcounting and undercounting for measuring steps, MVPA, and TST, depending on the used low-cost tracker. None of the trackers, including Fitbit (a high-cost tracker), showed high validity to measure MVPA. his study was the first to examine the concurrent validity of low-cost trackers. Validity was strongest for the measurement of steps there was evidence of validity for measurement of sleep in some trackers, and validity for measurement of MVPA time was weak throughout all devices. Validity ranged between devices, with Xiaomi having the highest validity for measurement of steps and VeryFit performing relatively strong across both sleep and steps domains. Low-cost trackers hold promise for monitoring and measurement of movement and sleep behaviors, both for consumers and researchers.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2021
DOI: 10.1186/S12889-020-10054-3
Abstract: Almost one in three Australian adults are now obese, and the rate continues to rise. The causes of obesity are multifaceted and include environmental, cultural and lifestyle factors. Emerging evidence suggests there may be temporal patterns in weight gain related, for ex le, to season and major festivals such as Christmas, potentially due to changes in diet, daily activity patterns or both. The aim of this study is to track the annual rhythm in body weight, 24 h activity patterns, dietary patterns, and wellbeing in a cohort of Australian adults. In addition, through data linkage with a concurrent children’s cohort study, we aim to examine whether changes in children’s body mass index, activity and diet are related to those of their parents. A community-based s le of 375 parents aged 18 to 65 years old, residing in or near Adelaide, Australia, and who have access to a Bluetooth-enabled mobile device or a computer and home internet, will be recruited. Across a full year, daily activities (minutes of moderate to vigorous physical activity, light physical activity, sedentary behaviour and sleep) will be measured using wrist-worn accelerometry (Fitbit Charge 3). Body weight will be measured daily using Fitbit wifi scales. Self-reported dietary intake (Dietary Questionnaire for Epidemiological Studies V3.2), and psychological wellbeing (WHOQOL-BREF and DASS-21) will be assessed eight times throughout the 12-month period. Annual patterns in weight will be examined using Lowess curves. Associations between changes in weight and changes in activity and diet compositions will be examined using repeated measures multi-level models. The associations between parent’s and children’s weight, activity and diet will be investigated using multi-level models. Temporal factors, such as day type (weekday or weekend day), cultural celebrations and season, may play a key role in weight gain. The aim is to identify critical opportunities for intervention to assist the prevention of weight gain. Family-based interventions may be an important intervention strategy. Australia New Zealand Clinical Trials Registry, identifier ACTRN12619001430123 . Prospectively registered on 16 October 2019.
Publisher: Oxford University Press (OUP)
Date: 17-06-2016
Abstract: Perceived control may promote social activity in older adults because in iduals with greater perceived control have greater confidence in their ability to achieve outcomes and are more likely to choose difficult activities, show persistence, and employ strategies to overcome challenges. Cross-sectional research has linked perceived control with social activity in life span and older adult s les but provides little insight into the direction of influence. We examined reciprocal associations between perceived control and social activity in order to establish temporal sequencing, which is one prerequisite for determining potential causation. Participants were 14,126 midlife and older adults from the German Ageing Survey. Using cross-lagged autoregressive modeling with age as the time metric (40-87 years), we examined reciprocal 3-year lagged associations between perceived control and social activity, while controlling for concurrent associations. Perceived control significantly predicted social activity 3 years later. Reciprocally, social activity significantly predicted perceived control 3 years later. The influence of perceived control on social activity was greater than the influence of social activity on perceived control. The finding that perceived control significantly predicts future social activity has potential implications for developing interventions aimed at promoting social activity in midlife and older adults.
Publisher: BMJ
Date: 16-02-2023
DOI: 10.1136/BJSPORTS-2022-106195
Abstract: To synthesise the evidence on the effects of physical activity on symptoms of depression, anxiety and psychological distress in adult populations. Umbrella review. Twelve electronic databases were searched for eligible studies published from inception to 1 January 2022. Systematic reviews with meta-analyses of randomised controlled trials designed to increase physical activity in an adult population and that assessed depression, anxiety or psychological distress were eligible. Study selection was undertaken in duplicate by two independent reviewers. Ninety-seven reviews (1039 trials and 128 119 participants) were included. Populations included healthy adults, people with mental health disorders and people with various chronic diseases. Most reviews (n=77) had a critically low A MeaSurement Tool to Assess systematic Reviews score. Physical activity had medium effects on depression (median effect size=−0.43, IQR=−0.66 to –0.27), anxiety (median effect size=−0.42, IQR=−0.66 to –0.26) and psychological distress (effect size=−0.60, 95% CI −0.78 to –0.42), compared with usual care across all populations. The largest benefits were seen in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy in iduals. Higher intensity physical activity was associated with greater improvements in symptoms. Effectiveness of physical activity interventions diminished with longer duration interventions. Physical activity is highly beneficial for improving symptoms of depression, anxiety and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders and people with chronic disease. Physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress. CRD42021292710.
Publisher: S. Karger AG
Date: 19-10-2017
DOI: 10.1159/000450786
Abstract: b i Background: /i /b Participation in activities is associated with a range of positive outcomes in adulthood. Research has shown that pain and physical symptoms are associated with less activity in older adults, whereas higher self-efficacy is associated with more activity. Such research tends to examine cross-sectional or long-term between-person change, limiting the opportunity to explore dynamic within-person processes that unfold over shorter time periods. b i Objectives: /i /b This study aimed to (1) replicate previous between-person associations of self-efficacy with engagement in activity and (2) examine whether daily variation in pain, physical symptoms, and self-efficacy corresponded with daily within-person variation in different types of activity. We predicted that participants would engage in less activity on days when they experienced more pain or physical symptoms than their average (a negative within-person association) and that participants would engage in more activity on days when self-efficacy was higher than average (a positive within-person association). b i Methods: /i /b This study used an online diary study to assess self- reported daily pain, physical symptoms, self-efficacy, and engagement in activity among 185 adults aged 51-84 years for up to 7 days. Multilevel modelling was used to examine whether between-person (average) and daily within-person variability in pain, physical symptoms, and self-efficacy were associated with social, physical, and mental activity. b i Results: /i /b In line with previous research, between-person self-efficacy was positively associated with social and physical activity. Supporting the hypotheses, within-person self-efficacy was also positively associated with social and physical activity. The results for pain and physical symptoms were less consistent. Between-person pain was positively associated with social activity. Age interactions indicated that within-person pain was negatively associated with social activity and positively associated with physical activity among older adults. Within-person physical symptoms were positively related to social and mental activity. b i Conclusion: /i /b Stable in idual differences as well as short-term within-person variation in physical and psychological functioning are associated with day-to-day variation in activity. Between-person associations did not always reflect within-person associations (e.g., for pain). These complex associations may be influenced by a range of factors including the type of activity and how it is defined (e.g., specific activities and their difficulty), the type of physical symptoms experienced, and age.
Publisher: Springer Science and Business Media LLC
Date: 31-07-2023
DOI: 10.1186/S12889-023-16277-4
Abstract: Obesity is a growing, global public health issue. This study aimed to describe the weight management strategies used by a s le of Australian adults examine the socio-demographic characteristics of using each strategy and examine whether use of each strategy was associated with 12-month weight change. This observational study involved a community-based s le of 375 healthy adults (mean age: 40.1 ± 5.8 years, 56.8% female). Participants wore a Fitbit activity monitor, weighed themselves daily, and completed eight online surveys on socio-demographic characteristics. Participants also recalled their use of weight management strategies over the past month, at 8 timepoints during the 12-month study period. Most participants (81%) reported using at least one weight management strategy, with exercise hysical activity being the most common strategy at each timepoint (40–54%). Those who accepted their current bodyweight were less likely to use at least one weight management strategy (Odds ratio = 0.38, 95% CI = 0.22–0.64, p 0.01) and those who reported being physically active for weight maintenance had a greater reduction in bodyweight, than those who did not (between group difference: -1.2 kg, p 0.01). The use of supplements and fasting were associated with poorer mental health and quality of life outcomes (p 0.01). The use of weight management strategies appears to be common. Being physically active was associated with greater weight loss. In iduals who accepted their current body weight were less likely to use weight management strategies. Fasting and the use of supplements were associated with poorer mental health. Promoting physical activity as a weight management strategy appears important, particularly considering its multiple health benefits.
Publisher: JMIR Publications Inc.
Date: 02-07-2021
Abstract: irtual assistants can be used to deliver innovative health programs that provide appealing, personalized, and convenient health advice and support at scale and low cost. Design characteristics that influence the look and feel of the virtual assistant, such as visual appearance or language features, may significantly influence users’ experience and engagement with the assistant. his scoping review aims to provide an overview of the experimental research examining how design characteristics of virtual health assistants affect user experience, summarize research findings of experimental research examining how design characteristics of virtual health assistants affect user experience, and provide recommendations for the design of virtual health assistants if sufficient evidence exists. e searched 5 electronic databases (Web of Science, MEDLINE, Embase, PsycINFO, and ACM Digital Library) to identify the studies that used an experimental design to compare the effects of design characteristics between 2 or more versions of an interactive virtual health assistant on user experience among adults. Data were synthesized descriptively. Health domains, design characteristics, and outcomes were categorized, and descriptive statistics were used to summarize the body of research. Results for each study were categorized as positive, negative, or no effect, and a matrix of the design characteristics and outcome categories was constructed to summarize the findings. he database searches identified 6879 articles after the removal of duplicates. We included 48 articles representing 45 unique studies in the review. The most common health domains were mental health and physical activity. Studies most commonly examined design characteristics in the categories of visual design or conversational style and relational behavior and assessed outcomes in the categories of personality, satisfaction, relationship, or use intention. Over half of the design characteristics were examined by only 1 study. Results suggest that empathy and relational behavior and self-disclosure are related to more positive user experience. Results also suggest that if a human-like avatar is used, realistic rendering and medical attire may potentially be related to more positive user experience however, more research is needed to confirm this. here is a growing body of scientific evidence examining the impact of virtual health assistants’ design characteristics on user experience. Taken together, data suggest that the look and feel of a virtual health assistant does affect user experience. Virtual health assistants that show empathy, display nonverbal relational behaviors, and disclose personal information about themselves achieve better user experience. At present, the evidence base is broad, and the studies are typically small in scale and highly heterogeneous. Further research, particularly using longitudinal research designs with repeated user interactions, is needed to inform the optimal design of virtual health assistants.
Publisher: JMIR Publications Inc.
Date: 03-06-2019
DOI: 10.2196/12484
Start Date: 2021
End Date: 2024
Funder: Department of Health
View Funded ActivityStart Date: 2022
End Date: 2026
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2019
End Date: 2014
Funder: National Health and Medical Research Council
View Funded Activity