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Publisher: SAGE Publications
Date: 07-07-2016
Abstract: Physical inactivity is a leading contributor to the burden of disease in men. Social–cognitive theories may improve physical activity (PA) interventions by identifying which variables to target to maximize intervention impact. This study tested the utility of Bandura’s social cognitive theory (SCT) to explain men’s PA during a 3-month weight loss program. Participants were 204 overweight/obese men ( M [ SD] age = 46.6 [11.3] years body mass index = 33.1 [3.5] kg/m 2 ). A longitudinal, latent variable structural equation model tested the associations between SCT constructs (i.e., self-efficacy, outcome expectations, intention, and social support) and self-reported moderate-to-vigorous PA (MVPA) and examined the total PA variance explained by SCT. After controlling for Time 1 cognitions and behavior, the model fit the data well (χ 2 = 73.9, degrees of freedom = 39, p .001 normed χ 2 = 1.9 comparative fit index = 0.96 standardized root mean residual = 0.059) and explained 65% of the variance in MVPA at Time 2. At Time 2, self-efficacy demonstrated the largest direct and total effects on MVPA (β direct = .45, p .001 β total = .67, p = .002). A small-to-medium effect was observed from intention to MVPA, but not from outcome expectations or social support. This study provides some evidence supporting the tenets of SCT when examining PA behavior in overweight and obese men. Future PA and weight loss interventions for men may benefit by targeting self-efficacy and intention, but the utility of targeting social support and outcome expectations requires further examination.
Publisher: Informa UK Limited
Date: 1992
Publisher: BMJ
Date: 06-2016
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: JMIR Publications Inc.
Date: 02-11-2021
Abstract: obile health apps that promote physical activity are being developed at a rapid rate. App-based interventions have the potential for wide reach and therefore, may be a useful tool in up-scaling physical activity interventions. In larger scale interventions, face-to-face assessments are less cost effective, and researchers often rely on surveys or built-in activity trackers to assess ongoing efficacy/effectiveness of outcomes. While there are valid means of assessing aerobic activity via smartphone apps, there is limited evidence of valid muscular fitness assessments that can be self-administered within mHealth. o evaluate the concurrent validity of upper and lower body muscular fitness that have been independently assessed by participants via the ecofit app, and face-to-face assessments conducted by a trained researcher. his study compared baseline data from the ecofit two-armed randomised controlled trial and self-assessed data collected via the ecofit smartphone app. As part of baseline assessment in a larger community-based physical activity intervention ‘ecofit’, participants undertook the validated 90-degree push-up and the 60-second sit-to-stand test face-to-face with a trained researcher. Those allocated to the intervention group received access to the ecofit app and were instructed to complete the self-assessed fitness tests within 14-days of receiving access to the app. To assess the concurrent validity, the self-assessed push-up and sit-to-stand tests were correlated using Spearman’s correlation coefficient against the research-assessed results. Bland-Altman plots were also used to allow visualisation of the differences between the self- and research-assessed tests. ifty-four participants completed at least one of the two muscular fitness self-assessments within 14-days of receiving the app, of these 24.1% and 100% completed the push-up and the sit-to-stand test respectively. The results found a strong significant correlation for the push-up test (0.83, p .001) and a moderate significant correlation for the sit-to-stand test (0.63, p .001). his study provides support for the concurrent validity of self-reported upper and lower body muscular fitness assessments (i.e., the push-up and sit-to-stand tests) in mHealth. While these tests may be a feasible option for large scale physical activity interventions, more research is needed to determine the generalisability of these results. he ecofit trial is registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR): ACTRN12619000868189.
Publisher: Wiley
Date: 16-03-2015
DOI: 10.1111/BJHP.12137
Abstract: To examine the effect of a gender-tailored, Social Cognitive Theory (SCT)-based weight loss maintenance (WLM) intervention on men's physical activity and healthy eating cognitions and behaviours in the 12 months after completing a weight loss programme. A two-phase, assessor-blinded, randomized controlled trial. Ninety-two overweight/obese men (mean [SD] age: 49.2 years [10.1], BMI: 30.7 [3.3] kg/m(2) ) who lost at least 4 kg after completing the 3-month SCT-based SHED-IT Weight Loss Program were randomly allocated to receive (1) the SCT-based SHED-IT WLM Program or (2) no additional resources (self-help control group). The 6-month gender-tailored SHED-IT WLM Program was completely self-administered and operationalized SCT behaviour change principles to assist men to increase moderate-to-vigorous physical activity (MVPA) and decrease energy-dense, nutrient-poor (discretionary) food consumption after initial weight loss. After randomization (WLM baseline), men were reassessed at 6 months (WLM post-test) and 12 months (6-month WLM follow-up). SCT cognitions (e.g., self-efficacy, goal setting), MVPA, and discretionary food consumption were assessed with validated measures. Following significant improvements in cognitions, MVPA and discretionary food consumption during the weight loss phase, intention-to-treat, linear mixed models revealed no significant group-by-time differences in cognitions or behaviours during the WLM phase. Initial improvements in MVPA and some cognitions (e.g., goal setting, planning, and social support) were largely maintained by both groups at the end of the study. Dietary effects were not as strongly maintained, with the intervention and control groups maintaining 57% and 75% of the Phase I improvements in discretionary food intake, respectively. An additional SCT-based WLM programme did not elicit further improvements over a self-help control in the cognitions or behaviours for MVPA or discretionary food intake of men who had lost weight with a SCT-based weight loss programme. Statement of contribution What is already known on this subject?Weight regain after weight loss (WL) is common. As successful weight loss maintenance (WLM) requires sustained improvements in cognitions and behaviours, health psychology can contribute to intervention development. However, little research has examined the utility of psychological theory in the context of a WLM randomised controlled trial. What does this study add? A theory-based WL program improved men's physical activity and dietary behaviours and cognitions. Men who also received a theory-based WLM program did not show further improvements in physical activity or dietary cognitions and behaviours compared to those that did not.
Publisher: Springer Science and Business Media LLC
Date: 02-04-2012
Abstract: This study aimed to develop and evaluate the reliability and factorial validity, of social-cognitive measures related to adolescent healthy eating behaviors. A questionnaire was developed based on constructs from Bandura’s Social Cognitive Theory and included the following scales: self-efficacy , intentions (proximal goals), situation (perceived environment), social support , behavioral strategies , outcome expectations and expectancies . The questionnaire was administered with a two week test-retest among secondary school students (n = 173, age = 13.72 ± 1.24). Confirmatory factor analysis was employed to examine model-fit for each scale using multiple indices including: chi-square index, comparative-fit index (CFI), goodness-of-fit index (GFI), and the root mean square error of approximation (RMSEA). Reliability properties were also examined (ICC and Cronbach’s alpha). The reliability and factorial validity of each scale is supported: fit indices suggest each model to be an adequate-to-exact fit to the data internal consistency was acceptable-to-good (α=0.65−0.79) rank order repeatability was strong (ICC = 0.81−0.89). Results support the reliability and factorial validity of social cognitive scales relating to healthy eating behaviors among adolescents. As such, the developed scales have utility for identifying potential social cognitive correlates of adolescent dietary behavior, mediators of dietary behavior change and validity testing of theoretical models based on Social Cognitive Theory.
Publisher: JMIR Publications Inc.
Date: 19-03-2018
DOI: 10.2196/12053
Publisher: Wiley
Date: 24-02-2016
DOI: 10.1111/OBR.12371
Abstract: Sedentary behaviour has emerged as a unique determinant of health in adults. Studies in children and adolescents have been less consistent. We reviewed the evidence to determine if the total volume and patterns (i.e. breaks and bouts) of objectively measured sedentary behaviour were associated with adverse health outcomes in young people, independent of moderate-intensity to vigorous-intensity physical activity. Four electronic databases (EMBASE MEDLINE, Ovid EMBASE, PubMed and Scopus) were searched (up to 12 November 2015) to retrieve studies among 2- to 18-year-olds, which used cross-sectional, longitudinal or experimental designs, and examined associations with health outcomes (adiposity, cardio-metabolic, fitness, respiratory, bone/musculoskeletal, psychosocial, cognition/academic achievement, gross motor development and other outcomes). Based on 88 eligible observational studies, level of evidence grading and quantitative meta-analyses indicated that there is limited available evidence that the total volume or patterns of sedentary behaviour are associated with health in children and adolescents when accounting for moderate-intensity to vigorous-intensity physical activity or focusing on studies with low risk of bias. Quality evidence from studies with robust designs and methods, objective measures of sitting, examining associations for various health outcomes, is needed to better understand if the overall volume or patterns of sedentary behaviour are independent determinants of health in children and adolescents.
Publisher: SAGE Publications
Date: 10-07-2014
Abstract: The science and practice of step counting in children (typically aged 6-11 years) and adolescents (typically aged 12-19 years) has evolved rapidly over a relatively brief period with the commercial availability of research-grade pedometers and accelerometers. Recent reviews have summarized considerations for assessing physical activity using pedometers in young people (both children and adolescents), but 3 areas have received little attention: pedometer monitoring protocols, minimal (as opposed to optimal) step counts necessary for maintaining basal levels of health, and appropriate pedometer-based interventions for young people. Therefore, the objective of this review was to evaluate the current evidence and identify future research directions in these areas. The challenges of objective monitoring of physical activity in children and adolescents reinforce the importance of using protocols that minimize participant burden and the potential for t ering/reactivity. Evidence for a sedentary lifestyle cut point is limited researchers are therefore encouraged to investigate several cut points (ie, , , steps/d) in children and adolescents to identify the health consequences of very low levels of ambulatory activity. Personalized messages may be necessary for health behavior change in pedometer-based interventions, but there is a need for more high-quality studies to develop the existing evidence base.
Publisher: Springer Science and Business Media LLC
Date: 20-08-2016
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: Springer Science and Business Media LLC
Date: 20-06-2015
DOI: 10.1007/S10995-015-1752-8
Abstract: Given the low levels of physical activity in girls, improving our understanding of the factors associated with girls' physical activity is important. In particular, exploring maternal correlates of girls' physical activity for both generations is important, given the paucity of research in this area. The primary aim of this study was to assess maternal correlates of objectively-measured physical activity in girls. A cross-sectional design was used to assess 40 girls [mean age 8.8 years mean body mass index (BMI) z-score = 0.7] and their mothers (mean age 39.1 years mean BMI = 27.6) prior to an intervention. Maternal correlates of daughters' accelerometer-assessed physical activity were evaluated. Daughters' outcomes included: % moderate-to-vigorous physical activity (MVPA), counts per minute (CPM) and % sedentary behavior (SED), screen time (mother-proxy) and BMI z-score (objectively measured). Maternal correlates included demographic, anthropometric, behavioral, activity-related parenting practices, and physical activity cognitions. Correlates were examined using regression models. For daughters' % MVPA, mothers' beliefs was significant in the final model (R(2) = 0.14 P = 0.01). For daughters' CPM, mothers' logistic support (P = 0.03), mothers' CPM (P = 0.02) and outcome expectations (P = 0.01) were all significant (R(2) = 0.24). For daughters' % SED, mothers' logistic support (P = 0.02) was significant (R(2) = 0.11). A number of maternal behaviors, social-cognitive and parenting correlates were found to be significantly associated with daughters' physical activity. Experimental studies are warranted, targeting mothers as the primary agents of change to increase physical activity among girls.
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: Springer Science and Business Media LLC
Date: 14-11-2016
DOI: 10.1007/S10865-016-9810-2
Abstract: The mechanisms of behavior change in youth screen-time interventions are poorly understood. Participants were 361 adolescent boys (12-14 years) participating in the ATLAS obesity prevention trial, evaluated in 14 schools in low-income areas of New South Wales, Australia. Recreational screen-time was assessed at baseline, 8- and 18-months, whereas potential mediators (i.e., motivation to limit screen-time and parental rules) were assessed at baseline, 4- and 18-months. Multi-level mediation analyses followed the intention-to-treat principle and were conducted using a product-of-coefficients test. The intervention had a significant impact on screen-time at both time-points, and on autonomous motivation at 18-months. Changes in autonomous motivation partially mediated the effect on screen-time at 18-months in single and multi-mediator models [AB (95% CI) = -5.49 (-12.13, -.70)]. Enhancing autonomous motivation may be effective for limiting screen-time among adolescent males. Australian New Zealand Clinical Trials Registry No: ACTRN12612000978864.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JSAMS.2017.04.017
Abstract: To determine the comparability and feasibility of wrist- and hip-worn accelerometers among free-living adolescents. 89 adolescents (age=13-14years old) from eight secondary schools in New South Wales (NSW), Australia wore wrist-worn GENEActiv and hip-worn ActiGraph (GT3X+) accelerometers simultaneously for seven days and completed an accelerometry behavior questionnaire. Bivariate correlations between the wrist- and hip-worn out-put were used to determine concurrent validity. Paired s les t-test were used to compare minutes per day in moderate-to-vigorous physical activity (MVPA). Group means and paired s le t-tests were used to analyze participants' perceptions of the wrist- and hip-worn monitoring protocols to assist with determining the feasibility. Wrist-worn accelerometry compared favorably with the hip-worn in average activity (r=0.88, p<0.001) and MVPA (r=0.84 p<0.001, mean difference=3.54min/day, SD=12.37). The wrist-worn accelerometer had 50% fewer non-valid days (75 days, 12%) than the hip-worn accelerometer (n=152, 24.4%). Participants reported they liked to wear the device on the wrist (p<0.01), and that it was less uncomfortable (p=0.02) and less embarrassing to wear on the wrist (p<0.01). Furthermore, that they would be more willing to wear the device again on the wrist over the hip (p<0.01). Our findings reveal there is a strong linear relationship between wrist- and hip-worn accelerometer out-put among adolescents in free-living conditions. Adolescent compliance was significantly higher with wrist placement, with participants reporting that it was more comfortable and less embarrassing to wear on the wrist.
Publisher: Oxford University Press (OUP)
Date: 08-06-2022
Abstract: Dietary modification is essential for the secondary prevention of cardiovascular disease. However, there are limited published evidence syntheses to guide practice in the cardiac rehabilitation (CR) setting. This systematic review's objective was to assess effectiveness and reporting of nutrition interventions to optimize dietary intake in adults attending CR. Randomized controlled trials (RCTs) of nutrition interventions within CR were eligible for inclusion and had to have measured change in dietary intake. MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and The Cochrane Library were searched from 2000 to June 2020, limited to publications in English. Evidence from included RCTs was synthesized descriptively. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. This review is registered on PROSPERO CRD42020188723. Of 13 048 unique articles identified, 11 were eligible. Randomized controlled trials were conducted in 10 different countries, included 1542 participants, and evaluated 29 distinct dietary intake outcomes. Five studies reported statistically significant changes in diet across 13 outcomes. Most nutrition interventions were not reported in a manner that allowed replication in clinical practice or future research. There is a gap in research testing high-quality nutrition interventions in CR settings. Findings should be interpreted in the light of limitations, given the overall body of evidence was heterogenous across outcomes and study quality 6 of 11 studies were conducted more than 10 years old. Future research should investigate strategies to optimize and maintain nutrition improvements for patients attending CR. PROSPERO CRD42020188723.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2018
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: BMJ
Date: 03-2022
DOI: 10.1136/BMJDRC-2021-002595
Abstract: Type 2 diabetes mellitus (T2DM) accounts for approximately 90% of diabetes cases globally. Regular physical activity is regarded as one of the key components in T2DM management. Aerobic exercise was traditionally recommended however, there is a growing body of research examining the independent effect of resistance training (RT) on glycemic control. This systematic review and meta-analysis aimed to conduct an update on the effects of RT on glycosylated hemoglobin (HbA1c) in adults with T2DM and examine the moderating effects of training effect (ie, muscular strength improvements), risk of bias and intervention duration. Peer-reviewed articles published in English were searched across MEDLINE, Embase, CINAHL, Scopus and SPORTDiscus from database inception until January 19, 2021. Each online database was systematically searched for randomized controlled trials reporting on the effects of RT on HbA1c in in iduals with T2DM. Twenty studies (n=1172) were included in the meta-analysis. RT significantly reduced HbA1c compared with controls (weighted mean difference=−0.39, 95% CI −0.60 to −0.18, p .001, I 2 =69.20). Training effect significantly (p .05) moderated the results, with larger improvements in muscular strength leading to greater reductions in HbA1c (β=−0.99, CI −1.97 to −0.01). Intervention duration and risk of bias did not significantly moderate the effects. As a secondary analysis, this study found no significant differences in HbA1c when comparing RT and aerobic training (p=0.42). This study demonstrates that RT is an effective strategy to decrease HbA1c in in iduals with T2DM. Importantly, RT interventions that had a larger training effect appeared more effective in reducing HbA1c, compared with interventions producing medium and small effects. PROSPERO registration number CRD42020134046.
Publisher: JMIR Publications Inc.
Date: 12-08-2016
DOI: 10.2196/JMIR.5664
Publisher: Elsevier BV
Date: 03-2017
Publisher: SAGE Publications
Date: 05-2015
DOI: 10.4278/AJHP.130619-LIT-313
Abstract: Evaluate the literature on interventions targeting tertiary education staff within colleges and universities for improvements in health behaviors such as physical activity, dietary intake, and weight loss. One online database, Medline, was searched for literature published between January 1970 and February 2013. All quantitative study designs, including but not limited to randomized controlled trials, quasi-experimental studies, nonrandomized experimental trials, cohort studies, and case-control studies, were eligible. Data extraction was performed by one reviewer using a standardized form developed by the researchers. Extraction was checked for accuracy and consistency by a second reviewer. Data in relation to the above objective were extracted and described in a narrative synthesis. Seventeen studies were identified that focused on staff within the tertiary education setting. The review yielded overall positive results with 13 reporting significant health-related improvements. Weight loss, physical activity and fitness, and/or nutrition were the focus in more than half (n = 9) of the studies. This appears to be the first review to examine health interventions for tertiary education staff. There is scope to enhance cross-disciplinary collaboration in the development and implementation of a “Healthy University” settings–based approach to health promotion in tertiary education workplaces. Universities or colleges could serve as a research platform to evaluate such intervention strategies.
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.MATURITAS.2017.05.013
Abstract: This study aimed to identify how different patterns of physical activity, sleep duration and sleep quality cluster together, and to examine how the identified clusters differ in terms of socio-demographic and health characteristics. Participants were adults from Brisbane, Australia, aged 42-72 years who reported their physical activity, sleep duration, sleep quality, socio-demographic and health characteristics in 2011 (n=5854). Two-step Cluster Analyses were used to identify clusters. Cluster differences in socio-demographic and health characteristics were examined using chi square tests (p<0.05). Four clusters were identified: 'Poor Sleepers' (31.2%), 'Moderate Sleepers' (30.7%), 'Mixed Sleepers/Highly Active' (20.5%), and 'Excellent Sleepers/Mixed Activity' (17.6%). The 'Poor Sleepers' cluster had the highest proportion of participants with less-than-recommended sleep duration and poor sleep quality, had the poorest health characteristics and a high proportion of participants with low physical activity. Physical activity, sleep duration and sleep quality cluster together in distinct patterns and clusters of poor behaviours are associated with poor health status. Multiple health behaviour change interventions which target both physical activity and sleep should be prioritised to improve health outcomes in mid-aged adults.
Publisher: Elsevier BV
Date: 09-2017
Publisher: Springer Science and Business Media LLC
Date: 06-08-2016
DOI: 10.1007/S11764-016-0565-0
Abstract: The purpose of the study is to investigate the impact of differing delivery schedules of computer-tailored physical activity modules on engagement and physical activity behaviour change in a web-based intervention targeting breast cancer survivors. Insufficiently active breast cancer survivors (n = 492) were randomly assigned to receive one of the following intervention schedules over 12 weeks: a three-module intervention delivered monthly, a three-module intervention delivered weekly or a single module intervention. Engagement with the website (number of logins, time on site, modules viewed, action plans completed) was measured using tracking software. Other outcomes (website acceptability, physical activity behaviour) were assessed using online surveys. Physical activity outcomes were analysed using regression models for both study completers and when applying intention-to-treat (using multiple imputation). Completers allocated to the monthly module group rated the intervention higher (b = 2.2 95 % CI = 0.02-4.53) on acceptability and had higher levels of resistance-training (IRR = 1.88, 95 % CI = 1.16-3.04) than those in the single module group. When accounting for missing data, these differences were no longer significant. The completion of at least two action plans was higher among those allocated to the monthly module group compared to those in the weekly module group (53 vs 40 %, p = 0.02) though the completion of at least two modules was higher in the weekly module group compared to the monthly module group (60 vs 46 % p = 0.01). There were no other significant between group differences observed. This study provides preliminary evidence that web-based computer-tailored interventions can be used to increase physical activity among breast cancer survivors. Further, there were some outcome differences based on how the tailored modules were delivered, with the most favourable outcomes observed in the monthly delivery group. This study will be useful for informing the design of future web-based interventions targeting breast cancer survivors.
Publisher: SAGE Publications
Date: 19-04-2017
Abstract: Background: Men are underrepresented in weight loss and type 2 diabetes mellitus (T2DM) prevention studies. Purpose: To determine the effectiveness of recruitment, and acceptability of the T2DM Prevention Using LifeStyle Education (PULSE) Program—a gender-targeted, self-administered intervention for men. Methods: Men (18–65 years, high risk for T2DM) were randomized to intervention ( n = 53) or wait-list control groups ( n = 48). The 6-month PULSE Program intervention focused on weight loss, diet, and exercise for T2DM prevention. A process evaluation questionnaire was administered at 6 months to examine recruitment and selection processes, and acceptability of the intervention’s delivery and content. Associations between self-monitoring and selected outcomes were assessed using Spearman’s rank correlation. Results: A pragmatic recruitment and online screening process was effective in identifying men at high risk of T2DM (prediabetes prevalence 70%). Men reported the trial was appealing because it targeted weight loss, T2DM prevention, and getting fit, and because it was perceived as “doable” and tailored for men. The intervention was considered acceptable, with men reporting high overall satisfaction (83%) and engagement with the various components. Adherence to self-monitoring was poor, with only 13% meeting requisite criteria. However, significant associations were observed between weekly self-monitoring of weight and change in weight ( r s = −.47, p = .004) and waist circumference ( r s = −.38, p = .026). Men reported they would have preferred more intervention contact, for ex le, by phone or email. Conclusions: Gender-targeted, self-administered lifestyle interventions are feasible, appealing, and satisfying for men. Future studies should explore the effects of additional non-face-to-face contact on motivation, accountability, self-monitoring adherence, and program efficacy.
Publisher: JMIR Publications Inc.
Date: 27-05-2016
DOI: 10.2196/RESPROT.4826
Publisher: Springer Science and Business Media LLC
Date: 30-09-2016
Publisher: Virginia Tech Libraries
Date: 2023
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: 17-06-2017
DOI: 10.1007/S00520-017-3786-5
Abstract: Participating in regular physical activity is a recommended cancer recovery strategy for breast cancer survivors. However, tailored support services are not widely available and most survivors are insufficiently active to obtain health benefits. Delivering tailored programs via the Internet offers one promising approach. However, recent evaluations of such programs suggest that major improvements are needed to ensure programs meet the needs of users and are delivered in an engaging way. Understanding participants' experiences with current programs can help to inform the next generation of systems. The purposes of this study are to explore breast cancer survivor's perspectives of and experiences using a novel computer-tailored intervention and to describe recommendations for future iterations. Qualitative data from a sub-s le of iMove More for Life study participants were analysed thematically to identify key themes. Participants long-term goals for participating in the program were explored by analysing open-ended data extracted from action plans completed during the intervention (n = 370). Participants negative and positive perceptions of the website and recommendations for improvement were explored using data extracted from open-ended survey items collected at the immediate intervention follow-up (n = 156). The majority of participants reported multi-faceted goals, consisting of two or more outcomes they hoped to achieve within a year. While clear themes were identified (e.g. 'being satisfied with body weight'), there was considerable variability in the scope of the goal (e.g. desired weight loss ranged from 2 to 30 kg). Participants' perceptions of the website were mixed, but clear indications were provided of how intervention content and structure could be improved. This study provides insight into how to better accommodate breast cancer survivors in the future and ultimately design more engaging computer-tailored interventions.
Publisher: SAGE Publications
Date: 30-08-2019
Abstract: To explore whether there was a difference in objectively measured physical activity and study participation between people who received their preferred study group allocation (matched) and those who did not receive their preferred study group (mismatched). Secondary data from the NewCOACH randomized controlled trial. Insufficiently active patients in the primary care settings in Sydney and Newcastle, Australia. One hundred seventy-two adults aged 20 to 81 years. Participants indicated their intervention preference at baseline for (1) five face-to-face visits with an exercise specialist, (2) one face-to-face visit and 4 telephone follow-ups with an exercise specialist, (3) written material, or (4) slight-to-no preference. Participants were then allocated to an intervention group and categorized as either “matched” or “mismatched” based on their indications. Participants who reported a slight-to-no preference was categorized as “matched.” Daily step count as measured by pedometers and study participation. Mean differences between groups in daily step count at 3 and 12 months (multiple linear regression models) and study participation at baseline, 3 months, and 12 months (χ 2 tests). Preference for an intervention group prior to randomization did not significantly (all P’s .05 using 95% confidence interval) impact step counts (differences of steps/day between groups) or study participation. Future research should continue to address whether the strength of preferences influence study outcome and participation and whether the study preferences change over time.
Publisher: Wiley
Date: 21-03-2012
DOI: 10.1111/J.1442-2018.2012.00677.X
Abstract: Obesity is a global issue, with healthcare practitioners increasingly involved in clinical interactions with people who are overweight or obese. These interactions are opportunities to provide evidence-based healthy lifestyle advice, and impact on public health. This study used a cross-sectional survey of Australian healthcare practitioners to investigate what influenced the provision of healthy lifestyle advice to obese and overweight clients. A modified theory of planned behavior was used to explore knowledge translation processes. Knowledge translation was linked to three factors: (i) a healthcare practitioner's education and confidence in the currency of their knowledge (ii) personal characteristics - whether they accepted that providing this advice was within their domain of practice and (iii) the existence of organizational support structures, such as access to education, and best practice guidelines. To fulfill the potential role healthcare practitioners can play in the provision of evidence-based health promotion advice requires organizations to provide access to practice guidelines and to instill a belief in their workforce that this is a shared professional domain.
Publisher: Human Kinetics
Date: 09-2015
Abstract: This study examined potential parenting-related mediators of children’s physical activity and dietary behavior change in the Healthy Dads, Healthy Kids (HDHK) community program. A randomized controlled trial was conducted with 45 overweight/obese (mean [SD] age = 39.8 [5.4] years BMI = 32.4 [3.8]) fathers and their children (n = 77 58% boys mean [SD] age = 7.7 [2.5] years). Families were randomized to either the HDHK program or wait-list control group. The program involved 7 sessions. Fathers and their children were assessed at baseline and at 14 weeks for physical activity (pedometery) and core food intake (Questionnaire). Fathers’ lifestyle-related parenting practices included self-efficacy, beliefs, modeling, logistic support, rules, cophysical activity, shared mealtime frequency and intentions. Significant intervention effects were found for cophysical activity and modeling physical activity. Cophysical activity mediated children’s physical activity in the intervention (‘mediated effect,’ AB = 653, 95% CI = 4–2050) and was responsible for 59.5% of the intervention effect. Fathers’ beliefs mediated children’s percent energy from core foods (AB = 1.51, 95% CI = 0.05–5.55) and accounted for 72.9% of the intervention effect. Participation in the HDHK program positively impacted on fathers’ cophysical activity with their child and beliefs about healthy eating which mediated changes in children’s diet and physical activity behaviors.
Publisher: Mary Ann Liebert Inc
Date: 02-2016
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: Wiley
Date: 03-02-2015
DOI: 10.1111/JPC.12836
Abstract: The aim of this study was to examine the test-retest reliability and concurrent validity of an adolescent single-item physical activity measure by comparing it with the existing Oxford Physical Activity Questionnaire (OPAQ) and accelerometer output. Participants were 123 adolescents (14.7 ± 0.5 years) from three secondary schools in New South Wales, Australia. To determine reliability, participants completed both questionnaires on two occasions separated by 2 weeks. To assess validity, participants wore Actigraph GT3X+ accelerometers for a 7-day monitoring period and completed both physical activity questionnaires. Bivariate correlations between self-reported moderate-to-vigorous physical activity (MVPA) and accelerometer MVPA min/day were calculated. The single-item (intra-class correlation coefficient (ICC) = 0.75, 95% confidence interval (CI) = 0.64-0.83, P < 0.001) ) and the OPAQ (ICC = 0.79, 95% CI = 0.69-0.86, P < 0.001) were both found to have moderate-to-strong reliability. Correlations between self-reported and objectively measured MVPA were similar for the single-item measure (r = 0.44, 95% CI = 0.24-0.63, P < 0.001) and the OPAQ (r = 0.50, 95% CI = 0.30-0.65, P < 0.001). These findings suggest the single-item measure can provide a reliable and valid assessment of youth physical activity.
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: Informa UK Limited
Date: 27-05-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2012
Publisher: Elsevier BV
Date: 2015
Publisher: Public Library of Science (PLoS)
Date: 12-2022
DOI: 10.1371/JOURNAL.PONE.0278374
Abstract: Mobile app-based interventions have the potential for wide-reach and therefore may be a useful tool in up-scaling physical activity interventions. In larger-scale interventions, face-to-face assessments are less cost-effective, and researchers often rely on surveys or activity trackers to assess outcomes. However, there is limited evidence of valid muscular fitness assessments that can be self-administered within mHealth interventions. As such, this study will evaluate the concurrent validity of upper and lower body muscular fitness that have been independently assessed by participants via the ecofit app, and face-to-face assessments conducted by a trained researcher. This study compared baseline data from two muscular fitness tests from the ecofit two-armed randomised controlled trial and self-assessed data collected via the ecofit smartphone app (i.e., validated 90-degree push-up and 60-second sit-to-stand test). To assess the concurrent validity, the self-assessed push-up and sit-to-stand tests (i.e., collected via the ecofit app) were correlated using Spearman’s correlation coefficient against the researcher-assessed results (i.e., objective results collected during baseline assessment for the ecofit trial). Bland-Altman plots were also used to allow visualisation of the differences between the self- and research-assessed tests. Participants (N = 54) completed the push-up (24.1%) and sit-to-stand (100%) tests within 14-days of receiving the app. The results revealed a strong significant correlation for the push-up test (0.83, p .001) and a moderate significant correlation for the sit-to-stand test (0.63, p .001). This study provides support for the concurrent validity of self-reported upper and lower body muscular fitness assessments (i.e., the push-up and sit-to-stand tests) in mHealth. While these tests may be a feasible option for large scale physical activity interventions, more research is needed to determine the generalisability of these results.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.AMEPRE.2017.06.016
Abstract: Primary care physicians are well placed to offer physical activity counseling, but insufficient time is a barrier. Referral to an exercise specialist is an alternative. In Australia, exercise specialists are publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. This trial aimed to (1) determine the efficacy of primary care physicians' referral of insufficiently active patients for counseling to increase physical activity, compared with usual care, and (2) compare the efficacy of face-to-face counseling with counseling predominantly via telephone. Three-arm pragmatic RCT. Two hundred three insufficiently active (<7,000 steps/day) primary care practice patients (mean age 57 years 70% female) recruited in New South Wales, Australia, in 2011-2014. (1) Five face-to-face counseling sessions by an exercise specialist, (2) one face-to-face counseling session followed by four telephone calls by an exercise specialist, or (3) a generic mailed physical activity brochure (usual care). The counseling sessions operationalized social cognitive theory via a behavior change counseling framework. Change in average daily step counts between baseline and 12 months. Data were analyzed in 2016. Forty (20%) participants formally withdrew completion rates at 3 and 6 months were 64% and 58%, respectively. Intervention attendance was high (75% received five sessions). The estimated mean difference between usual care and the combined intervention groups at 12 months was 1,002 steps/day (95% CI=244, 1,759, p=0.01). When comparing face-to-face with predominantly telephone counseling, the telephone group had a non-significant higher mean daily step count (by 619 steps) at 12 months. Provision of expert physical activity counseling to insufficiently active primary care patients resulted in a significant increase in physical activity (approximately 70 minutes of walking per week) at 12 months. Face-to-face only and counseling conducted predominantly via telephone were both effective. This trial provides evidence to expand public funding for expert physical activity counseling and for delivery via telephone in addition to face-to-face consultations. This trial is registered at www.anzctr.org.au/ ACTRN12611000884909.
Publisher: JMIR Publications Inc.
Date: 13-07-2015
DOI: 10.2196/JMIR.4086
Publisher: Informa UK Limited
Date: 20-07-2017
DOI: 10.1080/02640414.2017.1356026
Abstract: High Intensity Interval Training (HIIT) may be effective for accumulating VPA. However, the contribution of HIIT to overall physical activity is unknown. Our primary aim was to explore the impact of school-based HIIT on physical activity. The secondary aim was to explore within-in idual changes in physical activity after participating in HIIT. Participants [n = 65 15.8(0.6)years] were randomized to a HIIT or control group. Intervention groups participated in three HIIT sessions/week. GENEActiv accelerometers assessed objective physical activity at baseline and week-one, to detect changes in MPA and VPA. Intervention effects were examined using linear mixed models and evidence of a change in physical activity (i.e., compensation) were examined using multilevel linear regression models. The group-by-time interaction effects for MPA and VPA were small and moderate, respectively. Adjusted difference between groups for VPA was 1.70 min/day, 95%CI -1.96 to 5.36 p = 0.354 d = 0.55). Embedding HIIT within the school-day had a moderate effect on VPA compared to controls. Compensation analyses (i.e., in idual level) suggested that adolescents were more active on days when they participated in HIIT. Further studies are needed to test the effects of HIIT on adolescents' physical activity over extended time periods.
Publisher: Springer Science and Business Media LLC
Date: 24-03-2021
DOI: 10.1186/S40814-021-00823-1
Abstract: ecofit is an evidence-based multi-component physical activity intervention that integrates smartphone technology, the outdoor environment, and social support. In a previous efficacy trial, significant improvements were found across several clinical, fitness, and mental health outcomes among adults at risk of (or with) type 2 diabetes. The aim of the present pilot study was to evaluate a number of patient-centered and feasibility outcomes of the ecofit intervention in a “real-world” setting, using a scalable implementation model. ecofit was adapted and implemented by a rural municipal council in the Upper Hunter Shire, New South Wales, Australia, and evaluated using a single-group pre-post design. Inactive middle-aged and older adults ( N =59) were recruited and assessed at 6 (primary time-point) and 20 weeks (follow-up). Improvements were found in this predominantly overweight and obese s le for aerobic fitness, functional mobility, upper and lower body muscular fitness, systolic blood pressure, and waist circumference at 6 weeks. At 20 weeks, effects were found for aerobic fitness, functional mobility, upper and lower body muscular fitness, and systolic blood pressure. Overall, participants were satisfied with the ecofit program. Participants attended the 6-week primary time-point (66.1%) and follow-up at 20 weeks (41.6%). Our findings support the preliminary effectiveness and feasibility of the ecofit intervention delivered by municipal council staff following a brief training from the research team. This study provides valuable preliminary evidence to support a larger implementation trial.
Publisher: Springer Science and Business Media LLC
Date: 12-2022
DOI: 10.1186/S12966-022-01371-4
Abstract: Whole-of-school programs have demonstrated success in improving student physical activity levels, but few have progressed beyond efficacy testing to implementation at-scale. The purpose of our study was to evaluate the scale-up of the ‘Internet-based Professional Learning to help teachers promote Activity in Youth’ (iPLAY) intervention in primary schools using the RE-AIM framework. We conducted a type 3 hybrid implementation-effectiveness study and collected data between April 2016 and June 2021, in New South Wales (NSW), Australia. RE-AIM was operationalised as: (i) Reach: Number and representativeness of students exposed to iPLAY (ii) Effectiveness: Impact of iPLAY in a sub-s le of students ( n = 5,959) (iii) Adoption: Number and representativeness of schools that received iPLAY (iv) Implementation: Extent to which the three curricular and three non-curricular components of iPLAY were delivered as intended (v) Maintenance: Extent to which iPLAY was sustained in schools. We conducted 43 semi-structured interviews with teachers ( n = 14), leaders ( n = 19), and principals ( n = 10) from 18 schools (11 from urban and 7 from rural locations) to determine program maintenance. Reach: iPLAY reached ~ 31,000 students from a variety of socio-economic strata (35% of students were in the bottom quartile, almost half in the middle two quartiles, and 20% in the top quartile). Effectiveness: We observed small positive intervention effects for enjoyment of PE/sport (0.12 units, 95% CI: 0.05 to 0.20, d = 0.17), perceptions of need support from teachers (0.26 units, 95% CI: 0.16 to 0.53, d = 0.40), physical activity participation (0.28 units, 95% CI: 0.10 to 0.47, d = 0.14), and subjective well-being (0.82 units, 95% CI: 0.32 to 1.32, d = 0.12) at 24-months. Adoption: 115 schools received iPLAY. Implementation: Most schools implemented the curricular (59%) and non-curricular (55%) strategies as intended. Maintenance: Based on our qualitative data, changes in teacher practices and school culture resulting from iPLAY were sustained. iPLAY had extensive reach and adoption in NSW primary schools. Most of the schools implemented iPLAY as intended and effectiveness data suggest the positive effects observed in our cluster RCT were sustained when the intervention was delivered at-scale. ACTRN12621001132831.
Publisher: Wiley
Date: 24-03-2014
Publisher: Springer Science and Business Media LLC
Date: 15-01-2014
Abstract: Current recommendations for the prevention of type 2 diabetes advise modification of diet and exercise behaviors including both aerobic and resistance training. However, the efficacy of multi-component interventions involving a combination of these three components has not been established. The aims of this review were to systematically review and meta-analyze the evidence on multi-component (diet + aerobic exercise + resistance training) lifestyle interventions for type 2 diabetes prevention. Eight electronic databases (Medline, Embase, SportDiscus, Web of Science, CINAHL, Informit health collection, Cochrane library and Scopus) were searched up to June 2013. Eligible studies 1) recruited prediabetic adults or in iduals at risk of type 2 diabetes 2) conducted diet and exercise [including both physical activity/aerobic and resistance training] programs and 3) reported weight and plasma glucose outcomes. In total, 23 articles from eight studies were eligible including five randomized controlled trials, one quasi-experimental, one two-group comparison and one single-group pre-post study. Four studies had a low risk of bias (score ≥ 6/10). Median intervention length was 12 months (range 4–48 months) with a follow-up of 18 months (range 6.5 - 48 months). The diet and exercise interventions varied slightly in terms of their specific prescriptions. Meta-analysis favored interventions over controls for weight loss (-3.79 kg [-6.13, -1.46 95% CI], Z = 3.19, P = 0.001) and fasting plasma glucose (-0.13 mmol.L -1 [-0.24, -0.02 95% CI], Z = 2.42, P = 0.02). Diabetes incidence was only reported in two studies, with reductions of 58% and 56% versus control groups. In summary, multi-component lifestyle type 2 diabetes prevention interventions that include diet and both aerobic and resistance exercise training are modestly effective in inducing weight loss and improving impaired fasting glucose, glucose tolerance, dietary and exercise outcomes in at risk and prediabetic adult populations. These results support the current exercise guidelines for the inclusion of resistance training in type 2 diabetes prevention, however there remains a need for more rigorous studies, with long-term follow-up evaluating program efficacy, muscular fitness outcomes, diabetes incidence and risk reduction.
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.CCT.2014.12.001
Abstract: Excessive recreational screen time (i.e., screen use for entertainment) is a global public health issue associated with adverse mental and physical health outcomes. Considering the growing popularity of screen-based recreation in adolescents, there is a need to identify effective strategies for reducing screen time among adolescents. The aim of this paper is to report the rationale and study protocol for the 'Switch-off 4 Healthy Minds' (S4HM) study, an intervention designed to reduce recreational screen time among adolescents. The S4HM intervention will be evaluated using a cluster randomized controlled trial in eight secondary schools (N=322 students) in New South Wales, Australia. The 6-month multi-component intervention will encourage adolescents to manage their recreational screen time using a range of evidence-based strategies. The intervention is grounded in Self-Determination Theory (SDT) and includes the following components: an interactive seminar for students, eHealth messaging, behavioral contract and parental newsletters. All outcomes will be assessed at baseline and at 6-months (i.e., immediate post-test). The primary outcome is recreational screen time measured by the Adolescent Sedentary Activity Questionnaire (ASAQ). Secondary outcomes include: self-reported psychological well-being, psychological distress, global physical self-concept, resilience, pathological video gaming and aggression, and objectively measured physical activity (accelerometry) and body mass index (BMI). Hypothesized mediators of behavior change will also be explored. The S4HM study will involve the evaluation of an innovative, theory-driven, multi-component intervention that targets students and their parents and is designed to reduce recreational screen time in adolescents. The intervention has been designed for scalability and dissemination across Australian secondary schools.
Publisher: Springer Science and Business Media LLC
Date: 24-08-2016
Publisher: Elsevier BV
Date: 06-2023
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.YPMED.2017.08.027
Abstract: The risk and prevalence of Type 2 Diabetes (T2D) has dramatically increased over the past decade. The aim of this study was to develop, implement and evaluate a physical activity intervention to improve aerobic and muscular fitness among adults at risk of, or diagnosed with T2D. A 20-week, assessor blinded, parallel-group randomized controlled trial (RCT) was conducted at the University of Newcastle (June-December 2015). Adults were randomized to the intervention (n=42) or wait-list control group (n=42). The theory-based intervention included: Phase 1 (weeks 1-10) integrated group sessions (outdoor physical activity and cognitive mentoring), and the eCoFit smartphone application (app). Phase 2 (weeks 11-20) only included the eCoFit app. Participants were assessed at baseline, 10weeks and 20weeks. Linear mixed models (intention-to-treat) were used to determine group-by-time interactions at 10weeks (primary time-point) and 20weeks for the primary outcomes. Several secondary outcomes were also assessed. After 10weeks, significant group-by-time effects were observed for aerobic fitness (4.5mL/kg/min 95% CI [1.3, 7.7], d=0.68) and muscular fitness (lower body) (3.4 reps, 95% CI [2.7, 4.2], d=1.45). Intervention effects for secondary outcomes included significant increased physical activity (1330steps/week), improved upper body muscular fitness (5 reps arm-curl test), improved functionality (-1.8s timed-up and go test) reduced waist circumference (2.8cm) and systolic blood pressure (-10.4mmHg). After 20weeks, significant effects were observed for lower body muscular fitness and health outcomes. eCoFit is an innovative lifestyle intervention which integrates smartphone technology, social support, and the outdoor environment to improve aerobic and muscular fitness.
Publisher: JMIR Publications Inc.
Date: 03-06-2019
DOI: 10.2196/12484
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.YPMED.2016.07.014
Abstract: The primary objective was to evaluate the impact of the 'Switch-off 4 Healthy Minds' (S4HM) intervention on recreational screen-time in adolescents. Cluster randomized controlled trial with study measures at baseline and 6-months (post-intervention). Eligible participants reported exceeding recreational screen-time recommendations (i.e., >2h/day). In total, 322 adolescents (mean age=14.4±0.6years) from eight secondary schools in New South Wales, Australia were recruited. The S4HM intervention was guided by Self-Determination Theory and included: an interactive seminar, eHealth messaging, a behavioral contract and parental newsletters. The primary outcome was recreational screen-time. Secondary outcomes included mental health (i.e., well-being, psychological distress, self-perceptions), objectively measured physical activity, and body mass index (BMI). Outcome analyses were conducted using linear mixed models and mediation was examined using a product-of-coefficients test. At post-intervention, significant reductions in screen-time were observed in both groups, with a greater reduction observed in the intervention group (-50min/day versus -29min, p<0.05 for both). However, the adjusted difference in change between groups was not statistically significant (mean=-21.3min/day, p=0.255). There were no significant intervention effects for mental health outcomes, physical activity or BMI. Significant mediation effects for autonomous motivation were found. Participants in both the S4HM intervention and control groups significantly reduced their screen-time, with no group-by-time effects. Enhancing autonomous motivation might be a useful intervention target for trials aimed at reducing adolescents' recreational screen-time. ACTRN12614000163606.
Publisher: Informa UK Limited
Date: 17-08-2023
Publisher: Wiley
Date: 07-12-2016
DOI: 10.1002/OBY.21696
Abstract: To examine whether a gender-tailored weight loss maintenance (WLM) program could reduce men's weight regain following weight loss. Ninety-two men who lost at least 4 kg during a 3-month weight loss phase were randomized to receive: (i) a 6-month WLM program (WL + WLM n = 47) or (ii) no resources (WL-only n = 45). The WLM program included written materials and messages (SMS, video email) plus other resources (e.g., pedometer, Gymstick™). The primary outcome was weight change in the first year post-randomization. Participants were assessed at "-3 months" (preweight loss), "0 months" (randomization into the WLM Phase), "6 months," "1 year," and "3 years." Before randomization, participants lost a mean (SD) of 7.3 kg (2.5). Retention was 83% at 6 months and 1 year and 71% at 3 years. Intention-to-treat analysis detected a significant group × time difference in weight regain favoring the intervention group at 6 months (-1.9 kg, 95% CI -3.7 to -0.1) but not at 1- or 3-year follow-up. Three years after completing the original weight loss program the WL-only and WL + WLM groups had maintained 59% and 51% of their initial weight loss, respectively. Men with overweight/obesity demonstrated clinically meaningful WLM 3 years after successfully losing weight. An additional WLM program contributed to enhanced WLM effects in the short term only. (ACTRN12612000749808).
Publisher: Springer Science and Business Media LLC
Date: 05-2014
DOI: 10.1007/S40279-014-0196-4
Abstract: Physical fitness during childhood and adolescence has been identified as an important determinant of current and future health status. While research has traditionally focused on the association between cardio-respiratory fitness and health outcomes, the association between muscular fitness (MF) and health status has recently received increased attention. The aim of this systematic review and meta-analysis was to evaluate the potential physiological and psychological benefits associated with MF among children and adolescents. A systematic search of six electronic databases (PubMed, SPORTDiscus, Scopus, EMBASE, PsycINFO and OVID MEDLINE) was performed on the 20th May, 2013. Cross-sectional, longitudinal and experimental studies that quantitatively examined the association between MF and potential health benefits among children and adolescents were included. The search yielded 110 eligible studies, encompassing six health outcomes (i.e., adiposity, bone health, cardiovascular disease [CVD] and metabolic risk factors, musculoskeletal pain, psychological health and cognitive ability). The percentage of studies reporting statistically significant associations between MF and the outcome of interest was used to determine the strength of the evidence for an association and additional coding was conducted to account for risk of bias. Meta-analyses were also performed to determine the pooled effect size if there were at least three studies providing standardised coefficients. Strong evidence was found for an inverse association between MF and total and central adiposity, and CVD and metabolic risk factors. The pooled effect size for the relationship between MF and adiposity was r = -0.25 (95% CI -0.41 to -0.08). Strong evidence was also found for a positive association between MF and bone health and self-esteem. The pooled effect size for the relationship between MF and perceived sports competence was r = 0.39 (95% CI 0.34-0.45). The evidence for an association between MF and musculoskeletal pain and cognitive ability was inconsistent/uncertain. Where evidence of an association was found, the associations were generally low to moderate. The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits.
No related organisations have been discovered for Ronald Plotnikoff.
Start Date: 2013
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2015
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2012
End Date: 2014
Funder: Australian Research Council
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