Adolescent SIM OPAL_12-03-2022.xlsx

These are original and additional data for a manuscript on the relationship between a self-report measure of PA and accelerometr

Maximizing cognition in mild cognitive impairment and early stage dementia

Cognitive interventions aim to positively impact cognition and ideally enable function in day-to-day life. A range of approaches have been developed for people with mild cognitive impairment (MCI) and early stage dementia, including cognitive training, cognitive strategy training, single component training, and cognitive rehabilitation. Cognitive rehabilitation shows promise as the only approach that specifically tailors the intervention to the goals of individuals, whereas the other approaches typically utilize a standardized approach. A growing body of research suggests that individualized cognitive rehabilitation helps people reach their goals in day-to-day life and may even delay the onset of institutionalization. However, there is less evidence to suggest that cognitive rehabilitation impacts on broader outcomes such as quality of life, mood, and self-efficacy. Implications for future research and clinical practice are discussed, including the need for more research into cognitive rehabilitation in MCI groups and direct comparisons with other approaches.------------With an impact on millions globally, and billions of research dollars being invested in dementia research, this book will stimulate research in the area and inform researchers

Motivational interviewing with cognitive behaviour therapy influences physical activity patterns of adult ambulatory care patients in a regional hospital: Healthy4U randomised controlled trial

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Developing the Stroke Exercise Preference Inventory (SEPI)

Background: Physical inactivity is highly prevalent after stroke, increasing the risk of poor health outcomes including recurrent stroke. Tailoring of exercise programs to individual preferences can improve adherence, but no tools exist for this purpose in stroke. Methods: We identified potential questionnaire items for establishing exercise preferences via: (i) our preliminary Exercise Preference Questionnaire in stroke, (ii) similar tools used in other conditions, and (iii) expert panel consultations. The resulting 35-item questionnaire (SEPI-35) was administered to stroke survivors, along with measures of disability, depression, anxiety, fatigue and self-reported physical activity. Exploratory factor analysis was used to identify a factor structure in exercise preferences, providing a framework for item reduction. Associations between exercise preferences and personal characteristics were analysed using multivariable regression. Results: A group of 134 community-dwelling stroke survivors (mean age 64.0, SD 13.3) participated. Analysis of the SEPI-35 identified 7 exercise preference factors (Supervision-support, Confidence- challenge, Health-wellbeing, Exercise context, Home-alone, Similar others, Music- TV). Item reduction processes yielded a 13-item version (SEPI-13); in analysis of this version, the original factor structure was maintained. Lower scores on Confidence-challenge were significantly associated with disability (p = 0.002), depression (p = 0.001) and fatigue (p = 0.001). Self-reported barriers to exercise were particularly prevalent in those experiencing fatigue and anxiety. Conclusions: The SEPI-13 is a brief instrument that allows assessment of exercise preferences and barriers in the stroke population. This new tool can be employed by health professionals to inform the development of individually tailored exercise interventions

Telephone coaching is cost-effective for increasing physical activity for non-admitted hospital patients

Introduction: Interventions that promote physical activity in non-admitted hospital patients might provide an opportunity to reduce the burden of chronic disease. The cost-effectiveness of integrating a behaviour change intervention into non-admitted clinical care in a public hospital has not been documented.Methods: Seventy-two insufficiently active participants were randomised to an intervention group that received an education session and eight sessions of telephone coaching, or to a control group that received the education session only. Intervention costs were calculated during the trial and compared with the intervention effects on physical activity and quality-of life 6 months after the start of the intervention.Results: Relative to control, the intervention group completed 18 additional minutes of daily moderate to vigorous physical activity at an incremental cost-effectiveness ratio (ICER) of $10/minute, indicating that the intervention is cost-effective at low willingness-to pay thresholds. In regard to QALYs, the intervention (ICER =$3,760/QALY) was also found to be cost-effective at a willingness-to pay threshold of $30,000/QALY.Conclusion & Recommendation: Telephone coaching was found to be a cost-effective method of increasing physical activity and quality of life in insufficiently active non-admitted hospital patients. The lasting effects of the intervention and the cost-savings derived from increasing physical activity strengthens its position as a good value health intervention. Integrating telephone coaching into clinical care to promote changes in physical activity can contribute to individual health, and public health more broadly by increasing physical activity at low costs and offers a cost-effective investment to produce better public health outcome.</div

Developing a psychological support intervention to help injured athletes get Back in the Game

Abstract:Background: After serious knee injury, up to half of athletes do not return to competitive sport, despite recovering sufficient physical function. Athletes often desire psychological support to return to sport, but rehabilitation clinicians feel ill-equipped to deliver adequate support.Objective: To design and develop an Internet-delivered psychological support programme for athletes recovering from knee ligament surgery.Method: Our work developing and designing the Back in the Game intervention was guided by a blend of theory & evidence-based and target population-based strategies to developing complex interventions. We systematically searched for qualitative evidence related to athletes’ experiences, perspectives and needs for recovery and return to sport after anterior cruciate ligament (ACL) injury. Two reviewers coded and synthesised the results using thematic meta-synthesis. We systematically searched for randomised controlled trials (RCTs) reporting on psychological support interventions for improving ACL rehabilitation outcomes in athletes. One reviewer extracted the data (including effect estimates); a second reviewer checked the data for accuracy. The results were synthesised descriptively. We conducted feasibility testing in two phases: (1) technical assessment, and (2) feasibility and useability testing. For phase 1, we recruited clinicians and people with lived experience of ACL injury. For phase 2, we recruited patients aged between 15 and 30 years, who were within 8 weeks of ACL reconstruction surgery. Participants completed a 10-week version of the intervention, and semi-structured interviews evaluating acceptability, demand, practicality and integration. The project was approved by the Swedish Ethical Review Authority (2018/45-31).Results: Three analytic themes emerged from the meta-synthesis (n = 16 studies, 164 participants): (1) tools/strategies to support rehabilitation progress, (2) barriers and facilitators for physical readiness to return to sport, and (3) barriers and facilitators to psychological readiness to return to sport. Coping strategies, relaxation and goal setting may have a positive effect on rehabilitation outcomes after ACL reconstruction (n = 7 RCTs, 430 participants). There were no trials of psychological support interventions for improving return to sport. Eleven people completed phase 1 of feasibility testing (technical assessment) and identified 4 types of software errors that we fixed. Six participants completed feasibility and useability testing. Their feedback suggested the intervention was easy to access and addressed the needs of athletes who want to return to sport after ACL reconstruction. We refined the intervention to include more multimedia content, and support to access and use the intervention features.ConclusionThe Back in the Game intervention is a 24-week Internet-delivered self-guided programme comprising 7 modules that complements usual rehabilitation, changes focus as rehabilitation progresses, is easy to access and use, and includes different psychological support strategies.</div

Exercise and COVID‐19: reasons individuals sought coaching support to assist them to increase physical activity during COVID‐19

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Vocal ergonomics with sports coaches: Co-devised approaches to occupational voice

BACKGROUND: Work-system participation and factors are associated with occupational vocal health for vocally reliant workers, such as sports coaches. However, there is limited use of systems approaches and worker collaboration to address occupational voice. OBJECTIVE: The current research aimed to cooperatively consider coaches’ vocally reliant systems participation, including addressing vocal ergonomic factors that can create barriers for occupational vocal health and voice use. METHODS: Collaborative action inquiries explored vocal ergonomics with coaches (n = 24) from nine professional basketball teams. Across three basketball seasons, coaches and a subject matter expert identified what influenced coaches’ voices and trialed approaches to optimize vocally reliant coaching participation. Nine action inquiry methods were used, including search conferences, ergonomic approaches to enhance systems participation, and focus groups. Multi-level analyses were also undertaken. RESULTS: Participants cooperatively generated, implemented, and evaluated different strategies. A cumulative total of 57 strategies were explored within teams (team mean = 6.33, SD = 3, range = 4–14). Cross-case analysis identified 25 different strategy types. Overall, participants appraised 31.58% (18/57) strategies as supportive (i.e., enhanced facilitators for voice), 61.40% (35/57) strategies as somewhat supportive (i.e., some enhanced facilitators and some ongoing barriers), and 7.02% (4/57) strategies as unsupportive (i.e., pervasive ongoing barriers not mitigated by strategies). Further, factors across coaches’ work-systems continued to influence coaches’ voices in dynamic and complex ways. CONCLUSIONS: Collaboration with coaches enriched vocal ergonomic approaches by providing novel, context-anchored insights. Collaboration should form ‘part’ of broader mechanisms to support coaches’ voice use and vocal health at work.</p

Physical activity telephone coaching intervention for insufficiently physically active ambulatory hospital patients: Economic evaluation of the Healthy 4U-2 randomised controlled trial

The Healthy 4U-2 randomised controlled trial demonstrated that a physical activity (PA) telephone coaching intervention was effective for improving objectively-measured PA and health-related outcomes. The current study reports on an economic evaluation performed alongside the trial to determine whether this effective intervention is also cost-effective from a healthcare funder perspective. Participants (N = 120) were insufficiently physically active adults recruited from an ambulatory care clinic in a public hospital in regional Australia. The primary outcome was change in moderate-to-vigorous physical activity (MVPA) measured using accelerometers. Changes in quality-adjusted life-years (QALYs) were derived from the 12-Item Short Form Health Survey Questionnaire (SF-12). Incremental cost-effectiveness ratios (ICERs) were calculated for each outcome. Uncertainty of cost-effectiveness results were estimated using non-parametric bootstrapping techniques and sensitivity analyses. The mean intervention cost was $132 per person. The control group incurred higher overall costs compared to intervention ($2,465 vs. $1,743, respectively). Relative to control, the intervention resulted in incremental improvements in MVPA and QALYs and was deemed cost-effective. Probabilistic sensitivity analysis indicated that compared to control, the intervention would be cost-effective for improving MVPA and QALYs at very low willingness to pay thresholds. Sensitivity analyses indicated that results were robust to varied assumptions. This study shows that PA telephone coaching was a low-cost strategy for increasing MVPA and QALYs in insufficiently active ambulatory hospital patients. Findings of health benefits and overall cost-savings are uncommon and PA telephone coaching offers a potentially cost-effective investment to produce important public health outcomes

Active Women and Girls for Health and Wellbeing - Participation (July 2020)

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