Walk well:a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol

Background - Walking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities. This paper will provide details of the Walk Well intervention, designed for adults with intellectual disabilities, and a randomised controlled trial (RCT) to test its effectiveness. Methods/design - This study will adopt a RCT design, with participants allocated to the walking intervention group or a waiting list control group. The intervention consists of three PA consultations (baseline, six weeks and 12 weeks) and an individualised 12 week walking programme. A range of measures will be completed by participants at baseline, post intervention (three months from baseline) and at follow up (three months post intervention and six months from baseline). All outcome measures will be collected by a researcher who will be blinded to the study groups. The primary outcome will be steps walked per day, measured using accelerometers. Secondary outcome measures will include time spent in PA per day (across various intensity levels), time spent in sedentary behaviour per day, quality of life, self-efficacy and anthropometric measures to monitor weight change. Discussion - Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities, this RCT will examine if a walking intervention can successfully increase PA, health and wellbeing of adults with intellectual disabilities

Examining health promotion interventions for patients with chronic conditions using a novel patient-centered complexity model: protocol for a systematic review and meta-analysis.

BACKGROUND: Successful chronic care self-management requires adherence to healthy lifestyle behaviors, but many healthcare-based health promotion interventions have resulted in small and unsustainable changes in patient behavior. Patients with chronic conditions may already be overwhelmed by burdensome illnesses and treatments, and not have the capacity to respond well to the additional work required of behavior modifications. To explore this phenomenon, we will apply the cumulative complexity model (CCM), a patient-centered model of patient complexity, to a systematic review and meta-analysis of healthcare-based health behavior interventions. METHODS/DESIGN: This systematic review will include randomized trials published between 2002 and 2012 that compared healthcare-based interventions aimed at improving healthy diet and physical activity in community dwelling adult patients with chronic conditions. After extracting study and risk of bias features from each trial, we will classify the interventions according to the conceptual model. We will then use meta-analysis and subgroup analysis to test hypotheses based on the conceptual model. DISCUSSION: Healthcare providers need evidence of successful health promoting interventions for patients with chronic conditions who display common behavioral risk factors. To better understand how patients respond to interventions, we will apply the CCM, which accounts for both the capacity of patients with chronic conditions and their treatment-related workload, and posits that a balance between capacity and workload predicts successful enactment of self-care. Analysis will also include whether patients with multiple chronic conditions respond differently to interventions compared to those with single chronic conditions. The results of this review will provide insights as to how patients with chronic conditions respond to health-promoting interventions. REVIEW REGISTRATION: PROSPERO registration number: CRD42012003428

Views on luck and winning, self-control, and gaming service expectations of culturally and linguistically diverse Australian poker machine gamblers

Despite an increase in social diversity in recent years, the role of culture in gambling cognition and behaviour is not fully understood. Qualitative interviews examined subjective views of Australian poker machine (electronic gaming machine) gamblers from culturally and linguistically diverse (CALD) backgrounds. A total of 49 Australian poker machine gamblers from CALD backgrounds (20 Chinese, 15 Vietnamese and 14 Greek Australians) were interviewed regarding their views on the concept of luck and winning, self control, subjective meanings of gambling and gaming venue service expectations. The current findings showed that the majority of poker machine gamblers from CALD backgrounds believed that the payout of poker machines occurred randomly. Luck was defined, therefore, as being at the right place at the right time when the poker machine pays out. However, a small number of interviewees maintained an optimistic view about achieving gambling wins by using a certain system. While experienced gamblers and those with secondary school qualification or lower regarded poker machine gambling as a random potluck, a few young players with university education subscribed to a more elaborate endorsement in favour of their own systems to win on the poker machine. Australian CALD gamblers valued friendly professional service from gaming venue staff (e.g., courteous customer service, affordable, quality food and drink, personal greetings using first names) but disliked intrusive or over-friendly interactions. Implications of the findings on the role of superstition and cognition on gamblers’ beliefs are discusse