‘(B)lijf in Beweging’: Evaluatie van een bewegingsinterventie voor type 2 diabetespatiënten

status: publishe

Face-to-Face Versus Mobile Versus Blended Weight Loss Program: Randomized Clinical Trial

BACKGROUND: Conventional face-to-face weight loss and weight control programs are very labor intensive for both the patient and the provider. It is unclear to what extent conventional programs can be (partially) completed by mobile health (mHealth) apps. OBJECTIVE: The aim of this study was to compare the effectiveness of different weight loss programs using a combination of conventional and mobile programs among adults who are overweight (body mass index [BMI]>29 kg/m²). METHODS: A single-blinded randomized controlled trial among obese adults was performed from September 2015 to March 2016. The study took place in Leuven, Belgium. Of the 102 eligible (BMI >29 kg/m²) adults, 81 (79%) completed the study. The three intervention groups consisted of a conventional face-to-face weight loss program, a weight loss app program (app group), and a partial face-to-face and partial app program (combi group). All intervention groups received the same advice from a dietician and a physical activity coach during a 12-week period. The control group did not receive any information during the same period. Primary outcomes were weight reduction (5% decrease of baseline weight in kg), BMI, metabolic risk factors, dietary pattern, and physical activity. RESULTS: Significant more participants in all three intervention groups lost at least 5% or more of their weight at baseline compared with the control group. No significant difference was found between the combi group and the conventional group. A trend was found that more participants in the combi group lost 5% or more compared with the app group (19%), P=.06. A significant time x group effect was found for BMI and metabolic risk factors, with the control group having the worst results and the combi group being significantly better with regard to BMI compared with the app group. No significant group x time effects were found for the intake of different food and drinks and moderate to vigorous physical activity (MVPA). CONCLUSIONS: The results of this study show that a conventional weight loss program could partially be completed with an mHealth program without affecting the effectiveness. TRIAL REGISTRATION: Clinicaltrials.gov NCT02595671; https://clinicaltrials.gov/ct2/show/NCT02595671 (Archived by WebCite at http://www.webcitation.org/6w1H0x1Q6).status: publishe

The stAPP randomized controlled trial - A smartphone based intervention to interrupt and reduce prolonged sitting

Purpose: Currently, there is a need for interventions in which participants are made aware of the problem of prolonged sitting. Moreover, such interventions should encourage people to change their sedentary lifestyle. In this pilot study we developed ‘stAPP’, an innovative app for smartphones to reduce prolonged sitting. Methods: 58 participants (18-55 years) were recruited by flyers and e-mail and randomly assigned to a control group (CG, n=27) or an intervention group (IG, n=31). The study period lasted for 2 weeks during which sitting behavior of both groups was objectively measured by the ActivPAL. The CG was asked not to change lifestyle. The IG received the ‘stAPP’ system after 1 week and was asked to use it during the following week. The ‘stAPP’ system consisted of an app on the smartphone and a motion sensor worn on the thigh that monitored the user’s sitting status. During the development of the app, the principles of the Self Determination Theory were taken into account (i.e., satisfying the needs for autonomy, relatedness and competence). The app contained specific persuasive design elements, e.g. graphs that visualized sitting behavior, an index that reflected how well a participant was doing, achievements, alert messages when sitting for longer than 30 minutes … Results: No significant changes were found in the CG for any parameter. By contrast, in the IG, prolonged sitting behavior, expressed in total minutes and % of awakening hours, significantly decreased from pre to post-test (-184.8 minutes or -50.8% on a weekday, -137.0 minutes or -47.0% on a weekend day) (p<0.001, p=0.004, respectively). Moreover, the number of bouts including at least 30 minutes of uninterrupted sitting behavior decreased in the IG with 2.8 on a weekday (p<0.001), and with 1.9 on a weekend day (p=0.01). The average duration of those bouts decreased significantly in the IG (-13.0 minutes on a weekday (p=0.005), -13.2 minutes on a weekend day (p=0.03)). Standing behavior, expressed as total minutes and % of awakening hours, increased significantly in the IG on weekdays (+4.2% or + 40.5 minutes, p=0.04)). Conclusions: stAPP seems to be an efficient methodology to reduce sitting behavior in adults on the short term. More research is needed to investigate the long term effects. Key words: sitting behavior, smartphone application, persuasive technologies, healthy adultsstatus: publishe

Short- and long-term effects of a need-supportive physical activity intervention among patients with type 2 diabetes mellitus: A randomized controlled pilot trial

OBJECTIVE: This pilot trial evaluated the short- and long-term effects of a six-week need-supportive physical activity (PA) intervention among patients with type 2 diabetes mellitus, on health-related (HbA1c and physical fitness) and behavioral (objectively-measured and self-reported PA) outcomes. METHODS: To support the basic psychological needs for autonomy, relatedness and competence, the intervention included one in- and outtake session with a PA coach, an individualized PA program and a weekly PA group session. The intervention was set up in collaboration with a health insurance fund and with general practitioners. A total of forty-eight patients participated in the study and were randomly assigned to an intervention (n = 27) or a waiting-list control condition (n = 21). RESULTS: Linear mixed models did not reveal any significant interaction effects between time and condition (ps > .05). However, significant time effects across conditions were found: a decrease in HbA1c at short term and increases in self-reported PA at both short and long term and in physical fitness at long term (ps < .05). CONCLUSION: Although the intervention as a whole did not produce the expected impact, there seems a potential for brief but regular expert visit and measurement.status: publishe

Evaluation of stAPP: a smartphone-based intervention to reduce prolonged sitting among Belgian adults.

Excessive uninterrupted sitting, also known as sedentary behavior, has been detrimentally associated with several health outcomes. However, the general population is often unaware of these health risks. Mobile phone technology offers great potential to increase awareness and to initiate behavior change. This study examined the short-term effects of stAPP, a smartphone-based intervention, on prolonged sitting behavior. Fifty-eight participants were randomly assigned to an intervention group (IG, n = 31) or a control group (CG, n = 27). After 1 week of baseline assessment, the IG received stAPP (i.e. smartphone, smartphone app and corresponding motion sensor) and used it during the following week. CG participants were monitored during 2 weeks without receiving stAPP. Total daily sitting time and prolonged sitting bouts (>30 min bouts of sitting) were objectively assessed using activPAL3 inclinometers. Although no significant changes emerged in the CG in any of the sitting parameters, total sitting time (on weekdays; p = 0.032), number of prolonged sitting bouts (>30 min of sitting) [both on week- (p < 0.001) and weekend days (p = 0.008)] and average duration of prolonged sitting bouts [both on week- (p = 0.004) and weekend days (p = 0.029)] decreased significantly in the IG. The stAPP smartphone-based intervention constitutes a promising intervention tool to interrupt and reduce prolonged sitting behavior. Further long-term studies on a larger scale are needed to further explore the effectiveness of a smartphone-based intervention aimed at reducing prolonged sitting behavior.status: Published onlin

Links between key intervention elements and need support dimensions.

<p>Links between key intervention elements and need support dimensions.</p

Short- and long-term effects of a need-supportive physical activity intervention among patients with type 2 diabetes mellitus: A randomized controlled pilot trial

<div><p>Objective</p><p>This pilot trial evaluated the short- and long-term effects of a six-week need-supportive physical activity (PA) intervention among patients with type 2 diabetes mellitus, on health-related (HbA1c and physical fitness) and behavioral (objectively-measured and self-reported PA) outcomes.</p><p>Methods</p><p>To support the basic psychological needs for autonomy, relatedness and competence, the intervention included one in- and outtake session with a PA coach, an individualized PA program and a weekly PA group session. The intervention was set up in collaboration with a health insurance fund and with general practitioners. A total of forty-eight patients participated in the study and were randomly assigned to an intervention (<i>n</i> = 27) or a waiting-list control condition (<i>n</i> = 21).</p><p>Results</p><p>Linear mixed models did not reveal any significant interaction effects between time and condition (<i>p</i>s > .05). However, significant time effects across conditions were found: a decrease in HbA1c at short term and increases in self-reported PA at both short and long term and in physical fitness at long term (<i>p</i>s < .05).</p><p>Conclusion</p><p>Although the intervention as a whole did not produce the expected impact, there seems a potential for brief but regular expert visit and measurement.</p></div

Long-term effects–raw.

<p>Long-term effects–raw.</p

Demographic baseline characteristics.

<p>Demographic baseline characteristics.</p