Aerobic physical activity and resistance training: an application of the theory of planned behavior among adults with type 2 diabetes in a random, national sample of Canadians

<p>Abstract</p> <p>Background</p> <p>Aerobic physical activity (PA) and resistance training are paramount in the treatment and management of type 2 diabetes (T2D), but few studies have examined the determinants of both types of exercise in the same sample.</p> <p>Objective</p> <p>The primary purpose was to investigate the utility of the Theory of Planned Behavior (TPB) in explaining aerobic PA and resistance training in a population sample of T2D adults.</p> <p>Methods</p> <p>A total of 244 individuals were recruited through a random national sample which was created by generating a random list of household phone numbers. The list was proportionate to the actual number of household telephone numbers for each Canadian province (with the exception of Quebec). These individuals completed self-report TPB constructs of attitude, subjective norm, perceived behavioral control and intention, and a 3-month follow-up that assessed aerobic PA and resistance training.</p> <p>Results</p> <p>TPB explained 10% and 8% of the variance respectively for aerobic PA and resistance training; and accounted for 39% and 45% of the variance respectively for aerobic PA and resistance training intentions.</p> <p>Conclusion</p> <p>These results may guide the development of appropriate PA interventions for aerobic PA and resistance training based on the TPB.</p

Population-Based Estimates of Physical Activity for Adults with Type 2 Diabetes: A Cautionary Tale of Potential Confounding by Weight Status

At a population level, the method used to determine those meeting physical activity guidelines has important implications, as estimating “sufficient” physical activity might be confounded by weight status. The objective of this study was to test the difference between three methods in estimating the prevalence of “sufficient activity” among Canadian adults with type 2 diabetes in a large population sample (N = 1614) while considering the role of weight status as a potential confounder. Our results revealed that estimates of physical activity levels vary by BMI categories, depending on the methods examined. Although physical activity levels were lower in the obese, their energy expenditure estimates were not different from those who were overweight or of a healthy weight. The implications of these findings are that biased estimates of physical activity at a population level may result in inappropriate classification of adults with type 2 diabetes as “sufficiently active” and that the inclusion of body weight in estimating physical activity prevalence should be approached with caution

Factors influencing the adoption of an innovation: An examination of the uptake of the Canadian Heart Health Kit (HHK)

<p>Abstract</p> <p>Background</p> <p>There is an emerging knowledge base on the effectiveness of strategies to close the knowledge-practice gap. However, less is known about how attributes of an innovation and other contextual and situational factors facilitate and impede an innovation's adoption. The Healthy Heart Kit (HHK) is a risk management and patient education resource for the prevention of cardiovascular disease (CVD) and promotion of cardiovascular health. Although previous studies have demonstrated the HHK's content validity and practical utility, no published study has examined physicians' uptake of the HHK and factors that shape its adoption.</p> <p>Objectives</p> <p>Conceptually informed by Rogers' Diffusion of Innovation theory, and Theory of Planned Behaviour, this study had two objectives: (1) to determine if specific attributes of the HHK as well as contextual and situational factors are associated with physicians' intention and actual usage of the HHK kit; and (2), to determine if any contextual and situational factors are associated with individual or environmental barriers that prevent the uptake of the HHK among those physicians who do not plan to use the kit.</p> <p>Methods</p> <p>A sample of 153 physicians who responded to an invitation letter sent to all family physicians in the province of Alberta, Canada were recruited for the study. Participating physicians were sent a HHK, and two months later a study questionnaire assessed primary factors on the physicians' clinical practice, attributes of the HHK (relative advantage, compatibility, complexity, trialability, observability), confidence and control using the HHK, barriers to use, and individual attributes. All measures were used in path analysis, employing a causal model based on Rogers' Diffusion of Innovations Theory and Theory of Planned Behaviour.</p> <p>Results</p> <p>115 physicians (follow up rate of 75%) completed the questionnaire. Use of the HHK was associated with intention to use the HHK, relative advantage, and years of experience. Relative advantage and the observability of the HHK benefits were also significantly associated with physicians' intention to use the HHK. Physicians working in solo medical practices reported experiencing more individual and environmental barriers to using the HHK.</p> <p>Conclusion</p> <p>The results of this study suggest that future information innovations must demonstrate an advantage over current resources and the research evidence supporting the innovation must be clearly visible. Findings also suggest that the innovation adoption process has a social element, and collegial interactions and discussions may facilitate that process. These results could be valuable for knowledge translation researchers and health promotion developers in future innovation adoption planning.</p

Alberta Diabetes and Physical Activity Trial (ADAPT): A randomized theory-based efficacy trial for adults with type 2 diabetes - rationale, design, recruitment, evaluation, and dissemination

Background: The primary aim of this study was to compare the efficacy of three physical activity (PA) behavioural intervention strategies in a sample of adults with type 2 diabetes. Method/Design: Participants (N = 287) were randomly assigned to one of three groups consisting of the following intervention strategies: (1) standard printed PA educational materials provided by the Canadian Diabetes Association [i.e., Group 1/control group)]; (2) standard printed PA educational materials as in Group 1, pedometers, a log book and printed PA information matched to individuals' PA stage of readiness provided every 3 months (i.e., Group 2); and (3) PA telephone counseling protocol matched to PA stage of readiness and tailored to personal characteristics, in addition to the materials provided in Groups 1 and 2 (i.e., Group 3). PA behaviour measured by the Godin Leisure Time Exercise Questionnaire and related social-cognitive measures were assessed at baseline, 3, 6, 9, 12 and 18-months (i.e., 6-month follow-up). Clinical (biomarkers) and health-related quality of life assessments were conducted at baseline, 12-months, and 18-months. Linear Mixed Model (LMM) analyses will be used to examine time-dependent changes from baseline across study time points for Groups 2 and 3 relative to Group 1. Discussion: ADAPT will determine whether tailored but low-cost interventions can lead to sustainable increases in PA behaviours. The results may have implications for practitioners in designing and implementing theory-based physical activity promotion programs for this population

Theoretical Foundations to Guide Mindfulness Meditation: A Path to Wisdom

Mindfulness interventions are becoming increasingly popular across a wide variety of clinical and non-clinical settings where they are often employed to promote psychological well-being. Mindfulness in its original context presented in Buddhist practice is used to systematically understand one’s moment-to-moment experience, and to gradually develop self-knowledge and wisdom. Buddhist teachings describe wisdom as seeing things just as they are - a requisite for the complete freedom from suffering. In psychological writings, although the construct of wisdom lacks a commonly accepted definition, direct experiential self-knowledge is considered to be an essential element of wisdom. The purpose of this article is to examine the three major trainings of the Buddhist path, as well as some of the key Buddhist theoretical constructs, in order to explore their contribution to the gradual development of experiential self-knowledge and wisdom. In Buddhist traditions, mindfulness is practised in the context of a moral and philosophical system, and the mind is described as a sequence of momentary mental states, each distinct and discrete, their connections with one another being causal. We explain how a clear understanding of mindfulness within the context of this broader theoretical framework can be helpful to individuals engaging in different levels of the mindfulness meditation practice, and how this understanding can result in more sustained outcomes for mindfulness interventions. Further explorations are made into how various barriers and motivators to mindfulness meditation can be better understood by linking the theoretical aspects with current research literature on mindfulness

An examination of the relationships between dietary behaviours with physical activity and obesity in adults with type2 diabetes

The primary objective of the current study was to explore the relationship between 2 dietary behaviours — (i) fruit and vegetable intake and (ii) dietary fat intake — with body mass index (BMI) and physical activity. A secondary objective was to examine the reliability of these relationships at 6 and 18 months. Demographic factors, including height and weight to calculate BMI, were self-reported by a sample of adults with type 2 diabetes (n=1614) recruited through the Canadian Diabetes Association registry and through random-digit dialling. Physical activity levels were assessed using the Godin Leisure Time Exercise Questionnaire, while fruit, vegetable and dietary fat intake were measured using the Summary of Diabetes Self-Care Activities Measure. These variables were assessed at 3 time points: baseline, 6 months and 18 months. Two-way between-group analysis of variance was conducted separately for fruit and vegetable consumption and fat intake in order to examine the association of BMI categories and activity level and their interactions with these dietary behaviours. At baseline, participants reported consuming 5 or more servings of fruits and vegetables 5.2 days per week and high-fat foods 1.6 days per week. The mean BMI was 29.3 kg/m2, and 65% of participants were inactive (i.e. not meeting physical activity guidelines). There was a statistically significant main effect for both BMI (F=11.58, p<0.001) and activity level (F=18.45, p<0.001) for fruit and vegetable consumption, as well as a significant main effect for BMI when examining fat intake (F=5.42, p<0.01). The findings at 6 months were similar to baseline results, but were different at 18 months. Across the 3 study time points, there were no interactions observed for physical activity or BMI with either diet variable. Obese individuals reported significantly lower fruit consumption and higher fat consumption compared to their overweight and healthy-weight counterparts. Active individuals had a higher fruit and vegetable intake. These results will help guide the development of diabetes education programs that are tailored to better meet the needs of people with type 2 diabetes

Social cognitive theories used to explain physical activity behavior in adolescents: a systematic review and meta-analysis

Purpose: To systematically review and examine the explanatory power of key social-cognitive theories used to explain physical activity (PA) intention and behavior, among adolescents. Methods: A systematic review and meta-analysis of the literature was performed using the electronic databases Medline, Cumulative Index to Nursing and Allied Health Literature, SPORTdiscus, EBSCO and Education Resources Information Center, Proquest Education Journals Collection, Science Direct, Web of Science and Scopus for social-cognitive theories (i.e., Health Promotion Model, Theory of Planned Behavior, Theory of Reasoned Action, Protection Motivation Theory, Social Cognitive Theory/Self-Efficacy Theory, Health Belief Model, Self-Determination Theory, Transtheoretical Model) used to explain PA intention and behavior. Related keywords in titles, abstracts, or indexing fields were searched. Results: Twenty-three studies satisfied the inclusion criteria and were retained for data extraction and analysis; 16 were cross-sectional studies and seven were longitudinal studies. Most studies employed self-report measures. In general, the models explained greater proportions of variance for intention compared to behavior. The meta-analyses revealed 33% and 48% of the variance respectively for PA and intention were explained by social cognitive models. Conclusions: Few studies have tested the predictive capacity of social cognitive theories to explain objectively measured PA. The majority of PA variance remains unexplained and more theoretical research is needed

Physical activity related information sources predict physical activity behaviors in adults with Type 2 Diabetes

Physical activity (PA) is a key management strategy for type 2 diabetes. Despite the known benefits, PA levels are low. Whether the low level of PA is related to lack of knowledge or support is not fully understood. This study was conducted to describe where and how often adults with type 2 diabetes receive and seek information related to PA and examine the relationships between the source and quality of PA information with PA behaviors. A series of questions related to the source and quality of PA information were added to a baseline survey distributed to the participants (N = 244) of the Canadian Aerobic and Resistance Training in Diabetes (CARED) study. Physicians and television were found to be the main sources of PA-related information. In our cross-sectional model, sources of PA-related information other than that from health care professionals explained 14% (p = .05) and 16% (p < .05) of the variance for aerobic-based and resistance training behaviors and 22% (p < .01) and 15% (p < .05) for these behaviors in our longitudinal model. Physical activity (PA)-related information is widely available to adults with type 2 diabetes. Neither the quantity nor the quality of the PA information provided by health care professionals predicted PA behavior. These data provide further insight into the modes with which PA can be promoted to adults with type 2 diabetes

Testing a conceptual model related to weight perceptions, physical activity, and smoking in adolescents

The purpose of this study was to test a conceptual model based on theoretical and empirically supported relationships related to the influences of weight perceptions, weight concerns, desires to change weight, friends, age and location in relation to physical activity (PA) and smoking in adolescents. A total of 1242 males and 1446 females (mean age = 15.6 ± 1.3) were recruited from rural and urban Canadian schools. Study respondents provided self-reports of PA, ‘smoking’, ‘perceived body weight’, ‘desire to change weight’, ‘concern about weight gain’ and ‘friends' smoking and PA behaviors’. Results revealed an acceptable fitting model χ2 (40) = 155.63, P < 0.05, root mean square error of approximation = 0.047 and comparative fit index = 0.98. Large effect sizes for both genders were observed between friends' and adolescents' smoking behavior, and between perceived body weight and desire to change weight. Further, significant differences were identified between the male and female models [χ2 difference (24) = 65.28, P < 0.05]. Several findings of this study point to the need to design programs to motivate adolescent females to adopt healthy weight-control practices and to target young peoples' social networks to promote health behaviors, especially with regard to smoking