Correlates of pedometer use: Results from a community-based physical activity intervention trial (10,000 Steps Rockhampton)

Background: Pedometers have become common place in physical activity promotion, yet little information exists on who is using them. The multi-strategy, community-based 10,000 Steps Rockhampton physical activity intervention trial provided an opportunity to examine correlates of pedometer use at the population level. Methods: Pedometer use was promoted across all intervention strategies including: local media, pedometer loan schemes through general practice, other health professionals and libraries, direct mail posted to dog owners, walking trail signage, and workplace competitions. Data on pedometer use were collected during the 2-year follow-up telephone interviews from random population samples in Rockhampton, Australia, and a matched comparison community (Mackay). Logistic regression analyses were used to determine the independent influence of interpersonal characteristics and program exposure variables on pedometer use. Results: Data from 2478 participants indicated that 18.1% of Rockhampton and 5.6% of Mackay participants used a pedometer in the previous 18-months. Rockhampton pedometer users (n = 222) were more likely to be female (OR = 1.59, 95% CI: 1.11, 2.23), aged 45 or older (OR = 1.69, 95% CI: 1.16, 2.46) and to have higher levels of education (university degree OR = 4.23, 95% CI: 1.86, 9.6). Respondents with a BMI > 30 were more likely to report using a pedometer (OR = 1.68, 95% CI: 1.11, 2.54) than those in the healthy weight range. Compared with those in full-time paid work, respondents in 'home duties' were significantly less likely to report pedometer use (OR = 0.18, 95% CI: 0.06, 0.53). Exposure to individual program components, in particular seeing 10,000 Steps street signage and walking trails or visiting the website, was also significantly associated with greater pedometer use. Conclusion: Pedometer use varies between population subgroups, and alternate strategies need to be investigated to engage men, people with lower levels of education and those in full-time 'home duties', when using pedometers in community-based physical activity promotion initiatives

Moderators of health behavior initiation and maintenance in a randomized telephone counseling trial

Objective. This study compares moderators of initiation and maintenance of health behavior changes

Telephone interventions for physical activity and dietary behavior change a systematic review /

Background: Given the epidemic of lifestyle-related chronic diseases, building the evidence base for physical activity and dietary behavior change interventions with a wide population reach is of critical importance. For this purpose, telephone counseling interventions have considerable potential. Purpose: To systematically review the literature on interventions for physical activity and dietary behavior change in which a telephone was the primary method of intervention delivery, with a focus on both internal and external validity. Methods: A structured search of PubMed, Medline, and PsycInfo was conducted for studies published in English from 1965 to January 2006. Studies targeted primary or secondary prevention in adults, used randomized designs, and included physical activity and/or dietary behavior outcomes. Results: Twenty-six studies were reviewed, including 16 on physical activity, six on dietary behavior, and four on physical activity plus dietary behavior. Twenty of 26 studies reported significant behavioral improvements. Positive outcomes were reported for 69% of physical activity studies, 83% of dietary behavior studies, and 75% of studies addressing both outcomes. Factors associated with positive outcomes appear to be the length of intervention and the number of calls, with interventions lasting 6 to 12 months and those including 12 or more calls producing the most favorable outcomes. Data on the representativeness of participants, implementation of calls, and costs were reported much less frequently.Conclusions: There is now a solid evidence base supporting the efficacy of physical activity and dietary behavior change interventions in which the telephone is the primary intervention method. Thus, research studies on broader dissemination are necessary, and should address questions relevant to the translation of this body of work into population health practice

Death, contagion and shame: The potential of cancer survivors' advocacy in Zambia

Cancer has become a global health concern with marked differences in the incidence and mortality rates between developing and developed countries. Understanding the factors that shape uptake of preventative and screening services is the key. We use in-depth interviews with 13 Zambian urban-based female cancer survivors to explore the facilitators and barriers to screening, diagnosis and treatment, with a particular focus on cultural influences. We identified a central theme (i.e. a story told about cancer) in all of the interviews: 'cancer is a death sentence'. Most women referenced this theme to describe their own, their family members', or community members' reactions to their diagnosis, along with references to cancer as 'contagious' and 'a shameful illness'. We also identified a theme entitled 'survivors as advocates', within which women described engaging in advocacy work to challenge stigma, misconceptions and misinformation about cancer; and advocating early detection and diagnosis, compliance with medical treatment and the sharing of success stories. This analysis points to the need for survivors to be front and center of preventative efforts. Their personal experiences, legitimacy and connections in the community, and their enthusiasm in helping others should be fostered, particularly in low-resource settings

Telephone, print, and Web-based interventions for physical activity, diet, and weight control among cancer survivors: a systematic review

Purpose Broad-reach (non-face-to-face) modalities offer an accessible and cost-effective means to provide behavior change programs in diverse and growing cancer survivor populations. The purpose of this systematic review is to evaluate the efficacy of physical activity, dietary, and/or weight control interventions for cancer survivors in which telephone, short-message service, print, and/or Web is the primary method of delivery

Telephone, print, and Web-based interventions for physical activity, diet, and weight control among cancer survivors: a systematic review

Abstract Purpose Broad-reach (non-face-to-face) modalities offer an accessible and cost-effective means to provide behavior changeprogramsindiverseandgrowingcancersurvivorpopulations. The purpose of this systematic review is to evaluate the efficacyofphysicalactivity,dietary,and/orweight control interventions for cancer survivors in which telephone, shortmessage service, print, and/or Web is the primary method of delivery. Methods A structured search of PubMed, Embase, Web of Science,CINAHL,andCENTRAL(May2013)wasconducted. Included studies focused and reported onphysical activity (PA) and dietary change and/or weight control in adult cancer survivors, delivered at least 50 % of intervention contacts by broad-reach modality and included a control group. Study design,interventionfeatures,andbehavioral/weightoutcomes were extracted, tabulated, and summarized. Results Twenty-seven studies were included; 22 telephone, three Web, and two print. Sixteen studies targeted PA, two diet, and nine targeted multiple behaviors. Most studies (18/ 27)targetedasinglesurvivorgroup,namelybreastcancer(n=12). Nineteen of 27 studies found evidence for initiation of behavior change, with only eight reporting on maintenance and one on cost-effectiveness. Conclusions This review provides support for broad-reach modalities, particularly the telephone, in the delivery of lifestyleinterventionstocancersurvivors.Futureresearchshould evaluate (1) newer technologies (i.e., SMS and mobile phone applications), (2) interventions for diverse cancer survivors and those targeting multiple behaviors, (3) long-term outcomes, and 4) cost-effectiveness. ImplicationsforCancerSurvivors Broad-reachlifestyleinterventionsareeffective,withfurtherresearchneededtoevaluate their generalizability and integration into cancer care

A telephone-delivered physical activity and dietary intervention for type 2 diabetes and hypertension: does intervention dose influence outcomes?

Purpose. To examine associations of intervention dose with behavior change outcomes in a telephone counseling intervention for physical activity and dietary change

Preliminary Results from Exercise for Health : A Breast Cancer Recovery Project [Abstract]

The Exercise for Health program is a telephone-delivered exercise intervention for women with breast cancer (BC) living in regional Queensland. The effect of the program is being evaluated in the context of a randomised controlled trial. Consenting, newly diagnosed BC patients, treated in one of 8 regional Queensland hospitals, were randomly allocated to telephone-based exercise counselling (EC) or usual care (UC) at 6-weeks post-surgery. EC participants received an exercise workbook and 16 calls from an exercise physiologist over 8 months. Physical activity levels (PA) (Active Australia & CHAMPS), quality-of-life (FACTB+4), upper-body function (DASH) and fatigue (FACIT-Fatigue) were assessed at baseline (4-6 weeks post-surgery), 6- and 12-months post-surgery. Preliminary analyses of available 6-month data were conducted using t-tests and repeated measures ANCOVAs. Participating women (n=143; EC n=73, UC n=70) were aged 53±9 years and 30% met PA guidelines at baseline. Up to two thirds of the women received adjuvant therapy during the first 6 months following surgery. Greater improvements (mean change+SD) occurred for the EC vs UC group in weekly sessions of walking (1.83±4.3 vs -0.5±5.5, p=0.029) moderate-vigorous PA (5.0±6.5 vs -1.1±6.1, p=0.005) and strength training (1.9±2.9 vs -0.5±4.2 p<0.001), and in upper-body function, reflected by lower log-transformed disability scores (-0.34±0.44 vs -0.17±0.28, p=0.038). More EC than UC participants met PA guidelines at 6 months (46.3% vs 32.7%). Preliminary findings from this ongoing trial suggest that the telephone is a feasible and effective medium for delivering exercise counselling to newly diagnosed BC patients living in regional areas. \ud \u

Health status of long-term cancer survivors: Results from an Australian population-Based sample

Background: Despite considerable knowledge about the effect of cancer during the early stages of treatment and survivorship, understanding the longer-term effect of cancer has only recently become a priority. This study investigated the health implications of longer-term cancer survivorship in an Australian, population-based sample