Testing a brief, theory-guided video chat intervention for enhancing self-efficacy and lifestyle physical activity among low active working adults

Despite evidence of the many health benefits of engaging in regular physical activity, American adults’ physical activity levels are generally low (Centers for Disease Control and Prevention, 2017a. The most common reported barrier for low activity is lack of time (Bellows-Riecken & Rhodes, 2008; Cohen-Mansfield, Marx, & Guralnik, 2003; Manaf, 2013; Welch, McNaughton, Hunter, Hume, & Crawford, 2009). Self-efficacy, defined as one’s confidence in his or her ability to successfully complete a task, has been associated with the adoption and maintenance of physical activity behavior (Bandura, 1991). Prior research suggests that self-efficacy is often inflated at the start of a physical activity program and fluctuates (typically declines) as one is exposed to intervention and recognizes what it takes to fully commit to such a program in lieu of omnipresent motivational barriers (McAuley et al., 2011). Therefore, there is a demand for interventions that can effectively enhance or preserve self-efficacy levels at the start of a physical activity program. Such interventions may facilitate adherence to public health guidelines for physical activity. Lifestyle physical activity, an unstructured, but goal-oriented form of physical activity, affords individuals a high degree of flexibility in how they choose to meet public health guidelines. Indeed, lifestyle physical activity interventions have been successful for getting adults to meet the public health guidelines for aerobic activity (Dunn et al., 1998). Moreover, brief interventions (lasting no more than 20 minutes in length; Lamming et al., 2017) and interventions guided by Social Cognitive Theory (SCT; Mailey & McAuley, 2014) have been effective for increasing lifestyle physical activity levels among low-active populations. To date, no studies have tested the efficacy of a brief, theory-guided video chat intervention for enhancing self-efficacy for lifestyle physical activity. The purpose of this study was to test the feasibility and efficacy of a brief SCT-guided video chat intervention with the aim of enhancing physical activity-related self-efficacy, and in turn, lifestyle physical activity. Results provide support for the feasibility of delivering information remotely through video chats for low-active, working adults. Moreover, this study provides preliminary evidence for the utility of video chat intervention for promoting short-term increases in lifestyle physical activity self-efficacy. Further research is needed to replicate and extend these findings across a larger sample to develop an effective, viable method that can be disseminated and have a longer-lasting impact on full-time working adults’ health and quality of life

A systematic review and meta-analysis of adherence to physical activity interventions among three chronic conditions: cancer, cardiovascular disease, and diabetes

Abstract Background Physical activity is effective for the prevention and treatment of chronic disease, yet insufficient evidence is available to make comparisons regarding adherence to aerobic physical activity interventions among chronic disease populations, or across different settings. The purpose of this review is to investigate and provide a quantitative summary of adherence rates to the aerobic physical activity guidelines among people with chronic conditions, as physical activity is an effective form of treatment and prevention of chronic disease. Methods Randomized controlled (RCTs) trials where aerobic physical activity was the primary intervention were selected from PsychInfo, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Clinical Key, and SCOPUS from 2000 to 2018. Studies were included if the program prescription aligned with the 2008 aerobic physical activity guidelines, were at least 12 weeks in length, and included adult participants living with one of three chronic diseases. The data was extracted by hand and the PRISMA (preferred reporting items for systematic review and meta-analysis) guidelines were used to evaluate risk-of-bias and quality of evidence. Data were pooled using random-effect models. The primary outcome measure was program adherence and the secondary outcome measures were dropout and setting (e.g. home vs. clinic-based). Pooled effect sizes and 95% CiIs (confidence intervals) were calculated using random-effect models. Results The literature search identified 1616 potentially eligible studies, of which 30 studies (published between 2000 and 2018, including 3,721 participants) met the inclusion criteria. Three clinical populations were targeted: cancer (n = 14), cardiovascular disease (n = 7), and diabetes (n = 9). Although not statistically significant, adherence rates varied across samples (65, 90, and 80%, respectively) whereas dropout rates were relatively low and consistent across samples (5, 4, and 3%). The average adherence rate, regardless of condition, is 77% (95% CI = 0.68, 0.84) of their prescribed physical activity treatment. The pooled adherence rates for clinic-based and home-based programs did not differ (74% [95% CI, 0.65, 0.82] and 80% [95% CI, 0.65, 0.91], respectively). Conclusions The current evidence suggests that people with chronic conditions are capable of sustaining aerobic physical activity for 3+ months, as a form of treatment. Moreover, home-based programs may be just as feasible as supervised, clinic-based physical activity programs

Effects of Traditional vs. iPad-Enhanced Aerobic Exercise on Wayfinding Efficacy and Cognition: A Pilot Randomized Controlled Trial

The purpose of this pilot study was to test the feasibility and efficacy of an iPad-enhanced aerobic exercise intervention designed to enhance wayfinding efficacy and performance and relevant cognitive functioning among middle-aged adults at risk for cognitive impairment. Twenty-seven low active adults (21 females) aged 45 to 62 years (51.22 ± 5.20) participated in a ten-week randomized controlled trial. Participants were randomized to an iPad-enhanced aerobic exercise group (experimental group) or an aerobic exercise-only group (control group) following baseline assessment. Both groups exercised at 50% to 75% of age-predicted heart rate maximum for 30 to 50 min/d, 2 d/wk for 10 weeks. During aerobic exercise, the experimental group engaged in virtual tours delivered via iPad. Baseline and post-intervention assessments of wayfinding self-efficacy, wayfinding task performance, cognitive functioning, electroencephalogram (EEG), and psychosocial questionnaires were administered. The results suggest that ten weeks of iPad-enhanced, moderately intense aerobic exercise had specific effects on wayfinding self-efficacy; however, no statistical differences were found between groups on the behavioral wayfinding task or spatial memory performance at follow-up. Performance scores on an inhibitory attentional-control cognitive assessment revealed significant differences between groups, favoring the experimental group (p < 0.05). Virtual reality-enhanced aerobic exercise may prove to be an effective method for improving cognitive function and increasing confidence to navigate real-world scenarios among individuals at risk of cognitive impairment

A scalable, virtual weight management program tailored for adults with type 2 diabetes: effects on glycemic control

Abstract Background The objective was to test the efficacy of a scalable, virtually delivered, diabetes-tailored weight management program on glycemic control in adults with type 2 diabetes (T2D). Methods This was a single arm, three-site clinical trial. Participants had baseline HbA1c between 7–11% and BMI between 27–50 kg/m2. Primary outcome was change in HbA1c at 24 weeks. Secondary outcomes were changes in body weight, waist circumference, the Diabetes Distress Scale (DDS), quality of life (IWQOL-L), and hunger (VAS). Generalized linear effects models were used for statistical analysis. Results Participants (n = 136) were 56.8 ± 0.8 y (Mean ± SEM), 36.9 ± 0.5 kg/m2, 80.2% female, 62.2% non-Hispanic white. Baseline HbA1c, weight, and total DDS score were 8.0 ± 0.09%, 101.10 ± 1.47 kg, and 2.35 ± 0.08, respectively. At week 24, HbA1c, body weight, and total DDS decreased by 0.75 ± 0.11%, 5.74 ± 0.50%, 0.33 ± 0.10 units, respectively (all p < 0.001). Also, at week 24, quality of life increased by 9.0 ± 1.2 units and hunger decreased by 14.3 ± 2.4 units, (both p < 0.0001). Conclusions The scalable, virtually delivered T2D-tailored weight management program had favorable and clinically meaningful effects on glycemic control, body weight, and psychosocial outcomes

Exploring Health Disparities in Integrated Communities: Overview of the EHDIC Study

Progress in understanding the nature of health disparities requires data that are race-comparative while overcoming confounding between race, socioeconomic status, and segregation. The Exploring Health Disparities in Integrated Communities (EHDIC) study is a multisite cohort study that will address these confounders by examining the nature of health disparities within racially integrated communities without racial disparities in socioeconomic status. Data consisted of a structured questionnaire and blood pressure measurements collected from a sample of the adult population (age 18 and older) of two racially integrated contiguous census tracts. This manuscript reports on baseline results from the first EHDIC site, a low-income urban community in southwest Baltimore, Maryland (EHDIC-SWB). In the adjusted models, African Americans had lower rates of smoking and fair or poor self-rated health than whites, but no race differences in obesity, drinking, or physical inactivity. Our findings indicate that accounting for race differences in exposure to social conditions reduces or eliminates some health-related disparities. Moreover, these findings suggest that solutions to the seemingly intractable health disparities problem that target social determinants may be effective, especially those factors that are confounded with racial segregation. Future research in the area of health disparities should seek ways to account for confounding from SES and segregation