Examining adherence to activity monitoring devices to improve physical activity in adults with cardiovascular disease: A systematic review

Background Activity monitoring devices are currently being used to facilitate and monitor physical activity. No prior review has examined adherence to the use of activity monitoring devices amongst adults with cardiovascular disease. Methods Literature from June 2012 to October 2017 was evaluated to examine the extent of adherence to any activity monitoring device used to collect objective physical activity data. Randomized control trials comparing usual care against the use of an activity monitoring device, in a community intervention for adults from any cardiovascular diagnostic group, were included. A systematic search of databases and clinical trials registers was conducted using Joanna Briggs Institute methodology. Results Of 10 eligible studies, two studies reported pedometer use and eight accelerometer use. Six studies addressed the primary outcome. Mean adherence was 59.1% (range 39.6% to 85.7%) at last follow-up. Studies lacked equal representation by gender (28.6% female) and age (range 42 to 82 years). Conclusion This review indicates that current research on activity monitoring devices may be overstated due to the variability in adherence. Results showed that physical activity tracking in women and in young adults have been understudied

Ageing in a foreign land: the health experiences of European-born post-war migrants to Australia

It is commonly observed that immigrants display superior health upon arrival, and for some years following settlement, in their adopted country compared to their native-born counterparts. However, with increased years since migration there is a propensity for this health advantage to dissipate and for health trajectories of some migrant groups to reach, and in some cases fall below, the host national averages. This research aimed to explore the health status of older European-born immigrants as the burden and magnitude of disease outcomes in later life is unclear. This is due partly to a large body of dated literature relying on mortality and hospitalisation data to describe the health status of migrant populations and a historical trend to aggregate country of birth (COB) into large groupings ignoring inherent differences within and between birthplace groups. Using national Australian data, the health status of European and Australian-born groups were explored to provide a descriptive assessment of health outcomes at three points in time. This study illustrated that although both European and Australian-born groups displayed increases in the prevalence of selected chronic conditions, the European-born generally had better health and health-related outcomes. There was also some evidence to suggest that a health advantage may exist for European-born migrants in relation to some chronic conditions. Cross-sectional data collected from the South Australian Monitoring and Surveillance System (SAMSS) explored differences in chronic conditions and health-related risk factors between selected birthplaces (including those born in Australia, Germany, Italy and Greece). This study demonstrated that significant differences exist in the health profiles of birthplace groups, where Italian and Greeks experience higher prevalence of some chronic conditions and risk factors compared to the Australian and German-born. Pooled data collected via SAMSS and the Migrant Health Survey described and compared the demographic, health and health-related characteristics of selected birthplace groups at two points in time and examined the magnitude of change in disease outcomes relative to their Australian-born counterparts. Overall, the results indicated that the Greek and Italian-born had poorer health outcomes over time and displayed the largest change in their health and health-related outcomes. These findings suggested there is a considerable divergence in the long-term health outcomes experienced by selected COB groups and highlighted the value in undertaking birthplace specific analysis. Semi-structured interviews with Greek-born South Australians aged 60 years and over was undertaken to gain a deeper understanding of the health experiences and health-related outcomes of ageing Greek-born South Australians. The findings from this study indicated that 1) health service utilisation may not be an adequate indicator to explain the health differentials experienced by this cohort; 2) children may be Greek-born older migrants most important social resource and act as a vehicle for gaining access to health advice and the support they need in their day-to-day lives; and 3) life-course histories are pivotal in explaining health in later life. This research allowed for the comparisons of demographic, health and health-related outcomes to be analysed over time and across birthplace groups, providing additional information and insight into the diversity of outcomes within and between birthplace groups and adding depth to existing knowledge around migrant health outcomes.Thesis (Ph.D.) -- University of Adelaide, School of Social Sciences, 2016

The Keeping on Track Study: Exploring the Activity Levels and Utilization of Healthcare Services of Acute Coronary Syndrome (ACS) Patients in the First 30-Days after Discharge from Hospital

The aim of this study was to investigate the impact of bedside discharge education on activity levels and healthcare utilization for patients with acute coronary syndrome (ACS) in the first 30 days post-discharge. Knowledge recall and objective activity and location data were collected by global positioning systems (GPS). Participants were asked to carry the tracking applications (apps) for 30–90 days. Eighteen participants were recruited (6 metropolitan 12 rural) 61% ST elevation myocardial infarction (STEMI), mean age 55 years, 83% male. Recall of discharge education included knowledge of diagnosis (recall = 100%), procedures (e.g., angiogram = 40%), and comorbidities (e.g., hypertension = 60%, diabetes = 100%). In the first 30 days post-discharge, median steps per day was 2506 (standard deviation (SD) ± 369) steps (one participant completed 10,000 steps), 62% visited a general practitioner (GP) 16% attended cardiac rehabilitation, 16% visited a cardiologist, 72% a pharmacist, 27% visited the emergency department for cardiac event, and 61% a pathology service (blood tests). Adherence to using the activity tracking apps was 87%. Managing Big Data from the GPS and physical activity tracking apps was a challenge with over 300,000 lines of raw data cleaned to 90,000 data points for analysis. This study was an example of the application of objective data from the real world to help understand post-ACS discharge patient activity. Rates of access to services in the first 30 days continue to be of concern