Working to Increase Stability through Exercise (WISE): screening, recruitment, and baseline characteristics

Background The aim of this paper is to describe the utility of various recruitment modalities utilized in the Working to Increase Stability through Exercise (WISE) study. WISE is a pragmatic randomized trial that is testing the impact of a 3-year, multicomponent (strength, balance, aerobic) physical activity program led by trained volunteers or delivered via DVD on the rate of serious fall-related injuries among adults 65 and older with a past history of fragility fractures (e.g., vertebral, fall-related). The modified goal was to recruit 1130 participants over 2 years in three regions of Pennsylvania. Methods The at-risk population was identified primarily using letters mailed to patients of three health systems and those over 65 in each region, as well as using provider alerts in the health record, proactive recruitment phone calls, radio advertisements, and presentations at community meetings. Results Over 24 months of recruitment, 209,301 recruitment letters were mailed, resulting in 6818 telephone interviews. The two most productive recruitment methods were letters (72% of randomized participants) and the research registries at the University of Pittsburgh (11%). An average of 211 letters were required to be mailed for each participant enrolled. Of those interviewed, 2854 were ineligible, 2,825 declined to enroll and 1139 were enrolled and randomized. Most participants were female (84.4%), under age 75 (64.2%), and 50% took an osteoporosis medication. Not having a prior fragility fracture was the most common reason for not being eligible (87.5%). The most common reason provided for declining enrollment was not feeling healthy enough to participate (12.6%). Conclusions The WISE study achieved its overall recruitment goal. Bulk mailing was the most productive method for recruiting community-dwelling older adults at risk of serious fall-related injury into this long-term physical activity intervention trial, and electronic registries are important sources and should be considered

A growing opportunity: Community gardens affiliated with US hospitals and academic health centers

Background: Community gardens can reduce public health disparities through promoting physical activity and healthy eating, growing food for underserved populations, and accelerating healing from injury or disease. Despite their potential to contribute to comprehensive patient care, no prior studies have investigated the prevalence of community gardens affiliated with US healthcare institutions, and the demographic characteristics of communities served by these gardens. Methods: In 2013, national community garden databases, scientific abstracts, and public search engines (e.g., Google Scholar) were used to identify gardens. Outcomes included the prevalence of hospital-based community gardens by US regions, and demographic characteristics (age, race/ethnicity, education, household income, and obesity rates) of communities served by gardens. Results: There were 110 healthcare-based gardens, with 39 in the Midwest, 25 in the South, 24 in the Northeast, and 22 in the West. Compared to US population averages, communities served by healthcare-based gardens had similar demographic characteristics, but significantly lower rates of obesity (27% versus 34%, P < .001). Conclusions: Healthcare-based gardens are located in regions that are demographically representative of the US population, and are associated with lower rates of obesity in communities they serve

The Association between Gender and Physical Activity Was Partially Mediated by Social Network Size during COVID-19

The COVID-19 pandemic has disrupted physical activity, particularly among women. Limited research has explored how social network support may explain gender-based variations in physical activity during COVID-19. The purpose of this study was to examine the mediating role of social networks in the association between gender and physical activity during a pandemic. This cross-sectional survey assessed whether social network characteristics (i.e., in-person social network size, frequency of in-person social network interactions, and online friend network size) mediate the relationship between gender and either past-week or past-year physical activity. Multiple mediation analyses were conducted to determine the indirect effect of gender on physical activity through social networks. Among 205 participants, women (n = 129) were significantly less physically active (&beta; = &minus;73.82; p = 0.02) than men (n = 76) and reported significantly more Facebook friends (&beta; = 0.30; p &lt; 0.001) than men, which was inversely associated with past-week physical activity (&beta; = &minus;64.49; p = 0.03). Additionally, the indirect effect of gender on past-week physical activity through Facebook friends was significant (&beta; = &minus;19.13; 95% CI [&minus;40.45, &minus;2.09]). Findings suggest that social media sites such as Facebook could be used to encourage physical activity among women during a pandemic

Why just exercise if you can play? Interest in a modified sports program to enhance physical activity among primary care patients

Fewer adults meet guidelines for aerobic physical activity, and many report a lack of enjoyment as a barrier. This survey was designed to determine the interest of primary care patients in participating in program designed to maximize enjoyment. Primary care patients (n=540) in Central Pennsylvania reported their interest in participating in a “a regular fitness program where people your own age played games, such as softball, floor hockey and soccer, that were made to be easier to play and less competitive.” Mean age was 58.4years (SD=16.5, range=18–98). More than one-third (37.0%), including 59.6% of those under age 50, were interested in the modified sports fitness program. After adjusting for confounders, patients under age 40 were 5.9 (95% CI: 2.6–13.9) times as interested (v. age>70) and non-white patients were 3.4 (95% CI: 1.3–8.5) times interested. Female patients and those with hypertension, high cholesterol or obesity were equally interested. A fitness program that consists of modified sports may be of interest to most primary care patients under age 50. Patients' initial interest appears high enough to warrant further development and testing. Keywords: Physical activity, Exercise, Primary car

Engineering Online and In-Person Social Networks for Physical Activity: A Randomized Trial

Social networks can influence physical activity, but little is known about how best to engineer online and in-person social networks to increase activity