Piloting the feasibility and effectiveness of print- and telephone-mediated interventions for promoting the adoption of physical activity in Australian adults.

This study examined the feasibility and effectiveness for increasing physical activity of a print-based intervention, and a print- plus telephone-mediated intervention among mid-life and older Australian adults. A randomised controlled trial study design was used. In mid-2002, 66 adults (18 men, 48 women) aged 45-78 years, who identified themselves as underactive, were recruited through advertisements and word-of-mouth at two sites (Melbourne and Brisbane), and randomised to either the print or print-plus-telephone mediated intervention group. Participants in both groups attended an initial briefing session, and over the 12-week intervention period received an instructional newsletter and use of a pedometer (both groups), and individualised telephone calls (print-plus-telephone group only). Self-reported physical activity data were collected at baseline, 12 and 16 weeks. Measures of self-reported global physical activity, moderate-vigorous intensity activity and walking all showed increases between baseline and 12 weeks for both intervention groups. These increases were generally maintained by 16 weeks, although participants in the print-plus-telephone group maintained slightly higher levels of global reported activity and walking (by approximately 30 mins/wk) than those in the print group. These interventions show potential for promoting initial increases in physical activity among mid-life and older Australian adults, and should be evaluated across more extended time periods.     

Effects of wheelchair Tai Chi on physical and mental health among elderly with disability

A 12-week Wheelchair Tai Chi 10 Form (WTC10) intervention was conducted among elderly with disability to examine the effect of this WTC10 intervention on selected physical and mental health variables. Thirteen (age 87.23 ± 6.71) in the WTC10 intervention group and 15 (age 89.73 ± 6.31) in the control group completed the study. Independent t-tests and paired t-tests were employed to examine the differences between groups and within groups, respectively, at pretest and post-test. The WTC10 intervention group showed significant improvements in systolic and diastolic blood pressure, shoulder external rotation, left trunk rotation and total trunk rotation after the intervention. A 12-week WTC10 intervention had positive effects on blood pressure, range of motion at the shoulder and trunk, physical activity, and mental health among the elderly with disability. WTC10 is a feasible and safe exercise for the elderly with disability.     

Physical activity and motivational predictors of changes in health behavior and health among DM2 and CAD patients

This study tested a physical activity intervention and the self‐determination theory (SDT) process model of health‐behavior change and health among 108 adult patients with both diabetes mellitus type 2 (DM2) and coronary artery disease (CAD). Patients were randomly assigned to an organized physical activity intervention group (led by instructors) or a non‐physical activity control group. At baseline and after 12 months, we measured the following: needs satisfaction, autonomous and controlled motivation for physical activity, perceived competence for physical activity and blood sugar testing, physical activity and blood sugar testing, body weight, glucose control (HbA1c), and self‐perceptions of general health and vitality. The intervention produced, as hypothesized, significant changes in all study variables in favor of the experimental group (Cohen's d effect sizes: 0.23–0.72), except the non‐significant result for controlled motivation and body weight. The data supported the SDT process model, in which the effect of the intervention significantly predicted indirect changes in behavior and health through motivation variables. Considering the moderate to large effects on increases in motivation, behavior, and health, promoting organized physical activity programs that are perceived as need‐supportive may have important health implications for patients with DM2 and CAD.     

A systematic review of physical activity promotion in primary care office settings

OBJECTIVE: To assess the efficacy of physical activity promotion in primary care office settings. DESIGN: Systematic review of clinical trials in which the efficacy of physical activity promotion was investigated in a primary care office setting with at least one month of follow up. SUBJECTS: A total of 13,981 adults, aged 17-85+, were included from 203 practices in eight trials assessing physical activity promotion in primary care office settings. MAIN OUTCOME MEASURES: Odds ratios and 95% confidence intervals were calculated comparing the number of participants who increased their physical activity or were active at follow up in the intervention group with a control group for each study. RESULTS: Five of eight trials where positive with statistically significant results (range 0.91-6.56), but significant biases or limited clinical relevance of the outcomes were found in all trials. Short term trials of less than one year (four of four were positive), single-risk-factor trials (three of three were positive), randomised clinical trials (two of three were positive), and those assessing moderate levels of physical activity (three of four were positive) were most likely to find benefit. Only one of four trials lasting longer than a year were positive. CONCLUSION: There is limited evidence from well designed trials that office based physical activity promotion in primary care settings is efficacious in promoting changes in physical activity that could conceivably have lasting clinical benefits.


     

西沙某岛420名官兵心理健康调查分析

目的 了解海岛官兵心理健康状况及相关因素,提出防治对策.方法 采取症状自评量表(SCL-90)对西沙某岛420名官兵和内地海军某部450名官兵进行心理测试,比较2组人员心理健康状况.结果 西沙官兵一定程度上存在心理健康问题,且常见心理异常症状的发生率高于内地组,尤其以情绪低落、焦虑、恐惧、失眠、纳差等更为显著(P＜0.01).结论 影响心理健康状况的因素包括人员身份、文化程度、城乡来源和驻岛时间等.因此要加大对西沙官兵心理健康教育力度,严格新兵入伍心理检测,提高基层医务人员诊疗心理疾病水平,改善生活条件,丰富精神文化生活,以缓解小岛官兵心理问题,提高部队战斗力.     

Promoting physical activity with people in different places—A Dutch perspective

This paper describes five recent Dutch studies of the effectiveness of physical activity interventions carried out in diverse settings: general practice (GP), aged care facilities, and workplaces. The stage-based physical activity counselling carried out in the GP setting demonstrated a beneficial effect on the determinants of physical activity, but did not show any additional effect on physical activity behaviour, compared with standard physical activity advice. In contrast, the stage-based intervention through the workplace was effective in increasing physical activity, due mostly to an increase in vigorous-intensity activities. In the aged care setting, functional-skills training alone or in combination with resistance training showed functional improvement only in participants with high participation rates. Functional-skills training appeared to be more feasible than resistance training in this population of frail elderly. The two studies which aimed to promote earlier return-to-work among workers with sick leave due to non-specific low back pain also showed promising results. As a result, it was recommended that occupational physicians (OP) should refer workers with low back pain in the subacute phase of their sick leave to a low intensity intervention consisting of short meetings and exercises aimed at changing behaviour, and that the OPs contact other health care providers (GPs and physiotherapists) about the treatment strategy. Together, the results of these five Dutch studies suggest that it is feasible to successfully promote physical activity to groups of people in diverse places, with benefits in terms of both prevention and management of chronic disease and injury.     

Strengthening physical self-perceptions through exercise.

Two studies examined the effects of physical activity/exercise on physical self-perceptions, self-efficacy, body satisfaction, fitness and relationships among these variables. In study 1, 34 female undergraduates participated in a 10-week exercise/activity program. Participants were selected from existing classes forming a weight training, aerobic exercise and activity control group. Results revealed changes in physical self-perceptions, strength, and body composition over the 10-weeks. Improvements in physical self-perceptions and fitness occurred independent of exercise/activity group. Groups differed in the perceived importance attached to physical self-perceptions. Correlations among the measures revealed relationships among physical self-perceptions, body satisfaction, global self-esteem, and fitness. In study 2, we hypothesized that weight training would have a greater effect on physical self-perceptions and body image perceptions than physical education activity classes. Thirty-seven males and 28 females were selected from existing classes forming a weight training and activity group. Results revealed no significant changes in physical self-perceptions, body image, or global self-esteem over the 10-week program, while strength and physical self-efficacy improved. Correlations among measures from both studies offer preliminary support for Sonstroem and Morgan's model for the examination of self-esteem in exercise settings.     

Home-based walking improves cardiopulmonary function and health-related QOL in community-dwelling adults

The objective of our study was to investigate the effects of a home-based walking program on physical fitness and QOL among community residents. Subjects (n = 200, mean age: 64.2 years, range: 42 - 75 years) who participated in the 32-week trial were randomly allocated to one of two groups: an exercise (E) group and a control (C) group. The E group was instructed to increase the number of steps a day that they walked and to perform aerobic walking at a target heart rate for 20 minutes or more daily, 2 or more days a week. The C group was told to continue their normal level of activity. Outcome measures were the 3-minute shuttle stamina walk test (SSWT), 30-second chair-stand test (CS-30), and SF-36. Increases in SSWT values were significantly greater in the E group than in the C group (men 24.1 m vs. 6.3 m; women 8.8 m vs. 2.4 m), as were increases in CS-30 values (men 5.9 vs. 2.6; women 4.5 vs. - 0.1). On the SF-36, the scores in the E group for vitality and mental health increased significantly. Home-based walking is considered to be an effective and feasible method to improve physical fitness and QOL among community residents.     

Stepped-down intervention programs to promote self-managed physical activity in military service veterans: A systematic review of randomised controlled trials

ObjectivesA stepped-down program is one where clients transition from the care of a health professional to self-managed care. This study reviewed the effectiveness of stepped-down interventions to promote self-managed physical activity for health in military service veterans.DesignSystematic review.MethodsLiterature searches of 11 electronic databases were performed (up to 28th April 2020) to identify randomised controlled trials that assessed self-managed physical activity interventions in military service veterans. Data were extracted on study characteristics, intervention programs (with strategies mapped against a taxonomy of behaviour change techniques), and physical activity outcomes; secondary outcomes were physical fitness/function, psychosocial health, and cost effectiveness. Study quality was assessed using a 15-item checklist adapted from the TESTEX scale.ResultsSearches identified 26 studies (all from the United States; N = 45 to 531 participants) representing 17 intervention programs. Studies were of good quality (M = 10.7; SD = 2.3). More than half (54%) reported positive between-group intervention effects for physical activity outcomes (mean increase of 80 min/week in self-reported physical activity at 10–12 months). Physical fitness/function outcomes improved in 38% of studies, but no studies found significant intervention effects for psychosocial health or cost effectiveness outcomes. Behaviour change techniques most frequently used to elicit physical activity changes were education, goal setting, goal review and self-monitoring.ConclusionsStepped-down programs that include specific behaviour change techniques have the potential to promote self-management of physical activity in military service veterans. Multi-national randomised controlled trials that use objective physical activity measures are needed to further build the evidence base.     

Physical activity determinants of military health care recipients

This study describes physical activity determinants (motivation, self-efficacy, benefits/barriers, and stage of change) of 71 healthy, military-affiliated volunteers, 28 men and 43 women (mean age, 31 +/- 7 years) from a military primary care setting. The physical activity determinants were measured with investigator-administered questionnaires at three time points over 8 months. The Kruskal-Wallis analysis of variance indicated that there were significant differences (p < 0.0001) among factors determining self-efficacy, motivation, and benefits/barriers. The subjects reported being most confident that they could be physically active even if they had to do it by themselves. The chief benefit reported was an improvement in physical performance, whereas the leading barrier to physical activity was the physical exertion involved. The biggest motivator was the positive health effect gained. Most subjects considered themselves to be in the "maintenance" stage of change. This study provides a platform for the development of an effective physical activity intervention in this population.     

A cluster-analytical approach toward physical activity and other health related behaviors

PURPOSE: The purpose of our study was to investigate, on the basis of cluster analysis, whether healthy behavior clusters in a healthy or unhealthy way, whether physical activity can discriminate among those clusters, and whether the groups identified could be characterized by demographic variables. METHODS: The relationships between physical activity and other health related behaviors were studied in three age groups, ages 16-25, 35-45, and 50-65. Almost 2400 subjects from a medium-sized Belgian town were interviewed at home to assess their level of physical activity in the past year and to obtain information on other healthy behaviors. RESULTS: The two-cluster solution was found to be most reliable in all three age groups. Smoking discriminated most among the clusters. Cluster analysis divided each age group into a healthy and a more unhealthy subgroup, in which the healthy subgroup is larger than the unhealthy one. Sex differences were found in all three age groups, with more men in the unhealthy cluster. Socio-economic differences are especially strong in the two youngest samples. CONCLUSIONS: The hypothesis that leisure time physical activity had discriminating power between healthy and unhealthy subgroups was not confirmed. Physical activity seems to be a unique factor in contrast to other health related behaviors. In the future, specific intervention directed at the promotion of physical activity in the population is necessary.     

Collaborative intervention: a model for coordinated treatment of mental health issues within a ground combat unit

Involvement in combat imposes a psychological burden that affects all combatants, not only those who are vulnerable to emotional disorders or those who sustain physical wound distress. This burden of combat is also carried by the families of those who go to war. Although most ground combat units have a medical officer as well as a chaplain assigned to them, they do not have a mental health counselor or psychologist. Traditionally, the medical officer focuses on the treatment of physical symptoms, diseases, and physical injuries, whereas the chaplain treats spiritual and adjustment issues that may affect how well an individual service member functions personally and/or professionally. Located between these two points is a void, the treatment of psychological or emotional issues. By using the collaborative intervention model presented here, unit medical officers and chaplains can work together to treat these issues, thus reducing the number of service members needing referral to mental health agencies, decreasing the number of mental health-related medical separations, and increasing overall mission readiness. This article presents a model whereby medical officers and chaplains can enter this void together, treating these emotional issues collaboratively.     

Intervention-engagement and its role in the effectiveness of stage-matched interventions promoting physical exercise

Intervention-engagement has received little attention in sports medicine as well as research and promotion of physical exercise. The construct is important, however, in the understanding of why interventions work. This study aimed at shedding more light on the interplay of engagement and the subsequent effectiveness of physical exercise interventions. A three-stage model differentiating among nonintenders, intenders, and actors informed the intervention design in this study. In an Internet-based randomized controlled trial (RCT) with two measurement points, N = 326 participants received a stage-matched, stage-mismatched, or control treatment. Assessed variables were goal setting, planning, behavior, and intervention-engagement. It was found that regarding goal setting, nonintenders in the stage-matched intervention and those who engaged highly in the stage-matched intervention improved significantly over time. Regarding planning, intenders in the matched condition as well as all actors increased their levels over time. Regarding behavior, nonintenders and intenders having engaged highly in the intervention improved more than those having engaged little. In order to help nonintenders progress on their way toward goal behavior, it is necessary that they engage highly in a stage-matched intervention. Implications for exercise promotion are that interventions should also aim at increasing participants' intervention-engagement.     

Does physical activity impact on presenteeism and other indicators of workplace well-being?

The term 'presenteeism' is a relatively new concept in workplace health, and has come to signify being at work despite poor health and performing below par. Presenteeism, which is potentially critical to employers, has been associated with a range of psychosocial outcome measures, such as poor mental health and employee well-being. Physical activity is a potential strategy for reducing presenteeism, and for improving the mental health of employees. This article reviews evidence on the relationships between physical activity and employee well-being and presenteeism in the workplace, and identifies directions for research in an emerging field. Electronic and manual literature searches were used to identify 20 articles that met the inclusion criteria. These included 13 intervention trials (8 randomized controlled trials, 5 comparison trials) and 7 observational studies (3 cohort, 4 cross-sectional). Outcome measures were grouped into 'workplace well-being', 'psychosocial well-being' and 'physical well-being'. Studies measured a wide variety of outcomes, with absenteeism being the most commonly assessed. Evidence indicated a positive association between physical activity and psychosocial health in employees, particularly for quality of life and emotional well-being. However, findings were inconclusive as to the role of physical activity in promoting workplace well-being. Only one study reported on presenteeism, with mixed evidence for outcomes. This article indicates that physical activity and employee psychosocial health are positively related, but there is limited evidence of a relationship between physical activity and presenteeism. A standardized definition of presenteeism and an appropriate evaluation tool are key research priorities if the complex relationships between physical activity and workplace well-being are to be better understood.     

Struggling with cancer and treatment: young athletes recapture body control and identity through exercise: qualitative findings from a supervised group exercise program in cancer patients of mixed gender undergoing chemotherapy

Cancer and treatment can negatively affect the body's performance and appearance. Exercise has been tested in a few studies for altered body image among middle-aged women with breast cancer. The aim of the study was to explore how young pre-cancer athletes of both genders experience disease- and treatment-related physical fitness and appearance changes while undergoing chemotherapy and participating in a 6-week group exercise intervention. A prospective, explorative study using semi-structured interviews was conducted before and at termination of the intervention. The study included 22 cancer patients (median age 28 years). The young athletes experienced a change from a high level of physical activity, body satisfaction and a positive self-identity to a low level of physical activity, body denial and a negative self-identity. In the program, the patients experienced increased physical strength and recapture of certain aspects of their former positive body perception. Deterioation of muscle functions caused by chemotherapy was particularly painful to these patients, independent of gender and age. Young physically active patients are heavily dependent on their physical capacity, body satisfaction and self-identity. This should be taken into account when designing programs to rehabilitate and encourage these patients through the often-strenuous antineoplastic treatments.     

Attitudes towards exercise and physical activity behaviours in Greek schoolchildren after a year long health education intervention

Objective

To examine the short term effects of a health education programme on Greek primary schoolchildren

Methods

The school based intervention programme was applied to 29 children in the 6th grade of the 2nd Primary School of Agios Stefanos (∼12 000 inhabitants); 49 pupils from the 1st Primary School constituted the control group. To assess the effectiveness of the intervention, attitude and behavioural variables were measured before and after the intervention.

Results

After adjustment for initial differences in the assessed variables, pupils who took part in the intervention had more positive attitudes towards physical activity than the control group and scored significantly more highly on their intention to participate in physical activity. Moreover, pupils in the intervention group reported more hours/week spent in organised physical activities than pupils in the control group (mean (SD) 3.54 (0.32) v 2.54 (0.26), p<0.020). Finally, a higher proportion of pupils in the intervention classes matched the recommendations of 60 minutes of moderate to vigorous physical activity daily (77.4% v 55.1%, p<0.043).

Conclusions

Within the limitations of the study, the data show that school health education programmes have the potential to slow the age related decline in physical activity and help pupils establish lifelong, healthy physical activity patterns. Promoting healthy habits and physical activity behaviours during childhood may prevent some of the leading causes of morbidity and mortality in the Greek population, and also decrease direct healthcare costs and improve quality of life.     

Influence of a health education intervention on physical activity and screen time in primary school children: ‘Switch Off–Get Active’

Low levels of physical activity coupled with high levels of television viewing have been linked with obesity in children. The objective of this study was to assess the efficacy of 'Switch Off-Get Active', a 16-week controlled health education intervention, in increasing physical activity and reducing screen time and BMI in primary school children. A secondary objective was to compare children with high and low screen time. Participants were 312 children aged 10.2+/-0.7 years, attending nine schools in areas of social disadvantage. The 10-lesson, teacher-led intervention, conducted in spring 2003, emphasised self-monitoring, budgeting of time and selective viewing. Differences, adjusted for baseline values by ANCOVA, existed between intervention and control children at follow-up for self-reported physical activity (intervention +0.84 30 min blocks/day, 95%CI 0.11-1.57, p<0.05) and self-efficacy for physical activity (p<0.05) but not self-reported screen time (intervention--0.41 blocks/day, 95%CI--0.93-0.12, p=0.13) or BMI (p=0.63). Cross-sectional comparisons at baseline indicated lower physical activity, self-efficacy for physical activity and aerobic fitness and a higher BMI in children with high screen time. In conclusion, health education interventions can increase physical activity in primary school children but follow-ups of longer duration may be needed to demonstrate intervention effects on BMI.     

Are activity promotion interventions based on the transtheoretical model effective? A critical review

The health benefits of physical activity are well documented yet 70% of adults remain sedentary. It has been suggested that interventions based on the transtheoretical model of behaviour change (TTM) may be useful in promoting physical activity. Published work on the effectiveness of such interventions is therefore critically reviewed. Although there is evidence that TTM based activity promotion interventions are effective in promoting activity adoption, initial results on longer term adherence are disappointing.     

Effectiveness of a school-based intervention on physical activity and screen time among adolescents

ObjectivesTo evaluate the effectiveness of a multi-component school-based intervention on physical activity (PA) and screen time (ST) among urban adolescents in Bangladesh.DesignCluster-randomised controlled trial.MethodsEight high schools were randomly assigned to either intervention group (IG) or control group (CG). Participants (n = 160 per group, 40 school) were in grades 8–9. A 12-week multi-component intervention was developed based on the WHO's Health-Promoting Schools framework. The IG received weekly supervised circuit exercise (30 min/week), health education session (10 min/week) with health educational materials, and lunchtime sports activities (20 min/week). The main outcome measures included self-reported PA, ST, knowledge on PA and SB, which were assessed at baseline, 8 and 12 weeks. Repeated measures ANCOVA was used to evaluate the intervention effects.ResultsTotal PA (MET-min/week) was increased from baseline to 8 and 12 weeks in the IG (3%–5%) but decreased in the CG (5%–3%) and significantly improved in the IG compared to the CG (p < 0.001) over time. Average ST (min/day) reduced from baseline to 8 and 12 weeks in the IG (28%–35%), while remained unchanged in the CG (6%–5%). The IG had a significantly lower average ST than the CG at 12 weeks. The average knowledge scores on PA and SB were significantly higher in the IG than the CG at 12 weeks (p < 0.001).ConclusionsOur intervention has demonstrated some promising effects on increasing PA, reducing ST, and improving PA and SB knowledge. This study underscores the need for a scaled-up evaluation in other locations including rural settings.     

The relationships between physical activity,health status and psychological well-being of fertility-aged women

The purpose of this investigation was to measure the association between leisure time physical activity and health status, mental health and depression. The participants were women aged 18-45. The data were collected using questionnaires that were mailed to 1200 women. The response rate was 55%. The questionnaire contained three instruments: the General Health Questionnaire (GHQ), the Health Questionnaire for Adults, and the Beck Depression Inventory (BDI). The results showed that 52.8% of the sample were physically inactive. Physically active women experienced better mental health (P < 0.05), less depression (P < 0.05) and they had better general health status (P < 0.005). Differences in the emotional state (GHQ score) and depression (BDI score) between active (participating in exercise 3 or 1-2 times a week) and inactive women were significant (P < 0.05). Even a low level of physical activity (1-2 times per week) was positively related to women's mental health (P < 0.05).