MobileMums: A Randomized Controlled Trial of an SMS-Based Physical Activity Intervention

Background  

Postnatal women (<12 months postpartum) are at increased risk of physical inactivity.     

Efficacy and Mediation of a Theory-Based Physical Activity Intervention for African American Men Who Have Sex with Men: A Randomized Controlled Trial

Background

Few trials have tested physical-activity interventions among sexual minorities, including African American men who have sex with men (MSM).

Purpose

We examined the efficacy and mediation of the Being Responsible for Ourselves (BRO) physical-activity intervention among African American MSM.

Method

African American MSM were randomized to the physical-activity intervention consisting of three 90-min one-on-one sessions or an attention-matched control intervention and completed pre-intervention, immediately post-intervention, and 6- and 12-month post-intervention audio computer-based surveys.

Results

Of the 595 participants, 503 completed the 12-month follow-up. Generalized estimating equation models revealed that the intervention increased self-reported physical activity compared with the control intervention, adjusted for pre-intervention physical activity. Mediation analyses suggested that the intervention increased reasoned action approach variables, subjective norm and self-efficacy, increasing intention immediately post-intervention, which increased physical activity during the follow-up period.

Conclusions

Interventions targeting reasoned action approach variables may contribute to efforts to increase African American MSM’s physical activity.

Clinical trial registration

The trial was registered with the ClinicalTrials.gov Identifier NCT02561286.

     

Translating Physical Activity Interventions for Breast Cancer Survivors into Practice: An Evaluation of Randomized Controlled Trials

Background  Although physical activity (PA) interventions have been effective for improving health outcomes in breast cancer survivors, little is known relative to their potential for translation into practice. Purpose  This review was designed to provide a quantitative estimate of the reporting of both internal and external validity in recent studies of PA in breast cancer survivors (BCS). Methods  The Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was utilized to assess the reporting of internal and external validity in 25 randomized controlled trials (RCTs) of PA and BCS published between 1998 and 2008. Each trial was evaluated relative to the degree it met criteria for each of the above dimensions. Results  The majority of studies in this review reported dimensions reflecting internal validity. The overall level of detail relative to external validity of PA interventions was rarely reported, limiting the generalizability of study findings. Conclusions  As with many RCTs of health behavior change, detail relative to contextual elements of published PA interventions in BCS is limited. It is recommended that future physical activity interventions in BCS be designed to facilitate scalable and sustainable interventions for improving health outcomes in this population.     

Exploring the Efficacy and Moderators of Two Computer-Tailored Physical Activity Interventions for Older Adults: A Randomized Controlled Trial

Background  

Important health benefits can be derived when low-cost (e.g., computer-tailored) physical activity interventions for older adults demonstrate sustained effects.     

Physical Activity and Fitness Outcomes of a Lifestyle Intervention for Primary Care Patients with Depression and Anxiety: a Randomised Controlled Trial

Patients currently being treated for depression and/or anxiety were referred by their GP and randomised to a 12-week individually tailored diet and exercise lifestyle intervention or an attention control group. Assessments at baseline and 12 weeks included the Active Australia Survey for self-reported physical activity, chair stands, arm curls and a 3-min step test to measure physical fitness. Intent-to-treat analyses using linear mixed modelling showed both groups significantly improved participation in physical activity and muscular endurance. There were no significant differences in improvement between groups. The only group by time interaction was found for body mass index and indicated greater improvement in the intervention group compared to the attention control group. Motivated patients with depression and/or anxiety may be able to increase their participation in physical activity without regular individual support from an exercise physiologist. Alternate modes of support should be considered.     

Physical Activity, Heath-Related Fitness, and Health Experience in Adults with Childhood-Onset Epilepsy: A Controlled Study

Summary: Purpose: To show any possible associations between childhood-onset epilepsy and physical activity, health-related fitness, and health experience. Methods: A population-based cohort of 176 patients with epilepsy since childhood was monitored for a mean of 35 years. Patients with recurrent, unprovoked epileptic seizures with no associated initial neurologic impairment or disability, termed those with “epilepsy only” (n = 100), were compared with matched controls for self-reported physical activity, health experience, laboratory tests, body mass index, and muscle power tests. Results: On the basis of muscle tests, physical fitness proved to be significantly poorer in patients with “epilepsy only” than in matched controls. During the preceding year, 22% of patients and 24% of controls had reduced their physical activities because of some illness; only 2% reduced their physical activities because of epilepsy. No significant difference was found in blood status, except for a lower serum creatinine level in the patients. Current antiepileptic drug (AED) therapy appeared significantly associated with lower hemoglobin and creatinine levels and higher highdensity lipoprotein values. The patients perceived their health status to be comparable with that of controls, irrespective of physical inactivity, continued seizures, or AED monotherapy. However, patients receiving AED polytherapy perceived their health as rather poor or very poor significantly more often than did controls. Conclusions: Based on objective muscle tests, adults with childhood-onset “epilepsy only” have poorer physical fitness than do matched controls, but they have a feeling of good personal health.     

Aerobic Training Efficacy in Inflammation,Neurotrophins, and Function in Chronic Stroke Persons: A Randomized Controlled Trial Protocol

Background: Neuroinflammation is an important part of stroke pathophysiology and has both detrimental and beneficial effects after stroke. Besides that the enhancement of neurotrophins seems to be related to improvements in stroke recovery. Evidences suggest that exercise plays a role in modulating anti-inflammatory and neurotrophic effects. However, little is known about its impact in stroke survivors, mainly in chronic stroke. The purpose of this study is to investigate the efficacy of moderate-intensity treadmill exercise in changing inflammatory mediators, interleukin-6 (IL-6), soluble tumor necrosis factor receptors I and II (sTNFRI, sTNFRII), interleukin-10 (IL-10), and brain-derived neurotrophic factor (BDNF) levels in chronic stroke patients. The secondary objective is to investigate the effects of training in improve mobility and exercise capacity. Methods: This is a randomized controlled trial. Chronic stroke patients will be randomized to an experimental or control group, and will receive group interventions three times per week, over 12 weeks. The experimental group will receive moderate-intensity (60%-80% of maximum heart rate reserve) treadmill exercise. Control group will perform walking training on the ground (<40% of maximum heart rate reserve). Primary outcomes include IL-6, sTNFRI, sTNFRII, IL-10, and BDNF levels. Secondary outcomes include mobility and exercise capacity. Outcomes will be measured at baseline, postintervention, and at the 4-week follow-up. Discussion: The findings of this trial have the potential to provide important insights regarding the effects of an aerobic physical program in the inflammatory process and in the neuronal plasticity in stroke persons and its impact on mobility and exercise capacity.     

Lifestyle factors and risk of stroke in Seoul, south Korea

Background and purpose: The importance of stroke risk factors, especially lifestyle associated ones, may differ among different ethnic groups. The purpose of the present study is to elucidate the risk factors for stroke in Seoul, Korea. Subjects and Methods: Three-hundred four stroke patients and 249 age-matched controls were studied. Patients were divided into those with cerebral infarction (CI) and intracerebral hemorrhage (ICH). Using a structured interview, we assessed risk factors for stroke including lifestyle-associated factors: hypertension (HT); diabetes mellitus (DM); cigarette smoking; alcohol drinking; sodium intake; salt taste preference; physical activity and exercise; consumption of vegetables, fat, fish and fruits; body mass index; total body fat; and skinfold thickness of triceps, subscapular, and abdomen. The results were compared between patients and controls, and between CI and ICH. Results: There were 232 CI and 72 ICH. Multivariate logistic regression analyses revealed the following independent risk factors; for CI in men, HT, DM, high sodium intake, low intake of vegetables, and excessive abdominal skinfold thickness; for ICH in men, HT, heavy alcohol drinking, high sodium intake, excessive abdominal skinfold thickness, and low fat consumption; for CI in women, excessive abdominal skinfold thickness, and low fat consumption; for CI in women, HT, high sodium intake, excessive abdominal skinfold thickness, decreased triceps skinfold thickness, and lack of recent physical exercise. On subgroup comparison, DM was found to be a discriminant risk factor favoring CI (v ICH) in women. Conclusion: Our results showed that in Seoul, Korea, HT is the strongest risk factor for CI and ICH, and high sodium intake, lack of exercise, and central body fat deposition are relatively important factors related to stroke, whereas factors such as cigarette smoking, hypercholesterolemia, and body mass index are not. Low consumption of fat and heavy alcohol drinking appear to be related to the occurrence of ICH. Risk factors for stroke may differ among different ethnic groups and guidelines for stroke prevention should be based on a correct understanding of them.     

Six-Month Outcomes from Living Well with Diabetes: A Randomized Trial of a Telephone-Delivered Weight Loss and Physical Activity Intervention to Improve Glycemic Control

Background

Intensive lifestyle intervention trials in type 2 diabetes contribute evidence on what can be achieved under optimal conditions, but are less informative for translation in applied settings.

Purpose

Living Well with Diabetes is a telephone-delivered weight loss intervention designed for real-world delivery.

Methods

This study is a randomized controlled trial of telephone counseling (n?=?151) versus usual care (n?=?151); 6-month primary outcomes of weight, physical activity, HbA1c; secondary diet outcomes; analysis was by adjusted generalized linear models.

Results

Relative to usual care, telephone counseling participants had small but significantly better weight loss [?1.12 % of initial body weight; 95 % confidence interval (CI) ?1.92, ?0.33 %]; physical activity [relative rate (RR)?=?1.30; 95 % CI, 1.08, 1.57]; energy intake reduction (?0.63 MJ/day; 95 % CI, ?1.01, ?0.25); and diet quality (3.72 points; 95 % CI, 1.77, 5.68), with no intervention effect for HbA1c (RR?=?0.99; 95 % CI, 0.96, 1.01).

Conclusions

Results are discussed in light of challenges to intervention delivery.     

A Systematic Review of Randomized Controlled Trials on the Effectiveness of Computer-Tailored Physical Activity and Dietary Behavior Promotion Programs: an Update

Background

A review update is necessary to document evidence regarding the effectiveness of computer-tailored physical activity and nutrition education.

Purpose

The purpose of this study was to summarize the latest evidence on the effectiveness of computer-tailored physical activity and nutrition education, and to compare the results to the 2006 review.

Methods

Databases were searched for randomized controlled trials evaluating computer-tailored physical activity and nutrition education aimed at primary prevention in adults, published from September 2004 through June 2011.

Results

Compared to the findings in 2006, a larger proportion of studies found positive effects for computer-tailored programs compared to generic or no information, including those for physical activity promotion. Effect sizes were small and generally at short- or medium-term follow-up.

Conclusions

The results of the 2006 review were confirmed and reinforced. Future interventions should focus on establishing larger effect sizes and sustained effects and include more generic health education control groups and objective measurements of dietary behavior.     

A Review of Physical Activity Measures Used Among US Latinos: Guidelines for Developing Culturally Appropriate Measures

Background  As the US population continues to grow and diversify, there is a need for progressive physical activity measurement and cross-cultural research. Studies suggest that US Latinos are among the most sedentary of ethnic groups compared to others; however, study findings may be biased given that some measures may not be culturally sensitive for assessing behaviors that are not characterized as leisure time physical activity. Purpose  The primary objective of this review was to identify and evaluate measures used to quantify physical activity among US Latinos. Methods  A review of the literature was performed and studies examining levels of physical activity among Spanish and English speaking Latinos were documented. This process involved identifying existing guidelines for the purpose of culturally adapting and/or translating (into Spanish) physical activity measures for the Latino population. These guidelines were used as the minimal criteria for the evaluation of the 13 identified measures of physical activity. Results  Of these 13 measures, four were available in English and nine were available in Spanish. One English measure met the guidelines for being culturally adapted for assessing physical activity among Latinos. There were no Spanish measures that met all the guidelines for physical activity assessment among Spanish-speaking Latinos. Lastly, the identified guidelines for developing culturally appropriate measures were improved to advance physical activity measurement among ethnic and cultural groups. Conclusion  Future research should merit the use of culturally appropriate guidelines to increase the understanding of physical activity patterns in the USA. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Impact of a Community-Based Frailty Intervention Among Middle-Aged and Older Prefrail and Frail Homeless Women: A Pilot Randomized Controlled Trial

Interventions are needed to address frailty and other behaviors (e.g., drug and alcohol use) among prefrail and frail homeless women (P/FHW). The purpose of this pilot randomized controlled trial (RCT) was to compare the efficacy of a Frailty Intervention (FI) versus a Health Promotion (HP) program among P/FHW (N?=?32). Structured instruments assessed sociodemographics, individual, situational, health-related, and behavioral factors. While program differences were not statistically significant with the main outcome variables, medium-to-large effect sizes were found in favor of the HP program as it relates to physical and overall frailty, as well as, any drug use, alcohol use, and drug dependency. Based on these findings, it is critical to strengthen the HP program to optimize all domains of frailty (e.g., physical, psychological, and social) and substance use for P/FHW.     

Individual Factors and the Context of Physical Activity in Exercise Dependence: A Prospective Study of ‘Ultra-Marathoners’

Although there is a growing body of literature examining determinants and correlates of exercise dependence, there has been a lack systematic measures of individual factors combined with the context of physical activity characteristics. The aim of this prospective study was therefore to examine the relative influence of individual factors and environmental context of physical activity on exercise dependence. This study examined a group of 95 ‘ultra-marathoners’ of a 100 km race. Each participant completed a questionnaire that assessed individual factors (e.g., sex, age, BMI, marital status, etc.), context of the physical activity (e.g., environmental and social context of practice), and the effect on the body as a result of physical activity (e.g., body control and modification). For participants in this study, the strongest predictors of exercise dependence were individual factors (age and BMI), and exercising in the city in an unstructured space. It is concluded that an ecological model of physical activity could be applied to exercise dependence, and that exercise dependence could provide interesting insights into the promotion of physical activity as a health-related behaviour.     

The Impact of Substance Use, Sexual Trauma, and Intimate Partner Violence on Sexual Risk Intervention Outcomes in Couples: A Randomized Trial

Background

Few HIV prevention interventions focus on sexual risk reduction as mutual process determined by couple members, though risk behaviors are inter-dependent.

Purpose

This trial examined the impact of substance use, history of sexual trauma, and intimate partner violence on sexual risk associated with participation in a risk reduction intervention.

Methods

HIV seroconcordant and serodiscordant multicultural couples in Miami, Florida (n?=?216) were randomized to group (n?=?112) or individual (n?=?104) couple-based interventions.

Results

Group intervention participants increased condom use in couples in which women had a history of sexual trauma [F(2,221)?=?3.39, p?=?0.036] and by partners of alcohol users. History of sexual trauma was a determinant of conflict resolution, predicting negative communication and intimate partner violence.

Conclusions

Results emphasize the need for group sexual risk reduction interventions targeting sexual trauma, partner violence, and substance use among HIV seroconcordant and serodiscordant couples.     

A Randomized,Sham-Controlled Trial of Repetitive Transcranial Magnetic Stimulation Targeting M1 and S2 in Central Poststroke Pain: A Pilot Trial

ObjectivesCentral poststroke pain (CPSP), a neuropathic pain condition, is difficult to treat. Repetitive transcranial magnetic stimulation (rTMS) targeted to the primary motor cortex (M1) can alleviate the condition, but not all patients respond. We aimed to assess a promising alternative rTMS target, the secondary somatosensory cortex (S2), for CPSP treatment.Materials and MethodsThis prospective, randomized, double-blind, sham-controlled three-arm crossover trial assessed navigated rTMS (nrTMS) targeted to M1 and S2 (10 sessions, 5050 pulses per session at 10 Hz). Participants were evaluated for pain, depression, anxiety, health-related quality of life, upper limb function, and three plasticity-related gene polymorphisms including Dopamine D2 Receptor (DRD2). We monitored pain intensity and interference before and during stimulations and at one month. A conditioned pain modulation test was performed using the cold pressor test. This assessed the efficacy of the descending inhibitory system, which may transmit TMS effects in pain control.ResultsWe prescreened 73 patients, screened 29, and included 21, of whom 17 completed the trial. NrTMS targeted to S2 resulted in long-term (from baseline to one-month follow-up) pain intensity reduction of ≥30% in 18% (3/17) of participants. All stimulations showed a short-term effect on pain (17–20% pain relief), with no difference between M1, S2, or sham stimulations, indicating a strong placebo effect. Only nrTMS targeted to S2 resulted in a significant long-term pain intensity reduction (15% pain relief). The cold pressor test reduced CPSP pain intensity significantly (p = 0.001), indicating functioning descending inhibitory controls. The homozygous DRD2 T/T genotype is associated with the M1 stimulation response.ConclusionsS2 is a promising nrTMS target in the treatment of CPSP. The DRD2 T/T genotype might be a biomarker for M1 nrTMS response, but this needs confirmation from a larger study.