Initial outcomes from the Confident Moves online intervention to promote physical activity in adults with obesity: a longitudinal feasibility and acceptability pilot trial

A growing body of research highlights that adults with autism spectrum disorder (ASD) have poor health outcomes, yet effective health interventions are lacking for this population. While mobile health applications demonstrate potential for promoting physical activity (PA) in adults with ASD, scientific evidence for supporting this tool’s long-term effectiveness on PA behavior change remains inconclusive. This study aimed to provide the latest information on PA research and the prospective role of mobile health applications for promoting PA in adults with ASD. A literature review demonstrated that a few available studies show contradictory results regarding PA levels in adults with ASD, and behavior change techniques and gamification-guided mobile health applications can be promising tactics to leverage autism’s strengths and increase PA in these individuals. Optimizing design decisions based on needs analysis and user feedback is crucial to identifying and developing a sustainable mobile health intervention for PA promotion in adults with ASD.

The purpose of this qualitative study was to identify perceptions and barriers to physical activity in childhood and adulthood among Latina adults. Three focus groups, 2 dyadic interviews, and an individual interview were conducted using semi-structured interview guides with 23 Latina women aged 21-35. A thematic analysis approach employing inductive and deductive coding was utilized to code, categorize, and summarize data into themes. The themes that emerged focused on: (1) physical activity is enjoyable; (2) family influenced physical activity; (3) different lifestyle in the US influenced physical activity; (4) physical activity is important for health; and (5) responsibilities (eg, work, caregiving) as barriers to physical activity in adulthood. Perceptions and barriers to physical activity experienced in both childhood and adulthood should be considered in the promotion of physical activity among Latinas.

BackgroundExisting physical activity guidelines predominantly focus on healthy age-stratified target groups. The objective of this study was to develop evidence-based recommendations for physical activity (PA) and PA promotion for German adults (18–65 years) with noncommunicable diseases (NCDs).MethodsThe PA recommendations were developed based on existing PA recommendations. In phase 1, systematic literature searches were conducted for current PA recommendations for seven chronic conditions (osteoarthrosis of the hip and knee, chronic obstructive pulmonary disease, stable ischemic heart disease, stroke, clinical depression, and chronic non-specific back pain). In phase 2, the PA recommendations were evaluated on the basis of 28 quality criteria, and high-quality recommendations were analysed. In phase 3, PA recommendations for seven chronic conditions were deducted and then synthesised to generate generic German PA recommendations for adults with NCDs. In relation to the recommendations for PA promotion, a systematic literature review was conducted on papers that reviewed the efficacy/effectiveness of interventions for PA promotion in adults with NCDs.ResultsThe German recommendations for physical activity state that adults with NCDs should, over the course of a week, do at least 150 min of moderate-intensity aerobic PA, or 75 min of vigorous-intensity aerobic PA, or a combination of both. Furthermore, muscle-strengthening activities should be performed at least twice a week. The promotion of PA among adults with NCDs should be theory-based, specifically target PA behaviour, and be tailored to the respective target group. In this context, and as an intervention method, exercise referral schemes are one of the more promising methods of promoting PA in adults with NCDs.ConclusionThe development of evidence-based recommendations for PA and PA promotion is an important step in terms of the initiation and implementation of actions for PA-related health promotion in Germany. The German recommendations for PA and PA promotion inform adults affected by NCDs and health professionals on how much PA would be optimal for adults with NCDs. Additionally, the recommendations provide professionals entrusted in PA promotion the best strategies and interventions to raise low PA levels in adults with NCDs. The formulation of specific PA recommendations for adults with NCDs and their combination with recommendations on PA promotion is a unique characteristic of the German recommendations.

BackgroundEven without weight loss, adults with obesity can greatly benefit from regular physical activity. The Physical Activity Self-efficacy (PAS) intervention is an online behavioral intervention newly developed to promote physical activity in adults with obesity by providing capability-enhancing learning opportunities. The objective of this manuscript is to describe the protocol for a feasibility study designed to investigate the feasibility and acceptability of implementing the PAS online intervention for adults with obesity recruited from a local weight management center in the United States of America (USA).MethodsThe study design is a prospective, double-blind, parallel-group individual randomized pilot trial. Thirty participants will be randomly assigned to the PAS group or usual care group to achieve a 1:1 group assignment. Recruitment of participants is scheduled to begin on 1 March 2024 at a local weight management center within a private healthcare system in the USA. There are six eligibility criteria for participation in this study (e.g., a body mass index ≥ 25.00 kg/m2). Eligibility verification and data collection will be conducted online. Three waves of data collection will take up to 14 weeks depending on participants’ progress in the study. The primary feasibility outcomes in the study will be: (a) participation rate, (b) engagement behavior, and (c) a preliminary effect size estimate for the effect of the PAS intervention on physical activity. Instruments designed to measure demographic information, anthropometric characteristics, self-efficacy, and acceptability will be included in the survey battery. A research-grade accelerometer will be used to measure free-living physical activity objectively. Data will be analyzed using descriptive statistics and inferential statistical models under an intention-to-treat approach.DiscussionResults are intended to inform the preparation of a future definitive randomized controlled trial.Trial registrationClinicalTrials.gov, NCT05935111, registered 7 July 2023.

Measuring Physical Activity in Younger and Older Adults with Sickle Cell Disease Using Accelerometers

The internet is often considered as a very promising medium to disperse tailored health information because it can reach large numbers of people at low costs. However there exists little evidence for the efficacy of online tailored interventions. PURPOSE To evaluate the effectiveness of an online computerised tailored intervention program promoting physical activity (PA) in a small population sample. METHODS 526 adults (25–55 year) recruited in 6 different work places were randomised in 3 conditions: a tailored PA advice group (TPA), a tailored PA advice supplemented with reinforcement e-mails group (TPA+E) and a waiting-list control group receiving non tailored standard PA information (SPA). PA measurements were collected with the long IPAQ (paper and pencil version) at three times (pre, 3 and 6 months) for all participants. Objective PA measurements were taken in a subgroup (N=60), by wearing an accelerometer during 7 days. Further, a qualitative evaluation of the tailoring program, the reinforcement e-mails and the general PA information was done after 3 months. RESULTS 379 participants completed the paper and pencil questionnaire after 6 months. Repeated measures ANOVA were used to examine differences between intervention groups. After 6 months, total group PA levels were significantly higher for total PA (F=10.951, p=0.001), PA at moderate intensity (F=9.539, p < 0.01) and PA in leisure time (F=26.554, p < 0.001). However no significant time by group interaction effects were found. Accelerometer data did not show significant differences in PA levels between the three groups either. Participants evaluated the tailored PA advice more positive in comparison with the non-tailored standard information. The tailored advice was more read (97 vs 44%), more printed (65 vs 17%) and discussed with others (61.5 vs 32%) in comparison with the standard advice. 86% respondents in the of TPA+E was satisfied about the number and frequency of the reinforcement e-mails. 52% of the inactive participants found the information in the e-mails useful en 41% indicated that it helped them to change their behaviour. CONCLUSION Despite the positive evaluation of tailored advice and e-mails, no evidence was found that the online computerised tailored intervention program is a better way to enhance PA in comparison with online standard PA information. The Policy Research Centre sport, physical activity and health is supported by the Flemish Government.

Theory-based interventions to promote physical activity (PA) are more effective than atheoretical approaches; however, the comparative utility of theoretical models is rarely tested in longitudinal designs with multiple time points. Further, there is limited research that has simultaneously tested social-cognitive models with self-report and objective PA measures. The primary aim of this study was to test the predictive ability of three theoretical models (social cognitive theory, theory of planned behaviour, and protection motivation theory) in explaining PA behaviour. Participants were adults with type 2 diabetes (n = 287, 53.8% males, mean age = 61.6 ± 11.8 years). Theoretical constructs across the three theories were tested to prospectively predict PA behaviour (objective and self-report) across three 6-month time intervals (baseline-6, 6-12, 12-18 months) using structural equation modelling. PA outcomes were steps/3 days (objective) and minutes of MET-weighted PA/week (self-report). The mean proportion of variance in PA explained by these models was 6.5% for objective PA and 8.8% for self-report PA. Direct pathways to PA outcomes were stronger for self-report compared with objective PA. These theories explained a small proportion of the variance in longitudinal PA studies. Theory development to guide interventions for increasing and maintaining PA in adults with type 2 diabetes requires further research with objective measures. Theory integration across social-cognitive models and the inclusion of ecological levels are recommended to further explain PA behaviour change in this population. Statement of contribution What is already known on this subject? Social-cognitive theories are able to explain partial variance for physical activity (PA) behaviour. What does this study add? The testing of three theories in a longitudinal design over 3, 6-month time intervals. The parallel use and comparison of both objective and self-report PA measures in testing these theories.

To review the use of accelerometry as an objective measure of physical activity in adults and elderly people. A systematic review of studies on the use of accelerometty as an objective measure to assess physical activity in adults were examined in PubMed Central, Web of Knowledge, EBSCO and Medline databases from March 29 to April 15, 2010. The following keywords were used: "accelerometry," "accelerometer," "physical activity," "PA," "patterns," "levels," "adults," "older adults," and "elderly," either alone or in combination using "AND" or "OR." The reference lists of the articles retrieved were examined to capture any other potentially relevant article. Of 899 studies initially identified, only 18 were fully reviewed, and their outcome measures abstracted and analyzed. Eleven studies were conducted in North America (United States), five in Europe, one in Africa (Cameroon) and one in Australia. Very few enrolled older people, and only one study reported the season or time of year when data was collected. The articles selected had different methods, analyses, and results, which prevented comparison between studies. There is a need to standardize study methods for data reporting to allow comparisons of results across studies and monitor changes in populations. These data can help design more adequate strategies for monitoring and promotion of physical activity.

OBJECTIVE: To review the use of accelerometry as an objective measure of physical activity in adults and elderly people. METHODS: A systematic review of studies on the use of accelerometty as an objective measure to assess physical activity in adults were examined in PubMed Central, Web of Knowledge, EBSCO and Medline databases from March 29 to April 15, 2010. The following keywords were used: "accelerometry," "accelerometer," "physical activity," "PA," "patterns," "levels," "adults," "older adults," and "elderly," either alone or in combination using "AND" or "OR." The reference lists of the articles retrieved were examined to capture any other potentially relevant article. Of 899 studies initially identified, only 18 were fully reviewed, and their outcome measures abstracted and analyzed. RESULTS: Eleven studies were conducted in North America (United States), five in Europe, one in Africa (Cameroon) and one in Australia. Very few enrolled older people, and only one study reported the season or time of year when data was collected. The articles selected had different methods, analyses, and results, which prevented comparison between studies. CONCLUSIONS: There is a need to standardize study methods for data reporting to allow comparisons of results across studies and monitor changes in populations. These data can help design more adequate strategies for monitoring and promotion of physical activity.

In an age of scientific and technical innovation, with the rapid development of digital technologies, the promotion of physical activity among adults becomes relevant, as it is irreplaceably important to strengthen their overall health. The article reveals the attitude of health-care specialists to the importance of promoting physical activity in adults, needs, reasons for choice, conditioning factors, ways and means of promoting physical activity in adults, the possibilities for its increase and development, and the importance of the professionalism of health-care specialists in promoting physical activity in adults. The research confirmed the validity of theoretical approaches and empirical strategy from the point of view of health-care specialists, the importance of the promotion of physical activity for adults’ physical and mental health, a harmonious personality, quality of life, and social and economic well-being. Adults’ physical activity is determined by various mutually influencing factors, emphasising the possibilities of promoting physical activity for strengthening their health, empowering personal potential, focusing on the individuality of the person, applying andragogic access, learning from experience, etc.

Early motor skill competence as a mediator of child and adult physical activity

Aim: This study aimed to: describe Filipino PTs' knowledge of WHO physical activity (PA) guidelines and their use of behavioral change techniques (BCTs) and theories when promoting PA in older adults, and (2) explore factors that potentially influence their engagement in PA promotion. Methods: Filipino PTs who handled older adult clients from March to April 2020 answered an online orprinted survey. Recruitment was done through various practice sites and the PPTA. Descriptive statistics summarized responses and correlational analysis explored whether key determinants and relevant demographic characteristics were linked to PA promotion in older adult clients. Results: There were 72 respondents. Data collection was concluded early following the COVID pandemic restrictions and major changes in the PT practice landscape in the Philippines. More than half were unaware (59.15%), and most could not recall the WHO guidelines (98.61%) correctly. Respondents used a limited range of BCTs when promoting PA. While some were aware of at least one behavior change theory (66.66%), a number were unfamiliar with these (33.33%), with only a small proportion reporting regular use in practice. Eleven out of 18 domains of determinants of PA promotion as well as the age and years of practice of the respondents were found to have a statistically significant positive relationship with PA promotion. Conclusion and Implications: Study results can serve as the basis for programs that improve knowledge of Filipino PTs with regards to WHO PA guidelines and strengthen their use of a wider range of BCTs and theories to guide PA promotion in older adult clients. This can potentially place Filipino PTs at the forefront of addressing this public health concern in the aging Filipino population.

BackgroundInsufficient physical activity in the adult population is a global pandemic. Fun for Wellness (FFW) is a self-efficacy theory- and Web-based behavioral intervention developed to promote growth in well-being and physical activity by providing capability-enhancing opportunities to participants.ObjectiveThis study aimed to evaluate the effectiveness of FFW to increase physical activity in adults with obesity in the United States in a relatively uncontrolled setting.MethodsThis was a large-scale, prospective, double-blind, parallel-group randomized controlled trial. Participants were recruited through an online panel recruitment company. Adults with overweight were also eligible to participate, consistent with many physical activity–promoting interventions for adults with obesity. Also consistent with much of the relevant literature the intended population as simply adults with obesity. Eligible participants were randomly assigned to the intervention (ie, FFW) or the usual care (ie, UC) group via software code that was written to accomplish equal allocations to the FFW and UC groups. Data collection was Web based, fully automated, and occurred at three time points: baseline, 30 days after baseline (T2), and 60 days after baseline (T3). Participants (N=461) who were assigned to the FFW group (nFFW=219) were provided with 30 days of 24-hour access to the Web-based intervention. A path model was fit to the data consistent with the FFW conceptual model for the promotion of physical activity.ResultsThere was evidence for a positive direct effect of FFW on transport-related physical activity self-efficacy (beta=.22, P=.02; d=0.23), domestic-related physical activity self-efficacy (beta=.22, P=.03; d=0.22), and self-efficacy to regulate physical activity (beta=.16, P=.01; d=0.25) at T2. Furthermore, there was evidence for a positive indirect effect of FFW on physical activity at T3 through self-efficacy to regulate physical activity at T2 (beta=.42, 95% CI 0.06 to 1.14). Finally, there was evidence for a null direct effect of FFW on physical activity (beta=1.04, P=.47; d=0.07) at T3.ConclusionsThis study provides some initial evidence for both the effectiveness (eg, a positive indirect effect of FFW on physical activity through self-efficacy to regulate physical activity) and the ineffectiveness (eg, a null direct effect of FFW on physical activity) of the FFW Web-based behavioral intervention to increase physical activity in adults with obesity in the United States. More broadly, FFW is a scalable Web-based behavioral intervention that may effectively, although indirectly, promote physical activity in adults with obesity and therefore may be useful in responding to the global pandemic of insufficient physical activity in this at-risk population. Self-efficacy to regulate physical activity appears to be a mechanism by which FFW may indirectly promote physical activity in adults with obesity.Trial RegistrationClinicalTrials.gov NCT03194854; https://clinicaltrials.gov/ct2/show/NCT03194854.

ObjectiveThe use of financial incentives to promote physical activity (PA) has grown in popularity due in part to technological advances that make it easier to track and reward PA. The...

Rationale: There are low rates of physical activity in adults with overweight and obese BMIs. Internal experiences may be an important and under-addressed determinant of physical activity behavior, however they have not been measured with objectively measured physical activity in people with overweight or obese BMIs; therefore this study's first aim is to address this gap. The study's second aim is to examine a new approach to physical activity promotion that is based in acceptance, which has preliminary evidence in interventions but the theoretical model has not been directly tested. Methods: Adults (n=320) rated their internal experiences during a treadmill walking task at baseline of a behavioral weight loss trial. Participants also completed measurements of physical activity (accelerometer) and acceptance-based psychological processes (self-report) at baseline. Accelerometer measurement of physical activity was repeated six months after initial behavioral weight loss. Compound poisson linear models were utilized to test the relationships between internal experiences, acceptance-based psychological processes, and physical activity. Results: Higher ratings of energetic and strength were both separately positively associated with concurrent physical activity. Discomfort tolerance moderated the relationship between ratings of weak/strong and physical activity, and perceived exertion and physical activity. Other significant moderation models yielded results contrary to hypotheses, such that acceptance-based psychological processes had a larger effect at positive internal experiences. No model significantly predicted physical activity at six months. Conclusions: Results from the first aim suggest that there is divergence in the relationships between different internal experiences and physical activity, and it may be clinically helpful to include more specific measurement of internal experiences in future studies. Results from the second aim suggest that discomfort tolerance may be a key skill in physical activity promotion. However, overall acceptance-based psychological processes had a larger effect on positive internal experiences, suggesting that a positive affective experience may be necessary to create an environment conducive to skill utilization. Additionally, no models significantly predicted physical activity at six-months, suggesting that other factors such as the changes during weight loss may be more salient to physical activity engagement at six-months. Limitations in methodology and measurement of the internal experience and acceptance-based psychological processes are discussed. This study is the first to examine internal experiences, acceptance-based psychological processes, and objectively measured physical activity in adults with overweight or obese BMIs. Future studies should address the limitations of this study to further investigate the theoretical model of acceptance-based interventions for physical activity.