7-day Physical Activity Recall Research Articles

The application of infrared thermography in evaluation of patients at high risk for lower extremity peripheral arterial disease

We investigated the usefulness of infrared thermography in evaluating patients at high risk for lower extremity peripheral arterial disease (PAD), including severity, functional capacity, and quality of life. A total of 51 patients (23 males; age 70 ± 9.8 years) were recruited. They completed three PAD-associated questionnaires, including walking impairment, vascular quality of life, and 7-day physical activity recall questionnaires before a 6-minute walking test (6MWT). Ankle-brachial index (ABI) and segmental pressure were analyzed for PAD diagnosis and stenotic level assessment. The cutaneous temperature at shin and sole were recorded by infrared thermography before and after the walk test. Detailed demographic information and medication list were obtained. Twenty-eight subjects had abnormal ABI (ABI <1), while PAD was diagnosed in 20. No subjects had non-compressible artery (ABI >1.3). Demographic profiles and clinical parameters in PAD and non-PAD patients were similar, except for age, smoking history, and hyperlipidemia. PAD patients walked shorter distances (356 ± 102 m vs 218 ± 92 m; P < .001). Claudication occurred in 14 patients, while seven failed in completing the 6MWT. The rest temperatures were similar in PAD and non-PAD patients. However, the post-exercise temperature dropped in the lower extremities with arterial stenosis, but was maintained or elevated slightly in the extremities with patent arteries (temperature changes at sole in PAD vs non-PAD patients: -1.25 vs -0.15°C; P < .001). The exercise-induced temperature changes at the sole were not only positively correlated with the 6MWD (Spearman correlation coefficient = 0.31, P = .03), but was also correlated with ABI (Spearman correlation coefficient = 0.48, P < .001) and 7-day physical activity recall scores (Spearman correlation coefficient = 0.30, P = .033). By detecting cutaneous temperature changes in the lower extremities, infrared thermography offers another non-invasive, contrast-free option in PAD evaluation and functional assessment.

The GoodNEWS (Genes, Nutrition, Exercise, Wellness, and Spiritual Growth) Trial: A community-based participatory research (CBPR) trial with African-American church congregations for reducing cardiovascular disease risk factors — recruitment, measurement, and randomization

Introduction Although cardiovascular diseases (CVD) are the leading cause of death among Americans, significant disparities persist in CVD prevalence, morbidity, and mortality based on race and ethnicity. However, few studies have examined risk factor reduction among the poor and ethnic minorities. Methods Community-based participatory research (CBPR) study using a cluster randomized design — African-American church congregations are the units of randomization and individuals within the congregations are the units of analysis. Outcome variables include dietary change (Diet History Questionnaire), level of physical activity (7-Day Physical Activity Recall), lipoprotein levels, blood pressure, fasting glucose, and hemoglobin A1c. Results Eighteen (18) church congregations were randomized to either a health maintenance intervention or a control condition. Complete data were obtained on 392 African-American individuals, 18 to 70 years of age, predominantly employed women with more than a high school diploma. Treatment and intervention groups were similar at baseline on saturated fat intake, metabolic equivalent of tasks (METS) per day, and other risk factors for CVD. Conclusions The GoodNEWS trial successfully recruited and evaluated CVD-related risk among African-American participants using a CBPR approach. Several logistical challenges resulted in extending the recruitment, preliminary training, and measurement periods. The challenges were overcome with the assistance of a local community consultant and a professional event planner. Our experience supports the need for incorporating non-traditional community-based staff into the design and operational plan of CBPR trials.

Effect of Obesity on Cardiovascular Disease Risk Factors in African American Women

Obesity is a growing health care concern with implications for cardiovascular disease (CVD). Obesity and CVD morbidity and mortality are highly prevalent among African American women. This pilot study examined the association between obesity and the traditional and emerging CVD risk factors in a sample of African American women. Participants comprised 48 women (27 obese, 21 normal weight) aged 18-45. with no known history of CVD. The women completed demographic and 7-day physical activity recall questionnaires. Height and weight were used to determine body mass index (BMI). Hypertension risk was assessed using the average of two resting blood pressure (BP) measurements. Lipid profile, blood glucose, fibrinogen, high-sensitivity C-reactive protein (hs-CRP), plasminogen activator inhibitor-1 (PAI-1), soluble intercellular adhesion molecule-1 (sICAM-1), and E-selectin (eSel) levels were assessed using fasting blood samples. Laboratory findings were interpreted using the American Diabetes Association (ADA) and Adult Treatment Panel (ATP) III reference guidelines as well as manufacturers' reference ranges for the novel CVD risk factors. The most common traditional risk factors were physical inactivity (72.9%), positive family history of CVD (58.3%), and obesity (56.3%). Obese individuals had elevated systolic BP (p = .0002), diastolic BP (p = .0007) and HDL-cholesterol (p = .01), triglyceride (p = .02), hs-CRP (p = .002), and fibrinogen (p = .01), when compared with normal-weight women. The findings suggest an association between obesity and higher prevalence of both traditional and emerging CVD risk factors in young African American women.

Determinants Of Bone Mineral Density In African-american And Caucasian College-aged Women

Historically, studies have shown that African-American (AA) women have greater bone densities (BMD) than Caucasian (CA) women. However, evidence is evolving that AA women are at risk for low BMD as are their CA counterparts. There is some debate over what accounts for the differences in BMD among AA and CA women. PURPOSE: To explain the variance in BMD in AA and CA college-aged women. A secondary purpose is to examine the prevalence of low BMD among AA and CA college-aged women. METHODS: Women (N = 101) aged 18 - 30 completed a demographic questionnaire, a 7-day Physical Activity Recall, and a four-day food log that included food intake for two weekdays and two weekend days. DXA scans of the spine, non-dominant femur, and total body were performed using a Hologic Delphi-W (Waltham, MA) DXA machine. Food records were analyzed using the Nutrition Data System for Research (NDS-R, v. 4.01). Forward multiple linear regression was performed to measure the variance in femoral and spinal bone mineral density as predicted by seven variables: race, family history of osteoporosis, length of time on oral contraceptives, average calcium intake, body mass index (BMI), hours/week of physical activity and age. RESULTS: In this sample, 35.3% of the CA participants had low spinal BMD; and 7.8% had low femoral BMD. For AA, 42% had low spinal BMD; and 8% had low femoral BMD. Only body mass index (p = 0.001) and total hours of exercise (p = 0.017) were significant predictors of spinal BMD. Similarly, BMI (p = 0.010) and total hours of exercise (p = 0.007) were significant predictors of femoral BMD. These predictors explained 14.9% of the variance in spinal BMD and 13.1% of the variance in femoral BMD. CONCLUSIONS: Race was not a significant predictor of spinal or femoral BMD. Exercise and BMI, however, were significant predictors of both spinal and femoral BMD. It is possible that the other variables were not significant in predicting BMD due to the cross-sectional nature of the study. It is also possible that race was not a significant predictor of BMD because significant racial differences in BMD do not emerge until after menopause.

A Pilot Study Evaluating a Telephone‐Based Exercise Intervention for Pregnant and Postpartum Women

Exercise during pregnancy is associated with reduced rates of preeclampsia, gestational diabetes, anxiety, insomnia, and excessive weight gain. Continued exercise during the postpartum period is important for healthy weight loss and reduced anxiety. Unfortunately, pregnant and postpartum women are significantly less active than nonpregnant women. The purpose of this pilot study was to evaluate a telephone-based exercise intervention designed for pregnant and postpartum women. Healthy women (N = 37) who were pregnant (16 weeks' gestation or less) or postpartum (6 months or less) participated in a 3-month, telephone-based exercise intervention based on the transtheoretical model and social cognitive theory. Exercise was assessed by using the 7-Day Physical Activity Recall Interview. Pregnant participants significantly increased their exercise from a mean (standard deviation [SD]) of 60.47 (63.1) minutes per week at baseline to 132.9 (82.3) minutes at 3 months, F(1,13) = 9.96, P < .01. Postpartum participants significantly increased their exercise from a mean (SD) of 68.9 (63.5) minutes per week at baseline to 123.8 (48.8) minutes at 3 months, F(1,15) = 6.56, P < .05. Participants responded positively to the intervention by significantly increasing their exercise levels. There is a need for a large, randomized controlled trial examining the efficacy of telephone-based exercise interventions for pregnant and postpartum women.

Motivational counselling for physical activity in patients with coronary artery disease not participating in cardiac rehabilitation

Many patients with coronary artery disease (CAD) fail to attend cardiac rehabilitation following acute coronary events because they lack motivation to exercise. Theory-based approaches to promote physical activity among non-participants in cardiac rehabilitation are required. A randomized trial comparing physical activity levels at baseline, 6, and 12 months between a motivational counselling (MC) intervention group and a usual care (UC) control group. One hundred and forty-one participants hospitalized with acute coronary syndromes not planning to attend cardiac rehabilitation were recruited at a single centre and randomized to either MC (n = 69) or UC (n = 72). The MC intervention, designed from an ecological perspective, included one face-to-face contact and eight telephone contacts with a trained physiotherapist over a 52-week period. The UC group received written information about starting a walking programme and brief physical activity advice from their attending cardiologist. Physical activity was measured by: 7-day physical activity recall interview; self-report questionnaire; and pedometer at baseline, 6, and 12 months after randomization. Latent growth curve analyses, which combined all three outcome measures into a single latent construct, showed that physical activity increased more over time in the MC versus the UC group (µ(add) = 0.69, p < 0.05). Patients with CAD not participating in cardiac rehabilitation receiving a theory-based motivational counselling intervention were more physically active at follow-up than those receiving usual care. This intervention may extend the reach of cardiac rehabilitation by increasing physical activity in those disinclined to participate in structured programmes.

Does tailoring on additional theoretical constructs enhance the efficacy of a print-based physical activity promotion intervention?

To enhance a previously efficacious individually tailored physical activity (PA) promotion intervention by adding theoretical constructs to the tailored feedback. We randomly assigned 248 healthy, underactive (moderate to vigorous physical activity [MVPA] min/week < 90) adults (mean age = 48.8 years, SD = 10.0) to receive either (a) a theoretically tailored (based on 5 constructs from the transtheoretical model and social-cognitive theory [SCT]) print-based PA promotion intervention (print) or (b) the same theoretically tailored print-based PA promotion intervention plus enhanced tailoring addressing 5 additional SCT constructs (enhanced print). The 7-day physical activity recall administered at baseline, Month 6, and Month 12, with outcomes operationalized as percentage achieving 150 min/week of MVPA. When controlling for covariates, there was a nonsignificant trend in favor of the enhanced print condition reflecting 46% and 50% greater odds of achieving 150 min/week of MVPA at Month 6 and Month 12, respectively. Enhanced tailoring based on additional theoretical constructs may result in marginal improvements in physical activity outcomes.

Abstract PD08-09: Impact of a Telephone-Based Exercise Intervention on Physical Activity Behaviors and Fitness in a Cooperative Group Setting

Abstract Observational studies have demonstrated a 30-50% lower risk of disease-specific and overall mortality in physically active breast and colorectal cancer patients as compared to sedentary individuals. However, there have been no randomized trials looking at the impact of physical activity on cancer outcomes, and the optimal design of such a trial is not yet well-defined. The Active After Cancer Trial (AACT) is a multicenter feasibility study designed to evaluate the ability of a telephone-based intervention to increase physical activity in patients with breast and colorectal cancer. Methods: Sedentary (reporting less than 60 minutes/week of recreational activity) individuals with stage I-III breast or colorectal cancer were eligible for enrollment after completion of all adjuvant chemotherapy and radiation. Participants were randomized 1:1 to a centralized telephone coaching intervention, with a target goal of 180 minutes/week of physical activity, or to a usual care control group. Intervention participants received an average of 10 telephone contacts over 16-weeks. Initial calls focused upon building self-efficacy and later calls concentrated upon relapse prevention and maintenance of exercise behaviors. Participants underwent assessment of physical activity behaviors (7-Day Physical Activity Recall), fitness (6-Minute Walk Test), physical functioning (EORTC QLQ C-30), fatigue (FACIT) and exercise self-efficacy at baseline and 16 weeks after enrollment. Results: One hundred and twenty-one patients were enrolled through 10 Cancer and Leukemia Group B (CALGB) institutions; 100 patients had breast cancer and 21 had colorectal cancer. Average age was 54.3, 74% of patients had received chemotherapy and mean time since completion of adjuvant treatment was 24 months. Participants randomized to the exercise group experienced significant improvements in fitness and physical functioning as compared to controls. Table. Baseline measures and change (post-minus pre) scores in intervention and control patients (±SD) Intervention participants also reported a doubling in minutes of weekly physical activity, but this was not a significant increase compared to controls. Conclusions: Sedentary breast and colorectal cancer survivors can be enrolled in a physical activity intervention. A centralized telephone coaching intervention successfully increased fitness and physical functioning, although self-reported exercise time was not significantly changed. A large-scale clinical trial within the co-operative groups is feasible. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD08-09.

Computerized Tailored Physical Activity Reports: A Randomized Controlled Trial

Background Computerized, tailored interventions have the potential to be a cost-effective means to assist a wide variety of individuals with behavior change. This study examined the effect of computerized tailored physical activity reports on primary care patients' physical activity at 6 months. Design Two-group randomized clinical trial with physicians as the unit of randomization. Patients were placed in the intervention (n=187) or control group (n=207) based on their physician's assignment. Setting/participants Primary care physicians (n=22) and their adult patients (n=394) from Philadelphia PA. The study and analyses were conducted from 2004 to 2010. Intervention The intervention group completed physical activity surveys at baseline, 1, 3, and 6 months. Based on their responses, participants received four feedback reports at each time point. The reports aimed to motivate participants to increase physical activity, personalized to participants' needs; they also included an activity prescription. The control group received identical procedures, except that they received general reports on preventive screening based on their responses to preventive screening questions. Main outcome measures Minutes of physical activity measured by the 7-Day Physical Activity Recall interview at 6 months. Results Participants were 69% female, 59% African-American, and had diverse educational and income levels; the retention rate was 89.6%. After adjusting for baseline levels of activity and gender, there were no differences in physical activity at 6 months. The intervention group increased their total physical activity by a mean of 139 minutes; the control group had a mean increase of 109 minutes (p=0.45). Conclusions Although physical activity increased within both groups, computerized tailored physical activity reports did not significantly increase physical activity between groups at 6 months among ethnically and socioeconomically diverse adults in primary care. Computerized, tailored interventions have the potential to be a cost-effective means to assist a wide variety of individuals with behavior change. This study examined the effect of computerized tailored physical activity reports on primary care patients' physical activity at 6 months. Two-group randomized clinical trial with physicians as the unit of randomization. Patients were placed in the intervention (n=187) or control group (n=207) based on their physician's assignment. Primary care physicians (n=22) and their adult patients (n=394) from Philadelphia PA. The study and analyses were conducted from 2004 to 2010. The intervention group completed physical activity surveys at baseline, 1, 3, and 6 months. Based on their responses, participants received four feedback reports at each time point. The reports aimed to motivate participants to increase physical activity, personalized to participants' needs; they also included an activity prescription. The control group received identical procedures, except that they received general reports on preventive screening based on their responses to preventive screening questions. Minutes of physical activity measured by the 7-Day Physical Activity Recall interview at 6 months. Participants were 69% female, 59% African-American, and had diverse educational and income levels; the retention rate was 89.6%. After adjusting for baseline levels of activity and gender, there were no differences in physical activity at 6 months. The intervention group increased their total physical activity by a mean of 139 minutes; the control group had a mean increase of 109 minutes (p=0.45). Although physical activity increased within both groups, computerized tailored physical activity reports did not significantly increase physical activity between groups at 6 months among ethnically and socioeconomically diverse adults in primary care.

025 Lifestyle and health related quality of life changes in coronary and high CVD risk patients and their partners attending the MYACTION integrated vascular prevention programme in the community

Background Based on EUROACTION, we developed MYACTION, a novel community-based preventive cardiology programme for the UK NHS. It integrates preventive care of patients with CHD, traditionally managed in hospital programmes, with asymptomatic high risk individuals (eg, those at high total risk of developing CVD identified at Health Checks, or with diabetes) from primary care. It is family focussed and actively recruits the partners of all patients to the programme which includes a professional lifestyle intervention, and appropriate risk factor management, all undertaken in a community leisure facility. Methods Coronary patients (COR) from hospital and high risk individuals (HRI) with a CVD risk >20% over 10 years from primary care were invited with their partners to attend the programme. The initial assessment (IA) by cardiac specialist nurse, dietitian and physical activity specialist supported by a preventive cardiologist included measurements of dietary habits (Mediterranean diet score:MDS), physical activity (7-day physical activity recall), anthropometry, risk factors and HRQoL (Hospital Anxiety and Depression Scale, Dartmouth Coop and EQ-VAS). The 16-week programme included one to one lifestyle and risk factor management, educational workshops and supervised exercise sessions. All patients and partners had lifestyle and risk factor measurements made at IA and then at end of programme (EOP). Results Eighty-seven COR (61.3% of those referred) and 119 HRI (72.6%) attended with 93 partners (59.6%). 59 COR (67.8%), 85 HRI (71.4%) and 58 (63.0%) partners attended the EOP. 5 (25%) out of 20 COR, HRI and partners who were cigarette smokers had stopped smoking at EOP. Mean MDS improved significantly in COR +1.56, (95% CI 1.0 to 2.1), HRI + 1.3 (0.9 to 1.7) and partners + 1.4 (1.0 to 1.9). Proportions achieving physical activity guidelines improved significantly in COR + 47.2% (95% CI 31.8 to 62.5), HRI + 54.7% (40.9 to 68.4) and partners + 44.9% (28.9 to 60.9). Mean BMI and waist circumference were significantly reduced in COR: BMI −0.3 (−0.6 to −0.6) and waist −1.0 cm (−2.0 to −0); and HRI: BMI −0.7 (−0.8 to −0.2) and waist −2.4 cm (−3.4 to −1.5); and partners: BMI −0.4 (−0.8 to −0.1) and waist −1.9 (−2.8 to −1.1). Median anxiety scores were significantly reduced in COR: 6 (2.5,11) to 5 (2,8) but not in HRI and partners. Median depression scores were significantly reduced in COR: 3 (2,6.5) to 2 (1,5) and HRI: 3 (1,6) to 2 (1,5). Median total Dartmouth Coop scores were significantly reduced in COR: 21 (17,27) to 18 (15,23) and HRI: 18 (15,22) to 16 (13.5,20.5). EQ-VAS scores were significantly improved in COR: 70 (50,80) to 75 (68,80), in HRI: 72.5 (60,80) to 77 (70,88) and in partners: 75 (60,80) to 80 (70,90). Conclusions The MYACTION programme achieved real improvements in lifestyle, obesity management and in patient reported HRQoL outcomes. These results demonstrate that this novel programme is effective in reducing total CVD risk.

Healthy eating and active living program level 1 (HEAL) for breast cancer survivors.

e19645 Background: Breast cancer survivors often suffer treatment-related side effects, including fatigue, reduced physical function, and physical fitness. We designed a Healthy Eating and Active Living Level 1 (HEAL-1) program to introduce breast cancer survivors with self-management strategies to improve their physical and dietary lifestyle to achieve better cancer-related outcomes. Methods: We assess the effect of a multidisciplinary 6-week program on functional outcomes of breast cancer survivors. Women (N=10) with breast cancer who completed radiation and/or chemotherapy were assessed at three time points: 6 weeks prior to (pre-program), immediately before (baseline), and immediately after the program (post-program). The program involves a dietitian, fitness instructor, psychologist and physical therapist. All participants were evaluated on their fatigue (FACIT-Fatigue), physical function (6-Minute Walk Test (6MWT), Tandem Walk Test, 8-foot walk speed test), physical fitness (blood pressure, resting heart rate, strength, and flexibility), physical activity (7-day Physical Activity Recall), and food intake (3-day food diary). Each participant was provided with a pedometer and a log to record their daily steps counts. Results: The participants' mean age was 52.5 years (43 to 65). All had completed radiation and/or chemotherapy within one year. There was a significant improvement over time in fatigue (p<0.004), 6MWT (p<0.004), blood pressure (p<0.021), and resting heart rate (p<0.001), with fatigue having continued significant improvement between baseline and post-program compared to between pre-program and baseline. All other variables demonstrated an improvement trend over time. Conclusions: Preliminary findings show overall improvement trend in all aspects of functional outcome. Interestingly, fatigue, some physical function and physical fitness improve even within a short duration. We conclude that participation in an introductory lifestyle change program such as the HEAL-1 program has immediate short-term benefits. Long-term benefits will require further investigation. No significant financial relationships to disclose.

Testing The Efficacy Of An Enhanced, Individually Tailored, Theory-based, Print-delivered Exercise Promotion Intervention

Non-face-to-face interventions can have substantial public health impact given their high reach at relatively low cost. Individually tailored print-based exercise promotion interventions have been moderately successful; however, the content of individually tailored interventions has typically been based on a limited number of psychosocial constructs. PURPOSE: To compare our previously supported individually tailored print-based exercise promotion intervention based on the transtheoretical model and a limited number of social cognitive theory (SCT) variables (e.g., self-efficacy) to an enhanced version, which more fully incorporated SCT variables (e.g., planning, goal setting, self-monitoring, outcome expectancies). METHODS: This study was a randomized controlled trial of 248 healthy, previously sedentary adults, who were predominantly female (87.1%) and Non-Hispanic White (80.2%), with average age of 46.8 years. Participants were randomized to one of two 12-month exercise promotion programs. The 7-day physical activity recall (PAR) interview was completed at baseline, 6 and 12 months by a research assistant who was blinded to treatment condition. PAR data were transformed into a dichotomous variable representing meeting or not meeting the ACSM criteria for moderate intensity exercise (i.e., > 150 min/week). RESULTS: After adjusting for covariates, probability of meeting ACSM criteria for the tailored print versus enhanced tailored print interventions was 27% versus 39% (p =.18) at 6 months and 14% versus 21% at 12 months (p =.23). CONCLUSIONS: The enhancements to our previous print-based intervention did not result in significant differences in percent of participants meeting ACSM guidelines. However, given the potential for broad reach of the intervention, and the low cost of additional program enhancements, the impact of the intervention could be large, and thus dissemination of the enhanced intervention is warranted.

Racial Differences in Body Composition and Physical Activity Levels in College-Age Females

Overweight and obesity rates have continued to rise among all age groups and races in the United States. While physical activity levels among women increased 9% to 47% from 2001-2005, this did not prevent a rise in obesity rates, as they increased over this time period. The CDC estimates that 32% of females 18-24 years of age engage in leisure time activity. When examined by race, 35% of white, not Hispanic or Latino, and 25% of black, not Hispanic or Latino, females are regularly active. PURPOSE: The purpose of the present investigation was to examine the relationships between body composition and physical activity levels among black and white college-age females. METHODS: 83 college-age black (n=27, 19.0±0.7 years) and white (n=56, 18.7±0.7 years) females were recruited to participate in this study (18.8±0.7 years). Body composition (%Fat) was examined via Dual Energy X-ray Absorptiometry. Physical activity (PA) was measured via 7-day pedometer counts, while bouts of total, light, moderate and vigorous activity were assessed using a 7-day PA Recall. RESULTS: Black college-age females demonstrated higher weight (75.7±19.4 kg), %Fat (32.1±1.6%), body mass index (28.1±6.0 kg/m2), waist circumference (80.7±12.4 cm) and hip circumference (107.0±13.5 cm) when compared to their white counterparts (64.4±10.3 kg, 27.8±0.6%, 23.4±3.5 kg/m2, 73.3±0.1 cm, 98.4±7.1 cm, respectively). Additionally, when compared to white females, black females reported significantly lower PA levels (11494±417 steps vs. 8093±580 steps) and reduced bouts of total, moderate and vigorous intensity activity (13.5±0.8, 4.9±0.5, 3.3±0.3 bouts/week vs. 9.7±1.2, 2.7±0.5, 2.1±0.4 bouts/week). Our data reflect national statistics with white females being more active than black females, as 68% of white and 52% of black females were physically active (>150 min/wk) in our sample. No relationship existed between PA (steps or activity bouts) and body composition in either race (all p>0.05). When controlling for PA, racial differences remained, with whites having better body composition than blacks. CONCLUSION: White college-age females have improved body composition and activity levels compared to their black counterparts. However, the higher activity level in whites does not appear to account for the racial differences in body composition.

The Effect of Iron Supplementation During Menses on Iron Markers and Performance in Active Females

Fifty percent of all active females may have some form of iron deficiency, which could lead to a compromise in athletic performance. PURPOSE: The purpose of the study was to determine the effect of 7 days iron supplementation during menses on blood markers for iron status, high intensity exercise performance, and heart rate recovery (HRREC). METHODS: Twenty five active females (age=21.1 yrs, VO2max ≥ 45 mL.kg-1.min-1 or 8 hrs vigorous training/week) completed a Yo-Yo Intermittent Recovery Test Level 2 (YY2) and a blood draw before and after 7 days of iron supplementation (IRON, 65mg ferrous sulfate N=9), or a placebo (PLC, N=16). Blood was analyzed for blood lactate, hemoglobin (Hb), serum ferritin (sFer) and Hematocrit. Participants also completed a 7-day physical activity recall, O'Connor subjective fatigue scales (PF), muscle soreness scale (MS), and a supplement adherence journal. Heart rate was monitored before, during and after the YY2. RESULTS: There were no significant differences between IRON and PLC groups at baseline. ANOVA indicated significant differences between groups in sFer (p= 0.008) and Hb (p= 0.040) following 7 days of treatment. MS tended to decrease in IRON (p=0.052) and increase in PLC (p=0.051). CONCLUSION: One week of treatment had a positive effect on sFer and Hb levels in the IRON group. The impact of iron supplementation on MS, HRREC, PF and YY2 remains unclear at this time. Funded by Morrison Bruce Center and JMU CISAT Mini Grant Award.

The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial

Background: Recent systematic reviews have suggested that pedometers may be effective motivational tools to promote walking. However, studies tend to be of a relatively short duration, with small clinical based samples. Further research is required to demonstrate their effectiveness in adequately powered, community based studies. Objective: Using a randomized controlled trial design, this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts, self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations. Method: Sixty-three women and 16 men (49.2 years ± 8.8) were randomly assigned to either an intervention (physical activity consultation and 12-week pedometer-based walking program) or control (no action) group. Measures for step-counts, 7-day physical activity recall, affect, quality of life (n = 79), body mass, BMI, % body fat, waist and hip circumference (n = 76), systolic/diastolic blood pressure, total cholesterol and HDL cholesterol (n = 66) were taken at baseline and week 12. Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data. Results: Significant increases were found in the intervention group for step-counts (p < .001), time spent in leisure walking (p = .02) and positive affect (p = .027). Significant decreases were found in this group for time spent in weekday (p = .003), weekend (p = .001) and total sitting (p = .001) with no corresponding changes in the control group. No significant changes in any other health outcomes were found in either group. In comparison with the control group at week 12, the intervention group reported a significantly greater number of minutes spent in leisure time (p =

A Culturally Adapted Physical Activity Intervention for Latinas: A Randomized Controlled Trial

In the U.S., Latinos report particularly high levels of inactivity and related chronic illnesses and are in need of intervention. Thus, the purpose of the current study was to culturally and linguistically adapt an empirically supported, individually tailored physical activity print intervention for Latinos and then conduct an RCT of the modified program. An RCT was conducted. The sample included 93 overweight/obese (80%) Latinas with low income and acculturation. Data were collected in 2007-2008 and analyzed by intent-to-treat in 2009. Participants were randomly assigned to either (1) a culturally and linguistically adapted physical activity intervention (Seamos Activas) or (2) a wellness contact control condition. Self-report physical activity, as measured pre- and post-intervention (6 months, 87% retention) by the 7-Day Physical Activity Recall. Moderate-intensity (or greater) physical activity increased from an average of 16.56 minutes/week (SD=25.76) at baseline to 147.27 (SD=241.55) at 6 months in the intervention arm (n=45), and from 11.88 minutes/week (SD=21.99) to 96.79 (SD=118.49) in the wellness contact control arm (n=48). No between-group differences were seen in overall physical activity. Intervention participants reported significantly greater increases in cognitive (F[1, 91]=9.53, p=0.003) and behavioral processes of change (F[1, 91]=8.37, p=0.005) and available physical activity supplies and equipment at home (F[1, 91]=4.17, p=0.04) than control participants. Results supported the hypothesized feasibility, acceptability, and preliminary efficacy of individually tailored physical activity print interventions among Latinas. Although more research is needed to corroborate these findings, such high-reach, low-cost approaches have great potential to positively affect public health. NCT00724165.

Dancing to a different tune: The predictive utility of the theory of planned behaviour when the behaviour is constrained

Objective The predictive utility of the Theory of Planned Behaviour (TPB) was tested in a fit, healthy population who were required to exercise regularly. Four physical activity behaviours were examined: one volitional behaviour (dancing) and three activities offered during daily physical training (PT, i.e. running, swimming, team sport). Method RAF trainee aircraftsmen ( N = 186) completed a questionnaire assessing TPB constructs and past behaviour, followed by a 7-day Physical Activity Recall interview. Participants repeated the behaviour measures one-week later. During the week prior to participation, participants were “free living” and did not have to take PT sessions; during the week between measurement sessions, participants were on base, and so had to complete a compulsory 90 min exercise session, although they were free to choose the specific PT activity. Results While intentions were well predicted for all behaviours, the TPB variables explained more of the variance for the volitional behaviour (19.6%) than for constrained behaviours (average 3.5%). Addition of past behaviour resulted in minimal improvement of the existing TPB model of intention and future behaviour for all measured physical activities. Conclusion The TPB appears unsuitable for prediction of physical activity when behaviours are constrained by external influences, but appropriate when they are not. Using an assessment of past behaviour during a period when behaviour had different constraints on it than during the period of behaviour being predicted dramatically reduced the contribution of past behaviour compared to previous research.

When Adolescents Drop the Ball: Sustainability of Physical Activity in Youth

A majority of youth do not attain the recommended levels of physical activity. To develop interventions that will be more efficient at enabling healthy levels of physical activity during adolescence, a better understanding is needed about which specific types of physical activity adolescents are more likely to sustain and when they tend to stop participating in each specific type of activity. From 1999 to 2005, 1276 adolescents, initially aged 12-13 years, completed a 7-day physical activity recall every 3 months during each of 5 years of secondary school. The prevalence of participation in each of 29 specific physical activities in each of Grades 7-11 was computed. Survival analyses were used to estimate when adolescents who reported each activity at baseline tended to discontinue the activity. All analyses were conducted in 2008. The prevalence of participation in most activities declined over the 5 years; it did not increase for any activity. Within 2 years of baseline, the majority of adolescents discontinued participation in most activities in which they had reported participation at baseline. Sustained participation in a specific activity related both to its intensity (90%, 73%, and 40% of girls and 77%, 86%, and 60% of boys sustained participation in light-, moderate-, and vigorous-intensity activities, respectively) and its format (41% and 89% of girls and 69% and 90% of boys sustained participation in team and individual physical activities, respectively). Participation in almost all physical activities declined during adolescence. The time of discontinuation varied across activity types. Promoting activities that attract and sustain secondary school students may improve physical activity levels throughout adolescence.

Evaluation of a standard provision versus an autonomy promotive exercise referral programme: rationale and study design

BackgroundThe National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation.Methods/DesignDesign: An exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT) exercise on prescription intervention.Participants: 347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n = 7) or to the SDT-based intervention (n = 6).Outcomes measured at 3 and 6-months: Minutes of moderate or vigorous physical activity per week assessed using the 7-day Physical Activity Recall; physical health: blood pressure and weight; health status measured using the Dartmouth CO-OP charts; anxiety and depression measured by the Hospital Anxiety and Depression Scale and vitality measured by the subjective vitality score; motivation and processes of change: perceptions of autonomy support from the advisor, satisfaction of the needs for competence, autonomy, and relatedness via physical activity, and motivational regulations for exercise.DiscussionThis trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model (perceived autonomy support, need satisfaction, motivation regulations, outcomes) via structural equation modelling.Trial registrationThe trial is registered as Current Controlled trials ISRCTN07682833.

Comparing the 7-Day Physical Activity Recall with a Triaxial Accelerometer for Measuring Time in Exercise

The primary study aim was to evaluate associations of estimated weekly minutes of moderate-to-vigorous-intensity exercise from self-reports of the telephone-administered 7-Day Physical Activity Recall (7-Day PAR) with data captured by the RT3 triaxial accelerometer. This investigation was undertaken as part of the FRESH START study, a randomized clinical trial that tested an iteratively tailored diet and exercise mailed print intervention among newly diagnosed breast and prostate cancer survivors. A convenience sample of 139 medically eligible subjects living within a 60-mile radius of the study center provided both 7-Day PAR and accelerometer data at enrollment. Ultimately, substudy subjects (n = 115) were found eligible for the FRESH START study and randomized to one of two study treatment arms. Follow-up assessments at year 1 (n = 103) and year 2 (n = 99) provided both the 7-Day PAR and the accelerometer data. There was moderate agreement between the 7-Day PAR and the accelerometer with longitudinal serial correlation coefficients of 0.54 (baseline), 0.24 (year 1), and 0.53 (year 2), all P values <0.01, although the accelerometer estimates for weekly time in moderate-to-vigorous physical activity (PA) were much higher than those of the 7-Day PAR at all time points. The two methods were poorly correlated in assessing sensitivity to change from baseline to year 1 (rho = 0.11, P = 0.30). Using mixed models repeated-measures analysis, both methods exhibited similar nonsignificant treatment arm x time interaction P values (7-Day PAR = 0.22, accelerometer = 0.23). The correlations for three serial time points were in agreement with findings of other studies that compared self-reported time in exercise with PA captured by accelerometry. However, these methods capture somewhat different dimensions of PA and provide differing estimates of change over time.