Activity Advice Research Articles

Physical activity and exercise in peritoneal dialysis: International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations.

Life participation requiring physical activity and physical function is a key patient-reported outcome for people receiving peritoneal dialysis (PD). Clinician guidance is required from multidisciplinary sources regarding exercise and activity advice to address the specific needs of this group. From August 2020 through to June 2021, the Global Renal Exercise Network and the International Society for Peritoneal Dialysis reviewed the published literature and international clinical experience to develop a set of clinical practice points. A set of questions relevant to physical activity and exercise were developed from the perspective of a person receiving PD and were the basis for the practice point development. The GRADE framework was used to evaluate the quality of evidence and to guide clinical practice points. The review of the literature found sparse quality evidence, and thus the clinical practice points are generally based on the expert consensus of people receiving PD, PD exercise expert clinicians and experienced PD exercise researchers. Clinical practice points address timing of exercise and activity (post-catheter insertion, peritoneal space empty or full), the uptake of specific activities (work, sex, swimming, core exercise), potential adverse outcomes related to activity and exercise (exit site care, perspiration, cardiovascular compromise, fatigue, intra-abdominal pressure), the effect of exercise and activity on conditions of interest (mental health, obesity, frailty, low fitness) and exercise nutrition.

Impact of a National Peer-Led Training Program to Increase Brief Physical Activity Advice Given to Patients by Health Care Professionals.

The benefits of physical activity for preventing and managing long-term health conditions are well established and health care professionals could promote physical activity to patients. The current study aims to evaluate the impact of the Clinical Champions Physical Activity Training Program. Health care professionals attend a one-off in-person training session delivered by a trained Clinical Champion. Attendees at the Clinical Champions Physical Activity Training Program were asked to complete a baseline survey prior to the training session and follow-up surveys 4 and 12 weeks posttraining. A total of 5945 training attendees completed the baseline survey. A total of 1859 and 754 participants completed 4- and 12-week follow-up (31.3% and 12.7% response rate, respectively). Significant increases in confidence to deliver brief physical activity advice and knowledge of physical activity guidelines were reported at 12 weeks (P < .001). The perceived frequency of physical activity discussions with patients significantly increased (P < .001). Twelve weeks after training, fewer barriers in promoting physical activity were reported. The evaluation of the Clinical Champions Physical Activity Training Program demonstrated an increase in knowledge of physical activity guidelines, levels of confidence, and frequency of delivery of brief physical activity advice to patients. Further research is required to determine if this impact translates into changes to patients' physical activity behavior.

Influences on the use of digital tools in primary care to deliver physical activity advice

Abstract Background Increasing physical activity is a public health priority. The unique and critical role of healthcare professionals (HCPs) in primary care to help address physical inactivity is explicitly identified by various national physical activity (PA) frameworks. Yet, there may be various obstacles to the delivery of PA advice, such as lack of time, lack of confidence and lack of knowledge of where to refer people for further support. Digital technology provides new opportunities and has the potential to facilitate PA advice. However, it is unknown if and how digital tools are used within the context of primary care. The aim of the study was to understand the use of digital tools to support primary care consultations. Methods Twenty-five semi-structured interviews were conducted with HCPs in primary care. Data were analysed using thematic analysis to identify influences on the use of digital tools. Next, the themes were categorised using the COM-B model of behaviour to identify barriers and/or enablers to using digital tools to support the delivery of PA advice. Results The most prominent barriers and enablers related to included having the digital skills to use the systems, understanding of the PA assessment and advice, and the ability to tailor the tool to the HCPs needs. The opportunity factors included the limited digital resources available, organisational culture, and environmental stressors. The motivational influences included the level of familiarity with the tool, the confidence to use it, beliefs about a tool's usefulness, and professional identity. Conclusions A variety of influences were identified on the use of digital tools to support primary care consultations to deliver PA advice. These findings provide a foundation to design a system that addresses the barriers and leverages the facilitators to the efficient use of digital tools that support PA advice provision within the primary care context. Key messages There are various influences on the use of digital tools to support the provision of PA advice within primary care consultations, including skills, environmental and social factors, and motivation. The use of behaviour change theory allows us to systematically identify what barriers need to be addressed to assist HCPs in providing PA advice using efficient and flexible digital support tools.

Service Provider Hesitation in Credence Services: The Importance of Customer Expectations?

This research examines a novel reason for service providers withholding aspects of optimal service quality: hesitation. Previous research has shown that physiotherapists often hold back on delivering non-treatment based physical activity (NTPA) advice over concerns that it is not welcomed by patients. Using a survey method (N = 587), we found that users and non-users of physiotherapy find it likely and important to receive NTPA advice; NTPA is also positively linked to satisfaction. This study debates hesitation as a possible disconnect between customer expectations of value that is co-created in the physiotherapy clinic (“joint sphere”) vs. the outside of the clinic (“customer sphere”).

Physical Activity Advice for Prevention and Rehabilitation of Low Back Pain- Same or Different? A Study on Device-Measured Physical Activity and Register-Based Sickness Absence

Purpose We lack knowledge on whether the advice of “being physically active” should be the same for prevention and rehabilitation of low back pain (LBP). Sickness absence is a key outcome for LBP prevention and rehabilitation. We investigated the associations between physical activity and long-term sickness absence (LTSA) among employees with and without LBP. Methods Between 2011 and 2013, 925 Danish employees wore a Actigraph GTX3 accelerometer for 1–5 workdays to measure physical activity and reported LBP in past 7 days. Employees were followed for 4 years to determine their first register-based LTSA event (≥ 6 consecutive weeks). Results Among employees with LBP, increasing moderate-to-vigorous-intensity physical activity at work by 20 min and decreasing the remaining behaviors at work (ie., sitting, standing and light-intensity activity) by 20 min was associated with 38% (95% CI 17%; 63%) higher LTSA risk. Increasing light-intensity activity at work by 20 min and decreasing 20 min from the remaining behaviors was associated with 18% (95% CI 4%; 30%) lower risk. During leisure, increasing moderate-to-vigorous-intensity activity by 20 min or standing by 40 min was associated with 26% (95% CI 3%; 43%) lower and 37% (95% CI 0%; 87%) higher risk, respectively. Among employees without LBP, we found no such associations. Conclusions The physical activity advice ought to be different for LBP prevention and rehabilitation to reduce LTSA risk, and specified by domain and activity intensity. At work, employees with LBP should be advised to spend time on light-intensity physical activity and limit their time on moderate-to-vigorous-intensity physical activity. During leisure, employees should spend time on moderate-to-vigorous-intensity physical activity.

Online training resources to aid therapeutic radiographers in engaging in conversations about physical activity and diet: A mixed methods study

IntroductionThis study explored changes in therapeutic radiographers’ (TRs) self-reported knowledge and skills to engage in conversations about physical activity and diet with people living with and beyond cancer following completion of publicly available online courses. MethodsParticipants were randomly assigned to two of five online courses that aim to support health professionals to engage in conversations about physical activity and diet in the oncology setting. Participants rated their agreement with 18 statements related to the COM-B (capability, opportunity and motivation-behaviour) model components following completion of an online course on healthy diet (n = 16) and physical activity (n = 21). Semi-structured telephone interviews (n = 21) were also conducted. Analysis of the interviews was guided by the Theoretical Domains Framework. ResultsOverall, the online courses were acceptable and the TRs in this study self-reported improved COM to deliver advice on physical activity and diet. The inclusion of the evidence and scientific rationale on the benefits of diet and physical activity, and also guidance on how to start conversations with patients were highlighted as important features of the courses. Suggestions for adaptations to the nutrition courses included the need for content that accounts for the side effects cancer patients experience while undergoing treatment. To support the implementation of training and the delivery of advice on these topics, multi-disciplinary working, organisational support and guidance around professional role boundaries were highlighted as important. ConclusionCurrent publicly available online courses on physical activity and diet for oncology health professionals can reduce some barriers among TRs to providing advice to those living with and beyond cancer. Implications for practiceExisting online training courses could be used to support TRs to deliver physical activity and dietary advice in practice. Findings show that these courses can be disseminated within radiotherapy departments. The results also highlight a number of important considerations for the implementation of brief health behaviour advice and online training interventions on physical activity and diet within cancer care.

Reported practices related to, and capability to provide, first-line knee osteoarthritis treatments: a survey of 1064 Australian physical therapists

BackgroundPhysical therapists play a key role in providing first-line knee osteoarthritis treatments, including patient education and exercise therapy. ObjectivesDescribe Australian physical therapists’ awareness of guidelines; reported practices; and beliefs about capability, opportunity, motivation, and evidence. MethodsAn online cross-sectional survey was completed by physical therapists prior to attending the Good Living with osteoArthritis from Denmark (GLA:D®) Australia training courses (March 2017 to December 2019). The survey instrument was developed by an expert panel and was informed by the Theoretical Domains Framework. Results1064 physical therapists from all Australian states and territories participated. 11% (n = 121) could name an accepted guideline, 98% agreed it was their job to deliver patient education and exercise therapy, and 92% agreed this would optimise outcomes. Most reported providing strength exercise (99%), written exercise instructions (95%), treatment goal discussion (88%), and physical activity advice (83%) all or most of the time. Fewer provided aerobic exercise (66%), neuromuscular exercise (54%), and weight management discussion (56%) all or most of the time. Approximately one quarter (23–24%) believed they did not have the skills, knowledge, or confidence to provide education and exercise therapy recommended by guidelines, and just 48% agreed they had been trained to do so. ConclusionAustralian physical therapists treating knee osteoarthritis typically provide strength-based home exercise with written instructions, alongside goal setting and physical activity advice. Just one in nine could name a guideline. Education and training activities are needed to support physical therapists to access, read and implement guidelines, especially for aerobic and neuromuscular exercise, and weight management.

Factors associated with lack of improvement in submaximal exercise capacity of patients with heart failure.

AimsImprovement in exercise capacity is the primary goal of physical activity programmes for patients with heart failure (HF). Although activity programmes are effective for some patients, others do not benefit. Identifying factors related to a lack of improvement in submaximal exercise capacity may help us interpret findings and design new interventions. The aim of this study is to identify factors contributing to a lack of improvement in submaximal exercise capacity 3 months after physical activity advice or an exergame intervention in patients with HF. Additionally, we aimed to assess differences in lack of improvement in submaximal exercise capacity of patients whose baseline exercise capacity predicted a worse compared with better prognosis of HF.Methods and resultsThis secondary analysis of the HF‐Wii study analysed baseline and 3 month data of the 6 min walk test (6MWT) from 480 patients (mean age 67 years, 72% male). Data were analysed separately in patients with a pre‐defined 6 min walking distance at baseline of <300 m (n = 79) and ≥300 m (n = 401). Among patients with a baseline 6MWT of ≥300 m, 18% had deteriorated submaximal exercise capacity. In the multiple logistic regression analysis, lower baseline levels of self‐reported physical activity [odds ratio (OR) = 0.77, 95% confidence interval (CI) = 0.60–0.97], lower baseline levels of cognitive function (OR = 0.87, 95%CI = 0.79–0.96) were significantly associated with lack of improvement in exercise capacity at 3 months. Not randomized to exergaming (OR = 0.63, 95%CI = 0.37–1.09) was likely (P = 0.097) to be associated with lack of improvement in exercise capacity at 3 months. Among the 79 patients with baseline 6MWT of <300 m, 41% (n = 32) did not improve 6MWT distance at 3 months. Independent predictors for the lack of improvement for 6MWT were New York Heart Association class III/IV (OR = 4.68, 95%CI = 1.08–20.35), higher levels of serum creatinine (OR = 1.02, 95%CI = 1.003–1.03), lower cognitive function (OR = 0.86, 95%CI = 0.75–0.99), and fewer anxiety symptoms (OR = 0.84, 95%CI = 0.72–0.98).ConclusionsLower self‐reported physical activity and cognitive impairment predict lack of improvement in submaximal exercise capacity in HF patients. Patients who have a worse prognosis (score <300 m at the 6MWT) are often frail and gain less in exercise capacity. These patients may need a more comprehensive approach to have an effect on exercise capacity, including an individually tailored exercise programme with aerobic exercise (if tolerated) and strength exercises.

Retrospective review of pyrocarbon radial head replacement

Radial head arthroplasty is the preferred surgical management for complex, unreconstructable radial head fractures. There has been increasing use of pyrocarbon prostheses, with potential tribology and modulus advantages over metallic counterparts. This study aims to assess clinical and radiological outcomes for radial head replacement after trauma using a modular, uncemented pyrocarbon prosthesis. Between September 2009 and March 2020, a consecutive series of 22 trauma cases were available for review. Patients underwent radial head arthroplasty using a pyrocarbon prosthesis (Ascension Modular Radial Head System, Austin, TX). Recorded outcomes included clinical assessment, radiological evaluation, and patient-reported outcome measures specific to elbow function. Twenty-two patients (7 male, 15 female) with an average age of 51 years (range 21-64) were analyzed with a minimum 12 months of follow-up. All patients had complex radial head fractures, categorized as a Mason 3 or 4 injury. At follow-up, mean elbow range of motion included flexion 130° (range 100°-150°), extension 19° (0-50°), pronation 73° (30°-90°), and supination 70° (10°-90°). The mean Mayo Elbow Performance Index score was 83 (55-100), and Disabilities of the Arm, Shoulder and Hand score was 22 (2.5-60). Radiological evaluation showed 14 patients with asymptomatic proximal neck resorption and two patients with radiological stem loosening. In total, 3 of 22 implants were revised-2 were excised, and 1 revised to a long stem for traumatic implant fracture. Pyrocarbon radial head arthroplasty provided reliable functional results for patients after unreconstructable radial head fracture. The unique potential for fracture of the prosthesis should be considered in long-term follow-up, with appropriate activity advice to patients.

Do Prostate Cancer Survivors Want To Receive Physical Activity Advice From Their Physicians?

Do Prostate Cancer Survivors Want To Receive Physical Activity Advice From Their Physicians?

Correlates Of Receiving Physical Activity Advice In Chinese Patients With Chronic Diseases

Correlates Of Receiving Physical Activity Advice In Chinese Patients With Chronic Diseases

Previous life experiences and social relations affecting individuals wish for support when establishing healthy habits \u2013 a qualitative study of Norwegian Healthy Life Centre participants

BackgroundInterventions to reduce and prevent overweight, obesity and T2D has been advocated worldwide. In Norway, Healthy Life Centres have been established to help individuals to reduce and prevent diseases, offering physical activity and dietary advice to establish healthy habits. Previous life experiences, social support and help from health personnel could play a role in the process of establishing healthy habits. The aim of this study was to explore how two groups of Healthy Life Centre participants described their previous life experiences, social relations and wish for support from Healthy Life Centre personnel.MethodsA qualitative design was used, including 49 individual semi-structured interviews. The interviews for this study were performed in two different samples, one sample of participants applying for HLC participation in 2013 (n = 23) and one sample of participants invited to HLC participation in 2015 (n = 26). The data was analyzed using systematic text condensation.ResultsThree main themes in a chronological (past, present and future) order were identified: 1. Previous life experiences stamping life situation (past time). 2. Social relations being a support or a burden in everyday life (present time) and 3. Expressing wishes for HLC support (future).ConclusionsIn the process of establishing healthy habits, the need for help from personnel may be differentiated based on previous life experiences and present social relations.

Recruitment, Retention and Compliance of Overweight Inactive Adults with Intermediate Hyperglycaemia to a Novel Walking Intervention

This study evaluated the effectiveness of strategies used to recruit and retain overweight, inactive adults with intermediate hyperglycaemia (IHG) to a novel walking programme. Participant compliance to the nine-month randomised controlled trial (RCT) is also presented. Inactive overweight (BMI ≥ 25 kg/m2) adults (N = 42; n = 19 male, n = 23 female) aged between 18–65 years, with IHG were identified via three recruitment strategies (NHS database reviews, diabetic clinics, and a University population). Participants were randomly assigned to either Intervention Group (IG n = 22; n = 11 male, n = 11 female) or Usual Care (UC n = 20; n = 8 male, n = 12 female). IG followed a nine-month novel behaviour change intervention where they walked in accordance with physical activity guidelines using the beat of music to maintain appropriate cadence. UC received standard physical activity advice. Recruitment, retention, and intervention compliance were calculated using descriptive statistics (means or frequencies). Recruiting from a University population was the most successful strategy (64.2% response rate) followed by NHS database reviews (35.8%) and then diabetic clinics (0%). Study retention was ≥80% in both groups throughout the RCT. Intervention compliance was highest from baseline to four months (70.1 ± 39.2%) and decreased as the study progressed (43.4 ± 56.1% at four to six months and 37.5 ± 43.5% at follow-up). In total, 71.4% of IG walking completed throughout the study was at least moderate intensity. A novel walking intervention incorporating the use of music along with behaviour change techniques appears to positively influence the recruitment, retention, and walking compliance of this population.

Physical activity advice in the UK bowel cancer screening setting: qualitative healthcare professional perspectives.

Providing physical activity advice in the bowel cancer screening setting could help to reduce the risk of cancer and cardiometabolic disease in older adults. This study investigated the views of healthcare professionals (HCPs) regarding the provision of physical activity advice as part of the UK Bowel Cancer Screening Programme. A purposive sample of HCPs (aged 22-63 years, with 1-26 years of experience) from four bowel cancer screening disciplines (four endoscopists, four colorectal surgeons, four staff nurses and four specialist screening practitioners) were recruited from a large National Health Service gastroenterology unit. Data collection used individual interviews and focus groups, with topics being guided by an a priori topic guide. All interviews and focus groups were audio-recorded and transcribed verbatim. Three key themes, which contextualize the views and perceptions of HCPs recruited to the study, emerged from the framework analysis: (i) appraisal of the concept; (ii) perceived barriers to implementation; (iii) steps to implementation. While the general concept was viewed positively, there were differences of opinion and a range of perceived barriers were revealed. Ideas for effective implementation were also presented, taking into consideration the need for time efficiencies and importance of optimizing effectiveness. This qualitative study provided important insights into the perceptions of HCPs regarding the provision of physical activity advice in the bowel cancer screening setting, and yielded novel ideas for effective implementation.

Effect of a Smartphone App on Weight Change and Metabolic Outcomes in Asian Adults With Type 2 Diabetes

Lifestyle interventions are effective in diabetes management, with smartphone apps that manage health data and dietary and exercise schedules gaining popularity. However, limited evidence from randomized clinical trials exists regarding the effectiveness of smartphone-based interventions among Asian adults with type 2 diabetes. To compare the effects of a culturally contextualized smartphone-based intervention with usual care on weight and metabolic outcomes. This randomized clinical trial conducted at multiple primary care centers in Singapore included 305 adults with type 2 diabetes and body mass index (BMI) of 23 or greater who had literacy in English and smartphone access. Participants were recruited between October 3, 2017, and September 9, 2019, and were randomly assigned (1:1; stratified by gender, age, and BMI) to intervention (99 participants) or control (105 participants) groups. Participants' data were analyzed using intention-to-treat analysis. Both control and intervention participants received diet and physical activity advice from a dietitian at a baseline face-to-face visit. Intervention participants additionally used a smartphone app to track weight, diet, physical activity, and blood glucose and then communicated with dietitians for 6 months. Primary outcome was change in body weight, while secondary outcomes were changes in hemoglobin A1c (HbA1c), fasting blood glucose, blood pressure, lipids, and diet. Post hoc analyses included glycemic changes in the subgroup with HbA1c levels of 8% or greater and diabetes medication changes. Among the 204 randomized participants (mean [SD] age, 51.2 [9.7] years; 132 [64.7%] men), baseline mean (SD) BMI was 30.6 (4.3). Compared with the control group, intervention participants achieved significantly greater reductions in weight (mean [SD] change, -3.6 [4.7] kg vs -1.2 [3.6] kg) and HbA1c levels (mean [SD] change, -0.7% [1.2] vs -0.3% [1.0]), with a greater proportion having a reduction in diabetes medications (17 participants [23.3%] vs 4 participants [5.4%]) at 6 months. The intervention led to a greater HbA1c reduction among participants with HbA1c levels of 8% or higher (mean [SD] change, -1.8% [1.4] vs -1.0% [1.4]; P = .001). Intergroup differences favoring the intervention were also noted for fasting blood glucose, diastolic blood pressure, and dietary changes. In this study, a smartphone-based lifestyle intervention was more effective in achieving weight and glycemic reductions among Asian adults with type 2 diabetes compared with usual care, supporting the use of apps in lifestyle intervention delivery. anzctr.org.au Identifier: ACTRN12617001112358.

Laying the Foundation for Pregnancy Physical Activity Profiling: A Framework for Providing Tailored Physical Activity Advice and Guidance to Pregnant Women

The aim of this study was to examine the predictive utility of the theory of planned behaviour (TPB) in explaining pregnant women’s physical activity (PA) intentions and behaviour and to scrutinise the role of past behaviour within this context. Pregnant women (n = 89) completed the pregnancy physical activity questionnaire (PPAQ) and newly developed TPB questionnaire on two separate occasions during their pregnancy. Analyses were carried out in relation to three scenarios. Firstly, when considering the original TPB, intention emerged as the strongest determinant of pregnant women’s PA behaviour. Secondly, controlling for past behaviour attenuated the influence of intention and perceived behavioural control on behaviour, with neither of the original variables providing a unique influence. Finally, the addition of past behaviour added significantly to the prediction of intention with the model as a whole, explaining 85% of the variance in pregnant women’s PA intention, and with past behaviour uniquely contributing 44.8% of the variance. Pregnancy physical activity profiling based on intention and behaviour status is subsequently introduced as a novel and practical framework. This provides healthcare professionals with the opportunity and structure to provide tailored advice and guidance to pregnant women, thereby facilitating engagement with PA throughout motherhood.

Physical Activity Advice and Counselling by Healthcare Providers: A Scoping Review.

Background: Despite scientific evidence on prenatal physical activity and exercise, synthesized evidence is lacking on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers. The scoping review seeks to fill this gap by synthesizing available literature on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers to women during antenatal visits. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) search framework for scoping reviews was applied to retrieve original research articles on the prenatal physical activity and exercise practices of healthcare providers with pregnant women, published between 2010–2020, and available in English. The search databases included Google Scholar, PubMed, Science Direct, Scopus, EMBASE, The Cumulative Index for Nursing and Allied Health Literature (CINAHL), BIOMED Central, Medline and African Journal Online. Studies that fulfilled the eligibility criteria were retrieved for analysis. Results: Out of the 82 articles that were retrieved for review, 13 met the eligibility criteria. Seven of the articles were quantitative, four qualitative, one mixed-method and one controlled, non-randomised study, respectively. Three themes emerged as major findings. Healthcare providers affirmed their responsibility in providing prenatal physical activity advice and counselling to pregnant women; however, they seldom or rarely performed this role. Major barriers to prenatal physical activity and exercise included insufficient time, lack of knowledge and skills, inadequate or insufficient training, and lack of resources. Conclusion: This review highlights salient features constraining the uptake of prenatal physical activity and exercise advice/counselling by prenatal healthcare providers in both community and clinical settings. Prenatal physical activity advice and counselling are key components to the promotion of physical activity adherence during and post-partum pregnancy; this requires adequate knowledge of physical activity prescriptions and recommendations, which are personalised and contextual to environment. Research is needed to examine the prenatal physical activity advice and counselling from prenatal healthcare providers on issues hindering effective delivery of the aforementioned in the context of promoting prenatal physical activity in clinical or community settings.

Lifestyle management and compliance in coronary patients: The gender gap. Results from the ESC EORP EUROASPIRE V survey

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Fonds voor hartchirurgie - Fonds pour la Chirurgie Cardiaque OnBehalf EUROASPIRE studygroup BACKGROUND Although previous EUROASPIRE (European Survey Of Cardiovascular Disease Prevention And Diabetes) findings suggest only limited gender differences in the medication intake of coronary patients, the CVD risk factor profile in women remains suboptimal compared to men. Therefore, to further lower the risk of subsequent cardiovascular events, lifestyle behaviour in secondary prevention is crucial. Little is known about gender differences in prescribed lifestyle and patient compliance in tackling lifestyle related risk factor targets. PURPOSE The aim of this study is to identify gender differences in lifestyle prescription and lifestyle compliance after a coronary event. METHODS Analyses were carried out on the ESC EORP EUROASPIRE V survey data, including information from coronary patients recruited in 27 European countries. Consecutive patients &amp;lt;80 years were hospitalized for a CABG, PCI, acute myocardial infarction or acute myocardial ischaemia. Information on lifestyle prescription and lifestyle compliance, were obtained from standardized patient interviews (6 months to 2 years following hospital discharge). Logistic regression analyses adjusting for medical history (stroke, heart failure and diabetes) were performed. RESULTS Data was available for 8261 patients of which 25.8% were women. The mean (SD) age at interview was 62.9 (9.7) years for men and 65.4 (9.2) for women. Overall, no gender differences were observed in smoking cessation advice (85.2% vs. 84.5%; P = 0.90) and in smokers’ attempts to quit smoking (62.6% vs. 63.9%; P= 0.58). Also, no gender differences were observed in dietary advice (85.5% vs. 84.9%; P= 0.32) and in attempts to adopt a healthier diet (87.1% vs. 88.4%; P= 0.14). In contrast, although no gender differences were seen in weight changes among obese patients (60.1% vs. 58.2%; P = 0.49), women were less likely to receive advice on losing weight (75.1% vs. 71.6%; P = 0.02). Interestingly, the latter findings were driven by educational level. Women with a low education level were less likely to receive weight loss advice (71.8% vs. 52.9%; P &amp;lt; 0.001) and a lower proportion of them tried to lose weight (52.3% vs. 36.7%; P &amp;lt; 0.001), while no significant differences were observed in those with a high educational level. Furthermore, women were less likely to receive physical activity advice (63.8% vs. 59.6%; P &amp;lt; 0.001) and a lower proportion of them attempted to increase their physical activity levels (55.5% vs. 48.0%; P &amp;lt; 0.001). CONCLUSION These findings suggest worse lifestyle prescription and lifestyle changes for physical activity in women and worse weight loss prescription and weight loss compliance in low educated but not highly educated women. Specific attention should be given to women with a low educational level. Further quantitative and qualitative research is needed to understand the gender gap in lifestyle management.

P106 Planning and development of a long-term digital self-management tool for osteoarthritis: the Intelligent Knee Osteoarthritis Lifestyle App

Abstract Background/Aims There is strong evidence for beneficial effects of physical activity for people with knee osteoarthritis (KOA). While supervised exercise programmes are effective, they are resource intensive, typically of limited duration and hard to implement at scale. More accessible options should be developed to enable individuals to adopt and maintain appropriate physically active lifestyles. Smartphone apps can monitor activity and symptoms, providing feedback to support self-management. We aimed to co-design a KOA self-management app, with physiotherapists and people experiencing KOA, to support long-term physical activity. Methods We followed the Person-Based Approach to developing health interventions. We initially undertook a rapid review of clinical exercise guidelines and KOA position statements. Views from potential app users were elicited via focus groups, to determine attitudes towards physical activity, KOA self-management technology, and identify desired app features. Physiotherapists were interviewed to establish factors that feed into physical activity advice and recommendations in a clinical context, and determine which features they deemed appropriate to incorporate into an app. We then mapped established behaviour change techniques to potential features. Combining these sources of information, we developed guiding principles, then iteratively developed and refined the app through “think aloud” interviews with potential users and interviews with physiotherapists to assess appropriateness and safety. Results Literature scoping established positive effects for a range of exercise modes, with NICE guidelines highlighting physical activity, education and weight management as core treatments for KOA. Patient focus groups highlighted uncertainty about the potential benefits and/or harms associated with physical activity, as well as confusion regarding appropriate sources of information. Patients emphasised the importance of symptom tracking and the benefits of social support as an important factor in motivation to engage in and sustain activity. Interviews with physiotherapists revealed physical and psycho-social characteristics of patients to consider when recommending physical activities. Physiotherapists and patients both expressed the necessity for activities to be tailored to individual capabilities and preferences. Conclusion The Intelligent Knee Osteoarthritis Lifestyle App (iKOALA) is an evidence-based smartphone app to support long-term self-management for individuals with KOA. The app facilitates appropriate physical activity adoption and maintenance; provides feedback from linked wearable activity trackers; gives information and intelligently tailored physical activity options from patient preferences and symptoms. Broader self-management aspects include rehabilitation exercise content, symptom tracking and alerts, weight management tools and education resources. Crucially, for long-term maintenance, the app includes forum features, fostering social relatedness among users. The app has received positive feedback from potential users in terms of usability and perceived utility. Physiotherapists have provided positive clinical impressions and validated the appropriateness of the content and features. The app is undergoing extended user testing with patients, following which, we aim to assess the effectiveness of the app in a randomised trial. Disclosure E.A. Chowdhury: None. V. Ceballos Inza: None. M.J. Western: None. N.E. Walsh: None. J.L.J. Bilzon: None. S.L. Jones: None.

Recall, perceptions and determinants of receiving physical activity advice amongst cancer survivors: a mixed-methods survey

PurposeThis study explored cancer survivors’ views and experiences of receiving physical activity advice post-diagnosis. We also determined the influence of sociodemographic characteristics on the recall of physical activity advice and whether receiving advice was associated with meeting physical activity guidelines.MethodsAn anonymised, mixed-methods, 27-item survey was distributed to cancer survivors via online cancer communities in the UK.ResultsOf the 242 respondents, 52% recalled receiving physical activity advice. Of those who recalled receiving advice, only 30% received guidance on type of physical activity and 14% were referred to another source of information or exercise specialist. Advice was most often given after treatment cessation, with only 19% of respondents receiving advice during active treatment. Most respondents (56%) expressed a need for further information. There was no evidence of associations between sociodemographic characteristics and recall of physical activity advice. However, cancer survivors who perceived the physical activity advice they received as being appropriate (odds ratio [OR] 3.8, 95% confidence interval [95% CI]: 1.4–10.7) and those with a higher level of education (OR 3.2, 95% CI: 1.8–5.8) were more likely to meet aerobic exercise guidelines. Females were less likely to meet resistance exercise guidelines than males (OR 0.44, 95% CI: 0.21–0.90).ConclusionThere is scope to improve the provision of physical activity advice in cancer care by providing advice in a timely manner after diagnosis, referring patients to a suitable exercise or rehabilitation specialist when indicated, and using a tailored approach to ensure the advice is appropriate for specific sociodemographic groups.