Activity Behavior In Patients Research Articles

Geospatial Applications in Alzheimer’s Disease Research and Beyond: A Systematic Review

With the increasing prevalence and social impacts of Alzheimer’s disease (AD), innovative approaches to our understanding of its etiology, progression, and potential interventions are critical. Geospatial applications are a promising tool in addressing the complex spatial and temporal dynamics of AD. A substantial knowledge gap remains, however, regarding the comprehensive utilization and impact of geospatial applications in AD research. We comprehensively consider the current status of geospatial-information application in AD based on 159 research articles on geospatial applications published between 1991 and 2022 from the Web of Science and PubMed databases. Four main research themes are identified: geographic environmental factors, geographic disparities, activity behaviors, and care services. Geospatial information has been extensively applied using techniques such as spatial clustering and hotspot analysis. We investigate the influence of location and spatial factors on AD risk, the activity behavior of patients with AD using location data and spatial analysis, and medical-resource proximity via geospatial modeling and predictive analysis. Additionally, we identify three knowledge gaps: geographic environment measurement, spatiotemporal contrastive analysis of disease prevalence, and multidisciplinary integration. The review underscores the value of geospatial information in AD-related research and public health, offering researchers insights into prospective directions and collaborative opportunities with geographers.

Effects of an Individualized mHealth-Based Intervention on Health Behavior Change and Cardiovascular Risk Among People With Metabolic Syndrome Based on the Behavior Change Wheel: Quasi-Experimental Study.

Metabolic syndrome (MetS) is a common public health challenge. Health-promoting behaviors such as diet and physical activity are central to preventing and controlling MetS. However, the adoption of diet and physical activity behaviors has always been challenging. An individualized mobile health (mHealth)-based intervention using the Behavior Change Wheel is promising in promoting health behavior change and reducing atherosclerotic cardiovascular disease (ASCVD) risk. However, the effects of this intervention are not well understood among people with MetS in mainland China. We aimed to evaluate the effects of the individualized mHealth-based intervention using the Behavior Change Wheel on behavior change and ASCVD risk in people with MetS. We conducted a quasi-experimental, nonrandomized study. Individuals with MetS were recruited from the health promotion center of a tertiary hospital in Zhejiang province, China. The study involved 138 adults with MetS, comprising a control group of 69 participants and an intervention group of 69 participants. All participants received health education regarding diet and physical activity. The intervention group additionally received a 12-week individualized intervention through a WeChat mini program and a telephone follow-up in the sixth week of the intervention. Primary outcomes included diet, physical activity behaviors, and ASCVD risk. Secondary outcomes included diet self-efficacy, physical activity self-efficacy, knowledge of MetS, quality of life, and the quality and efficiency of health management services. The Mann-Whitney U test and Wilcoxon signed rank test were primarily used for data analysis. Data analysis was conducted based on the intention-to-treat principle using SPSS (version 25.0; IBM Corp). Baseline characteristics did not differ between the 2 groups. Compared with the control group, participants in the intervention group showed statistically significant improvements in diet behavior, physical activity behavior, diet self-efficacy, physical activity self-efficacy, knowledge of MetS, physical health, and mental health after a 12-week intervention (P=.04, P=.001, P=.04, P=.04, P=.001, P=.04, P=.04, and P<.05). The intervention group demonstrated a statistically significant improvement in outcomes from pre- to postintervention evaluations (P<.001, P=.03, P<.001, P=.04, P<.001, P<.001, and P<.001). The intervention also led to enhanced health management services and quality. The individualized mHealth-based intervention using the Behavior Change Wheel was effective in promoting diet and physical activity behaviors in patients with MetS. Nurses and other health care professionals may incorporate the intervention into their health promotion programs.

Use of Wearable Activity Trackers to Improve Physical Activity Behavior in Patients With Rheumatic and Musculoskeletal Diseases: A Systematic Review and Meta-Analysis.

Wearable activity trackers (WATs) could be a promising strategy to improve physical activity in patients with rheumatic and musculoskeletal diseases (RMDs). The aim was to assess the adherence to and effectiveness of WATs to increase physical activity levels in patients with RMDs. A systematic review was performed to identify all cohorts and controlled trials evaluating WATs in patients with RMDs, published between 2000 and 2018, by searching Medline, Embase, PsycINFO, and Cochrane. Data collected pertained to adherence, effectiveness on physical activity, or effectiveness on symptoms (pain, function, quality of life, or fatigue). Meta-analyses were performed with a random effects model. Of 2,806 references, 17 studies were included, with a total of 1,588 patients: 8 studies (47%) in osteoarthritis, 5 (29%) in low-back pain, and 3 (18%) in inflammatory arthritis. Adherence assessed in 4 studies was high (weighted mean ± SD time worn was 92.7% ± 4.6%). A significant increase in physical activity was noted (mean difference 1,520 steps [95% confidence interval (95% CI) 580, 2,460], I² = 77%; or 16 minutes [95% CI 2, 29] of moderate-to-vigorous physical activity, I² = 0%). A significant increase in pain was found for long interventions (>8 weeks) (standardized mean difference 0.25 [95% CI 0.07, 0.43], I² = 0%). WATs in patients with RMDs had a high short-term adherence, with a significant increase in the number of steps and time spent in moderate-to-vigorous physical activity, although pain should be monitored. WATs may be an effective option to increase physical activity in this at-risk population.

Development and validation of the healthcare providers patient-activation scale

It has become increasingly important to assess healthcare providers' role in chronic disease self-management (CDSM) and patient activation (PA). The present study extends previous work relating to patients' behaviours by assessing healthcare providers' own behaviours in supporting PA. 50 items were generated: half assessed a PA approach; half reflected a non-patient-activation approach. 105 healthcare providers working in cardiac rehabilitation who were participants in a CDSM online training program completed the items pre- and post-training. Factor analysis determined the presence of higher order factors. Item responses pre- and post-training were compared to assess sensitivity to change. Results indicated the presence of two factors: 'patient-activation approach' and 'non-patient-activation approach'. While both demonstrated good internal consistency, the' non-PA approach' had superior discriminatory validity and sensitivity to change. Healthcare providers' beliefs about the importance of patient-activation behaviours can be measured by 40-item Healthcare Provider-Patient Activation Scale (HP-PAS). The scale could be easily converted to measure healthcare providers' actual PA behaviours. The HP-PAS could be used to assess the effectiveness of clinician training for healthcare providers working in cardiac rehabilitation and other areas of CDSM. Further reliability and validity testing within other healthcare provider samples is warranted.

Sex differences in physical activity among Ghanaian patients with sickle cell disease.

IntroductionMusculoskeletal pain and functional limitations experienced by patients with Sickle Cell Disease (SCD) impact their physical activity and social behaviour. Yet, we know little about physical activity behaviour in patients with SCD. The aim of this study was to investigate gender differences in physical activity, sedentary time and measures of fitness among Ghanaian adults with SCD. The study also determined the association between outcome variables in this population.MethodsPatients with SCD attending a sickle cell clinic in a tertiary hospital in Accra, Ghana participated in this cross-sectional study. Physical activity, sedentary time, body composition, flexibility and cardiovascular endurance were assessed. Demographic data were also collected by self-report.ResultsFifty three participants enrolled in the study. Of these, more than half were females (60.4%) and the average age of the participants was (M: 26.8, SD: 8.5 years). The total physical activity reported by the participants was different between males and females (t = 2.610, p = 0.012). However, there were no gender differences in sedentary time, body composition, flexibility and cardiovascular endurance. A moderately significant association was found between sedentary time and cardiovascular endurance (r = 0.437, p = 0.001).ConclusionThe findings suggest that gender differences in physical activity are apparent in patients with SCD. Investigations into the mechanisms underpinning these differences are warranted. Additionally, longitudinal observations of objectively measured physical activity may be useful to validate these results in a larger sample.

Understanding physical activity behavior in patients with bladder cancer before and after radical cystectomy: a qualitative interview study

Objective: To explore the determinants of physical activity in patients with bladder cancer before and after radical cystectomy. Design: A qualitative research design using semi-structured face-to-face interviews. Setting and subjects: A total of 30 interviews were conducted with people diagnosed with bladder cancer and treated with radical cystectomy at Ghent University Hospital. Main measures: The interviews were audiotaped and transcribed verbatim. Framework analysis with constant comparison between and within interviews was applied until final topics were derived from interpreting the data. Results: Physical activity behavior in patients with bladder cancer is determined multifactorial with condition-related (e.g. urinary symptoms, comorbidities), therapy-related (e.g. fatigue, diarrhea), patient-related (e.g. outcome expectations, coping skills, definitions of physical activity), social/economic-related (e.g. social support, attractive environment) and health system–related (e.g. physicians’ advice, information) factors. Conclusion: The results of this study can guide the development of theory-based behavior change interventions to increase physical activity in bladder cancer patients.

Validation of a Noninvasive, Disposable Activity Monitor for Clinical Applications.

The study evaluated the concurrent and criterion validity of a new, disposable activity monitor designed to provide objective data on physical activity and energy expenditure in clinical populations. A sample of healthy adults (n = 52) wore the disposable Metria IH1 along with the established Sensewear armband (SWA) monitor for a 1-week period. Concurrent validity was examined by evaluating the statistical equivalence of estimates from the Metria and the SWA. Criterion validity was examined by comparing the relative accuracy of the Metria IH1 and the SWA for assessing walking/running. The absolute validity of the 2 monitors was compared by computing correlations and mean absolute percent error (MAPE) relative to criterion data from a portable metabolic analyzer. The output from 2 monitors was highly correlated (correlations > 0.90) and the summary measures yielded nearly identical allocations of time spent in physical activity and energy expenditure. The monitors yielded statistically equivalent estimates and had similar absolute validity relative to the criterion measure (12% to 15% error). The disposable nature of the adhesive Metria IH1 monitor offers promise for clinical evaluation of physical activity behavior in patients. Additional research is needed to test utility for counseling and behavior applications.

Text to Move: A Randomized Controlled Trial of a Text-Messaging Program to Improve Physical Activity Behaviors in Patients With Type 2 Diabetes Mellitus.

BackgroundText messages are increasingly being used because of the low cost and the ubiquitous nature of mobile phones to engage patients in self-care behaviors. Self-care is particularly important in achieving treatment outcomes in type 2 diabetes mellitus (T2DM).ObjectiveThis study examined the effect of personalized text messages on physical activity, as measured by a pedometer, and clinical outcomes in a diverse population of patients with T2DM.MethodsText to Move (TTM) incorporates physical activity monitoring and coaching to provide automated and personalized text messages to help patients with T2DM achieve their physical activity goals. A total of 126 English- or Spanish-speaking patients with glycated hemoglobin A1c (HbA1c) >7 were enrolled in-person to participate in the study for 6 months and were randomized into either the intervention arm that received the full complement of the intervention or a control arm that received only pedometers. The primary outcome was change in physical activity. We also assessed the effect of the intervention on HbA1c, weight, and participant engagement.ResultsAll participants (intervention: n=64; control: n=62) were included in the analyses. The intervention group had significantly higher monthly step counts in the third (risk ratio [RR] 4.89, 95% CI 1.20 to 19.92, P=.03) and fourth (RR 6.88, 95% CI 1.21 to 39.00, P=.03) months of the study compared to the control group. However, over the 6-month follow-up period, monthly step counts did not differ statistically by group (intervention group: 9092 steps; control group: 3722 steps; RR 2.44, 95% CI 0.68 to 8.74, P=.17). HbA1c decreased by 0.07% (95% CI –0.47 to 0.34, P=.75) in the TTM group compared to the control group. Within groups, HbA1c decreased significantly from baseline in the TTM group by –0.43% (95% CI –0.75 to –0.12, P=.01), but nonsignificantly in the control group by –0.21% (95% CI –0.49 to 0.06, P=.13). Similar changes were observed for other secondary outcomes.ConclusionPersonalized text messaging can be used to improve outcomes in patients with T2DM by employing optimal patient engagement measures.

A Multimodal mHealth Intervention (FeatForward) to Improve Physical Activity Behavior in Patients with High Cardiometabolic Risk Factors: Rationale and Protocol for a Randomized Controlled Trial.

BackgroundPhysical inactivity is one of the leading risk factors contributing to the rising rates of chronic diseases and has been associated with deleterious health outcomes in patients with chronic disease conditions. We developed a mobile phone app, FeatForward, to increase the level of physical activity in patients with cardiometabolic risk (CMR) factors. This intervention is expected to result in an overall improvement in patient health outcomes.ObjectiveThe objective of this study is to evaluate the effect of a mobile phone–based app, FeatForward, on physical activity levels and other CMR factors in patients with chronic conditions.MethodsThe study will be implemented as a 2-arm randomized controlled trial with 300 adult patients with chronic conditions over a 6-month follow-up period. Participants will be assigned to either the intervention group receiving the FeatForward app and standard care versus a control group who will receive only usual care. The difference in physical activity levels between the control group and intervention group will be measured as the primary outcome. We will also evaluate the effect of this intervention on secondary measures including clinical outcome changes in global CMR factors (glycated hemoglobin, fasting blood glucose, blood pressure, waist circumference, Serum lipids, C-reactive protein), health-related quality of life, health care usage, including attendance of scheduled clinic visits and hospitalizations, usability, and satisfaction, participant engagement with the FeatForward app, physician engagement with physician portal, and willingness to engage in physical activity. Instruments that will be used in evaluating secondary outcomes include the Short-Form (SF)-12, app usability and satisfaction questionnaires, physician satisfaction questionnaire. The intention-to-treat approach will be used to evaluate outcomes. All outcomes will be measured longitudinally at baseline, midpoint (3 months), and 6 months. Our primary outcome, physical activity, will be assessed by mixed-model analysis of variance with intervention assignment as between-group factor and time as within-subject factor. A similar approach will be used to analyze continuous secondary outcomes while categorical outcomes will be analyzed by chi-square test.ResultsThe study is still in progress and we hope to have the results by the end of 2016.ConclusionsThe mobile phone–based app, FeatForward, could lead to significant improvements in physical activity and other CMR factors in patients.

Pulmonary Rehabilitation and Physical Activity in Patients with Chronic Obstructive Pulmonary Disease.

Physical inactivity is common in patients with chronic obstructive pulmonary disease (COPD) compared with age-matched healthy individuals or patients with other chronic diseases. Physical inactivity independently predicts poor outcomes across several aspects of this disease, but it is (at least in principle) treatable in patients with COPD. Pulmonary rehabilitation has arguably the greatest positive effect of any current therapy on exercise capacity in COPD; as such, gains in this area should facilitate increases in physical activity. Furthermore, because pulmonary rehabilitation also emphasizes behavior change through collaborative self-management, it may aid in the translation of increased exercise capacity to greater participation in activities involving physical activity. Both increased exercise capacity and adaptive behavior change are necessary to achieve significant and lasting increases in physical activity in patients with COPD. Unfortunately, it is readily assumed that this translation occurs naturally. This concise clinical review will focus on the effects of a comprehensive pulmonary rehabilitation program on physical activity in patients with COPD. Changing physical activity behavior in patients with COPD needs an interdisciplinary approach, bringing together respiratory medicine, rehabilitation sciences, social sciences, and behavioral sciences.

Physical activity and the association with fatigue and sleep in Danish patients with rheumatoid arthritis

The aim of this study was to examine physical activity behavior in patients with rheumatoid arthritis and to identify potential correlates of regular physical activity including fatigue, sleep, pain, physical function and disease activity. A total of 443 patients were recruited from a rheumatology outpatient clinic and included in this cross-sectional study. Physical activity was assessed by a four-class questionnaire, in addition to the Physical Activity Scale. Other instruments included the Multidimensional Fatigue Inventory (MFI), the Pittsburgh Sleep Quality Index and the Health Assessment Questionnaire. Disease activity was obtained from a nationwide clinical database. Of the included patients, 80% were female and mean age was 60 (range 21-88years). Hereof, 22% (n=96) were regularly physically active, and 78% (n=349) were mainly sedentary or having a low level of physical activity. An inverse univariate association was found between moderate to vigorous physical activity, and fatigue (MFI mental, MFI activity, MFI physical and MFI general), sleep, diabetes, depression, pain, patient global assessment, HAQ and disease activity. The multivariate prediction model demonstrated that fatigue-related reduced activity and physical fatigue were selected in >95% of the bootstrap samples with median odds ratio 0.89 (2.5-97.5% quantiles: 0.78-1.00) and 0.91 (2.5-97.5% quantiles: 0.81-0.97), respectively, while disease activity was selected in 82% of the bootstrap samples with median odds ratio 0.90. Moderate to vigorous physical activity in patients with rheumatoid arthritis is associated with the absence of several RA-related factors with the most important correlates being reduced activity due to fatigue, physical fatigue and disease activity.

SP0107 Education, monitoring and outcome in providers of a self-regulation program to increase physical activity in rheumatoid arthritis

There are at least two obvious purposes to study providers of behavior change interventions; 1) to assess treatment integrity, i.e. to what degree the intervention was delivered as intended, and...

Physical activity behaviour in patients with metabolic syndrome

Physical activity improves the clinical course of the metabolic syndrome and its risk factors. The aim of this study was to investigate the physical activity behaviour in patients with metabolic syndrome in regard to the recommendation of the Federal Offices of Public Health (BAG) and Sports (BASPO): "to exercise half an hour a day at a medium intensity." 47 patients with metabolic syndrome were recruited from the Outpatient Department of the Division of Internal Medicine of the University Hospital Zurich. 24 patients were included and physical activity behaviour was assessed by using the International Physical Activity Questionnaires. All of the patients knew about the positive effect of physical activity on the course of the metabolic syndrome although 62% of the patients (n = 15) had no knowledge of the BAG/BASPO recommendations. 54% of the patients (n = 13) performed physical activity in accordance to the recommendation with or without knowing the recommendations. Most of the patients (n = 21, 87%) were motivated to improve their physical activity, but missing opportunities and instructions were important reasons for not being physically active. Patients with metabolic syndrome usually know about the positive effect of physical activity on the course of their disorder and are motivated to improve physical activity behaviour. However, the BAG/BASPO recommendations are not widely known and should therefore become more popular and better communicated particularly to patients with metabolic syndrome. Furthermore, patients have to be supported and instructed practically how to get physically active in accordance with their co-morbidities.

An evolving perspective on physical activity counselling by medical professionals.

BackgroundPhysical inactivity is a modifiable risk factor for many chronic conditions and a leading cause of premature mortality. An increasing proportion of adults worldwide are not engaging in a level of physical activity sufficient to prevent or alleviate these adverse effects. Medical professionals have been identified as potentially powerful sources of influence for those who do not meet minimum physical activity guidelines. Health professionals are respected and expected sources of advice and they reach a large and relevant proportion of the population. Despite this potential, health professionals are not routinely practicing physical activity promotion.DiscussionMedical professionals experience several known barriers to physical activity promotion including lack of time and lack of perceived efficacy in changing physical activity behaviour in patients. Furthermore, evidence for effective physical activity promotion by medical professionals is inconclusive. To address these problems, new approaches to physical activity promotion are being proposed. These include collaborating with community based physical activity behaviour change interventions, preparing patients for effective brief counselling during a consultation with the medical professional, and use of interactive behaviour change technology.SummaryIt is important that we recognise the latent risk of physical inactivity among patients presenting in clinical settings. Preparation for improving patient physical activity behaviours should commence before the consultation and may include physical activity screening. Medical professionals should also identify suitable community interventions to which they can refer physically inactive patients. Outsourcing the majority of a comprehensive physical activity intervention to community based interventions will reduce the required clinical consultation time for addressing the issue with each patient. Priorities for future research include investigating ways to promote successful referrals and subsequent engagement in comprehensive community support programs to increase physical activity levels of inactive patients. Additionally, future clinical trials of physical activity interventions should be evaluated in the context of a broader framework of outcomes to inform a systematic consideration of broad strengths and weaknesses regarding not only efficacy but cost-effectiveness and likelihood of successful translation of interventions to clinical contexts.

1 How to change physical activity behaviour in patients

1 How to change physical activity behaviour in patients