Physical Activity Behavior Change Research Articles

Effectiveness and cost-effectiveness of a 12-month automated text message intervention for weight management in postpartum women with overweight or obesity: protocol for the Supporting MumS (SMS) multisite, parallel-group, randomised controlled trial

IntroductionThe reproductive years can increase women’s weight-related risk. Evidence for effective postpartum weight management interventions is lacking and engaging women during this life stage is challenging. Following a promising pilot...

Changes in Accelerometer-measured Physical Activity and Sedentary Behavior From Before to After COVID-19 Outbreak in Workers.

The novel coronavirus disease 2019 (COVID-19) pandemic may have reduced opportunities for engaging in physical activity (PA) and increased sedentary behavior (SB) among workers. However, most previous studies used self-reported assessments. This study aimed to examine the changes in accelerometer-measured PA and SB from before to after COVID-19 outbreak among Japanese workers. This 1-year longitudinal study used data from the annual health check-ups of workers who lived in the Tokyo metropolitan area. Baseline and follow-up data were collected from June to November of 2019 and June to November of 2020, respectively. Participants were asked to wear the accelerometer on their hip during awake hours for at least 10 days in both the surveys. Before the analysis, considering the difference in wearing time, time spent in PA and SB were converted to the percentage of wearing time. To investigate the changes in PA or SB from before to during COVID-19 outbreak, paired t-tests were performed. Of the 757 eligible participants, 536 were included in the analysis (70.8%). Participants' mean age was 53.3 years, 69.6% were female, and most were full-time employees. Time spent in PA decreased, regardless of weekdays or weekends, although changes on the weekends were not significant. Conversely, time spent in SB increased on both weekdays and weekends in 2020. These changes corresponded to approximately 10 minutes per day decrease in PA and increase in SB. Objectively measured PA decreased and SB increased by approximately 10 minutes per day after the COVID-19 outbreak among Japanese workers.

Abstract PO4-11-09: Feasibility of physical activity behaviour change for women living with metastatic breast cancer, a randomised controlled trial

Abstract Background Physical activity benefits women living with metastatic breast cancer by improving outcomes such as physical function, health-related quality of life and fatigue. These findings have been reported within well-resourced trials that involve exercise equipment and supervision. Home or community-based settings, however, may be preferable and more accessible. This trial evaluated the feasibility of a remotely delivered behaviour change intervention for increasing physical activity for women living with metastatic breast cancer, and evaluated the program’s efficacy. Methods A 12-week randomised controlled trial was conducted in which 20 women living with metastatic breast cancer were recruited from a metropolitan outpatient cancer clinic. Inclusion criteria were over 18 years old, English speaking, ambulatory, and not regularly active at time of recruitment. Participants were randomised 1:1 to an intervention or attention control group. Both groups received a recommendation for 150 minutes of physical activity, a wrist-worn activity monitor, a physical activity diary, and nine phone or video call sessions (six weekly, three fortnightly). The intervention group received individualised behaviour change advice on topics such as physical activity benefits, motivation, barriers and social support; the attention control group received a recurring symptom questionnaire and no behavioural advice. Feasibility outcomes included recruitment, dropout and session adherence rates, and acceptability of methods was evaluated with an interview at trial completion. Baseline and 12-week outcomes included: i) physical activity minutes measured with a 5-day Actigraph wear, ii) 6-minute walk distance, iii) 30-second sit-to-stands, iv) questionnaires for self-reported physical activity, health-related quality of life, fatigue, behavioural factors (stage of change, self-efficacy, decisional balance, processes of change, social support), and patient-specific function. Questionnaires were measured again at 18 weeks. Results Recruitment, baseline measures and within-trial sessions are completed; 12 and 18-week measures will conclude late August. Thirty-two women were approached to enrol the target sample of 20, with exclusion reasons being disinterest (n=5), health problems (n=4), loss of contact (n=2) and already physically active (n=1). Median age was 62 years (IQR: 60-69), and median time since metastatic diagnosis was 4 years (IQR: 1-5). Twelve women had bone metastases, and ten had a musculoskeletal comorbidity. Session delivery through video or phone calls were equally preferred (n=10 each). Participants completed 84% of the sessions, with reasons for missed sessions consisting of forgetting (55%), feeling unwell (24%), IT problems (7%), holiday (7%), and work commitments (7%). Median session duration for the intervention group was 23 minutes (IQR: 20-28), and control group was 17 minutes (IQR: 14-21). The preferred type of physical activity was predominantly walking, and no adverse events were reported. Four women dropped out after loss of contact. Compared to age-matched normative values, baseline outcomes varied: actigraphy-measured physical activity was low (median: 68 minutes/day, IQR: 45-88), self-reported physical activity was high (median: 289 MET-minutes/day, IQR: 52-728), 6-minute walk distance was equal (median: 529m, IQR: 416-579), 30-second sit-to-stands were low (median: 11, IQR: 8-14), health-related quality of life was high (median: 80, IQR: 70-100), and fatigue was equal (median: 30, IQR 20-40). Conclusions Women living with metastatic breast cancer were generally receptive of the trial, and recruitment, dropout and session adherence rates were positive. The women who dropped out were more physically active, physically functional and/or rated higher on the questionnaires, indicating that the trial may be more suited to those with limited physical activity experience. Citation Format: Mark Liu, Sharon Kilbreath, Elizabeth Dylke, Jasmine Yee, Jane Beith. Feasibility of physical activity behaviour change for women living with metastatic breast cancer, a randomised controlled trial [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-11-09.

Enhancing physical activity participation among female employees: evaluating the effectiveness of an educational intervention.

This paper evaluates the effectiveness of an educational intervention based on the transtheoretical model aimed at increasing physical activity (PA) participation among female employees in Bandar Abbas city (Iran) healthcare centers in December 2017 and August 2018. Using a semi-experimental interventional study design with a randomized and multi-stage method, 100 participants were included in both the intervention (n=50) and control groups (n=50). Data collection involved questionnaires assessing demographic information (age, gender, marital status and education), stages of change in PA behavior, Perceived Benefits, Barriers and Self-efficacy. The data were analyzed using SPSS-16, employing both descriptive (mean, SD, frequency, percentage) and inferential statistics (t-tests, chi-squared tests, etc.). Prior to the educational intervention, 19 participants (0.38%) in the intervention group engaged consistently in PA (stages 4-5). After 3 and 6 months of intervention, these numbers increased to 29 (0.58%) and 25 (0.50%), respectively. This improvement was statistically significant compared to the pre-intervention stage (P<0.001). The findings highlight the importance of theory-based behavior change models and health education programs in promoting PA and combating sedentary lifestyles. Although focused on a specific population in Bandar Abbas, the intervention can serve as a model for similar programs targeting diverse social classes and populations.

Perspectives of people with myasthenia gravis on physical activity and experience of physical activity advice from health professionals in the Australian context: a qualitative study

Purpose Physical activity is an important modifiable determinant of health. There has been a historical aversion to movement in people with myasthenia gravis (MG) due to the pathophysiology of the disease, however, research suggests engagement in physical activity is safe and does not exacerbate symptoms. There are currently no studies investigating the qualitative perspectives of people with MG on physical activity. The aim of this study was to explore perceptions of physical activity, barriers, enablers, and participants’ experiences of physical activity advice from health professionals. Materials and methods Semi-structured interviews were used, with verbatim transcripts analysed using content analysis. Results Ten adults (median age 64.5 years) living in Australia with generalised MG were interviewed. Key findings were identified: (1) Physical activity is perceived to be important for general health and for MG; (2) Medical management and social support are key enablers; (3) Fatigue and pain are potential barriers; and (4) Experiences with healthcare professionals were considered insufficient and failed to provide disease specific advice regarding MG and physical activity. Conclusion People with MG have unique barriers and enablers to physical activity engagement that clinicians should consider when providing physical activity behaviour change support to this population.

Enhancing Awareness of Physical Activity Guidelines among Saudi College Students: The 150 Minutes Program

Objective. This study evaluates the effectiveness of the “150 Minutes Program” in increasing awareness and fostering positive behavior changes regarding recommended physical activity guidelines among Saudi college students. Initiated as part of the national “Sports for All Challenge,” this program targets college students to improve their understanding of the U.S. Department of Health and Human Services’ physical activity guidelines. Methods. Engaging over 250 Saudi college students from 17 student groups across the United States, the program employs two intervention strategies: a general awareness campaign and the application of physical activity guidelines tailored to the Saudi student community. The study assesses the program’s impact through pre-/post-surveys, evaluating changes in participants’ awareness levels and physical activity behaviors. Results. A total of 110 participants completed either the presurvey (n = 35) or postsurvey (n = 75). Results indicate a significant rise in participants’ awareness of recommended physical activity guidelines, increasing from an initial 4% to 22.9%. Postprogram surveys reveal positive shifts in physical activity behaviors, with 51.4% of participants meeting adult physical activity guidelines, compared to 40% before the program. The average physical activity levels also demonstrated an increase. Conclusion. The 150 Minutes Program proves effective not only in enhancing awareness but also in instigating positive physical activity behavior changes among Saudi college students. The study contributes valuable insights to the evolving landscape of physical activity interventions within college populations, emphasizing the need for targeted programs, and collaborations with student organizations to ensure sustained impact and scalability.

Physical Activity in Individuals Newly Diagnosed With Multiple Sclerosis Through the Lens of the COM-B Model.

Physical activity (PA) is a promising intervention for disease modification and symptom management in multiple sclerosis (MS); however, there is a lack of research focusing on PA behavior change interventions for persons newly diagnosed with MS. Such PA behavior change interventions should be developed based on a strong empirical foundation of understanding the behavior and its determinants (ie, what to target for changes to occur). To that end, this qualitative study examined factors explaining PA in persons newly diagnosed with MS and identified potential targets for future behavior change intervention development based on the Capability-Opportunity-Motivation-Behavior (COM-B) model. Twenty individuals diagnosed with MS within the past 2 years underwent one-on-one semistructured interviews using questions developed based on the COM-B model. Data were analyzed using reflective thematic analysis, and the identified themes were then mapped with the COM-B model. Factors explaining PA in the study sample were identified across the COM-B components. The typical factors include knowledge and skills to sufficiently engage in PA with appropriate approaches, ability to adapt and navigate through new environmental and social difficulties after diagnosis, and motivation resulting from a combination of factors, such as outcome expectation, belief of capabilities, role/identity, reinforcement, and emotions. The COM-B model was applied successfully in this study to understand PA behavior and identify potential targets for behavior change in individuals newly diagnosed with MS. Future behavior change interventions should consider addressing these factors to generate effective PA behavior change in this population.

Changes in physical activity and sedentary behavior during the first COVID-19 pandemic- restrictions in Germany: a nationwide survey

BackgroundThe COVID-19 pandemic restrictions posed challenges to maintaining healthy lifestyles and physical well-being. During the first mobility restrictions from March to mid-July 2020, the German population was advised to stay home, except for work, exercise, and essential shopping. Our objective was to comprehensively assess the impact of these restrictions on changes in physical activity and sedentary behavior to identify the most affected groups.MethodsBetween April 30, 2020, and May 12, 2020, we distributed a COVID-19-specific questionnaire to participants of the German National Cohort (NAKO). This questionnaire gathered information about participants’ physical activity and sedentary behavior currently compared to the time before the restrictions. We integrated this new data with existing information on anxiety, depressive symptoms, and physical activity. The analyses focused on sociodemographic factors, social relationships, physical health, and working conditions.ResultsOut of 152,421 respondents, a significant proportion reported altered physical activity and sedentary behavioral patterns due to COVID-19 restrictions. Over a third of the participants initially meeting the WHO’s physical activity recommendation could no longer meet the guidelines during the restrictions. Participants reported substantial declines in sports activities (mean change (M) = -0.38; 95% CI: -.390; -.378; range from -2 to + 2) and reduced active transportation (M = -0.12; 95% CI: -.126; -.117). However, they also increased recreational physical activities (M = 0.12; 95% CI: .117; .126) while engaging in more sedentary behavior (M = 0.24; 95% CI: .240; .247) compared to pre-restriction levels. Multivariable linear and log-binomial regression models indicated that younger adults were more affected by the restrictions than older adults. The shift to remote work, self-rated health, and depressive symptoms were the factors most strongly associated with changes in all physical activity domains, including sedentary behavior, and the likelihood to continue following the physical activity guidelines.ConclusionsMobility patterns shifted towards inactivity or low-intensity activities during the nationwide restrictions in the spring of 2020, potentially leading to considerable and lasting health risks.

Physical activity behaviour change in black prostate cancer survivors: a qualitative study using the Behaviour Change Wheel.

Black individuals have a higher cancer burden and face greater obstacles to access cancer care resources when compared to White individuals. Radical prostatectomy is the standard surgical treatment and a common treatment option for prostate cancer; however, when compared to their White counterparts, Black individuals treated for prostate cancer often experience higher treatment-related side effects, resulting in a difficult recovery period. Physical activity is effective in alleviating treatment-related side effects; however, little is known about the barriers and facilitators to physical activity experienced by Black individuals after surgical management of prostate cancer to inform the design of physical activity interventions. Twelve Black individuals underwent radical prostatectomy for prostate cancer participated in a focus group study. We used the Behaviour Change Wheel, which incorporates Capability, Opportunity, Behaviour (COM-B) model and the complementary Theoretical Domains Framework (TDF), as our guiding theoretical framework. Data was analyzed using deductive qualitative analysis. Facilitators and barriers were identified for all components of the Behaviour Change Wheel. Capability appeared to be a central factor to how participants described their physical activity engagement. Opportunity and motivation were described as both barriers and facilitators for behaviour change when occurring in isolation; however, when co-occurring with the presence of capability, they were described as facilitators that influence participants' physical activity engagement. Our results demonstrate barriers and facilitators that are recognized among Black individuals who have undergone radical prostatectomy for prostate cancer. The design of a physical activity intervention needs to consider the physical and psychological capabilities as the fundamental basis with the additional support of physical activity opportunity and motivation. Intersectionality across capability, opportunity, and motivation is essential to intervention design and development to increase physical activity in Black individuals surgically treated for prostate cancer.

Determinants of body weight changes during Ramadan fasting in India amid COVID-19: A cross-sectional study.

Ramadan intermittent fasting (RIF) presents unique challenges and opportunities for public health and clinical practice, especially in populations with a high prevalence of non-communicable diseases. This study aims to investigate the impact of RIF on weight change among Indian Muslims and explore the associated demographic, dietary, and behavioral factors. A cross-sectional survey was conducted with a sample of Indian Muslim adults who observed RIF. Participants were asked to report their demographic information, family and personal health history, and dietary and lifestyle behaviors before and during Ramadan month. The primary outcome was body weight change, with secondary outcomes including changes in dietary patterns, physical activity, and other health-related lifestyle behaviors. The study found that during Ramadan, nearly half of the participants (48.5%) self-reported a retained initial weight, while a significant fraction (30.9%) self-reported a modest weight reduction between 0.5 to 2.5 kg at the end of Ramadan. Additionally, self-reported eating practices demonstrated moderately altered by about half (48.4%) of the study participants, with 32.2% reporting minor changes and 8.2% indicating substantial changes. An urban residence was associated with a higher likelihood of weight gain, where urban residents showed 3 times the odds of increased weight compared to rural inhabitants. Employment status emerged as a significant determinant for weight fluctuation, influencing both weight gain and loss. During Ramadan, there was a significant rise in snacking frequency, increasing from 21.7% to 32.6% in comparison with pre-Ramadan. The consumption of large quantities of food more frequently grew from 14.9% to 36%, and the incidence of eating despite not being hungry went up from 17.4% to 33.2%. The study demonstrates that RIF is associated with variable changes in body weight among adult Indian Muslims, influenced by urbanization, employment status, and dietary changes. The findings suggest that clinicians should provide tailored advice about body weight regulation during Ramadan and consider integrating community-based health initiatives within religious settings to improve health outcomes.

PHYSICAL ACTIVITY AND SOCIAL COGNITIVE THEORY CORRELATES AMONG POSTOPERATIVE PERSONS WITH CROHN'S DISEASE: PRELIMINARY RESULTS FROM A CROSS-SECTIONAL ANALYSIS

Abstract INTRODUCTION There is increasing research and clinical interest in physical activity (PA) behavior among persons with Crohn's disease (CD), but little is known regarding PA and its correlates among postoperative persons with CD. This is important as most patients with CD will require surgery within 10 years of diagnosis which may drastically alter PA levels and its benefits for CD. As found in past studies with other patient populations (e.g., colorectal cancer survivors), understanding the cognitive and behavioral factors associated with PA engagement among postoperative adults with CD is useful for informing the development of PA behavior change interventions for this population. This cross-sectional study examined self-reported PA levels and its associations with social cognitive theory (SCT) variables among postoperative persons with CD. METHODS Participants included 30 persons with CD who completed an online survey between November 2022 and June 2023. Of those participants, 18 reported a history of CD-related surgery. The survey assessed demographic and clinical characteristics, disease activity (Harvey-Bradshaw Index), leisure time exercise (Godin Leisure-Time Exercise Questionnaire and International Physical Activity Questionnaire), and related SCT variables (exercise self-efficacy, social support, outcome expectations, goal setting, and planning). Analyses included independent sample t-tests and non-parametric bivariate correlations (rs) for comparing PA levels and SCT survey scores among participants with and without a history of surgery. RESULTS There were differences in PA and SCT variables based on surgical history. Postoperative participants engaged in significantly more PA (t = 2.17, p = 0.04) and reported greater outcome expectations (t = 2.45, p = 0.02) and goal setting (t = 2.22, p = 0.04) scores compared with CD participants without a history of surgery. Among postoperative participants, only exercise goal setting was significantly correlated with PA (rs = .53, p = 0.03) such that postoperative participants with greater exercise goal setting behaviors reported higher levels of PA. None of the SCT variables were significantly associated with PA in the sample of participants without a history of surgery. CONCLUSIONS This study yielded novel findings regarding PA behavior and its SCT correlates in a small sample of postoperative persons with CD. The results suggest the need for further research into exercise goal setting as a potential target of behavior change interventions for increasing PA among postoperative persons with CD.

Increasing physical activity among Indonesian adolescents: a social marketing intervention reflection

Purpose This paper aims to provide an overview of a social marketing intervention that aimed to increase physical activity (aligned to UN SDG 3) among adolescents in Bali, Indonesia. Design/methodology/approach Three sequential phases were followed to deliver the social marketing intervention. Phrase 1 (formative research) gained insights that guided a subsequent social marketing intervention. Phase 2 (pilot intervention) gathered preliminary results, to support the development of the final intervention. Phase 3 (intervention) evaluated the effectiveness of the two-month social marketing intervention. Findings The results from the intervention tested in this paper identified significant behaviour change in physical activity, demonstrating the effectiveness of the intervention. Furthermore, the paper identifies which intervention inputs contribute to behaviour change and which do not. Research limitations/implications This paper describes the outcomes from an eight-week pilot programme that aimed to increase rates of physical activity for Indonesian adolescents and provides early evidence of impact. Practical implications This study found that providing adolescents with the opportunity to play team sports increases physical activity behaviour. Originality/value There is a lot of ground that needs to be made in terms of designing programs capable of achieving impact in the Global South. The approach reported in this paper can serve as a best-practice model for researchers wanting to drive lasting behaviour change to overcome known inequities in the Global South.

Physical Activity and Health of Middle-Aged and Older Japanese Across the COVID-19 Pandemic: Differential Outcomes Highlight a Problematic Life Stage.

COVID-19 caused major disruptions across the super-aged nation of Japan, yet few studies explored temporal changes among middle-aged and older cohorts from baseline to the height of community transmission. Changes in physical activity and sedentary behavior during global pandemics may alter patterns of morbidity and mortality among susceptible aging populations. This study investigated patterns of physical activity, sitting behavior, and health among representative samples of middle-aged and older adults in Tokyo before and during the pandemic. Repeated online surveys were conducted with quota samples of 800 Tokyo residents in 2019 and 2021 using validated Japanese-language measures, including the short form-International Physical Activity Questionnaire and the Basic Ecological Health Scale-6. Statistical analyses included comparative evaluations of activity parameters by age cohort, gender, and selected covariates. Statistical tests included the Kruskal-Wallis test, Mann-Whitney U test, chi-square test for Independence and Hierarchical Regression. Over 34% of respondents were inactive at each data collection point, and 72% reported negative impacts of COVID-19 on their physical activities. Older adults showed no significant changes in their activity and sitting behavior and reported better health compared with those in middle age across the pandemic. Middle-aged males reported a significant decline in total activity of 33% across the pandemic period (U = 16,958, z = -2.64, p = .008, r = .13). Middle-aged females reported the lowest levels of physical activity, and health, and showed a 29% increase in sitting behavior across the pandemic (U = 16,925, z = -2.68, p = .007, r = .13). Subjective health status was consistently associated with higher overall activity and walking before and during the pandemic. Differential outcomes were identified between age and gender regarding health, physical activity, walking, and sitting across the pandemic with significantly worse impacts reported among middle-aged samples. These results have implications for healthy transitions to later life and the design of postpandemic interventions to address activity opportunities in Japan.

Interventions Based on Behavior Change Techniques to Encourage Physical Activity or Decrease Sedentary Behavior in Community-Dwelling Adults Aged 50-70: Systematic Review With Intervention Component Analysis.

Increasing physical activity (PA) and/or decreasing sedentary behaviors is important in the delay and prevention of long-term conditions. PA can help maintain function and independence and decrease the need for hospitalization/institutionalization. Activity rates often decline in later life resulting in a need for interventions that encourage uptake and adherence through the use of Behavior Change Techniques (BCTs). We conducted a systematic review of the evidence for interventions that included BCTs in community-dwelling adults with a mean age of 50-70. The review followed PRISMA guidelines. The interventions were psychosocial, nonpharmacological, and noninvasive interventions utilizing components based on BCTs that evaluated change in PA and/or sedentary behavior. Intervention Component Analysis (ICA) was used to synthesize effectiveness of intervention components. Twelve randomized controlled trials were included in this review. The mean sample age was 50-64. Thirteen BCTs were used across all studies, and the most commonly used techniques were goals and planning, feedback and monitoring, and natural consequences. Seven intervention components linked with BCTs were found: personalized goal setting, tailored feedback from facilitators, on-site and postintervention support, education materials and resources, reinforcing change on behavior and attitudes, self-reported monitoring, and social connectedness. All components, except for social connectedness, were associated with improved health behavior and PA levels. The interventions that use BCTs have incorporated strategies that reinforce change in behavior and attitudes toward PA.

Experiences of Participants with Spinal Cord Injury at an Active Rehabilitation Camp.

This study explored the physical, social, and psychological benefits of an active rehabilitation (AR) camp as experienced by participants with spinal cord injury (SCI), and perceived fitness and mastery of being physically active six months after the camp. The study used a mixed-method design with pre- (n = 23), post- (n = 23), and follow-up questionnaires (n = 18) and individual interviews (n = 8). Fuzzy qualitative comparative analysis (fsQCA) was used to analyze the quantitative data and qualitative content analysis was used to analyze the qualitative data. Results showed that benefits were mainly experienced in the social and psychological domains. As for the physical domain, younger and more recently injured persons with tetraplegia reported more benefits. Six months after the camp, being in the preparation stage of change and being somewhat physically active were necessary and sufficient conditions for experiencing mastery of physical activity regardless of injury type, but only persons with paraplegia experienced fitness benefits. Qualitative data shed further light on the perceived benefits of the camp. The knowledge gained from this study might help practitioners to tailor interventions to individual needs and researchers to ask questions that take into consideration the complexity of active rehabilitation and changes in physical activity behavior for people with SCI.

Development of a behavior change intervention to improve physical activity in patients with COPD using the behavior change wheel: a non-randomized trial

The aim of this study was to evaluate whether a theory-based behavior change intervention could promote changes in physical activity (PA) and sedentary behavior (SB) among patients with chronic obstructive pulmonary disease (COPD), as well as its effects on symptoms of dyspnea, lung function, exercise capacity, self-efficacy, and health-related quality of life (HRQoL). A quasi-experimental design and convenience sampling were adopted. A total of 92 patients with stable COPD were recruited from outpatient and inpatient centers of two hospitals in Zhejiang Province, China. Both the experimental and control groups received standard medical care provided in the hospital. The experimental group performed a PA program based on the behavior change wheel theory. Outcomes were measured at baseline (T0) and after 4 weeks (T1), 8 weeks (T2), and 12 weeks of the intervention (T3). The primary outcome was PA measured by the International Physical Activity Questionnaire (IPAQ). Secondary outcomes included SB measured by the IPAQ, dyspnea measured by the modified Medical Research Council (mMRC) questionnaire, exercise capacity assessed by 6-min walk distance (6MWD), self-efficacy measured by the Exercise Self-Regulatory Efficacy Scale (EX-SRES), and HRQoL measured by the COPD Assessment Test (CAT). In addition, we measured lung function using a spirometer at baseline and 12 weeks. Of the 89 patients included in this study, 64 were male (71.91%), with a mean age of 67.03 ± 6.15 years. At 12 weeks, the improvements in PA, SB, mMRC, 6MWD, EX-SRES and CAT were all statistically significant (P < 0.05) in the experimental group compared to the control group. Repeated measures analysis of variance showed that there were group effects and time effects on total PA, SB, mMRC, 6MWD, EX-SRES, and CAT in both groups (P < 0.001). However, there was no significant difference in pulmonary function between the two groups before and after intervention (P < 0.05). The PA program based on theory significantly increased PA levels, reduced sedentary time, enhanced exercise capacity and self-efficacy as well as HRQoL in patients with stable COPD. Due to the limited intervention time in this study, the pulmonary function of COPD patients may not be reversed in a short time, and the long-term effect of this program on the pulmonary function of patients needs to be further explored.Trial registration: Clinical Trials.gov (ChiCTR2200060590). Registered 05/06/2022.

A Videoconference Physical Activity Intervention for Colorectal Cancer Survivors: A Pilot Randomized Controlled Trial

Physical activity (PA) after a colorectal cancer (CRC) diagnosis can improve physical function and quality of life and is associated with decreased mortality rates and longer disease-free survival. The accelerated use of videoconference technology during and following the COVID-19 pandemic offers an opportunity to explore the potential of a virtually supervised intervention to help survivors of CRC increase PA. A two-arm single blind pilot randomized controlled trial of individuals who had completed treatment for CRC within the previous five-years (NCT03781154, 12/19/2018). The 12-week intervention consisted of circuit-based, combined aerobic and resistance exercise, twice per week for approximately one-hour per session, and five social cognitive theory-based PA behavior change discussion sessions. All intervention components were delivered in real-time via Zoom. Feasibility and acceptability were assessed, and the effects of the intervention were explored for the outcomes of PA (activPAL™ accelerometers and self-report), social cognitive theory constructs (barriers self-efficacy and outcome expectations), and physical fitness (submaximal aerobic capacity, upper and lower body muscular strength and endurance). Twenty-nine eligible individuals (55.2% women, &lt;em&gt;Mean&lt;/em&gt; = 61 ± 11 years old, &lt;em&gt;Mean&lt;/em&gt; = 22.0 ± 15.1 months since diagnosis) were randomized to the videoconference PA intervention (&lt;em&gt;n&lt;/em&gt; = 15) or a PA education control (&lt;em&gt;n&lt;/em&gt; = 14). A total of &lt;em&gt;N&lt;/em&gt; = 25 completed the study for a retention rate of 86.7% in the intervention arm and 85.7% in the control. Adherence to intervention components was &gt;86%. The intervention was highly acceptable with ≥90% responding “yes” or “definitely yes” that they enjoyed participating. Trends suggested that intervention participants had greater improvements in accelerometer measured steps per day, daily minutes of light PA, sedentary time, and aerobic fitness. There was no change in social cognitive theory constructs, and muscular strength and endurance improved in both the intervention and control. A 12-week videoconference PA intervention was feasible and acceptable among survivors of CRC, and the greatest magnitude of difference for intervention effects was observed for light PA and sedentary time. A fully powered trial is needed to determine efficacy of the intervention for increasing PA and physical functioning.

Let's Move with Leon—A qualitative evaluation of a UK digital intervention to improve physical activity in people with a musculoskeletal condition

ObjectiveThis article presents a qualitative evaluation of a 13-week digital intervention, ‘Let's Move with Leon’, designed to improve physical activity in people with a musculoskeletal condition. Study designA qualitative evaluation embedded within a randomised controlled trial assessing the effectiveness of the intervention at improving self-reported physical activity. MethodsA total of 184 participants received the intervention and were asked each week for 13 weeks to provide comment on their use and the usefulness of the digital physical activity behaviour change intervention. In addition, after 13 weeks, 12 participants took part in a semistructured interview to understand their use and the usefulness of the intervention. A thematic analysis was conducted on the combined qualitative data set. ResultsA total of 128 of the 184 intervention participants (70.11%) provided at least one qualitative comment over the course of the evaluation (mean number of comments per participant = 5); in total, 674 comments were received. The thematic analysis identified three themes: (1) dipping in and out, (2) one size does not fit all and (3) monitoring and feedback. The qualitative data suggest that participants used the intervention sporadically, dipping in and out due to other commitments, and competing programmes, their changing physical ability, confidence and motivation. Not getting off to a good start was detrimental to use; many wanted to come back to the programme at a more appropriate time. A ‘one size fits’ approach catered for some but not all participants. Whilst not a predetermined intervention component the act of monitoring levels of activity as a data collection method seemed to encourage physical activity but may also result in negative social comparisons. ConclusionDigital physical activity behaviour change interventions are not one-size-fits-all; personalisation is key. Monitoring of activity by a named person can create commitment. Many dip in and out. Digital physical activity behaviour change interventions could complement physiotherapy exercises for people with musculoskeletal conditions. Signposting to local activities should be considered.

Multimodal Neuromarkers Predict Successful Physical Activity Engagement in Older Adults with Vascular Disease

AbstractBackgroundPhysical inactivity is a significant risk factor for cognitive decline, particularly in vulnerable populations including those with cardiovascular risk‐factors1. To better understand the mechanisms that support positive physical activity engagement, the current study aimed to evaluate whether neuromarkers can predict future change in physical activity among older adults with a newly diagnosed cardiovascular risk‐factor.MethodWe analyzed baseline resting‐state functional and structural magnetic resonance imaging (MRI) data from the UK‐Biobank, a large population longitudinal cohort (n = 365; mean age = 62.10 years ± 6.5; cognitively normal). Brain imaging was obtained at baseline, and physical activity data was obtained at baseline and follow‐up after 5 years. Inclusion criteria were a new diagnosis of a cardiovascular risk factor (hypertension, type‐II diabetes‐mellitus, dyslipidemia, cardiac angina or myocardial infarction) between baseline and follow‐up; and did not meet the World Health Organization recommended 150 minutes/week of moderate or 75 minutes/week of vigorous physical activity at baseline. Demographic variables including age, sex, and education were included as covariates of non‐interest.To assess whether baseline resting‐state brain imaging predicts future change in physical activity behaviour, we performed a kernel‐ridge‐regression model with 5‐fold nested‐cross‐validation. Preprocessed neuroimaging data was used as input for the analysis, and the machine‐learning pipeline included feature reduction using grid‐search, hyperparameter selection, and model‐building: the model predicts whether test subject successfully increased physical activity engagement at follow up (reported above 150 min/week moderate or 75 min/week vigorous physical activity). Permutation‐testing (100 times) was performed before evaluating prediction metrics using accuracy and Receiver Operating Characteristic curves.ResultOur prediction model delivered an accurate performance with average accuracy of 0.861 ± 3.8, and 0.883 ± 4.2 area under the curve (AUC) in predicting future behaviour change from physically inactive at baseline to physically active in follow up.ConclusionThese results show baseline brain imaging can accurately predict physical activity behavior change in older adults with new cardiovascular disease. Leveraging machine‐learning methods to predict future lifestyle engagement will help characterize the neural mechanisms that support successful lifestyle change after a new cardiovascular diagnosis.1. Gallen et al. Trends in Cog Sci. 2019

Designing EXercise for Cognitive hEalth in depression and anxiety: the EXCEL study

AbstractBackgroundPhysical inactivity significantly contributes to chronic disease burden, including increasing dementia risk. Physical activity (PA) can benefit cognitive health for groups at high‐risk of dementia, such as people experiencing cognitive concerns (including mild cognitive impairment and subjective cognitive decline), and mental health symptoms. However, understanding how to best enable people with co‐occurring cognitive and mental health concerns to increase PA for dementia risk reduction (DRR) remains challenging for researchers, resulting in lower adherence in clinical trials and limiting the impact of implementation in clinical practice. The EXCEL PA implementation study incorporated design approaches from behavioral science that were novel to DRR, to improve intervention tailoring and engagement. We report findings from the first phase of EXCEL, which aimed to understand PA behavior change needs in this population and identify unique intervention tailoring requirements to enable more effective engagement.MethodThe study used the Capability, Opportunity and Motivation (COM‐B) model of behavior change as an organizing framework. Middle‐aged and older people (aged 45 – 85 years) experiencing subjective cognitive decline (SCD) or mild cognitive impairment (MCI) and mild‐moderate depression or anxiety were interviewed. Themes from semi‐structured interviews examining PA and DRR perspectives were triangulated with findings from published PA intervention trials to identify convergent and complementary themes. Integrated findings were mapped to the study framework to develop a specified, contextualized model of key factors influencing PA behavior change and matched intervention approaches.ResultData from 21 interviews and 24 relevant papers were included. Identified areas requiring behavior change support in the target population that have not been emphasized in theory or previous interventions included:• Emotional regulation• Turning intentions into action despite distractions or barriers• Confidence in existing skills, including to overcome barriers and regulate emotionThese aligned with and extended COM‐B and provided a model to guide the EXCEL intervention.ConclusionThis novel model used behavioral science methods to tailor an intervention for people experiencing cognitive concerns and depression or anxiety, supporting improved PA engagement and impact for an at‐risk population (see Ellis et al. AAIC‐23, submitted, for trial results).