Physical Activity Intervention For Women Research Articles

A lifestyle physical activity intervention for women in alcohol treatment: A pilot randomized controlled trial

IntroductionCompared to men, women with alcohol use disorder (AUD) are more likely to drink to manage stress and negative affect. Given women's risk for poor drinking outcomes, it is critical to develop and test interventions that target these affective factors. Physical activity improves negative affect and has emerged as a promising adjunct to AUD treatment and, thus, may be especially valuable for women. MethodsFifty women with AUD (49.9 ± 12.0 years of age) participated in either a 12-week telephone-delivered lifestyle physical activity plus Fitbit (LPA + Fitbit) or a health education contact (HEC) control intervention following a partial hospital addictions treatment program. The study examined changes in drinking behaviors, mental health outcomes, and physical activity engagement post-intervention using both conventional test statistics and standard effect sizes. ResultsHigher rates of continuous abstinence during the 12-week period were observed in the LPA + Fitbit condition (55.6 %) than in the HEC condition (33.6 %); odds ratio = 2.97. However, among women who drank any alcohol during the 12-weeks, slightly higher rates of heavy drinking and drinks/day were observed among women in the LPA + Fitbit condition. Significant differences for improved mental health outcomes (including depression, anxiety, negative affect, positive affect, perceived stress, and behavioral activation) and increased self-reported physical activity were consistently observed among participants in the LPA + Fitbit condition, relative to HEC. ConclusionsThe LPA + Fitbit program had a positive impact on alcohol abstinence, mental health, and physical activity in adult women receiving treatment for AUD. Future research should continue to investigate the optimal implementation strategies, duration, and intensity of LPA interventions in the context of a fully-powered RCT.

DNP-PhD Collaboration in NINR-Funded Physical Activity Trials: A Series of Case Studies.

Collaboration between Doctor of Nursing Practice (DNP) scholars and Doctor of Philosophy (PhD) scholars is crucial to efficiently advance and disseminate nursing science. Also, DNP-PhD collaboration can help achieve priorities outlined in the recent National Institute of Nursing Research (NINR) Strategic Plan. The purpose of this series of case studies is to describe exemplars of ongoing DNP-PhD collaborations across three NINR-funded trials (1 completed, 2 ongoing) testing physical activity interventions for women at risk for cardiovascular disease. In our three physical activity intervention trials for women, we categorized examples of DNP-PhD collaboration by the four phases of the team-based research model (development, conceptualization, implementation, and translation). Across all three trials, DNP and PhD scholars contributed successfully to all phases of research in an iterative manner. Future work should focus on expanding DNP-PhD collaboration in behavioral trials, which can inform adapted, contemporary models of iterative DNP-PhD collaboration.

Designing physical activity interventions for women aged 50+: a qualitative study of participant perspectives

BackgroundThe Active Women over 50 trial tested a scalable program for increasing physical activity among women aged 50+. The program included information, activity tracker and email support. This study sought to describe the participant perspectives of the Active Women over 50 program and considerations for designing physical activity interventions for this demographic.MethodsWomen who completed the Active Women over 50 trial were purposively recruited for maximum variation in age, employment, carer responsibility, medical conditions and physical activity. Individual semi-structured interviews explored their perspectives on physical activity, Active Women over 50 program components and suggestions for future iterations. Data were thematically analysed.ResultsParticipants’ capacity to be physically active was shaped by an interplay of factors. Our analysis generated four main themes relating to physical activity in general and to the program: Age and gender matters, Physical activity is social, Strategising for physical activity and the Self-responsibility discourse. At this midlife stage, physical activity participation was challenged by personal, life-stage and cultural factors, alongside a tension of the self-responsibility discourse which also impacted the program experience. Social factors and finding a suitable strategy for motivation were deemed integral aspects of being active. Future programs could consider facilitation of social networks and accountability, life-stage health information and positive framing to support self-responsibility.ConclusionA range of strategies is key to supporting women over 50 to be more physically active due to the variety of circumstances and levels of agency experienced. We offer suggestions that do not need to be resource intensive but could be incorporated into a scaled program.

A self-efficacy-enhancing physical activity intervention in women with high-risk factors for gestational diabetes mellitus: study protocol for a randomized clinical trial

BackgroundGestational diabetes mellitus (GDM) is one of the most common medical disorders in pregnancy. Evidence has demonstrated that moderate-intensity physical activity may reduce the risk of gestational diabetes. However, women at risk of GDM spend most of their time performing sedentary behaviors. Although researchers identified self-efficacy as a mediator to overcome physical activity barriers, exercise intervention during pregnancy based on self-efficacy theory has not been discussed so far. Furthermore, there is conflicting evidence regarding the effects of a physical exercise intervention on the incidence of GDM and other maternal or neonatal outcomes in women at higher risk for GDM.Methods/designA single-center, parallel, randomized controlled trial will be conducted in a maternal–child health care center. A total of 244 pregnant women at high risk for GDM will be randomized into a study group receiving a self-efficacy-enhancing physical activity intervention or a control group receiving the usual care. The intervention will consist of four group sessions and everyday reminders by WeChat (Tencent, Shenzhen, China). The program will begin at approximately 13–14+6 gestational weeks and end at 36+6 gestational weeks. The primary outcomes will include the incidence of GDM, blood sugar values, and physical activity. The secondary outcomes will include physical activity self-efficacy, gestational weight gain, maternal outcomes, and neonatal outcomes.DiscussionThe findings of this research will contribute toward understanding the effects of a self-efficacy theory-oriented physical activity program on the incidence of GDM, blood sugar values, physical activity level, gestational weight gain, physical activity self-efficacy, maternal outcomes, and neonatal outcomes.Trial registrationChinese Clinical Trial Registry (CHiCTR) ChiCTR2200056355. Registered on February 4, 2022.

Abstract 11350: DNP-PhD Collaboration in NIH-funded Physical Activity Trials for Women at Risk for Cardiovascular Disease: A Team Science Approach

Doctorally prepared nurse scholars with the doctor of nursing practice (DNP) and the doctor of philosophy (PhD) degrees are equally well suited to engage in scholarship to advance cardiovascular nursing and health outcomes. Collaboration between DNP and PhD scholars is crucial to develop interventions to improve cardiovascular outcomes and encourage efficient translation of research findings into practice. The purpose of this paper is to (1) provide a targeted review of the current state of literature on examples of DNP-PhD collaboration, and (2) describe ongoing DNP-PhD collaborations across three NIH-funded trials (1 completed, 2 ongoing) testing physical activity interventions for women at risk for cardiovascular disease. First, a targeted review was conducted to identify examples of DNP-PhD collaboration, and identified 12 published articles. Articles described the DNP-PhD collaborations in research/scholarship ( n = 8) and education ( n = 5). Of the research articles, there was evidence of collaboration in evidence-based practice projects for various health outcomes. However, none of the articles described DNP-PhD collaboration in NIH-funded clinical trials, including behavioral interventions for cardiovascular health. Three physical activity interventions for women at risk for cardiovascular disease were or are being tested in three trials (NCT01700894, NCT03558828, NCT04556305). Examples of DNP-PhD collaboration are categorized according to the four Team Science Phases. Research teams are led by PhD nurse scholars who oversee design and implementation (Development, Conceptualization, Implementation, Translation). DNP scholars provide clinical feedback in advisory panels and focus groups (Development, Conceptualization), provide training to intervention teams, lead personal call and group interventions (Implementation), facilitate patient referrals for participation (Implementation), oversee intervention safety (Implementation, Translation), and contribute to dissemination (Translation). DNP-PhD collaboration is important for all phases of NIH behavioral trials to optimize outcomes. There is a need for additional publications to detail applicable DNP-PhD collaborations in NIH-funded nursing research.

Physical activity interventions using behaviour change theories for women with breast cancer: a systematic review and meta-analysis.

Physical activity is a well-established strategy to alleviate breast cancer-related adverse outcomes. To optimise health benefits, behaviour change theories provide frameworks to support women in improving their physical activity. This review aimed to evaluate (i) the effects of behaviour change theory-based physical activity interventions for women with breast cancer and (ii) the application of these theories. Seven online databases were searched. Trials were included if randomised and controlled, involved physical activity interventions ≥ 12weeks duration, used a behaviour change theory, and participants were < 3years post-cancer treatment. Risk of bias and theory use were assessed. Data were synthesised narratively and meta-analysed. Forty articles describing 19 trials were included. Overall risk of bias was moderately high. Post-intervention pooled effect estimates were medium for self-reported (SMD = 0.57) and objectively measured physical activity (SMD = 0.52). Most trials cited the social cognitive theory (n = 10) and transtheoretical model (n = 9). Trials rarely applied theories in their entirety, expounded on behavioural mechanisms, or tailored interventions according to behavioural constructs. The most commonly used types of behavioural techniques were goals and planning (n = 18), shaping of knowledge (n = 18), feedback and monitoring (n = 17), and comparisons of outcomes (n = 17). The included trials were effective for increasing physical activity in women with breast cancer. Theories were applied using a wide range of approaches and levels of rigour, although shared the use of common behavioural techniques. Future research may benefit breast cancer survivors by more comprehensively applying behaviour change theories, emphasising individual patient needs and goals.

Sarcopenia and serum biomarkers of oxidative stress after a 6-month physical activity intervention in women with metastatic breast cancer: results from the ABLE feasibility trial

PurposeSarcopenia has been identified as an important prognostic factor for patients with cancer. This study aimed at exploring the potential associations between a 6-month physical activity intervention and muscle characteristics, sarcopenia, oxidative stress and toxicities in patients with metastatic breast cancer.MethodsWomen newly diagnosed with metastatic breast cancer (N = 49) participated in an unsupervised, personalized, 6-month physical activity intervention with activity tracker. Computerized tomography images at the third lumbar vertebra were analysed at baseline, three months and six months to assess sarcopenia (muscle mass index < 40 cm2/m2) and muscle quality (poor if muscle attenuation < 37.8 Hounsfield Units). Oxidative markers included plasma antioxidant enzymes (catalase, glutathione peroxidase and superoxide dismutase activities), prooxidant enzymes (NADPH oxidase and myeloperoxidase activities) and oxidative stress damage markers (advanced oxidation protein products, malondialdehyde (MDA) and DNA oxidation.ResultsAt baseline 53% (mean age 55 years (SD 10.41)) were sarcopenic and 75% had poor muscle quality. Muscle cross sectional area, skeletal muscle radiodensity, lean body mass remained constant over the six months (p = 0.75, p = 0.07 and p = 0.75 respectively), but differed significantly between sarcopenic and non-sarcopenic patients at baseline and 6-months. Sarcopenic patients at baseline were more likely to have an increase of MDA (p = 0.02) at 6 months. Being sarcopenic during at least one moment during the 6-month study was associated with a higher risk of developing severe toxicities (grade > 2) (p = 0.02).ConclusionsThis study suggests potential benefits of physical activity for maintenance of muscle mass. Sarcopenia can alter many parameters and disturb the pro and antioxidant balance.

Learn to Run for Anxiety Sensitivity: A Short-Term, Community-Based, Accessible Physical Activity Intervention for Women

Women, relative to men, are at particularly high risk for anxiety and depression, perhaps in part due to their heightened levels of anxiety sensitivity (AS). Physical activity (PA) is an accessible mental health intervention that may be particularly beneficial for women. Using a within-subjects pre-post mixed methods design, this study tested the acceptability, appropriateness, feasibility, and evidence-base of a community-based PA intervention for AS among women at high risk for anxiety and depression. Participants were 45 women with high AS who completed an 8-week group PA intervention. Data were collected via self-report questionnaires, interviews, and recruitment, participation, and retention rates. Results suggest the intervention is acceptable, appropriate, and feasible. Interviews reveal high intervention satisfaction and perceived benefits beyond AS reduction. There was a relatively high attrition rate that suggests room for improvement. The intervention significantly reduced AS, as well as panic, social anxiety, generalized anxiety, and depression symptoms. In the context of the preliminary nature of this study, results suggest the use of community-delivered, group-based PA as a mental health intervention strategy for women is worth further exploration. There is potential for collaboration between the health system, PA delivery professionals, and community organizations to improve access to care.

Adiposity and cardiovascular outcomes in three-year-old children of participants in UPBEAT, an RCT of a complex intervention in pregnant women with obesity.

Maternal obesity is associated with offspring cardiometabolic risk. UPBEAT was a randomised controlled trial of an antenatal diet and physical activity intervention in 1555 women with obesity. The intervention was associated with lower gestational weight gain, healthier diet and metabolic profile in pregnancy, and reduced infant adiposity at six months. We have investigated whether the UPBEAT intervention influenced childhood cardiometabolic outcomes or was associated with sustained improvements in maternal lifestyle 3-years after delivery. In UPBEAT mother-child dyads at the 3-year follow-up, we assessed childhood blood pressure, resting pulse rate, and adiposity (body mass index, skinfold thicknesses, body fat, waist and arm circumferences) and maternal diet, physical activity, and anthropometry. 514 three-year-old children attended the appointment (49% intervention, 51% standard care). There was no difference in the main outcome of interest, subscapular skinfold thickness, between the trial arms (-0.30 mm, 95% confidence interval: -0.92, 0.31). However, the intervention was associated with a lower resting pulse rate (-5 bpm [-8.41, -1.07]). There was also a non-significant lower odds of overweight/obesity (OR 0.73; 0.50, 1.08). Maternal dietary improvements observed in the UPBEAT trial, including glycaemic load and saturated fat were maintained 3-years postpartum. This study has demonstrated that an antenatal dietary and physical activity intervention in women with obesity is associated with lower offspring pulse rate and sustained improvement in maternal diet. Whilst larger than previous cohorts, there remains potential for bias from attrition and these findings require validation in future cohorts.

Recruitment and retention in a self-directed “walking” intervention: Feasibility study in women with metastatic breast cancer during active treatment.

e13084 Background: Health related quality of life (HRQOL) and physical function are greatly impacted by the diagnosis and treatment of metastatic breast cancer (MBC). This study investigates the ability of women with MBC to engage in moderate walking during active treatment, with exercise monitored through a FitbitTM activity tracker. Methods: This is a single-site feasibility study of a home-based, self-directed physical activity intervention for women with MBC who could have had up to three lines of treatment. Questionnaires were completed at baseline, 12 weeks, and 24 weeks. Results: Sixty patients were consented, with mean age 55 (SD 11.1), 21% non-white, and 56% ECOG = 0. 36% were in their 3rd or 4th line of chemotherapy treatment. 65% had metastases to the bone, 46% to the lung, and 33% to the liver; mean number of metastasis sites was 2 (range 1 to 4). N = 52 completed all baseline measurements; N = 40 remained in the study at 3 months, and N = 29 at 6 months. Of the N = 31 (52%) lost to attrition, N = 6 were due to death, N = 5 due to deterioration, and N = 20 due to patient withdrawal from the study. Mean walking steps per day of at least 4000 was achieved in months 1, 2 and 3 by 41%, 50%, and 41% of participants. In months 4, 5 and 6, these percentages were 45%, 51% and 39%. On a scale from 1 = very confident to 10 = not at all confident about “continuing to walk or be physically active after completing the study”, confidence scores were 2.8 (SD 2.8) at 3 months and 2.9 (2.9) at 6 months. Conclusions: Forty-nine percent of women with MBC who signed up for a home-based walking program during active treatment were able to complete the 24-week intervention, with high proportions of these women walking more than 4000 steps per day. Moderate walking is feasible for women with MBC on active treatment.

Feasibility and Health Benefits of an Individualized Physical Activity Intervention in Women With Metastatic Breast Cancer: Intervention Study.

BackgroundThere is limited knowledge regarding the potential benefits of physical activity in patients with metastatic breast cancer.ObjectiveThe Advanced stage Breast cancer and Lifestyle Exercise (ABLE) Trial aimed to assess the feasibility of a physical activity intervention in women with metastatic breast cancer and to explore the effects of physical activity on functional, psychological, and clinical parameters.MethodsThe ABLE Trial was a single-arm, 6-month intervention study with a home-based, unsupervised, and personalized walking program using an activity tracker. At baseline and 6 months, we assessed anthropometrics, functional fitness, physical activity level, sedentary behavior, quality of life, fatigue, and tumor progression. Paired proportions were compared using the McNemar test and changes of parameters during the intervention were analyzed using the Wilcoxon signed-rank test, the Mann-Whitney test, and Spearman rank correlations.ResultsOverall, 49 participants (mean age 55 years; recruitment rate 94%) were enrolled and 96% adhered to the exercise prescription (attrition rate 2%). Statistically significant improvements in the 6-minute walking distance test (+7%, P<.001) and isometric quadriceps strength (+22%, P<.001), as well as decreases in body mass index (-2.5%, P=.03) and hip circumference (-4.0%, P<.001) were observed at 6 months. Quality of life remained stable and a nonstatistically significant decrease (-16%, P=.07) in fatigue was observed.ConclusionsThe high recruitment and adherence rates suggest the willingness of patients with metastatic breast cancer to participate in a physical activity program. The beneficial outcomes regarding physical fitness and anthropometry of this unsupervised physical activity program may encourage these patients to maintain a physically active lifestyle. Future randomized controlled trials with larger sample sizes are warranted.Trial RegistrationClinicalTrials.gov NCT03148886; https://clinicaltrials.gov/ct2/show/NCT03148886

Physical activity preferences before and after participation in a 6-month physical activity intervention among women with metastatic breast cancer.

This secondary analysis of the ABLE Trial (ClinicalTrials.gov NCT03148886) aimed to assess physical activity preferences before and after a 6-month physical activity intervention for women recently diagnosed with metastatic breast cancer and to investigate demographic and clinical correlates of these preferences. Forty-nine patients participated in the ABLE Trial, a single-arm, unsupervised 6-month physical activity intervention with activity trackers. At baseline and 6months, physical activity preferences, physical activity level, clinical variables, demographics and social vulnerability were assessed. At baseline, 49 participants were included, among whom 85% were interested in receiving physical activity counselling and 89% were interested in following a physical activity programme designed for metastatic breast cancer. At the end of the study, more participants preferred practising in a community fitness centre (66%) rather than at home (19% vs. 44% at baseline, p=.03). A higher social vulnerability score and not being treated by chemotherapy at baseline were significantly associated with lower desire to receive physical activity counselling (p=.01 and p=.04 respectively). This study will help design future studies within patients with metastatic breast cancer in accordance with their preferences. Designing tailored physical activity interventions according to the participant's preferences may be one key to success for adherence.

Exploring the effectiveness of physical activity interventions in women with previous gestational diabetes: A systematic review of quantitative and qualitative studies.

Women with previous Gestational Diabetes Mellitus (GDM) have seven times the risk of Type 2 diabetes later in life compared to women without GDM. Physical activity can reduce this risk and most women with previous GDM are not physically active.AimsTo explore: (1) effectiveness of physical activity interventions for women with previous GDM; (2) factors that women with previous GDM perceive influence their physical activity; (3) how these factors are addressed by the interventions.MethodsA systematic review of quantitative (aim 1) and qualitative (aim 2) studies with a mixed-methods synthesis (aim 3) was conducted in October 2017 following Cochrane methodology. Of 8101 articles identified, twenty-eight studies were included in total: 18 in Review 1 and 10 in Review 2.ResultsFour interventions significantly increased physical activity and 14 had either mixed effectiveness or no changes in physical activity. Reporting of intervention components and study quality varied greatly. Relevant qualitative factors included accounting for childcare issues, social support and cultural sensitivities. Interventions that incorporated these factors were associated with effectiveness. Education about how to reduce future risk of Type 2 diabetes and using pedometers in interventions were not associated with intervention effectiveness. Other factors that future interventions should address consist of ‘putting others before yourself’; ‘putting off lifestyle change’; ‘lack of support from healthcare professionals’ and ‘being a healthy role model for families’.ConclusionCombining the results of qualitative and quantitative studies can provide a nuanced understanding of the effectiveness of physical activity and lifestyle interventions.

Measure, Record, Share: Weight Loss, Biometrics, and Self-Tracking in the U.S.

W earable fitness devices are currently enjoying a moment of heightened popularity. 2 Lupton D Self-tracking, health and medicine. Health Sociol Rev. 2017; 26: 1-5https://doi.org/10.1080/14461242.2016.1228149 Crossref Scopus (53) Google Scholar Health professionals, industry executives, and consumers all seem to be touting the possibility for these devices to assist with everything from chronic disease management to sleep monitoring and more. 3 Evenson KR Wen F Furberg RD Assessing validity of the Fitbit indicators for U.S. public health surveillance. Am J Prev Med. 2017; 53: 931-932https://doi.org/10.1016/j.amepre.2017.06.005 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar The popularity of these wearable health tracking devices is provoking a great deal of commentary in both professional and popular media. On one side, there are positive stories, as in the case where wearing a fitness tracker helped Emergency Department physicians save a man's life when he suffered a stroke. 4 Moore E Man's Fitbit helps save his life. USA Today. 2016; (Published April 9, 2016. Accessed May 31,)www.usatoday.com/story/tech/nation-now/2016/04/09/fitbit-mans-doctors-save-his-life/82830114/Date: 2018 Google Scholar Also, numerous clinical trials are underway using self-monitoring software technology as their major source of evidence. 5 Comstock J 18 more clinical trials using Fitbit activity tracker right now. Mobi Health News. 2018; (Published April 13, 2016. Accessed May 31,)www.mobihealthnews.com/content/18-more-clinical-trials-using-fitbit-activity-trackers-right-nowDate: 2018 Google Scholar On the other hand, some physicians have worried about how their medically inexpert patients might use or interpret the data their wearable device gives them, possibly jeopardizing their health. 6 Cha A Health and data: can digital fitness monitors revolutionize our lives?. The Guardian. 2015; (Published May 19, 2015. Accessed May 31,)www.theguardian.com/society/2015/may/19/digital-fitness-technology-data-heath-medicineDate: 2018 Google Scholar Other discourse about these devices can tend towards the dystopian in nature, rife with the possibility of infringements on privacy by workplaces and municipalities because the Fitbit brand of wearable tracker in particular has recently become a popular tool of corporate wellness programs. 7 Farr C How Fitbit became the next big thing in corporate wellness. Fast Company. 2016; (Published April 18, 2016. Accessed May 31,)www.fastcompany.com/3058462/how-fitbit-became-the-next-big-thing-in-corporate-wellnessDate: 2018 Google Scholar Though fitness tracking appears to have many potentially positive applications from a public health standpoint, concerns remain, ranging from the possible limitations of lasting behavioral changes, to the accuracy of devices, to the cost associated with acquiring the technology. 8 Cadmus-Bertram LA Marcus BH Patterson RE Parker BA Morey BL Randomized trial of a Fitbit-based physical activity intervention for women. Am J Prev Med. 2015; 49: 414-418https://doi.org/10.1016/j.amepre.2015.01.020 Abstract Full Text Full Text PDF PubMed Scopus (284) Google Scholar

Perceptions of a Peer Modeling Workplace Physical Activity Intervention for Women.

A workplace physical activity (PA) study tested a novel use of peers to deliver the intervention. Peer models provided vicarious experience for living physically active lifestyles to a group of inactive women. The purpose of this study was to describe participants' perceptions of the peer modeling intervention. Nine women from the intervention group ( n = 26) participated in a 90-minute focus group. Qualitative description using thematic analysis was used to identify themes from the focus group transcript. Two themes about the intervention were "I am left wanting more" and "focus on food." Two themes about the peer models were "real people" and "it is doable." Focus group participants perceived the peer modeling PA intervention favorably; however, they desired more attention to healthy eating and more time with peer models. Replication of the study accounting for themes identified by focus group participants is needed to strengthen the peer modeling intervention.

Feasibility and Effect of a Peer Modeling Workplace Physical Activity Intervention for Women.

Most working women do not meet current guidelines for physical activity (PA). A 12-week pilot study tested a workplace, peer modeling PA intervention. Inactive female employees from a health system were randomized to an attention control group (ACG; n = 26) or an intervention group (IG; n = 26). The ACG received health information. The IG participated in six group sessions with an active peer model and received an exercise prescription and PA information. Pre and post measures were PA (ActiGraph), Estimated VO2max (cycle ergometer), resting heart rate (HR), glucose and lipids, and cardiovascular risk. Using hierarchical linear modeling, no significant group by time effects were found. Although PA increased in both groups, F( df = 1) = 11.4, p = .002, the IG had greater improvements in fitness (VO2max, HR) and cardiovascular risk (total cholesterol, triglyceride, low density lipoprotein [LDL], calculated risk score) compared with ACG. Results support repeating this intervention in a fully powered study.

A six week contextualised physical activity intervention for women living with HIV and AIDS of low socioeconomic status: a pilot study

ABSTRACTResearch has consistently shown the benefits of regular physical activity (PA) for women living with HIV and AIDS (WLWHA). This study is a pilot, randomised controlled crossover trial, reporting the effects of a contextualised PA intervention amongst a sample of 21 HIV positive Xhosa-speaking women of low socioeconomic status (SES). The study determined total moderate-to-vigorous PA (TMVPA) as measured subjectively by the Global Physical Activity Questionnaire (GPAQ), total weekly steps (TWS) as measured by a pedometer, and self-efficacy for PA as measured by the Physical Exercise Self-efficacy scale (PESES). Multivariate analysis of covariance (MANCOVA) was used to compute the impact of the intervention on TMVPA, TWS, and self-efficacy for PA from baseline to six weeks, and baseline to 12 weeks post-intervention controlling for pre-test differences in TMVPA. Results showed that participants exposed to the intervention had significant increases in PA as measured by TMVPA (p = .027), TWS (p = .032), as well as exercise self-efficacy (p = .000) from pre-test to 6 weeks. Insignificant findings were reported for all three variables when measured from baseline to 12 weeks. In conclusion, the findings of the pilot study suggest that the intervention was effective in producing significant increases in PA in a sample of PLWHA of low SES over six weeks. Careful consideration of behavioural constructs, such as self-efficacy, can help WLWHA of low SES to adopt regular PA as a complementary therapy for managing their health.

Abstract P284: ClusterAnalysis of Objectively Measured Physical Activity Patterns in Women in the mPEDTrial

Background: Determining patterns of physical activity throughout the day could assist in developing more personalized interventions or physical activity guidelines in general, and in particular for women, who are less likely to be physically active than men. Objective: The aims of this report are to identify clusters of women based on accelerometer measured raw metabolic equivalent values (METs) and a normalized version of the METs ≥ 3 data and to compare sociodemographic and cardio metabolic risks among these identified clusters. Methods: 215 women wearing an accelerometer for at least 8 hours per day for the last 7 days prior to the randomization visit were analyzed. A K-means clustering method, the Lloyd’s algorithm, was used. To choose the number of clusters, we used the elbow method, looking at the percentage of variance explained as a function of the number of clusters. Results: The results of k means cluster analyses of raw METs revealed three different clusters (Figure 1) and the Low Active Group (n=102) had the highest depressive symptoms score compared to the Afternoon Active (n=65) and Morning Active (n=48) groups (overall P &lt; .001). Based on a normalized version of the METs ≥ 3 data Figure 2), the moderate to vigorous physical activity (MVPA) Evening Peak group (n = 108) had higher BMI, and waist and hip circumference than the MVPA Noon Peak group (n=61) (overall P =.03, .02, and .03 respectively). Conclusions: Categorizing physical inactive individuals into more specific activity patterns could aid in creating timing, frequency, duration, and intensity of physical activity interventions for women. Further research is needed to confirm these cluster groups using a large national dataset.

Objectively Measured Baseline Physical Activity Patterns in Women in the mPED Trial: Cluster Analysis.

BackgroundDetermining patterns of physical activity throughout the day could assist in developing more personalized interventions or physical activity guidelines in general and, in particular, for women who are less likely to be physically active than men.ObjectiveThe aims of this report are to identify clusters of women based on accelerometer-measured baseline raw metabolic equivalent of task (MET) values and a normalized version of the METs ≥3 data, and to compare sociodemographic and cardiometabolic risks among these identified clusters.MethodsA total of 215 women who were enrolled in the Mobile Phone Based Physical Activity Education (mPED) trial and wore an accelerometer for at least 8 hours per day for the 7 days prior to the randomization visit were analyzed. The k-means clustering method and the Lloyd algorithm were used on the data. We used the elbow method to choose the number of clusters, looking at the percentage of variance explained as a function of the number of clusters.ResultsThe results of the k-means cluster analyses of raw METs revealed three different clusters. The unengaged group (n=102) had the highest depressive symptoms score compared with the afternoon engaged (n=65) and morning engaged (n=48) groups (overall P<.001). Based on a normalized version of the METs ≥3 data, the moderate-to-vigorous physical activity (MVPA) evening peak group (n=108) had a higher body mass index (P=.03), waist circumference (P=.02), and hip circumference (P=.03) than the MVPA noon peak group (n=61).ConclusionsCategorizing physically inactive individuals into more specific activity patterns could aid in creating timing, frequency, duration, and intensity of physical activity interventions for women. Further research is needed to confirm these cluster groups using a large national dataset.Trial RegistrationClinicalTrials.gov NCT01280812; https://clinicaltrials.gov/ct2/show/NCT01280812 (Archived by WebCite at http://www.webcitation.org/6vVyLzwft)

Accessing and engaging women from socio-economically disadvantaged areas: a participatory approach to the design of a public health intervention for delivery in a Bingo club.

BackgroundOur aim was to use participatory methods to investigate the feasibility and acceptability of using Bingo clubs for the design and delivery of an evidence-based physical activity and/or healthy eating intervention to socio-economically disadvantaged women. This paper describes the participatory process that has resulted in a physical activity intervention for women aged >55 years, ready for pilot-testing in a Bingo club setting.MethodsStudies using different quantitative and qualitative approaches were conducted among customers and staff of a Bingo club in a city of 85,000 inhabitants in central Scotland. These were designed to take the views of different stakeholders into account, with a view to enhancing uptake, engagement and effectiveness with any proposed intervention.ResultsSixteen relevant studies were identified in a literature review that generated ideas for intervention components. A questionnaire completed by 151 women in the Bingo club showed that almost half (47 %) aged >55 years were not meeting physical activity guidelines; evidence backed up by accelerometer data from 29 women. Discussions in six focus groups attended by 27 club members revealed different but overlapping motivations for attending the Bingo club (social benefits) and playing Bingo (cognitive benefits). There was some scepticism as to whether the Bingo club was an appropriate setting for an intervention, and a dietary intervention was not favoured. It was clear that any planned intervention needed to utilise the social motivation and habitual nature of attendance at the Bingo club, without taking women away from Bingo games. These results were taken forward to a 5-h long participative workshop with 27 stakeholders (including 19 Bingo players). Intervention design (form and content) was then finalised during two round table research team meetings.ConclusionsIt was possible to access and engage with women living in areas of socio-economic disadvantage through a Bingo club setting. A physical activity intervention for women >55 years is realistic for recruitment, will address the needs of potential recipients in the Bingo club, appears to be feasible and acceptable to club members and staff, and has been designed with their input. A pilot study is underway, investigating recruitment, retention and feasibility of delivery.