The impact of short-term incentives on physical activity in a UK behavioural incentives programme.
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ABSTRACT:
SUBMITTER: Hajat C
PROVIDER: S-EPMC6746750 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
Publications
The impact of short-term incentives on physical activity in a UK behavioural incentives programme.
Hajat Cother C Hasan Ali A Subel Shaun S Noach Adam A
NPJ digital medicine 20190916
This observational study investigates whether the provision of ongoing short-term-incentives for verified physical activity increases and sustains levels of physical activity. We compared UK members at baseline (years 1 and 2) prior to Vitality's Active Rewards (VAR) intervention commencing (year 3) and follow-up (year 4) for verified, self-reported (encompassing additional physical activities), mortality relative risk and satisfaction with physical activity. Members were categorised into low-ac ...[more]
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Project description:BackgroundMost adults with overweight/obesity participating in behavioural weight loss (BWL) programmes never achieve prescribed physical activity (PA) levels. This study examined changes in PA barriers, their relationships with accelerometer-measured PA during and after a 12-month BWL programme, and associations between PA barriers and participant characteristics.MethodsAdults (N = 283) in a BWL programme completed the Barriers to Being Active Quiz, a 21-item self-report measure that assesses seven perceived PA barriers, and they wore an accelerometer for seven consecutive days at baseline and at 6 (midtreatment), 12 (end of treatment), 18 (6-mo follow-up), and 24 months (12-mo follow-up). Weight and height were measured, and demographic information was collected at baseline.ResultsRepeated-measures analyses of variance (ANOVAs) revealed a significant quadratic effect of time on total PA barriers, P < .001, such that PA barriers decreased by midtreatment, remained below baseline levels by end of treatment, but increased to near-baseline levels by follow-up. Perceived PA barriers were negatively associated with baseline moderate-to-vigorous PA (MVPA), P < .001, and decreases in perceived PA barriers were related to greater MVPA at 6 (P = .004), 12 (P < .001), and 24 months (P = .007). Participants who were younger, P = .02, and white, P = .009, reported more baseline barriers.ConclusionsPerceived PA barriers meaningfully decreased during BWL treatment, which in turn was associated with greater MVPA. This pattern suggests that, on average, BWL effectively addresses perceived PA barriers, which contributes to increased PA. Future research should identify interventions to maintain decreases in barriers after end of treatment.
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Project description:BackgroundDespite a global call for action and growing burden of non-communicable diseases (NCD) associated with physical inactivity, effective interventions to increase community-wide physical activity (PA) remain few. NCDs accounted for 80% of Singapore's disease burden (2015) and yet 40% of Singaporeans did not meet minimum recommended weekly PA despite evidence of the benefits to cardiorespiratory health, diabetes and cancer prevention.MethodsA large-scale public health intervention was initiated in 2015 to increase population-level PA through incidental daily walking. Intervention components included fitness trackers, redeemable rewards and gamification, implemented in a mutually-reinforcing manner within an eco-system supportive of PA and informed by real-time data analytics. Mean daily step count at baseline and post-intervention were compared across periods, and the influence of participant sub-groups characteristics on overall results, using significance tests. Standards for Reporting on Implementation Studies (StaRI) were adhered to.ResultsIntervention reach increased fourfold from 129,677 participants in wave 1 (2015-16) to 690,233 in wave 3 (2017-18) amounting to a total of 1,184,410 Step Challenge participations. Mean days of fitness tracker use increased from 2.4 to 5.0?days/week among participants completing the Challenge in wave 1 and from 5.3 to 6.0?days/week in wave 3. The mean number of daily steps between pre-Challenge and Challenge periods increased by 4163 (sd=1360; p<?0.001) in wave 1, by 2242 (sd=334; p<?0.001) in wave 2 and by 1645 steps/day (sd=54; p<?0.001) in wave 3. Mean daily step increases between wave 1 and 3 also suggest that incidental PA was maintained, a finding supported by a 2017 national population survey showing that incidental PA among adults increased from 5% in 2010 to 14% in 2017 while moderate-intensity PA increased from 5 to 10% over the same period.ConclusionPopulation-level PA was effectively increased through multi-level interventions integrating technology, behavioural economics, gamification, marketing, communications and community linkages within a supportive context- and climate-appropriate environment. Responsive data analytics were instrumental to strengthen implementation by tailoring modalities that maximise effectiveness at population-level. Further analyses are needed to explore potential barriers, challenges or unmet needs in sub-groups with lower uptake to tailor future interventions for greater reach and impact.
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Project description:A nationwide survey was conducted during the first UK lockdown to further understanding of the degree to which motives for exercise were associated with physical activity (PA) behaviours and, in turn, how PA behaviours were associated with mental health. A cross-sectional design was employed and data were collected by use of a one-off online survey (N = 392; 18-85 years; M BMI = 25.48; SD BMI = 5.05; 314 women). Exercise motives, PA, and mental health were measured by use of the Behavioural Regulations in Exercise Questionnaire-3, Brunel Lifestyle Physical Activity Questionnaire, and General Health Questionnaire-12, respectively. Participants were also asked to specify their average step count per day, if they used a mobile device for this purpose (n = 190). Analyses comprised hierarchical regressions and partial correlations. Results indicated that behavioural regulations were more strongly associated with planned PA pre-lockdown, compared to during lockdown. There were no differences observed in explained variance between pre- and during lockdown for unplanned PA and steps per day. Planned and unplanned PA were significant explanatory variables for mental health both pre- and during lockdown, but sedentary behaviour was not. Partial correlations, with BMI and age partialled out, showed that steps per day were not correlated with mental health either pre- or during lockdown. The range of variables used to explain planned and unplanned PA and mental health suggest that people's motives to exercise were tempered by lockdown. For those who routinely measured their steps per day, the step count was unrelated to their mental health scores both pre- and during lockdown. It appears that engagement in regular PA confers some minor benefits for mental health.
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Project description:Further research is needed to improve the evidence regarding determinants of physical activity (PA) as a crucial step to plan higher effective intervention strategies. The goal of the present study is to identify socio-demographic and clinical characteristics of primary care (PHC) insufficiently active patients that are associated with longitudinal changes in the level of physical activity.Longitudinal analysis of baseline socio-demographic and clinical predictors of physical activity change in insufficiently active PHC patients who participated in a PA-promoting multi-centre randomized clinical trial conducted from October 2003 through March 2006. The primary outcome measure was the self-reported physical activity assessed with the 7-day Physical Activity Recall (PAR), at baseline, 6, 12 and 24 months. Baseline covariates included sex, age, social class, anthropometric measures and other cardiovascular risk factors or associated diseases (Diabetes, HTA, tobacco use, etc.), and stage of readiness to change PA. Generalized linear mixed models were used to estimate longitudinal association of studied variables on PA change over the three follow-up measurements.A total of 3691 patients (85% of the 4317 recruited in the trial) with at least one follow-up measurement were included in the longitudinal analysis. At baseline, analysed patients (mean age: 50.6 years; 64.6% women) devoted 34.7 minutes and 2.36 metabolic equivalent hours per week (MET.h/week) to moderate and vigorous physical activity. Older age, male gender, higher social class, lower BMI, diagnosis of diabetes or hypertension, and measurement season were significant predictors of PA longitudinal change. The effect of baseline readiness to change on PA dose was modified by time, showing a positive gradient in favour of those with more readiness to change that increases significantly at 12 and 24 months (p-value interaction < .0001).Identified baseline characteristics such as readiness to change and risk factors can guide physicians to prioritize time and intervention efforts for maximizing their impact on insufficiently active PHC patients.
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Project description:Interventions: The intervention arm is named HoPS, an acronym of Home-based Physical Activity for Survivors.
HoPS intervention programme aims to improve physical activity level among cancer survivors, in particular breast and colorectal cancer by employing Social Cognitive Theory (SCT) in the development of the programme. It combines of psychoeducation and social media approach to behavioural intervention. Participants of the HoPS will be provided with a non-tailored printed material and gradual tapering down of face-to-face group meetings to improve knowledge and skills of physical activity. While WhatsApp is used as a structured direct remote feedback strategy to allow for supervised home-based physical activity.
1. Face-to-face group meetings
There will be 2 meet up sessions for all participants in the HoPS group. The sessions provide a standardized lectures deliver by the researcher using power point slides. The first session of lecture (1-hour duration) will cover the areas of a brief introduction of HoPS programme, physical activity knowledge and goal setting. The second session of lecture (15-minutes duration) will cover for barriers to physical activity and following that a sharing session (15-minutes duration) by a role model (a cancer survivor) to share her experience in engaging in physical activity. In each of the sessions, after the lectures, an exercise session will be conducted by a certified exercise instructor with at least 3 years experienced in coaching for exercise. The duration of this exercise session will be 2 hours and the focus is train the participants on how to perform a proper and correct exercise for cancer survivors. This will involved aerobic exercises and resistance exercis
Primary outcome(s): Total MET-minutes/week using validated IPAQ [Baseline, at 8-week (immediately after intervention) and at 16-week post intervention]
Study Design: Purpose: Educational / counselling / training; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Parallel;Type of endpoint: Efficacy
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| S-EPMC3201968 | biostudies-literature
Project description:ObjectiveDevelop a behavioural analysis of factors influencing postnatal physical activity (PA) according to the 'capability, opportunity, motivation and behaviour' (COM-B) model of behaviour to inform intervention development using the Behaviour Change Wheel (BCW).DesignCross-sectional, multi-method study using semi-structured interviews and a quantitative questionnaire.SettingChildren's centres and mother and baby groups in Hertfordshire and Cambridgeshire, UK.ParticipantsConvenience samples of postnatal women were interviewed (n=16) and completed the questionnaire (n=158).MethodsSemi-structured interviews followed a preprepared topic guide exploring the COM-B model components and analysed using framework analysis. The questionnaire, based on the self-evaluation of behaviour questionnaire, was adapted using patient and public involvement and findings from the interviews. Questionnaire participants rated their agreement with 22 predefined statements related to COM-B model components. Mean, SD and 95% CI were calculated and each item categorised according to importance. Demographic data were collected.ResultsThe questionnaire identified that new mothers would be more active if they had more time, felt less tired, had accessible childcare, were part of a group, advised by a healthcare professional, able to develop a habit and had more motivation. Additional themes emerging from qualitative data were engaging in PA groups with other new mothers, limited physical stamina following complicated births, social interaction, enjoyment and parental beliefs as motivation, provision of child-friendly PA facilities and environments and babies' unpredictable routines.ConclusionThe behavioural analysis presented in this paper identifies and adds detail on the range of factors influencing the target behaviour. Some are unique to the target population, requiring targeted interventions for postnatal women, whereas some are individualised, suggesting the need for individually tailored interventions. We will use the behavioural analysis presented to design an intervention using the subsequent steps in the BCW.
| S-EPMC6686995 | biostudies-literature
Project description:ObjectivePhysical activity (PA) in the US knee osteoarthritis (OA) population is low, despite well-established health benefits. PA program implementation is often stymied by sustainability concerns. We sought to establish parameters that would make a short-term (3-year efficacy) PA program a cost-effective component of long-term OA care.MethodUsing a validated computer microsimulation (Osteoarthritis Policy Model), we examined the long-term clinical (e.g., comorbidities averted), quality of life (QoL), and economic impacts of a 3-year PA program, based upon the SPARKS (Studying Physical Activity Rewards after Knee Surgery) Trial, for inactive knee OA patients. We determined the cost, efficacy, and impact of PA on QoL and medical costs that would make a PA program a cost-effective addition to OA care.ResultsAmong the 14 million with knee OA in the US, >4 million are inactive. Participation of 10% in the modeled PA program could save 200 cases of cardiovascular disease, 400 cases of diabetes, and 6,800 quality-adjusted life-years (QALYs). The program had an incremental cost-effectiveness ratio (ICER) of $16,100/QALY. Tripling PA program cost ($860/year) raised the ICER to $108,300/QALY; varying QoL benefits from PA yielded ICERs of $8,800/QALY-$99,900/QALY; varying background cost savings from PA did not qualitatively impact ICERs. Offering the PA program to any adults with knee OA (not only inactive) yielded $31,000/QALY.ConclusionA PA program with 3-year efficacy in the knee OA population carried favorable long-term clinical and economic benefits. These results offer justification for policymakers and payers considering a PA intervention incorporated into knee OA care.
| S-EPMC7357284 | biostudies-literature
Project description:BACKGROUND:Patients with breast cancer undergoing chemotherapy and radiotherapy experience fatigue and other treatment side effects. Integrative therapies combining physical activity and dietary counseling are recommended; however to date no large randomized controlled trial has been conducted during adjuvant therapy. The Adapted Physical Activity and Diet (APAD) intervention was evaluated for its ability to decrease fatigue (primary outcome), anxiety, depression, body mass index (BMI), and fat mass, and enhance muscular and cognitive performances, and quality-of-life (QoL). METHODS:Women diagnosed with early breast cancer (N?=?143, mean age?=?52?±?10?years) were randomized to APAD or usual care (UC). APAD included thrice-weekly moderate-intensity mixed aerobic and resistance exercise sessions and 9 dietetic consultations. Patient-reported outcomes (PROs) and anthropometric, muscular, and cognitive variables were measured at baseline, 18?weeks (end of chemotherapy), and 26?weeks (end of radiotherapy and intervention), and at 6- and 12-month post-intervention follow-ups. Multi-adjusted linear mixed-effects models were used to compare groups over time. RESULTS:Significant beneficial effects of the APAD intervention were observed on all PROs (i.e., fatigue, QoL, anxiety, depression) at 18 and 26?weeks. The significant effect on fatigue and QoL persisted up to 12-month follow-up. Significant decreases in BMI, fat mass, and increased muscle endurance and cognitive flexibility were observed at 26?weeks, but did not persist afterward. Leisure physical activity was enhanced in the APAD group vs UC group at 18 and 26?weeks. No significant effect of the intervention was found on major macronutrients intake. CONCLUSIONS:A combined diet and exercise intervention during chemotherapy and radiotherapy in patients with early breast cancer led to positive changes in a range of psychological, physiological and behavioral outcomes at the end of intervention. A beneficial effect persisted on fatigue and QoL at long term, i.e., 1?year post-intervention. Diet-exercise supportive care should be integrated into the management of early breast cancer patients. TRIAL REGISTRATION:The APAD study was prospectively registered on ClinicalTrials.gov (NCT01495650; date of registration: December 20, 2011).
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