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Understanding low adherence to an exercise program for adolescents with obesity: the HEARTY trial.

ABSTRACT: Introduction:Despite efforts to improve adherence to physical activity interventions in youth with obesity, low adherence and attrition remain areas of great concern. Objective:The study was designed to determine which physiological and/or psychological factors predicted low adherence in adolescents with obesity enrolled in a 6-month exercise intervention study aimed to improve body composition. Methods:Three hundred four adolescents with obesity aged 14-18 years who volunteered for the HEARTY (Healthy Eating Aerobic and Resistance Training in Youth) randomized controlled trial completed physiological (body mass index, waist circumference, per cent body fat, resting metabolic rate and aerobic fitness) and psychological (body image, mood, self-esteem and self-efficacy) measures. Results:One hundred forty-one out of 228 (62%) randomized to exercise groups had low adherence (completed <70% of the prescribed four exercise sessions per week) to the intervention protocol. Logistic regression revealed that there were no baseline demographic or physiological variables that predicted low adherence in the participants. Appearance concern (a subscale of body image) (odds ratio [OR] 1.46, 95% confidence interval [CI]: 1.01, 2.1, P = 0.04), depressive mood (OR 1.12, 95% CI: 1.01, 1.23, P = 0.03) and confused mood (OR 1.16, 95% CI: 1.05, 1.27, P = 0.003) (two subscales of mood) were significant predictors of low adherence. Conclusions:Adolescents with obesity who had higher appearance concerns and depressive and confused moods were less likely to adhere to exercise. Body image and mood should be screened to identify adolescents who may be at high risk of poor adherence and who may need concurrent or treatment support to address these psychological issues to derive maximal health benefits from an exercise programme.

SUBMITTER: Alberga AS

PROVIDER: S-EPMC6819972 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Understanding low adherence to an exercise program for adolescents with obesity: the HEARTY trial.

Alberga A S AS Sigal R J RJ Sweet S N SN Doucette S S Russell-Mayhew S S Tulloch H H Kenny G P GP Prud'homme D D Hadjiyannakis S S Goldfield G S GS

Obesity science & practice 20190820 5

<h4>Introduction</h4>Despite efforts to improve adherence to physical activity interventions in youth with obesity, low adherence and attrition remain areas of great concern.<h4>Objective</h4>The study was designed to determine which physiological and/or psychological factors predicted low adherence in adolescents with obesity enrolled in a 6-month exercise intervention study aimed to improve body composition.<h4>Methods</h4>Three hundred four adolescents with obesity aged 14-18 years who volunt ...[more]

PMID: 31687168

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Project description:BACKGROUND:An unresolved debate lingers over the effect of past behavior on motivational patterns and future behavior stability in the exercise context. Theorists argue that past behavior has a residual effect on future behavior; however, empirical studies have shown that past behavior displays significant power in predicting behavior recurrence in the future. The present research aimed to examine the effect of past behavior and motivational determinants on future exercise adherence. METHODS:Data from 437 Portuguese gym exercisers (female = 235; male = 202) aged between 18 and 53 years (M = 31.14; SD = 9.47), with exercise experience ranging from 6 to 12 months (M = 9.41; SD = 1.33) were considered for research. Participants completed a multi-section survey measuring interpersonal behaviors, basic psychological needs, behavioral regulations, and intentions. Data from past behavior and future exercise adherence were collected using computerized records of their attendance at the gym. RESULTS:Positive and significant correlations paths were evidenced among perceived supportive behaviors, needs satisfaction, autonomous motivation, intentions and future exercise adherence. Similar results were presented among perceived thwarting behaviors, needs frustration, and controlled motivation. Regression paths showed that perceived supportive behavior, basic needs satisfaction, and autonomous motivation displayed positive and significant effects on future behaviors; thus, past behavior displayed the highest coefficient on future exercise adherence. Fitness professionals should aim at creating supportive environments, thus, improving the likelihood of being perceived by exercisers as need-supportive individuals. By doing so, as a result, exercisers would experience increased levels of autonomous motivation and higher rates of future exercise attendance at the gym. Hence, exercisers will gradually form their positive past exercise experience, increasing the probability of engaging in an exercise in the future.

Project description:BACKGROUND:In biomedical prevention trials, correct and consistent use of the investigational product is crucial to determine efficacy. Product adherence in VOICE, a phase 2B randomized trial of a vaginal gel and oral tablets for HIV prevention, was low (~ 34%), yet self-reported adherence and retention was high (> 90%). This analysis from VOICE-D, a post-trial qualitative ancillary study, explores motivations to participate in VOICE, and possible sources of misalignment between the stated priorities of the trial and the participants. METHODS:VOICE-D enrolled 171 former VOICE participants to investigate, among other things, reasons for joining and remaining in the trial. Local language in-depth interviews and focus groups were transcribed and translated into English and coded and analyzed using NVivo. Data on motivation to join obtained from a VOICE termination visit survey of 106 participants were also analyzed to corroborate the VOICE-D findings. RESULTS:Participants primarily participated for personal health benefits (e.g. free healthcare and HIV testing) and reported remaining enrolled from a sense of commitment to the trial. Altruistic motivations were the most commonly stated motivation on the termination visit survey; qualitatively, many of those stating altruistic reasons also desired personal health benefits. Joining for financial reimbursement was not commonly mentioned. Social networks influenced recruitment and spread therapeutic misconception. CONCLUSIONS:Women's participation for personal health benefits highlighted their desire to monitor their HIV risk and overall health. Helping participants view use of investigational products as improving social capital and reminding participants of their study responsibilities may improve trial outcomes. Understanding the reasons for participating in studies will help to ensure alignment between priorities of researchers and participants. TRIAL REGISTRATION:NCT02358616 ; Posted February 9, 2015, retrospectively registered.

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Dataset Information

Understanding low adherence to an exercise program for adolescents with obesity: the HEARTY trial.

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Understanding low adherence to an exercise program for adolescents with obesity: the HEARTY trial.

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