This study investigated how physical functioning and perceived disability are related to depressive symptoms in adults with arthritis (n=401). Participants self-reported depressive symptoms and ...disability. Objective measures of physical functioning included the 30-second chair stand test, 6-minute walk test, gait speed, balance, grip strength, and the seated reach test. Separate quantile regression models tested associations between each functional measure and depressive symptoms, controlling for age, gender, race, BMI, self-reported health status, and arthritis medication use. The association between perceived disability and depressive symptoms was also tested. Participants averaged 56.3±10.7 years; 85.8% were women; 64.3% were white. Lower distance in the 6-minute walk test, fewer chair stands, slower gait speed, and greater perceived disability were associated with greater depressive symptoms in unadjusted models (Ps<0.05). Fewer chair stands and greater perceived disability were associated with more depressive symptoms in adjusted models (Ps<0.05). Balance, grip strength, and seated reach were not related to depressive symptoms. The perception of being disabled was more strongly associated with depressive symptoms than reduced physical functioning. To reduce the risk of depression in arthritic populations, it may be critical to not only address physical symptoms but also to emphasize coping skills and arthritis self-efficacy.
Objective
The objective of this study was to describe participant engagement and examine predictors of weight loss and points earned through the point-based incentive system of the Social Pounds Off ...Digitally (POD) app.
Materials and methods
Overweight and obese adults with Android smartphones/tablets (body mass index 25–49.9 kg/m2; N = 24) were recruited for a 3-month weight loss intervention. Participants completed a survey assessing demographics and personality and had their weight measured. Participants received the content of the intervention via podcasts and used the Social POD app to self-monitor diet, physical activity, and weight. The Social POD app contained: tracking features; in-app notifications to track; pre-set goals for tracking; newsfeed for updates on others’ goal attainment; ability to earn and track points for usage (exchanged for study-provided prizes); and a message screen. Analyses examined relationships between percent weight loss, personality characteristics, and total points earned.
Results
A total of 4843 points were earned (mean = 202 ± 105 points/participant). Most participants earned all three prizes (62.5%), followed by two prizes (21%), no prizes (12.5%), and one prize (4%). Total points earned significantly predicted percent weight loss (B = −0.02, p = .01), and higher conscientiousness significantly predicted greater total points earned (B = 10.27, p = .01), but other personality characteristics assessed did not.
Conclusion
A mobile app yielded moderately high participant engagement, as demonstrated by points earned. Earning points was significantly associated with percent weight loss, and conscientiousness was significantly associated with total points earned. Future research should examine whether point systems impact health behavior and weight loss when rewards are discontinued.
Clinical trial registration number
NCT02344836
Growing research suggests regular physical activity as a strategy for reducing risk of Alzheimer’s disease (AD); however, there is little research available regarding public messages about the ...connection between physical activity and brain health. This study aimed to (a) examine the volume and content of regular physical activity and brain health messages being distributed by national organizations, and (b) explore how informal caregivers perceive and comprehend brain health messages. Methods included (a) a content analysis of 155 online documents related to physical activity and aging that were located on national physical activity organizations’ websites, and (b) a thematic analysis of transcripts and observer notes from two focus groups with 10 informal caregivers recruited at a support organization for AD caregivers in the southeastern United States. Content analysis results revealed limited information about the physical activity and brain health connection. Focus group results revealed that caregivers had limited exposure to information about the physical activity and brain health connection and were concerned about the credibility of this information. Further research is needed regarding brain health and physical activity messages and the potential benefits of collaboration among physical activity organizations, researchers, and health care professionals in delivering consistent and credible messages to the public.
Performing and publishing mediator analyses, whether significant or null, provides insight into where research efforts should focus and will assist in developing effective and powerful behaviour ...change interventions. The present study examined whether self-efficacy, social support and church support mediated changes in leisure-time physical activity (PA) and fruit and vegetable (F&V) consumption in a faith-based intervention.
A 15-month PA and F&V intervention, guided by the structural ecological model, targeted the social, cultural and policy influences within the church. Outcomes and mediators were measured at baseline and follow-up. Data were collected from 2007 to 2011. MacKinnon's product of coefficients tested for mediation.
Sixty-eight African Methodist Episcopal churches in South Carolina, USA.
Five hundred and eighty-two (PA) and 588 (F&V) church members.
Despite the significant increases in PA and F&V consumption, none of the hypothesized mediators were significant mediators of change in PA or F&V consumption. When examining each path of the mediation model, the intervention did not change any of the hypothesized mediators. However, changes in some mediators were associated with changes in outcomes.
Although there was no significant mediation, the association between changes in mediators and changes in PA and/or F&V consumption suggest that these variables likely play some role in changing these behaviours. Future studies should consider mediation analyses a priori, putting careful thought into the types of measures used and the timing of those measures, while also being cognizant of participant and staff burden. Finding a balance will be fundamental in successfully understanding how interventions exert their effects.
Abstract Background Research shows high prevalence of complementary and alternative medicine (CAM) use in individuals with arthritis. Little is known about CAM use and objectively measured physical ...functional performance. Objective The main objective was to determine if CAM use was associated with self-reported symptoms and physical functional performance in adults with arthritis. The secondary objectives were to describe the perceived helpfulness and correlates of CAM use. Methods We analyzed cross-sectional data from a self-administered questionnaire and objectively measured physical functional performance prior to randomization to a self-paced exercise program or control condition ( n = 401). We used the Fisher's exact test, analysis of variance, and general linear models to examine the association of CAM use with socio-demographic characteristics, symptoms and functional performance. Logistic regression computed the odds of perceiving CAM as helpful by level of use. Results Most respondents had used CAM (76%). Dietary supplements were the most-used (53.1%). Female gender and college education predicted greater number of modalities used. Compared to non-users, use of any CAM was associated with greater fatigue and lower grip strength; relaxation techniques with lower walk distance and gait speed; dietary change with greater pain and stiffness and lower walk distance; and yoga with lower pain and stiffness, greater walk distance, chair stands, seated reach and gait, but lower grip strength. Perceived help was positively associated with the number of modalities used. Conclusions Associations between CAM and symptoms or functional performance were mixed. Only yoga showed positive associations; however, yoga practitioners were more physically active overall than non-practitioners.
Background
Improved understanding of the mediators of physical activity (PA) interventions could lead to improvements in theory and programs.
Purpose
To examine the 24-month mediating effects of ...psychosocial variables on PA and cardiorespiratory fitness (CRF) outcomes in 878 initially sedentary adults aged 35-75 participating in the Activity Counseling Trial.
Methods
Participants were assigned to one of three intervention arms: physician advice, assistance, or counseling. MacKinnon’s product of coefficients was used to test for longitudinal and contemporaneous mediation.
Results
Changes in behavioral processes of change from baseline to 24 months significantly mediated the relationship between the active intervention arms and improvements in PA and CRF from baseline to 24 months in both men and women. None of the other psychosocial variables tested met criteria for mediation.
Conclusions
Results indicate that behavioral interventions should incorporate methods to encourage participants to use these behavioral strategies as they attempt to become more active.
Background: Cyberchondria is excessive worrying about one's health that develops following internet search for medical and health information. Aim: This study investigates how the development of ...cyberchondria relates to characteristics of the person searching the internet including their medical history, age, and health-related anxiety. Materials and Methods: A cross-sectional survey was conducted between 2015 and 2016. The "Dr. Net" survey consisted of 32 questions based on previously published surveys probing the use of internet search for health-related information. Participants were recruited from the authors' own social network by receiving a hyperlink through social media platforms and e-mails. One hundred and ninety-one English-speaking individuals, majority from Canada and the USA, completed the "Dr. Net" questionnaire online and anonymously through SurveyMonkey®. Results: Females sought health-care advice earlier than males (**P = 0.005). Younger age groups exhibited higher frequencies of internet search, daily versus weekly, versus monthly versus yearly, with differences between the 21 and 30 versus >60 (***P = 0.000), 21-30 versus 51-60 (**P = 0.011), 21-30 versus 31-40 (**P = 0.019), 31-40 versus 51-60 (**P = 0.012), 41-50 versus 51-60 (**P = 0.021), and <20 versus >60 years' age groups (**P = 0.024). 30.7% reported developing cyberchondria. Indicators of cyberchondria correlated with older age (r = 0.154, P=**0.036), negative medical history (r = 0.191, **P = 0.013), health anxiety (r = 0.268, ***P = 0.000), and hypochondria (r = 0.142, P = 0.062). Less than four percent perceived their internet search as disadvantageous. Conclusion: Cyberchondria was reported by a third of those who conducted health-related internet searches, with higher frequencies in older, previously healthy individuals who had health anxiety.
Faith-based organizations are promising settings for implementation science because they can reach populations bearing a disproportionate burden of chronic disease. This study examined how ...implementation strategies influenced implementation outcomes in Faith, Activity, and Nutrition (FAN) statewide dissemination. Ninety-three (9%) of 985 invited churches enrolled; 91 (98%) and 83 (89%) completed baseline and 12-month assessments. Community Health Advisors trained and provided phone technical assistance to church committees, led by a FAN coordinator. Church committees were charged with developing plans and installing healthy eating (HE) and physical activity (PA) policies, opportunities, messages and pastor support (implementation outcomes). Structural equation modeling examined how implementation strategies influenced implementation outcomes. Nearly all (99%) FAN coordinators and 60% of pastors attended training, 57% of committees submitted program plans and 51%/54% (HE/PA) of committees met 'every few months'. Statistically significant (P < 0.05) model paths showed positive influences of strategies on implementation outcomes: pastor training on HE and PA pastor support; plan completion on HE and PA messages, PA policies and opportunities as well as FAN committee meetings and committee meetings on HE pastor support, HE policies, PA opportunities and HE and PA messages. This study advances implementation science and provides a model applicable to organizations such as worksites and schools.
To examine the influence of chronic time-in-bed (TIB) restriction on selected health-related outcome variables in older long sleepers.
Randomized, controlled trial.
Home-based.
Forty-two older adults ...(aged 50-70 y) who reported sleeping at least 8.5 hours. Following extensive screening, participants were assessed for 10 weeks.
During a two-week baseline, participants followed their usual sleep-wake habits. Participants were then randomized to one of two eight-week treatments: (1) TIB restriction, in which participants were asked to follow a fixed sleep schedule with a TIB of 90 minutes less than recorded during baseline or (2) a control treatment, which involved following a fixed sleep schedule (consistent with average baseline) but no TIB restriction.
Continuous wrist actigraphic sleep estimation indicated that TIB restriction elicited significant reductions in TIB and total sleep time compared with the control treatment and significant (albeit modest) improvements in sleep efficiency and sleep latency. However, compared with the control treatment, TIB restriction elicited no significant change in depression, sleepiness, health-related quality of life, or neurobehavioral performance. Moreover, follow-up assessments for one year indicated that, after completing the experiment, the participants assigned to TIB restriction continued to restrict their TIB (at their own initiative) by an average of approximately one hour.
The results suggest good tolerance of chronic moderate TIB restriction, without detrimental effects, among older long sleepers.
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