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Online-Delivered Group and Personal Exercise Programs to Support Low Active Older Adults' Mental Health During the COVID-19 Pandemic: Randomized Controlled Trial.
Beauchamp, MR, Hulteen, RM, Ruissen, GR, Liu, Y, Rhodes, RE, Wierts, CM, Waldhauser, KJ, Harden, SH, Puterman, E
Journal of medical Internet research. 2021;23(7):e30709
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A widely scalable, nonpharmacological, and cost-effective approach promoted by the World Health Organization to support mental health during the pandemic corresponds to regular physical activity. The aim of this study was to assess whether a group-based online exercise programme or a personal online exercise programme compared to a waitlist control can improve the psychological health of previously low active older adults during the early stages of the COVID-19 pandemic. The study is a prospective, 3-arm, parallel, randomized controlled trial. Two-hundred and forty-one low active older adults, aged between 65 and 69 years, were enrolled in the study. Participants were stratified to ensure equal distribution of men and women across conditions. Results indicate that both physical activity programmes showed improvements in mental health when compared with control participants, which represents a notable outcome for older adults in the current COVID-19 pandemic. Authors conclude that virtually delivered interventions are feasible and, when delivered in a group setting, can aid the retention of previously low active older adults.
Abstract
BACKGROUND In response to the COVID-19 pandemic, experts in mental health science emphasized the importance of developing and evaluating approaches to support and maintain the mental health of older adults. OBJECTIVE The aim of this study was to assess whether a group-based exercise program relative to a personal exercise program (both delivered online) and waitlist control (WLC) can improve the psychological health of previously low active older adults during the early stages of the COVID-19 pandemic. METHODS The Seniors COVID-19 Pandemic and Exercise (SCOPE) trial was a 3-arm, parallel randomized controlled trial conducted between May and September 2020 in which low active older adults (aged ≥65 years) were recruited via media outlets and social media. After baseline assessments, consented participants were randomized to one of two 12-week exercise programs (delivered online by older adult instructors) or a WLC condition. A total of 241 older adults (n=187 women) provided baseline measures (via online questionnaires), were randomized (ngroup=80, npersonal=82, ncontrol=79), and completed measures every 2 weeks for the duration of the trial. The trial's primary outcome was psychological flourishing. Secondary outcomes included global measures of mental and physical health, life satisfaction, and depression symptoms. RESULTS The results of latent growth modeling revealed no intervention effects for flourishing, life satisfaction, or depression symptoms (P>.05 for all). Participants in the group condition displayed improved mental health relative to WLC participants over the first 10 weeks (effect size [ES]=0.288-0.601), and although the week 12 effect (ES=0.375) was in the same direction the difference was not statistically significant (P=.089). Participants in the personal condition displayed improved mental health, when compared with WLC participants, in the same medium ES range (ES=0.293-0.565) over the first 8 weeks, and while the effects were of a similar magnitude at weeks 10 (ES=0.455, P=.069) and 12 (ES=0.258, P=.353), they were not statistically significant. In addition, participants in the group condition displayed improvements in physical health when compared with the WLC (ES=0.079-0.496) across all 12 weeks of the study following baseline. No differences were observed between the personal exercise condition and WLC for physical health (slope P=.271). CONCLUSIONS There were no intervention effects for the trial's primary outcome (ie, psychological flourishing). It is possible that the high levels of psychological flourishing at baseline may have limited the extent to which those indicators could continue to improve further through intervention (ie, potential ceiling effects). However, the intervention effects for mental and physical health point to the potential capacity of low-cost and scalable at-home programs to support the mental and physical health of previously inactive adults in the COVID-19 pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT04412343; https://clinicaltrials.gov/ct2/show/NCT04412343.
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Psychological mediators of exercise adherence among older adults in a group-based randomized trial.
Beauchamp, MR, Liu, Y, Dunlop, WL, Ruissen, GR, Schmader, T, Harden, SM, Wolf, SA, Puterman, E, Sheel, AW, Rhodes, RE
Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 2021;(3):166-177
Abstract
OBJECTIVE To examine the psychological mediators of exercise adherence among older adults in a group-based physical activity randomized controlled trial. METHOD Older adults (≥65 years) were randomized to one of three conditions as part of the "GrOup-based physical Activity for oLder adults" (GOAL) randomized controlled trial. These included similar age same gender (SASG) and similar age mixed gender (SAMG) exercise programs that were informed by the tenets of self-categorization theory, and a "standard" mixed age mixed gender (MAMG) exercise program. Participants represented a subgroup (n = 483, Mage = 71.41 years) from the larger trial (n = 627) who completed measures of the trial's putative psychological mediators (i.e., group cohesion and affective attitudes) over the course of the 24-week exercise programs. RESULTS Piecewise latent growth modeling revealed different trajectories between participants in the two intervention conditions (SASG, SAMG) when compared with the comparison MAMG condition with regard to perceptions of group cohesion and affective attitudes. Results of subsequent cross-lagged panel modeling revealed that better program adherence in the two intervention conditions, when compared with the referent MAMG condition, was mediated by perceptions of group cohesion. CONCLUSIONS The findings provide insight into how the two intervention programs differentially strengthened perceptions of group cohesion and affective attitudes over time. Consistent with self-categorization theory, the results also shed light on the role of group cohesion, in particular, as a psychological mechanism of action to promote older adults' exercise adherence behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Cardiorespiratory fitness and accelerometer-determined physical activity following one year of free-living high-intensity interval training and moderate-intensity continuous training: a randomized trial.
Jung, ME, Locke, SR, Bourne, JE, Beauchamp, MR, Lee, T, Singer, J, MacPherson, M, Barry, J, Jones, C, Little, JP
The international journal of behavioral nutrition and physical activity. 2020;17(1):25
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High-intensity interval training (HIIT), is considered an effective and time-efficient type of exercise and has been shown to improve cardiorespiratory fitness (CRF). However, little is known about long term adherence and effectiveness. The aim of this randomized trial was to compare the effects of HIIT and moderate intensity continuous training (MICT) in people with obesity or overweight and low activity levels. 99 participants were randomly assigned to HIIT (75 minutes per week) or MICT (150 minutes per week) and received a two-week exercise counselling programme including behaviour change techniques. Participants tracked their exercise for 12 months using a mobile application. Both groups experienced significant improvements in CRF, body fat and waist circumference over the 12 months study, with no differences between groups. Both groups increased their weekly exercise time, but the MCIT group increased exercise time significantly more than the HIIT group (by 33 minutes more). The authors concluded that although participants in the MCIT group spent double as much time exercising than the HIIT group, there were no differences in the health benefits after one year.
Abstract
BACKGROUND Free-living adherence to high-intensity interval training (HIIT) has not been adequately tested. This randomized trial examined changes in cardiorespiratory fitness (CRF) and accelerometer-measured purposeful physical activity over 12 months of free-living HIIT versus moderate-intensity continuous training (MICT). METHODS Ninety-nine previously low-active participants with overweight/obesity were randomly assigned to HIIT (n = 47) or MICT (n = 52). Both interventions were combined with evidence-based behaviour change counselling consisting of 7 sessions over 2 weeks. Individuals in HIIT were prescribed 10 X 1-min interval-based exercise 3 times per week (totalling 75 min) whereas individuals in MICT were prescribed 150 min of steady-state exercise per week (50 mins 3 times per week). Using a maximal cycling test to exhaustion with expired gas analyses, CRF was assessed at baseline and after 6 and 12 months of free-living exercise. Moderate-to-vigorous physical activity of 10+ minutes (MVPA10+) was assessed by 7-day accelerometry at baseline, 3, 6, 9, and 12 months. Intention to treat analyses were conducted using linear mixed models. RESULTS CRF was improved over the 12 months relative to baseline in both HIIT (+ 0.15 l/min, 95% CI 0.08 to 0.23) and MICT (+ 0.11 l/min, 95% CI 0.05 to 0.18). Both groups improved 12-month MVPA10+ above baseline (HIIT: + 36 min/week, 95% CI 17 to 54; MICT + 69 min/week, 95% CI 49 to 89) with the increase being greater (by 33 min, 95% CI 6 to 60) in MICT (between group difference, P = 0.018). CONCLUSION Despite being prescribed twice as many minutes of exercise and accumulating significantly more purposeful exercise, CRF improvements were similar across 12 months of free-living HIIT and MICT in previously low-active individuals with overweight/obesity.
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'Active'ating thoughts about affect: elicitation of physical activity judgements in insufficiently active women.
Ruissen, GR, Rhodes, RE, Beauchamp, MR
Psychology & health. 2019;(5):590-608
Abstract
OBJECTIVE A growing body of evidence suggests that affective judgements are distinct from, and exert greater influence on, physical activity behaviours than instrumental judgements. DESIGN As part of a randomised controlled trial, 110 insufficiently active, female, university students were randomised to (a) an affective mental contrasting condition, (b) an instrumental mental contrasting condition, or (c) a 'standard' mental contrasting intervention (with no modifications). In the analyses concerning the trial's primary outcome, the affective mental contrasting condition was found to be more effective for increasing physical activity than the standard or instrumental conditions. The purpose of this study was to qualitatively examine the physical activity outcomes and obstacles elicited from participants as part of the three mental contrasting interventions within this trial. RESULTS 32 lower-order physical activity judgement themes, categorised within seven high-order themes, were derived through the use of the mental contrasting intervention. In addition to identifying several affective and instrumental outcomes and obstacles that have previously been recognised, participants in this study also highlighted contextualised responses that describe complicated relationships that exist between affective and instrumental judgements. CONCLUSIONS This study provides fine-grained insight into cognitive processes derived from a novel intervention involving insufficiently active women.
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Brief Exercise Counseling and High-Intensity Interval Training on Physical Activity Adherence and Cardiometabolic Health in Individuals at Risk of Type 2 Diabetes: Protocol for a Randomized Controlled Trial.
Bourne, JE, Little, JP, Beauchamp, MR, Barry, J, Singer, J, Jung, ME
JMIR research protocols. 2019;(3):e11226
Abstract
BACKGROUND Worldwide incidence of type 2 diabetes (T2D) is rapidly increasing. Given the numerous negative health consequences associated with T2D, prevention of this disease has become a priority. Lifestyle changes, including regular exercise, can reduce the onset of T2D in those at elevated risk. However, long-term adherence to exercise is often poor in this population. Existing lifestyle interventions targeting exercise are labor intensive and costly for staff and participants. Evidence-informed counseling delivered in a manner that reduces dependence on staff and facilitates self-regulatory skills could alleviate time and financial barriers while promoting independent exercise. OBJECTIVE This protocol outlines the design, recruitment, and proposed analysis of a brief, 2-week evidence-informed exercise counseling intervention combined with either high-intensity interval training (HIIT) or traditional moderate-intensity continuous training (MICT). METHODS Small Steps for Big Changes is a 2-arm randomized controlled trial that will examine the effectiveness of combining brief exercise counseling with HIIT or MICT on adherence to moderate and vigorous exercise over 1 year. Cardiorespiratory fitness will be assessed at baseline, post intervention (2 weeks), and at 6- and 12-month follow-up. Physical activity behavior will be examined at baseline, post intervention, and 3-, 6-, 9-, and 12-month follow-up. The impact of the intervention on psychosocial outcomes pertinent to exercise adherence will be examined. RESULTS Data collection was complete in March 2017. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2019. CONCLUSIONS The results of this brief intervention have the potential to inform future public health efforts designed to increase exercise in individuals at risk of T2D. TRIAL REGISTRATION ClinicalTrials.gov NCT02164474; https://clinicaltrials.gov/ct2/show/NCT02164474 (Archived by WebCite at http://www.webcitation.org/74Hx1ipj6). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/11226.
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School Physical Activity Intervention Effect on Adolescents' Performance in Mathematics.
Lubans, DR, Beauchamp, MR, Diallo, TMO, Peralta, LR, Bennie, A, White, RL, Owen, K, Lonsdale, C
Medicine and science in sports and exercise. 2018;(12):2442-2450
Abstract
PURPOSE The primary aim of this study was to test the effect of a school-based physical activity intervention on adolescents' performance in mathematics. A secondary aim was to explore potential mechanisms that might explain the intervention effect. METHODS The Activity and Motivation in Physical EDucation intervention was evaluated using a two-arm cluster randomized controlled trial in 14 secondary schools located in low socioeconomic areas of Western Sydney, Australia. Study participants (n = 1173) were grade 8 students (mean age = 12.94 yr, SD = 0.54). The multicomponent intervention was designed to help teachers maximize students' opportunities for moderate-to-vigorous physical activity (MVPA) during physical education (PE) and enhance students' motivation toward PE. Mathematics performance was assessed as part of national testing in grade 7, which was the year before the trial began and then again in grade 9. Potential mediators were: (i) proportion of PE lesson time that students spent in MVPA and leisure time MVPA (%), measured using Actigraph GT3X+ accelerometers, and (ii) students' self-reported engagement (behavioral, emotional, and cognitive) during mathematics lessons. Mediators were assessed at baseline (grade 8) and follow-up (grade 9, 14-15 months after baseline). RESULTS The effect of the intervention on mathematics performance was small-to-medium (β = 0.16, P < 0.001). An intervention effect was observed for MVPA% in PE (β = 0.59, P < 0.001), but not for leisure time MVPA or any of the engagement mediators. There were no significant associations between changes in potential mediators and mathematics performance. CONCLUSIONS The Activity and Motivation in Physical EDucation intervention had a significant positive effect on mathematics performance in adolescents. However, findings should be interpreted with caution as the effect was small and not associated with changes in hypothesized mediators.
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Mediators of Psychological Well-being in Adolescent Boys.
Lubans, DR, Smith, JJ, Morgan, PJ, Beauchamp, MR, Miller, A, Lonsdale, C, Parker, P, Dally, K
The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2016;(2):230-6
Abstract
PURPOSE The aim of this study was to explore the effect of the Active Teen Leaders Avoiding Screen-time (ATLAS) intervention on psychological well-being in adolescent boys and to examine the potential mediating mechanisms that might explain this effect. METHODS ATLAS was evaluated using a cluster randomized controlled trial in 14 secondary schools located in low-income communities (N = 361 adolescent boys, mean age = 12.7 ± .5 years). The 20-week intervention was guided by self-determination theory and involved: professional development for teachers, provision of fitness equipment to schools, enhanced school sport sessions, researcher-led seminars, a smartphone application, and parental strategies for reducing screen time. Assessments were conducted at baseline and immediately post intervention (8 months). Psychological well-being was measured using the Flourishing Scale. Motivational regulations (intrinsic, identified, introjected, controlled, and amotivation) and basic psychological needs (autonomy, competence, and relatedness) in school sport, muscular fitness, resistance training skill competency, and recreational screen time were examined as potential mediating mechanisms of the intervention effect. RESULTS The intervention effect on well-being was small but statistically significant. Within a multiple mediator model, changes in autonomy needs satisfaction, recreational screen time, and muscular fitness significantly mediated the effect of the intervention on psychological well-being. CONCLUSIONS In addition to the physical health benefits, targeted physical activity programs for adolescent boys may have utility for mental health promotion through the mechanisms of increasing autonomy support and muscular fitness and reducing screen time.
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GrOup based physical Activity for oLder adults (GOAL) randomized controlled trial: study protocol.
Beauchamp, MR, Harden, SM, Wolf, SA, Rhodes, RE, Liu, Y, Dunlop, WL, Schmader, T, Sheel, AW, Zumbo, BD, Estabrooks, PA
BMC public health. 2015;:592
Abstract
BACKGROUND Physical activity has health benefits across the lifespan, yet only 13 % of Canadian older adults are sufficiently active. Results from a number of observational studies indicate that adults display positive preferences for exercising with others of a similar age and same gender, and that intra-group age- and gender-similarity are associated with elevated exercise adherence. However, research has yet to experimentally examine the extent to which intra-group age- and gender-related similarity affect exercise adherence behaviors. METHODS/DESIGN The GrOup-based physical Activity for oLder adults (GOAL) trial is a three-arm randomized control trial that will examine the efficacy of two different group-based exercise programs for older adults (informed by the tenets of self-categorization theory) in relation to a standard group-based exercise program. Within this manuscript we outline the design and proposed evaluation of the GOAL trial. The first arm is comprised of exercise groups made up of participants of a similar-age and of the same gender; the second arm consists of groups with similar-aged mixed gender participants; the control arm is comprised of mixed-aged mixed gender participants. We aim to compare the adherence rates of participants across conditions, as well as potential moderation effects and mediating mechanisms. DISCUSSION Results from this trial will inform intervention designs to improve the exercise adherence behaviors of older adult. At a systems-level, should support be derived for the efficacy of the interventions tested in this trial, changing group composition (i.e., age, gender) represents a feasible program adaptation for physical activity centers. TRIAL REGISTRATION ClinicalTrials.gov # NCT02023632 . Registered December 13, 2013.
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Group-based lifestyle sessions for gestational weight gain management: a mixed method approach.
Harden, SM, Beauchamp, MR, Pitts, BH, Nault, EM, Davy, BM, You, W, Weiss, P, Estabrooks, PA
American journal of health behavior. 2014;(4):560-9
Abstract
OBJECTIVE To integrate group-based lifestyle sessions (GBLS) within prenatal care for gestational weight gain (GWG) management. METHODS In Study 1, participants attended GBLS during prenatal care visits. Participants in Study 2 attended off-site GBLS whereby care providers were asked to discuss the program with patients. Process and outcome evaluation were conducted through a mixed-methods approach. RESULTS In both pre-experimental feasibility studies, data provide preliminary support for GBLS (eg, positive care provider and patient feedback, weight gain patterns) as well as highlight areas for future research (eg, lack of GWG management discussions, preference for GBLS location). CONCLUSIONS GBLS represents a promising approach to GWG management. Future research should assess the generalizability, sustainably, and compatibility of GBLS within prenatal care.