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Methodology of an exercise intervention program using social incentives and gamification for obese children.
Fang, Y, Ma, Y, Mo, D, Zhang, S, Xiang, M, Zhang, Z
BMC public health. 2019;(1):686
Abstract
BACKGROUND Traditional exercise [supervised exercise (SE)] intervention has been proved to be one of the most effective ways to improve metabolic health. However, most exercise interventions were on a high-cost and small scale, moreover lacking of the long-term effect due to low engagement. On the other hand, it was noteworthy that gamification and social incentives were promising strategies to increase engagement and sustain exercise interventions effects; as well as mobile technologies such as WeChat also can provide an appropriate platform to deploy interventions on a broader, low-cost scale. Thus, we aim to develop a novel exercise intervention ('S&G exercise intervention') that combines SE intervention with gamification and social incentives design through WeChat, with the aim of improving metabolic health and poor behaviors among overweight and obesity children. METHODS We propose a randomized controlled trial of a 'S&G exercise intervention' among 420 overweight and obese children who have at least one marker of metabolic syndrome. Children will be randomized to control or intervention group in a 1:1 ratio. The exercise intervention package includes intervention designs based on integrated social incentives and gamification theory, involving targeted essential volume and intensity of activity (skipping rope) as well as monitoring daily information and providing health advice by WeChat. Participants will undertake assessments at baseline, at end of intervention period, in the follow-up time at months 3,6,12. The primary outcome is outcome of metabolic health. Secondary outcomes include behavioral (e.g., diary physical activity, diet) and anthropometric measures (e.g., body fat rate and muscle mass). DISCUSSIONS This will be the first study to design an exercise intervention model that combines traditional supervised exercise (SE) intervention with gamification and social incentives theory through WeChat. We believed that this study could explore a low-cost, easy-to-popularize, and effective exercise intervention model for improving metabolic health and promote healthy among obese children. Furthermore, it will also provide important evidence for guidelines to prevent and improve metabolic health and health behaviors. TRIAL REGISTRATION 10-04-2019;Registration number: ChiCTR1900022396 .
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The 24-month metabolic benefits of the healthy living partnerships to prevent diabetes: A community-based translational study.
Pedley, CF, Case, LD, Blackwell, CS, Katula, JA, Vitolins, MZ
Diabetes & metabolic syndrome. 2018;(3):215-220
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Abstract
AIMS: Large-scale clinical trials and translational studies have demonstrated that weight loss achieved through diet and physical activity reduced the development of diabetes in overweight individuals with prediabetes. These interventions also reduced the occurrence of metabolic syndrome and risk factors linked to other chronic conditions including obesity-driven cancers and cardiovascular disease. The Healthy Living Partnerships to Prevent Diabetes (HELP PD) was a clinical trial in which participants were randomized to receive a community-based lifestyle intervention translated from the Diabetes Prevention Program (DPP) or an enhanced usual care condition. The objective of this study is to compare the 12 and 24 month prevalence of metabolic syndrome in the two treatment arms of HELP PD. MATERIALS AND METHODS The intervention involved a group-based, behavioral weight-loss program led by community health workers monitored by personnel from a local diabetes education program. The enhanced usual care condition included dietary counseling and written materials. RESULTS HELP PD included 301 overweight or obese participants (BMI 25-39.9kg/m2) with elevated fasting glucose levels (95-125mg/dl). At 12 and 24 months of follow-up there were significant improvements in individual components of the metabolic syndrome: fasting blood glucose, waist circumference, HDL, triglycerides and blood pressure and the occurrence of the metabolic syndrome in the intervention group compared to the usual care group. CONCLUSIONS This study demonstrates that a community diabetes prevention program in participants with prediabetes results in metabolic benefits and a reduction in the occurrence of the metabolic syndrome in the intervention group compared to the enhanced usual care group.
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Opportunities and challenges of behavior change support systems for enhancing habit formation: A qualitative study.
Karppinen, P, Oinas-Kukkonen, H, Alahäivälä, T, Jokelainen, T, Teeriniemi, AM, Salonurmi, T, Savolainen, MJ
Journal of biomedical informatics. 2018;:82-92
Abstract
UNLABELLED The formation of healthy habits is considered to play a fundamental role in health behavior change. A variety of studies on Health Behavior Change Support Systems (HBCSS) have been conducted recently, in which individuals use such systems to influence their own attitudes or behaviors to achieve their personal goals. However, comparatively much less research has been devoted to studying how the users of these systems form habits with the help of HBCSS, or to understanding how to design these systems to support habit formation. OBJECTIVE The objective of this article is to study HBCSS user experiences regarding habit formation through an intervention study targeted at establishing a healthier lifestyle. This study also aims to map habit formation stages, as suggested by Lally and Gardner, with the Persuasive System Design (PSD) model. The application domain is the prevention of metabolic syndrome, in which 5% weight loss can significantly reduce the prevalence of the syndrome. METHODS This study employs a web-based HBCSS named Onnikka, a lifestyle intervention designed for the prevention of metabolic syndrome for participants who are at risk of developing a metabolic syndrome or are already suffering from it. The system under investigation was designed according to the principles of the PSD model and Behavior Change Support System framework. Lally and Gardner's research on the stages of habit formation were used to study the extent to which the Onnikka system was able to enhance the development of new habits. A total of 43 Onnikka users were interviewed for this study during and after a 52-week intervention period. The research approach employed here was hermeneutics, which leans ontologically toward the social construction of reality, gained through language, consciousness, and shared meaning. In addition, the system's login data and participants' weight measurements were utilized to build an interpretation of the results. RESULTS The findings of this study suggest that IT habits appear to have a strong linkage with use adherence, whereas lifestyle habits did not seem to be directly related to the 5% weight loss among study participants. Moreover, habit formation stages provide a possible explanation for why self-monitoring, reminders, and tunneling were perceived as especially valuable features in this study. CONCLUSIONS For sustainable weight management, holistic e-health interventions are required, and the PSD model offers a practical approach for designing and developing them. Recognizing the stages of habit formation provides additional valuable guidance for designing systems that help shape an individual's habits.
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Systematic Review of the Effect of Lifestyle Interventions on the Components of the Metabolic Syndrome in South Asian Migrants.
Martin, CA, Gowda, U, Smith, BJ, Renzaho, AMN
Journal of immigrant and minority health. 2018;(1):231-244
Abstract
A systematic review was undertaken to identify lifestyle intervention studies in South Asian migrant populations to determine the effect on the components of the metabolic syndrome. A total of seven studies were identified, of which six focused on educational advice and the seventh on intensive exercise intervention. Four studies were Randomised Controlled Trials of which two studies reported significant reductions in waist circumference. One of these studies focused on home based education with cooperation of the home cook (adjusted waist reduction of 1.9 cm, 95 % CI 0.52-3.3 cm; p = 0.007) and the other entailed an intensive physical activity program (adjusted waist reduction 3.4 cm, 95 % CI 2.0-4.7 cm). The evidence whether lifestyle intervention studies in South Asians can improve components of the metabolic system is not clear. Further lifestyle interventions for South Asians should be culturally adapted, involve friends and family, especially those with cooking responsibilities.
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[Effect of the DiabetIMSS program on cardiovascular risk, blood pressure and HDL cholesterol in patients with metabolic syndrome].
Mendoza-Romo, MA, Montes-Acuña, JF, Zavala-Cruz, GG, Nieva-de Jesús, RN, Ramírez-Arreola, MC, Andrade-Rodríguez, HJ
Revista medica del Instituto Mexicano del Seguro Social. 2017;(1):32-39
Abstract
OBJECTIVE The aim of this paper is to evaluate the effect of the DiabetIMSS program on cardiovascular risk, blood pressure and HDL cholesterol in patients with metabolic syndrome. METHODS Quasi-experimental intervention study. Non-probabilistic convenience sampling. 35 subjects in the educational strategy one year were included. The following variables were collected: age, gender, smoking, total cholesterol, HDL cholesterol, systolic and diastolic blood pressure; cardiovascular risk calculator based on Framingham is calculated. Descriptive and inferential statistical percentages with Student t test was used. RESULTS There was an increase in the proportion of subjects increased their subsequent figures HDL cholesterol intervention, there by generating an increase of protective factor (p < 0.05). Because of the blood pressure a marked improvement in all ranges of blood pressure (p < 0.05) was presented. CONCLUSIONS The educational strategy for the control of diabetic patients presented a favorable performance in HDL-cholesterol and blood pressure, reducing the risk of cardiovascular patients.
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Effects of a lifestyle modification programme to reduce the number of risk factors for metabolic syndrome: a randomised controlled trial.
Watanabe, M, Yokotsuka, M, Yamaoka, K, Adachi, M, Nemoto, A, Tango, T
Public health nutrition. 2017;(1):142-153
Abstract
OBJECTIVE To determine the effectiveness of a personal support lifestyle education programme (PSMetS) for reducing risk factors in individuals with metabolic syndrome (MetS). DESIGN A two-arm randomised controlled trial. SETTING Companies in metropolitan Tokyo, Japan. SUBJECTS Male workers with diagnosed MetS or a high risk for MetS according to the Counselling Guidance Program, Japan (n 193). RESULTS The reduction in the number of risk factors for MetS (as defined according to the criteria published by the Japanese Ministry of Health, Labor and Welfare in April 2007 (MHLW-MetS)) in the PSMetS group was not significantly different from that in the usual care group by van Elteren's test (baseline-adjusted P=0·075) for intention-to-treat (ITT), while it was significant (baseline-adjusted P=0·038) for per-protocol set (PPS). The proportion of MHLW-MetS was significantly different between groups by van Elteren's test (baseline-adjusted P=0·031). Two components of MHLW-MetS showed significant reductions in the PSMetS group: waist circumference (baseline-adjusted P=0·001) and BMI (baseline-adjusted P=0·002). PPS and ITT analyses showed similar results. CONCLUSIONS For male workers with MHLW-MetS or a high risk of MHLW-MetS, PSMetS reduced the number of risk factors for MHLW-MetS.
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Metabolic risk management, physical exercise and lifestyle counselling in low-active adults: controlled randomized trial (BELLUGAT).
Ensenyat, A, Espigares-Tribo, G, Machado, L, Verdejo, FJ, Rodriguez-Arregui, R, Serrano, J, Miret, M, Galindo, G, Blanco, A, Marsal, JR, et al
BMC public health. 2017;(1):257
Abstract
BACKGROUND The primary aim of this study is to evaluate the effectiveness of different doses (intensity) of supervised exercise training - concomitant with lifestyle counselling - as a primary care intervention tool for the management of metabolic syndrome risk factors in low-active adults with one or more such factors (programme name in Catalan: Bellugat de CAP a peus). METHODS/DESIGN Three-arm, randomized controlled clinical trial implemented in the primary care setting, with a duration of 40 weeks (16 weeks intervention and 24-week follow-up). Adults aged 30 to 55 years with metabolic risk factors will be randomized into three intervention groups: 1) aerobic interval training (16 supervised training lessons) plus a healthy lifestyle counselling programme (6 group and 3 individual meetings); 2) low-to-moderate intensity continuous training (16 supervised training lessons) plus the same counselling programme; or 3) the counselling- programme without any supervised physical exercise. The main output variables assessed will be risk factors for metabolic syndrome (waist circumference, blood pressure, and levels of plasma triglycerides, high-density lipoproteins and glucose), systemic inflammation, cardiorespiratory fitness, physical activity and sedentary behaviour, dietary habits, health-related quality of life, self-efficacy and empowerment. Economic factors will also be analysed in order to determine the cost-effectiveness of the programme. These variables will be assessed three times during the study: at baseline, at the end of the intervention, and at follow-up. We estimate to recruit 35 participants per group. DISCUSSION The results of this study will provide insight into the immediate and medium-term effects on metabolic risk and lifestyle of a combined approach involving aerobic interval training and a multidisciplinary behavioural intervention. If effective, the proposed intervention would provide both researchers and practitioners in this field with a platform on which to develop similar intervention programmes for tackling the repercussions of an unhealthy lifestyle. TRIAL REGISTRATION Clinical trials.gov. NTC02832453 . Registered 6 July 2016 (retrospectively registered).
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Physical activity and nutrition program for adults with metabolic syndrome: Process evaluation.
Tran, VD, Jancey, J, Lee, A, James, A, Howat, P, Thi Phuong Mai, L
Evaluation and program planning. 2017;:128-133
Abstract
INTRODUCTION The Vietnam Physical Activity and Nutrition (VPAN) program aimed to improve physical activity and nutrition for adults aged 50-65 years with Metabolic Syndrome in Vietnam. The VPAN program consisted of a range of resources and strategies, including an information booklet, resistance band, face-to-face education sessions, and walking groups. This process evaluation assessed the participation, fidelity, satisfaction, and reasons for completing and not-completing the VPAN. METHODS Data were collected by mixed-methods from a sample of 214 intervention participants. Quantitative data were collected via surveys (n=163); qualitative data via face-to-face exit interviews with intervention program completers (n=10) and non-completers (n=10), and brief post education session discussions. RESULTS Most participants (87%-96%) reported the program resources and strategies useful, assisting them to increase their physical activity level and improving their diet. The education sessions were the most preferred strategy (97%) with high attendance (>78% of participants). The main reasons for withdrawal were work commitments and being too busy. CONCLUSION The evaluation indicated that the program reached and engaged the majority of participants throughout the six-month intervention. The combination of printed resources and face-to-face intervention components was a suitable approach to support lifestyle behavioural change in the Vietnamese population.
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[A PARADIGM SHIFT IN THE PERCEPTION OF HEALTH MAINTENANCE FROM INCREASING PHYSICAL ACTIVITY TO DECREASING PHYSICAL INACTIVITY].
Rotman, D, Constantini, N
Harefuah. 2016;(6):374-7, 385, 384
Abstract
Modern man spends most of his waking hours (50-70%) in one form or another of sedentary behavior, defined as activity conducted in a sitting or reclining position involving low energy expenditure. The remaining waking hours are spent performing low intensity physical activity (25-45%) and medium-high intensity physical activity (less than 5%): Despite this distribution, medical research has focused on the impact of increasing medium-high intensity physical activity and many health organizations' recommendations are in accordance. In recent years, research conducted has begun to examine the effect inactivity has on health and has shown that excess sedentary behaviour is an independent risk factor for a wide range of medical problems such as obesity, metabolic syndrome, poor cardiovascular health profile, diabetes mellitus, and possibly cancer. Although the higher risk brought on by sedentary behaviour is partially reduced by increasing medium-high intensity physical activity, it is not completely neutralized. One way to diminish the harm caused by long hours of sitting is to take short breaks during periods of prolonged sitting in order to walk. According to these findings, it is worthwhile to recommend reducing the hours spent in sedentary behaviour, or at least to take frequent short breaks ("activity snacks") during periods of prolonged sitting to get up and walk around.
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Development and evaluation of an enhanced diabetes prevention program with psychosocial support for urban American Indians and Alaska natives: A randomized controlled trial.
Rosas, LG, Vasquez, JJ, Naderi, R, Jeffery, N, Hedlin, H, Qin, F, LaFromboise, T, Megginson, N, Pasqua, C, Flores, O, et al
Contemporary clinical trials. 2016;:28-36
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Abstract
Diabetes is highly prevalent, affecting over 25 million adults in the US, yet it can be effectively prevented through lifestyle interventions, including the well-tested Diabetes Prevention Program (DPP). American Indian/Alaska Native (AIAN) adults, the majority of whom live in urban settings, are more than twice as likely to develop diabetes as non-Hispanic whites. Additionally, prevalent mental health issues and psychosocial stressors may facilitate progression to diabetes and hinder successful implementation of lifestyle interventions for AIAN adults. This 2-phased study first engaged community stakeholders to develop culturally-tailored strategies to address mental health concerns and psychosocial stressors. Pilot testing (completed) refined those strategies that increase engagement in an enhanced DPP for urban AIAN adults. Second, the enhanced DPP will be compared to a standard DPP in a randomized controlled trial (ongoing) with a primary outcome of body mass index (BMI) and a secondary outcome of quality of life (QoL) over 12months. Obese self-identified AIAN adults residing in an urban setting with one or more components of the metabolic syndrome (excluding waist circumference) will be randomized to the enhanced or standard DPP (n=204). We hypothesize that addressing psychosocial barriers within a culturally-tailored DPP will result in clinical (BMI) and superior patient-centered (QoL) outcomes as compared to a standard DPP. Exploratory outcomes will include cardiometabolic risk factors (e.g., waist circumference, blood pressure, fasting glucose) and health behaviors (e.g., diet, physical activity). Results of this trial may be applicable to other urban AIAN or minority communities or even diabetes prevention in general.