Movement- and Posture-based Measures of Sedentary Patterns and Associations with Metabolic Syndrome in Hispanic/Latino and non-Hispanic Adults.

BACKGROUND: Sedentary behavior has been identified as a significant risk factor for Metabolic Syndrome (MetS). However, it is unclear if the sedentary pattern measurement approach (posture vs. movement) impacts observed associations or if associations differ for Hispanic/Latino communities, who have higher risk of MetS. METHODS: Participants from the Community of Mine (CoM) study (N = 602) wore hip-based accelerometers for 14 days and completed MetS-associated biomarker assessment (triglycerides, blood pressure, fasting glucose, HDL cholesterol, waist circumference). Sedentary patterns were classified using both cutpoints (movement-based) and the Convolutional Neural Network Hip Accelerometer Posture (CHAP) algorithm (posture-based). We used logistic regression to estimate associations between MetS with sedentary patterns overall and stratified by Hispanic/Latino ethnicity. RESULTS: CHAP and cutpoint sedentary patterns were consistently associated with MetS. When controlling for total sedentary time and moderate to vigorous physical activity, only CHAP-measured median sedentary bout duration (OR = 1.15, CI: 1.04, 1.28) was significant. In stratified analysis, CHAP-measured median bout duration and time spent in sedentary bouts ≥ 30 min were each associated with increased odds of MetS, but the respective associations were stronger for Hispanic/Latino ethnicity (OR = 1.71 and 1.48; CI = 1.28-2.31 and 1.12-1.98) than for non-Hispanic/Latino ethnicity (OR = 1.43 and 1.40; CI = 1.10-1.87 and 1.06-1.87). CONCLUSIONS: The way sedentary patterns are measured can impact the strength and precision of associations with MetS. These differences may be larger in Hispanic/Latino ethnic groups and warrants further research to inform sedentary behavioral interventions in these populations.

Effective method for life-style modifications focused on dietary sodium intake in chronic kidney disease: sub-analysis of the FROM-J study.

BACKGROUND: Lifestyle modifications by educational sessions are an important component of multidisciplinary treatment for chronic kidney disease (CKD). We attempted to identify the best method to teach these modifications in order to ensure their acceptance by patients and investigated its effectiveness in CKD practice. METHODS: This study is a post-hoc analysis of the FROM-J study. Subjects were 876 CKD patients in the advanced care group of the FROM-J study who had received lifestyle modification sessions every 3 months for 3.5 years. Two-hundred and ten males (32.6%) and 89 females (38.2%) showed success in sodium restriction. In this study, we examined factors affecting sodium restriction in these subjects. RESULTS: Subjects received three or more consecutive educational sessions about improvement of salt intake. The median salt-intake improvement maintenance period was 407 days. The number of dietary counseling sessions (OR 1.090, 95%CI: 1.012-1.174) in males and the number of dietary counseling sessions (OR 1.159, 95%CI: 1.019-1.318), CKD stage progression (OR 1.658, 95%CI: 1.177-2.335), and collaboration with a nephrologist (OR 2.060, 95%CI: 1.073-3.956) in females were identified as significant factors improving salt intake. The only factor contributing to the maintenance of improved salt intake was the continuation of dietary counseling (p = 0.013). CONCLUSION: An increased number of educational sessions was the only successful approach for males to implement and maintain an improved salt intake. Providing the resources for continuous counseling is beneficial for lifestyle modifications and their maintenance in the long-term management of CKD. Continuous counseling for lifestyle modifications is highly cost-effective. TRIAL REGISTRATION: The FROM-J study was registered in UMIN000001159 on 16/05/2008.

Examining the Impact of a Behavior Modification Program on Disease Prevention Behaviors among Individuals at Risk of Diabetes: A Quasi-Experimental Investigation.

This study aimed to develop and test a behavior modification intervention to prevent type 2 diabetes (T2DM) among at-risk individuals. The primary goal was to compare diabetes prevention behaviors and fasting blood sugar levels between the intervention and comparison groups. This study utilizes a quasi-experimental design to develop a behavior modification intervention for preventing diabetes. It involves two groups, each with pre- and post-intervention assessments, comprising 60 at-risk individuals equally divided into intervention and comparison groups. The 8-week intervention includes components like risk assessment, dietary skill enhancement, exercise, stress management, and social media platforms (data recording training, follow-up visits, reminders, and visual aids). Data collection includes self-administered questionnaires and blood sugar level measurements. Statistical analysis involved paired t-tests for within-group comparisons and independent t-tests for between-group differences. The findings showed that the intervention group achieved significantly higher average scores in nutrition, exercise, and stress management, and had significantly lower average blood sugar levels compared to the comparison group. These results suggest that healthcare providers and policymakers should develop community health programs and public health policies that incorporate integrative care, leverage social media platforms, and foster collaboration with other health professionals to improve outcomes for individuals at risk of T2DM.

2024 AAFP intercat tension guidelines: recognition, prevention and management.

Social tension or conflict between household cats is common but, because it often manifests as subtle behavioral changes, it can go unnoticed; it is precisely because most signs are subtle and unrecognized that the term 'tension' is used. Where associated tension-related chronic fear-anxiety leads to more overt behavioral concerns and stress-associated disease, cats may face relinquishment by caregivers or even euthanasia if the tension is not relieved. The '2024 AAFP intercat tension guidelines: recognition, prevention and management' have been authored by a Task Force of board-certified veterinary and applied behaviorists and clinical experts in feline medicine and behavior convened by the American Association of Feline Practitioners. The aim is to support veterinary professionals in understanding social behavior between cats and, more specifically, in recognizing intercat tension, preventing or minimizing its occurrence and managing the stressors. In developing the Guidelines, the Task Force has modified the five pillars of a healthy feline environment to provide a framework to assist the prevention or management of intercat tension in households with two or more cats. Because feline social behavior is often misunderstood, the Guidelines debunk 10 common myths that have the potential to negatively impact the wellbeing of companion cats. Extensively illustrated with visual examples of intercat tension and an Appendix detailing a number of case studies, the Guidelines also include a comprehensive table of psychotherapeutic medications, and a detailed algorithm that outlines a systematic approach to preventing, recognizing and resolving intercat tension. A step-by-step approach to introducing a new cat into a household with one or more resident cats is included to further support veterinarians, and a range of management tools to promote client education accompany the Guidelines.

Protection motivation theory in predicting intentional behaviors regards schistosomiasis: a WeChat-based qualitative study.

Background: Modifications of behavior can help reduce the risk of transmission by disrupting the parasite life cycle. Behavior intension is a necessary intermediate step in behavior change. This study aimed to explore protection motivation theory (PMT) in predicting likelihood of engagement in protective behavior against infection with Schistosoma. Methods: In China, a questionnaire for data collection was sent to users who followed the WeChat public account from June 2 to 6, 2023. Factors affecting intentional behavior of participants were analyzed using stepwise regression analysis and structural equation modeling. Results: A total of 2,243 valid questionnaires were collected, with a mean age of 30 ± 8.4 years. Approximately 1,395 (62.2%) participants reported that they had been exposed to wild waters in daily work and life. About 51.0 and 50.7% of respondents reported never having been exposed to wild water in the last 3 and 6 months, respectively. Results indicated that prior knowledge of schistosomiasis was associated with the 7 PMT subconstructs, which then influenced future preventative behaviors. Conclusion: Behavior intentionis a complicated and indispensable part of behavior change that is influenced by professional knowledge, socio-economic status, and personal characteristics. The effective dissemination of knowledge regards schistosomiasis should be strengthened to emphasize the effectiveness of protective measures against infection and severe disease.

BRIDGE to liver health: implementation of a group telehealth psychoeducational program through shared medical appointments for MASLD management.

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a significantly costly and increasingly prevalent disease, with treatment focused on lifestyle intervention. Integrating education and behavioral health into clinical care offers opportunities to engage and empower patients to prevent progression of liver disease. We describe the design and implementation of Behavioral Resources and Intervention through Digital Group Education (BRIDGE), a 6-session group telehealth program led by advanced practice providers (APPs) in 90-min shared medical appointments (SMAs) with small groups of MASLD patients in an academic outpatient hepatology clinic. The program contains multi-component group interventions, with didactic education and behavioral coaching, while leveraging peer-based learning and support. METHODS: A mixed-methods exploratory pilot study was conducted. Feasibility and acceptability of the clinical intervention were assessed by tracking recruitment, attendance, and retention of BRIDGE participants, patient interviews, and debriefing of clinician and staff views of the clinical program. Implementation metrics included program development time, workflow and scheduling logistics, and billing compliance for sustainability. Finally, patient parameters including changes in liver enzymes, FIB-4, weight, and BMI from pre- to post-BRIDGE were retrospectively analyzed. RESULTS: We included 57 participants (median age 57, interquartile range (IQR) 50 - 65 years), 38 (67%) female, 38 (67%) white, and 40% had public insurance. Thirty-three (58%) participants completed all six sessions, while 43 (75%) attended at least five sessions. Patients who completed all sessions were older (median age 61 vs 53.5; p = 0.01). Gender, race/ethnicity, and insurance type were not significantly associated with missed sessions, and patients had similar rates of completion regardless of weight, BMI, or stage of liver disease. Barriers to completion included personal illness, family reasons, work commitments, or insurance issues. Prior to BRIDGE, median BMI was 31.9 (SD 29 - 36), with a median weight loss of 2 pounds (IQR -2 - 6) after BRIDGE. CONCLUSION: The BRIDGE telehealth SMA program was feasible, well-attended, and positively reviewed. This pilot study informs future iterations of program development and evaluation of outcome measures.

Arriba por la Vida Estudio: a randomized controlled trial promoting standing behavior to reduce sitting time among postmenopausal Latinas.

Postmenopausal Hispanic/Latina (N = 254) women with a body mass index (BMI) ≥ 25 kg/m2 were randomized to an intervention to reduce sitting time or a comparison condition for 12 weeks. The standing intervention group received three in-person health-counseling sessions, one home visit, and up to eight motivational interviewing calls. The heart healthy lifestyle comparison group (C) received an equal number of contact hours to discuss healthy aging. The primary outcome was 12-week change in sitting time measured via thigh-worn activPAL. Group differences in outcomes were analyzed using linear mixed-effects models. Participants had a mean age of 65 (6.5) years, preferred Spanish language (89%), BMI of 32.4 (4.8) kg/m2, and sat for an average of 540 (86) minutes/day. Significant between-group differences were observed in reductions of sitting time across the 12-week period [Mdifference (SE): C - 7.5 (9.1), SI - 71.0 (9.8), p < 0.01]. Results demonstrate that coaching models to reduce sitting are feasible and effective.

Erratum: Feasibility pilot study of a Japanese teaching kitchen program.

[This corrects the article DOI: 10.3389/fpubh.2023.1258434.].

Culturally sensitive patient-centered healthcare: a focus on health behavior modification in low and middle-income nations-insights from Indonesia.

Patient-centered, culturally sensitive healthcare acknowledges the profound impact of cultural beliefs on health behaviors and outcomes, particularly vital in low and middle-income countries (LMICs). Within Indonesia, distinct cultural factors are pivotal in empowering patients, necessitating their integration into healthcare practices. For example, the cultural concept of gotong royong, emphasizing communal collaboration, presents an opportunity to foster community support networks among patients. Moreover, honoring familial ties and involving family members in decision-making enhances patient empowerment. Acknowledging and incorporating spiritual and religious beliefs, which are deeply rooted in Indonesian culture, into healthcare interventions further augments patient empowerment and well-being. In LMICs, including Indonesia, achieving patient empowerment demands implementing critical strategies. Community-based interventions harness local resources and engage the community to drive health behavior change. Culturally sensitive communication bridges the gap between healthcare providers and patients, respecting language nuances and cultural norms. Patient education fosters a comprehensive understanding of health conditions, thereby encouraging active involvement in decision-making. Tailored behavior modification techniques, aligned with cultural beliefs and practices, support the adoption of healthier behaviors among patients. This review emphasizes the pivotal role of patient-centered, culturally sensitive healthcare in LMICs, particularly in Indonesia. It delves into strategies to promote health behavior change within these unique contexts, emphasizing the importance of cultural sensitivity and patient-centered care. The discourse also explores the cultural landscape impacting healthcare, acknowledging the challenges faced in delivering comprehensive healthcare services within these diverse cultural contexts. Additionally, it outlines innovative approaches and success stories in implementing patient-centered care, highlighting how cultural factors intersect with healthcare outcomes. By advocating for integrating culture-specific patient empowerment practices into healthcare methodologies, this article underscores the potential for improved health outcomes, heightened patient engagement, and the delivery of culturally relevant services within LMICs.

Men With Type II Diabetes in Peru: The Role of Masculine Gender Norms in the Perception of Family Support.

Type II diabetes is increasingly becoming a problem in Latin American countries such as Peru. People living with diabetes must incorporate several behavioral changes in their everyday lives, which are done outside the purview of medical professionals. Support from friends and family members is essential to the successful management of any chronic condition. Our study discusses the role of family involvement in supporting the management of diabetes among Peruvian men and examines how masculine norms play a role in the way such support is received and perceived, and their influence in motivation to adhere to treatment recommendations. In-depth interviews with 20 men from a low socioeconomic status, aged 27 to 68 with a diagnosis of Type II diabetes were conducted. Our analysis suggests the importance of the close, complex, and integrated experience that connects family members and patients with a chronic condition. Participant accounts demonstrate they receive multiple forms of support from a diverse range of social relationships. The overwhelming majority of the people giving the support were female and were especially significant in supporting management practices. The participants' accounts were able to demonstrate how living with a chronic condition, such as diabetes, affects the whole family-physically, mentally, and emotionally-and they experience the disease as one unit. Our study demonstrates the need for a family health experience approach that considers masculine gender norms around health and provides relevant insights to inform family-based treatments and therapies to allow for more and better targeted health care for men.

Effect of acetaminophen on relieving orthodontic pain with clear aligner based on GAD-7: A retrospective research.

Objectives: Patients may have uncomfortable feelings during orthodontic treatment, which can directly lead to dissatisfaction. So in order to improve the patient's sense of pleasure during the treatment, it would be of great benefit if orthodontic pain can be relieved. Materials and methods: We included 150 patients wearing clear aligners from 18 to 30 years old during 2018-2020. Then designed following groups to determine the effectiveness of both verbal behavior modification and combination therapy with acetaminophen in reducing treatment pain: Group A, generalized anxiety disorder 7 (GAD-7) scored 0-4; Group B, GAD-7 scored 5-9; Group C, GAD-7 scored 10-14; and Group D, GAD-7 scored 15-21. Results: There was a difference in the visual analog scale (VAS) between verbal behavior modification with and without a 300-mg acetaminophen tablet oral QD in Group A (received the intervention at 8 h and 1 d), Group B at 8 h and 1 d, Group C at 8 h, 1 d, 2 d, and 3 d, and Group D at 8 h, 1 d, 2 d, 3 d, and 4 d. After 8 h, 1 d, 2 d, 3 d, and 4 d in patients with verbal behavior modification, VAS was markedly increased in Group D compared with Group A, B and C. Furthermore, after 8 h and 1 d in patients with verbal behavior modification and 300-mg acetaminophen tablet oral QD, VAS was strongly enhanced in Group D. Conclusions: Dental anxiety is strongly associated with pain in orthodontic patients receiving clear aligners. Acetaminophen administration may be a benefit in orthodontic pain that results from clear aligners, especially in the group with more GAD-7.

Outcomes of a Remote Cardiac Rehabilitation Program for Patients Undergoing Atrial Fibrillation Ablation: Pilot Study.

BACKGROUND: Risk factor modification, in particular exercise and weight loss, has been shown to improve outcomes for patients with atrial fibrillation (AF). However, access to structured supporting programs is limited. Barriers include the distance from appropriate facilities, insurance coverage, work or home responsibilities, and transportation. Digital health technology offers an opportunity to address this gap and offer scalable interventions for risk factor modification. OBJECTIVE: This study aims to assess the feasibility and effectiveness of a 12-week asynchronous remotely supervised exercise and patient education program, modeled on cardiac rehabilitation programs, in patients with AF. METHODS: A total of 12 patients undergoing catheter ablation of AF were enrolled in this pilot study. Participants met with an exercise physiologist for a supervised exercise session to generate a personalized exercise plan to be implemented over the subsequent 12-week program. Disease-specific education was also provided as well as instruction in areas such as blood pressure and weight measurement. A digital health toolkit for self-tracking was provided to facilitate monitoring of exercise time, blood pressure, weight, and cardiac rhythm. The exercise physiologist remotely monitored participants and completed weekly check-ins to titrate exercise targets and provide further education. The primary end point was program completion. Secondary end points included change in self-tracking adherence, weight, 6-minute walk test (6MWT), waist circumference, AF symptom score, and program satisfaction. RESULTS: The median participant age was 67.5 years, with a mean BMI of 33.8 kg/m2 and CHADs2VASC (Congestive Heart Failure, Hypertension, Age [≥75 years], Diabetes, Stroke/Transient Ischemic Attack, Vascular Disease, Age [65-74 years], Sex [Female]) of 1.5. A total of 11/12 (92%) participants completed the program, with 94% of expected check-ins completed and 2.9 exercise sessions per week. Adherence to electrocardiogram and blood pressure tracking was fair at 81% and 47%, respectively. Significant reductions in weight, waist circumference, and BMI were observed with improvements in 6MWT and AF symptom scores (P<.05) at the completion of the program. For program management, a mean of 2 hours per week or 0.5 hours per patient per week was required, inclusive of time for follow-up and intake visits. Participants rated the program highly (>8 on a 10-point Likert scale) in terms of the impact on health and wellness, educational value, and sustainability of the personal exercise program. CONCLUSIONS: An asynchronous remotely supervised exercise program augmented with AF-specific educational components for patients with AF was feasible and well received in this pilot study. While improvements in patient metrics like BMI and 6MWT are encouraging, they should be viewed as hypothesis generating. Based on insights gained, future program iterations will include particular attention to improved technology for data aggregation, adjustment of self-monitoring targets based on observed adherence, and protocol-driven exercise titration. The study design will need to incorporate strategies to facilitate the recruitment of a diverse and representative participant cohort.

Feasibility pilot study of a Japanese teaching kitchen program.

Background: This pilot study examined the feasibility of a new lifestyle modification program involving a "Teaching Kitchen" in Japan. Our goal was to explore (1) feasibility of the program; (2) acceptability for class frequency (weekly vs. bi-weekly); and (3) changes in biometrics, dietary intakes, and lifestyle factors. Methods: A total of 24 employees with obesity in a Japanese company were recruited. Participants were randomly divided into two groups (weekly or bi-weekly group), each attending the program consisting of four two-hour classes (lectures on nutrition, exercise, mindfulness, and culinary instructions). Participants were observed for changes in dietary intakes, biometrics, and health related quality of life over the subsequent 3 months. We tested the between-group differences in changes using linear mixed-effect models. Results: The program completion rates were 83.3% in total (91.7% for weekly group and 75.0% for bi-weekly group). From baseline to post-intervention, significant decreases were observed in weight (p < 0.001), body mass index (p < 0.001), diastolic blood pressure (p = 0.03), body fat mass (p < 0.001), and dietary intakes in total fat (p = 0.03) and sodium (p = 0.008) among 17 participants who were available for measurements. Improvements in biometrics remained significant 1 month after the intervention (all p ≤ 0.03 in 14 participants). Participants' health related quality of life was significantly improved in bodily pain, general health, vitality, and mental component score (all p ≤ 0.047). Conclusions: The new Japanese Teaching Kitchen program is feasible with high program completion rates in Japanese office workers with obesity. While this was a small feasibility study, significant multiple improvements in dietary intakes, biometrics, and health related quality of life suggest that this line of inquiry warrants further exploration to address obesity and obesity-related diseases in Japan.

How to get back on track? Experiences of patients and healthcare professionals regarding weight recurrence and needs for an intervention after bariatric-metabolic surgery.

Background: Multidisciplinary lifestyle interventions are recommended as a first step in treating weight recurrence after bariatric-metabolic surgery (BMS). However, little is known about the experience of patients and healthcare professionals (HCP) with these interventions and how they should be tailored to the patients' needs. The aim of this study was to gain more insight into the experiences and needs of patients and HCP regarding weight recurrence after BMS and an intervention to get Back on Track. In addition, attitudes towards integrating e-Health into the care program were explored. Methods: A qualitative process evaluation of an intervention for weight recurrence, the Back on Track (BoT), was conducted by means of in-depth interviews and focus groups with 19 stakeholders, including patients and HCP involved in BoT. Interviews were transcribed verbatim. Data were analyzed through thematic analysis. Results: Patients and HCP reported a wide array of causes of weight recurrence. Patients found it difficult to decide when weight recurrence is problematic and when they should ask for help. Patients reported feeling like the exception and ashamed, therefore experiencing a high threshold to seek help. E-Health was seen as a promising way to improve tailoring, screening, autonomy for the patient, and accessible contact. Conclusion: Patients should be adequately counselled on weight recurrence after BMS and the importance of intervening early. It is important to lower the threshold for seeking help. For example by offering more long-term standard care or by adding e-Health to the intervention.

From Hive to Highway: Waste Honeycombs as a Sustainable Modifier for Asphalt Binder Formulations in South Korea.

Navigating the crossroads of sustainable infrastructure and innovative waste management, this research unveils the potential of waste honeycombs (WHCs)-an overlooked byproduct of apiculture-as a potent modifier for asphalt binder formulations. This endeavor addresses the dual challenge of enhancing road pavement sustainability and mitigating environmental degradation. A meticulous methodology evaluated the impact of varying WHC concentrations (5, 10, and 15 wt.%) on the asphalt binder, examining its attributes pre- and post-aging. Employing an array of analytical tools-thin-layer chromatography-flame ionization detection (TLC-FID); Fourier transform-infrared spectroscopy (FT-IR); scanning electron microscopy (SEM); thermogravimetric analysis (TGA); and a suite of conventional tests such as penetration, softening point, viscosity, ductility, dynamic shear rheometer (DSR), and multiple stress-creep recovery (MSCR)-provided a comprehensive insight into the binder's behavior. TLC-FID analyses revealed that WHC, with its 92 wt.% resin content, altered the SARA profile across distinct aging conditions, notably reducing asphaltene content, a factor linked to binder stiffness. The colloidal instability index (IC) further attested to this, pointing to a more thermodynamically stable system with WHC's inclusion. Meanwhile, FT-IR confirmed a physical interaction between WHC and asphalt without introducing new chemical entities. SEM observations highlighted the superior miscibility of WHC with asphalt, evidenced by a unique microtexture. With marked precision, TGA assessments unveiled a bolstering of asphalt's inherent thermal resilience consequent to a minor WHC integration. From the conventional tests, shifts in penetration, softening point, and viscosity were observed, with reduced viscosity, indicating improved workability. Lastly, while rutting potential was sensitive to WHC concentrations, fatigue resistance notably heightened with minor to moderate WHC inclusions. In essence, this pioneering study advocates for WHC's integration into asphalt formulations, offering enhanced road performance coupled with sustainable waste utilization. The findings underscore the synergy between environmental stewardship and infrastructural advancement.

The effect of mHealth program on behavior modification and health outcomes among patients with diabetes: A randomized controlled trial study.

Background: Mobile health presents a promising alternative in the digital era. Mobile health apps (mHealth), when combined with the concept of self-management, are considered one of the methods for incorporating technology-based interventions into the healthcare system. Objective: This study aimed to determine the effect of mHealth (specifically, the Diabetic Care App) on foot care behavior, dietary behavior, foot condition, and fasting blood glucose levels among patients with uncontrolled diabetes mellitus. Methods: A single randomized controlled trial was conducted at a government-run primary clinic in Northern Malaysia, involving 58 patients with uncontrolled diabetes who were assigned to two groups. The intervention group received the Diabetic Care App, attended a 2-hour face-to-face session, and was included in a WhatsApp group, while the control group received standard care. Relevant assessments were conducted for both groups in Week 1 and Week 5. The study was conducted from February 2020 to November 2020, and parametric and non-parametric statistics were used for data analysis. Results: Pretest-posttest comparisons in both groups revealed significant findings for foot care behavior (p <0.01), dietary behavior (p <0.01), and foot condition (p <0.01), except for fasting blood glucose levels. In inter-group comparisons, a significant difference was observed only in foot care behavior (p <0.01) and dietary behavior (p <0.01). Conclusion: The results indicate that technology-based interventions are beneficial for modifying behavior, specifically in terms of foot care and dietary behavior, in this study. The study highlights the applicability of mHealth for nurses in patient education and self-management of chronic conditions. Future research should explore app utilization among patients with chronic conditions. Clinical trial registration number: NCT04260100 (registered at https://clinicaltrials.gov/ct2/show/NCT04260100).

Development of a physical activity counseling intervention for people with chronic respiratory disease based on the health action process approach.

BACKGROUND: Physical activity (PA) counseling holds promise for increasing PA levels in people with chronic respiratory disease, though little long-term change has been shown to date. Here, we describe the development of a Health Action Process Approach-based PA counseling intervention that aims to promote PA and exercise in people with chronic respiratory disease who are enrolled in pulmonary rehabilitation. METHODS: To collaborate in defining and refining the intervention, we convened a varied team of authors that included a panel of five stakeholder partners: three patients, one clinician, and one health behavior change researcher. We completed three steps in the intervention development process: (1) initial intervention creation, (2) iterative intervention refinement, and (3) assessment of intervention acceptability. In step 1, we created an initial draft of the PA counseling intervention based on the HAPA theoretical framework, previous evidence in people with chronic respiratory disease, and clinical experience. In step 2, we used qualitative methods of focus groups and interviews to further develop and refine the intervention. Fifteen meetings occurred with the five-member stakeholder partner panel (six focus groups with the three patient partners, four interviews with the clinician partner, and five interviews with the researcher partner) over 5 months to systematically elicit input and incorporate it into the intervention. In step 3, we measured the intervention acceptability using five-point Likert scale ratings. RESULTS: Intervention materials included the eligibility screen, participant workbook, and leader guide. We identified key themes in the input from the stakeholder partners and incorporated this input into the intervention content and methods. Ratings of the intervention by the stakeholder partners (n=5) were high with mean ratings ranging 4.0-5.0 on a five-point scale. CONCLUSIONS: This development process successfully engaged an intervention development team with diverse perspectives and resulted in a PA counseling intervention for people with chronic respiratory disease. The intervention's strong theoretical underpinning, person-centeredness, and the contributions from varied perspectives during intervention development position it well for future evaluations of feasibility, efficacy, and effectiveness.

Evaluating the Efficacy of Behavior Modification Strategies on Physical Activity Levels Among Incarcerated Youth.

This study examined the impact of prompting only and prompting combined with independent group-oriented contingency on incarcerated adolescent males' physical activity level during a sport-leadership program. An alternating treatment design was employed to allow for the evaluation among multiple treatment conditions. The study occurred during 35 consecutive sport programming lessons at a juvenile correctional facility. Participants were 16 adolescent males (Mage = 18.79). Two behavior modification strategies, prompting only and prompting combined with independent group-oriented contingency, were employed. Data were plotted graphically so visual analysis could be determined in order to explore any functional associations between the treatment conditions (e.g., interventions) and target behavior (e.g., step count). Prompting only slightly increased physical activity, whereas prompting in conjunction with independent group-oriented contingency elevated activity levels by 36%, with a smaller standard deviation indicating that all participants were equivalently physically active. The results of this study underpin the expansive benefits of sport-leadership programming, not just in similar programs' ability to develop life skill integration, positively impact life during incarceration, improve attitudes, and promote physical activity, but also to provide elevated opportunities for youth to be physically active.

Enhancing Functional Ability in Chronic Nonspecific Lower Back Pain: The Impact of EMG-Guided Trunk Stabilization Exercises.

BACKGROUND: Nonspecific lower back pain (NSLBP) is described as pain that is not caused by an identifiable, well-known disease, such as infection, tumor, osteoporosis, fracture, structural deformity, inflammatory condition, radicular syndrome, or cauda equina syndrome. AIM: The aim of this study was to determine the effect of EMG-guided trunk stabilization exercises on functional disability associated with LBP. MATERIALS AND METHODS: A single-blinded pre- and post-test experimental comparative design was used for this study. Fifty individuals with chronic NSLBP were screened for inclusion criteria. Of these, forty were randomly grouped into the EMG group receiving trunk-stability exercises with electromyography biofeedback and non-EMG group receiving trunk-stabilization exercises without EMG biofeedback. Participants performed five trunk-stability exercises 3 days a week for 4 weeks. The intensity of pain, range of motion, functional disability, and balance were measured at baseline and after 4 weeks. RESULTS: Both techniques indicated a significant effect on chronic NSLBP; however, trunk-stability exercises combined with EMG biofeedback produced better results in alleviating the intensity of pain, increasing the range of motion, and improving functional disabilities and static balance. CONCLUSION: The present study confirms that trunk-stability exercises with EMG biofeedback can be practiced safely, contributes to a greater boost in neuromuscular efficiency in the lumbar flexors and extensors, and is effective in modifying functional disability for patients with NSLBP.