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Qualitative and quantitative research into the development and feasibility of a video-tailored physical activity intervention
Corneel Vandelanotte, W Kerry Mummery
International Journal of Behavioral Nutrition and Physical Activity , 2011, DOI: 10.1186/1479-5868-8-70
Abstract: Five focus groups (n = 30), aimed at males and females, aged between 35 and 60 years, that do not meet the physical activity recommendation, were conducted to allow in-depth discussion of various elements related to the development of an online video-tailored intervention. In addition, a series of questions were delivered to a random sample (n = 1261) of Australians, using CATI survey technology, to gain more information and add a quantitative assessment of feasibility related to the development of the intervention. Focus group data was transcribed, and summarised using Nvivo software. Descriptive and frequency data of the survey was obtained using SPSS 18.0.Nearly all of the focus group participants supported the concept of a video-tailored intervention and 35.8% of survey participants indicated that they would prefer a video-based over a text-based intervention. Participants with a slow internet-connection displayed a lower preference for video-based advice (31.9%); however less than 20% of the survey sample indicated that downloading videos would be slow. The majority of focus group and survey participants did not support the idea of using mobile phones to receive this kind of intervention and indicated that video-tailored messages should be shorter than 5 minutes. Video-delivery of content is very rich in information, which increases the challenge to appropriately tailor content to participant characteristics; focus-group outcomes indicated a large diversity in participant preferences. 52.4% of survey participants indicated that the videos should be convincing and motivating.These results provide valuable information to develop an innovative video-tailored physical activity intervention. The results support the feasibility of such intervention, both in terms of users being ready to participate in it, as well as from a point of view whereby current internet infrastructure is able to cope with the demands of downloading videos. Though promising, a number of specif
Improving diet, physical activity and other lifestyle behaviours using computer-tailored advice in general practice: a randomised controlled trial
Parekh Sanjoti,Vandelanotte Corneel,King David,Boyle Frances M
International Journal of Behavioral Nutrition and Physical Activity , 2012, DOI: 10.1186/1479-5868-9-108
Abstract: Background The adoption and maintenance of healthy behaviours is essential in the primary prevention of chronic non-communicable diseases. This study evaluated the effectiveness of a minimal intervention on multiple lifestyle factors such as diet, physical activity, smoking and alcohol, delivered through general practice, using computer-tailored feedback. Methods Adult patients visiting 21 general practitioners in Brisbane, Australia, were surveyed about ten health behaviours that are risk factors for chronic, non-communicable diseases. Those who completed the self-administered baseline questionnaire entered a randomised controlled trial, with the intervention group receiving computer-tailored printed advice, targeting those health behaviours for which respondents were not meeting current recommendations. The primary outcome was change in summary lifestyle score (Prudence Score) and individual health behaviours at three months. A repeated measures analysis compared change in these outcomes in intervention and control groups after adjusting for age and education. Results 2306 patients were randomised into the trial. 1711 (76%) returned the follow-up questionnaire at 3 months. The Prudence Score (10 items) in the intervention group at baseline was 5.88, improving to 6.25 at 3 months (improvement = 0.37), compared with 5.84 to 5.96 (improvement = 0.12) in the control group (F = 13.3, p = 0.01). The intervention group showed improvement in meeting recommendations for all individual health behaviours compared with the control group. However, these differences were significant only for fish intake (OR 1.37, 95% CI 1.11-1.68), salt intake (OR 1.19, 95% CI 1.05-1.38), and type of spread used (OR 1.28, 95% CI 1.06-1.51). Conclusion A minimal intervention using computer-tailored feedback to address multiple lifestyle behaviours can facilitate change and improve unhealthy behaviours. Although individual behaviour changes were modest, when implemented on a large scale through general practice, this intervention appears to be an effective and practical tool for population-wide primary prevention. Trial Registration The Australian New Zealand Clinical Trials Registry: ACTRN12611001213932
Development and reliability testing of a self-report instrument to measure the office layout as a correlate of occupational sitting
Duncan Mitch J,Rashid Mahbub,Vandelanotte Corneel,Cutumisu Nicoleta
International Journal of Behavioral Nutrition and Physical Activity , 2013, DOI: 10.1186/1479-5868-10-16
Abstract: Background Spatial configurations of office environments assessed by Space Syntax methodologies are related to employee movement patterns. These methods require analysis of floors plans which are not readily available in large population-based studies or otherwise unavailable. Therefore a self-report instrument to assess spatial configurations of office environments using four scales was developed. Methods The scales are: local connectivity (16 items), overall connectivity (11 items), visibility of co-workers (10 items), and proximity of co-workers (5 items). A panel cohort (N = 1154) completed an online survey, only data from individuals employed in office-based occupations (n = 307) were used to assess scale measurement properties. To assess test-retest reliability a separate sample of 37 office-based workers completed the survey on two occasions 7.7 (±3.2) days apart. Redundant scale items were eliminated using factor analysis; Chronbach’s α was used to evaluate internal consistency and test re-test reliability (retest-ICC). ANOVA was employed to examine differences between office types (Private, Shared, Open) as a measure of construct validity. Generalized Linear Models were used to examine relationships between spatial configuration scales and the duration of and frequency of breaks in occupational sitting. Results The number of items on all scales were reduced, Chronbach’s α and ICCs indicated good scale internal consistency and test re-test reliability: local connectivity (5 items; α = 0.70; retest-ICC = 0.84), overall connectivity (6 items; α = 0.86; retest-ICC = 0.87), visibility of co-workers (4 items; α = 0.78; retest-ICC = 0.86), and proximity of co-workers (3 items; α = 0.85; retest-ICC = 0.70). Significant (p ≤ 0.001) differences, in theoretically expected directions, were observed for all scales between office types, except overall connectivity. Significant associations were observed between all scales and occupational sitting behaviour (p ≤ 0.05). Conclusion All scales have good measurement properties indicating the instrument may be a useful alternative to Space Syntax to examine environmental correlates of occupational sitting in population surveys.
The development of an internet-based outpatient cardiac rehabilitation intervention: a Delphi study
Corneel Vandelanotte, Trudy Dwyer, Anetta Van Itallie, Christine Hanley, W Kerry Mummery
BMC Cardiovascular Disorders , 2010, DOI: 10.1186/1471-2261-10-27
Abstract: A three-round Delphi study among cardiac rehabilitation experts was conducted. In the first round, 43 experts outlined opinions they had on the development of an online ORC platform into an open-ended electronic questionnaire. In the second round, 42 experts completed a structured (five-point scale) electronic questionnaire based on first round results, in which they scored items on their relevance. In the third round, the same experts were asked to re-rate the same items after feedback was given about the group median relevance score to establish a level of consensus.After the third round, high consensus was reached in 120 of 162 (74%) questionnaire items, of which 93 (57% of 162 items) also had high relevance according to the experts. The results indicate that experts strongly agreed on desired website content, data obtained from the patient, and level of interaction with patients that should be part of an Internet-based OCR intervention.The high rates of consensus and relevance observed among cardiac rehabilitation experts are an indication that they perceived the development and implementation of an Internet-based ORC intervention as feasible, and as a valuable alternative to face-to-face programs. In many ways the experts indicated that an Internet-based ORC program should mimic a traditional face-to-face program, and emphasize the crucial role of the cardiac rehabilitation manager who interacts with patients from a distance. The present study revealed practical insights into how Internet OCR interventions should be designed and opens the door for the development of such an intervention to be subsequently examined in a longitudinal and experimental study.In developed countries cardiovascular disease (CVD) continues to be the leading cause for mortality and morbidity in men and women and reducing its burden remains an important public health priority [1,2]. Controlling the CVD epidemic requires a multifaceted strategy targeting recognised modifiable risk factors
Meta-analysis of internet-delivered interventions to increase physical activity levels
Cally A Davies, John C Spence, Corneel Vandelanotte, Cristina M Caperchione, W Kerry Mummery
International Journal of Behavioral Nutrition and Physical Activity , 2012, DOI: 10.1186/1479-5868-9-52
A review of the nature and effectiveness of nutrition interventions in adult males – a guide for intervention strategies
Taylor Pennie J,Kolt Gregory S,Vandelanotte Corneel,Caperchione Cristina M
International Journal of Behavioral Nutrition and Physical Activity , 2013, DOI: 10.1186/1479-5868-10-13
Abstract: Background Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. Methods A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1) published from January 1990 to August 2011 and 2) male only studies (≥18 years) or 3) where males contributed to >90% of the active cohort. A study must have described, (i) a significant change (p<0.05) over time in an objective measure of body weight, expressed in kilograms (kg) OR Body Mass Index (BMI) OR (ii) at least one significant change (p<0.05) in a dietary intake measure to qualify as effective. To identify emerging patterns within the research a descriptive process was used. Results Nine studies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg) and/or BMI (kg/m2) changes (p≤0.05). Four studies had effective interventions (p<0.05) targeting determinants of dietary intake and dietary behaviours and/or nutritional intake. Intervention features, which appeared to be associated with better outcomes, include the delivery of quantitative information on diet and the use of self-monitoring and tailored feedback. Conclusion Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to guide researchers in making informed decisions on how to best utilise resources in interventions to engage adult males while highlighting the need for improved reporting of intervention protocols.
Cross-Sectional Associations between Multiple Lifestyle Behaviors and Health-Related Quality of Life in the 10,000 Steps Cohort
Mitch J. Duncan, Christopher E. Kline, Corneel Vandelanotte, Charli Sargent, Naomi L. Rogers, Lee Di Milia
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0094184
Abstract: Background The independent and combined influence of smoking, alcohol consumption, physical activity, diet, sitting time, and sleep duration and quality on health status is not routinely examined. This study investigates the relationships between these lifestyle behaviors, independently and in combination, and health-related quality of life (HRQOL). Methods Adult members of the 10,000 Steps project (n = 159,699) were invited to participate in an online survey in November-December 2011. Participant socio-demographics, lifestyle behaviors, and HRQOL (poor self-rated health; frequent unhealthy days) were assessed by self-report. The combined influence of poor lifestyle behaviors were examined, independently and also as part of two lifestyle behavior indices, one excluding sleep quality (Index 1) and one including sleep quality (Index 2). Adjusted Cox proportional hazard models were used to examine relationships between lifestyle behaviors and HRQOL. Results A total of 10,478 participants provided complete data for the current study. For Index 1, the Prevalence Ratio (p value) of poor self-rated health was 1.54 (p = 0.001), 2.07 (p≤0.001), 3.00 (p≤0.001), 3.61 (p≤0.001) and 3.89 (p≤0.001) for people reporting two, three, four, five and six poor lifestyle behaviors, compared to people with 0–1 poor lifestyle behaviors. For Index 2, the Prevalence Ratio (p value) of poor self-rated health was 2.26 (p = 0.007), 3.29 (p≤0.001), 4.68 (p≤0.001), 6.48 (p≤0.001), 7.91 (p≤0.001) and 8.55 (p≤0.001) for people reporting two, three, four, five, six and seven poor lifestyle behaviors, compared to people with 0–1 poor lifestyle behaviors. Associations between the combined lifestyle behavior index and frequent unhealthy days were statistically significant and similar to those observed for poor self-rated health. Conclusions Engaging in a greater number of poor lifestyle behaviors was associated with a higher prevalence of poor HRQOL. This association was exacerbated when sleep quality was included in the index.
Do Personally Tailored Videos in a Web-Based Physical Activity Intervention Lead to Higher Attention and Recall? – An Eye-Tracking Study
Stephanie Alley,Cally Jennings,Nayadin Persaud,Ronald C. Plotnikoff,Corneel Vandelanotte
Frontiers in Public Health , 2014, DOI: 10.3389/fpubh.2014.00013
Abstract: Over half of the Australian population does not meet physical activity guidelines and has an increased risk of chronic disease. Web-based physical activity interventions have the potential to reach large numbers of the population at low-cost, however issues have been identified with usage and participant retention. Personalized (computer-tailored) physical activity advice delivered through video has the potential to address low engagement, however it is unclear whether it is more effective in engaging participants when compared to text-delivered personalized advice. This study compared the attention and recall outcomes of tailored physical activity advice in video- vs. text-format. Participants (n = 41) were randomly assigned to receive either video- or text-tailored feedback with identical content. Outcome measures included attention to the feedback, measured through advanced eye-tracking technology (TobiiX 120), and recall of the advice, measured through a post intervention interview. Between group ANOVA’s, Mann–Whitney U tests and chi square analyses were applied. Participants in the video-group displayed greater attention to the physical activity feedback in terms of gaze-duration on the feedback (7.7 vs. 3.6 min, p < 001), total fixation-duration on the feedback (6.0 vs. 3.3 min, p < 001), and focusing on feedback (6.8 vs. 3.5 min, p < 001). Despite both groups having the same ability to navigate through the feedback, the video-group completed a significantly (p < 0.001) higher percentage of feedback sections (95%) compared to the text-group (66%). The main messages were recalled in both groups, but many details were forgotten. No significant between group differences were found for message recall. These results suggest that video-tailored feedback leads to greater attention compared to text-tailored feedback. More research is needed to determine how message recall can be improved, and whether video-tailored advice can lead to greater health behavior change.
A mass campaign too often? Results of a vaccination coverage survey in the Dikgale-Soekmekaar district
J Vandelanotte, M van den Akker, A Depoorter
South African Medical Journal , 2003,
Abstract: Objectives. To determine the routine and mass immunisation coverage in children aged between 12 and 23 months in the Dikgale-Soekmekaar district, Northern Province, South Africa. Design. Cross-sectional community-based vaccination prevalence survey using a two-stage cluster sampling technique. Methods. Data on the vaccination status of the children were obtained from the vaccination document of each child or by means of a vaccination history if the vaccination document was not available. A structured interview based on a fieldtested questionnaire was conducted with one caretaker of each child. Results. Each of the routine programme vaccines reached a coverage level of more than 90%, except for measles (85%) and Haemophilus influenzae (Hib) 1, 2, 3 (8%, 5% and 2% respectively). Seventy-nine per cent of all children were fully immunised through the routine services. The two polio mass campaign rounds reached coverage levels of 80% and 57% respectively. The measles campaign reached 75% of the study population. The overall measles coverage rate (routine and mass campaign) was 96%. Conclusions. The routine immunisation service in the district functions very well. The polio mass campaign in the district was redundant. However, the measles campaign increased the coverage rate in the population to 96%, which exceeds the theoretical herd immunity level of 92 - 95%. This may have averted a measles outbreak in the district.
Integrating intensified case finding of tuberculosis into HIV care: an evaluation from rural Swaziland
Susan Elden, Timothy Lawes, S?ren Kudsk-Iversen, Joris Vandelanotte, Sabelo Nkawanyana, William Welfare, John Walley, John Wright
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-118
Abstract: Nurses and lay counsellors conducted ICF using a TB screening tool and patient pathway at all HIV service entry points in clinics and the hospital. The patient pathway had three-stages; screening, sputum smear diagnosis and TB treatment initiation. Outcomes and losses to follow up were monitored at each stage. Patient demographics, access, and service feasibility and effectiveness were compared at hospital and clinic sites.1467 HIV patients at clinics and the hospital were screened over a 3 month period. Large losses to follow up occurred prior to the sputum diagnosis stage; only 47% (n = 172) of TB suspects provided a specimen. 28 cases of smear positive TB were diagnosed and 24 commenced treatment. People screened at clinics were significantly more likely to be female, older, and from rural or geographically remote areas (p < 0.001). There was no significant difference between the hospital and clinics sites in the proportion of all participants screened who were smear positive (x2 = 1.909; p = 0.16). The number needed to screen to detect one sputum positive TB case was 34 at clinics and 63 at the district hospital.ICF was operationally feasible and became established as a routine aspect of tuberculosis and HIV integrated care. ICF in community clinics was potentially more accessible to an underserved, rural population and was as effective as the hospital service in detecting smear positive TB.Tuberculosis remains the leading cause of morbidity and mortality amongst people living with HIV/AIDS worldwide [1]. Of the 1.37 million people with active TB who are also co-infected with HIV worldwide, 80% live in Sub-Saharan Africa [2]. In 2007 the tuberculosis case detection rate in the Africa Region was 47%. This remains far short of the Global Stop TB Strategy target of 70% of incident smear-positive cases detected and treated in DOTS programmes [3]. Passive case finding through directly observed short-course strategy (DOTS) is no longer seen as an adequate response to
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