Controlled randomized trial of walking exercise with positive education on cardiovascular fitness and happiness in retired older adults

Abstract

Aim: Regular walking exercise (RWE) is associated with increased cardiovascular fitness and might elevate subjective psychological well-being. Positive education links positive psychology concepts with self-efficacy through the curriculum, which helps foster well-being. This study examines if regular walking exercise with positive education has better effects on cardiovascular fitness and happiness than RWE alone in retired older adults.Methods: Three arms of experimental design were used: pedometer walking exercise training (PWET); positive education and pedometer walking exercise training (PEPWET); and pedometer walking exercise (PWE). Trained walking exercise was provided to the PWET and PEPWET groups by a walking exercise coach three times per week, for 45 min per session for 12 weeks. Positive education was designed and led by a licensed PhD psychologist every other week. Of 150 participants, 60, 60 and 30 were randomly assigned to PWET, PEPWET and PWE, respectively. Demographic information, Chinese Happiness Inventory, RWE, and 6-min walking distance were assessed before and after the intervention.Results: The percentage of participants who practiced RWE after 12 weeks was significantly higher in the PEPWET group (96.7%), followed by the PWET (75%) and PWE groups (40%). Cardiovascular fitness in the PWET and PEPWET groups was significantly better than in the PWE group. Chinese Happiness Inventory scores in the PWET and PEPWET groups were significantly higher than in the PWE group, and the PEPWET group also showed significantly higher Chinese Happiness Inventory scores than the PWET group.

mHealth interventions targeting movement behaviors in Asia: A scoping review

“…The included studies were published between 2007 and 2021, and 87.5% (70/80) were published between 2014 and 2021 (see Figure 2). Studies were from 17 countries/territories out of a possible 55: 14 from Japan 57–70 ; 12 from Korea 54,71–81 ; nine from China 82–89 ; eight from Hong Kong 90–97 ; seven from Singapore 56,98–103 ; five from Saudi Arabia 104–108 ; four each from Iran, 109–112 Taiwan, 113–116 Malaysia, 117–120 and Thailand 121–124 ; three each from India 51,125,126 ; and one each from Bangladesh, 127 Indonesia, 128 Oman, 129 Pakistan, 130 Qatar, 131 and Turkey 132 (see Figure 3). Of these 17 countries/territories, eight are classified as high‐income, six are upper middle‐income, and three are lower middle‐income countries/territories.…”

“…The type of mHealth technology used in the interventions varied. Fifty‐six interventions used a single mHealth component: delivered wholly via an app (23/80, 28.7% 68–70,79,82,83,85,88,89,91,92,95–97,103,106–109,113,114,124,126,128–130 ), pedometer (not app based; 19/80, 23.8% 55,60–68,87,94,112,115,116,119,120,123,132 ), or text messages (14/80, 17.5% 51,72–75,84,90,93,96,110,111,117,118,125 ). The remaining 24 interventions used a combination of an app and text messages (7/80, 8.8% 59,99,101,104,122,127,131 ), wearable plus associated app (e.g., Fitbit app; 7/80, 8.8% 57,77,80,81,98,100,121 ), pedometer (not app based) along with text messages (4/80, 5.0% 54,71,86,133 ), or wearable and associated app and text messages together (3/80, 3.8% 76,78,105 ).…”

“…Most interventions (53/80, 66.3%) were delivered entirely remotely (i.e., no face‐to‐face or telephone‐based intervention components). Twenty‐one (26.3%) interventions had one or more in‐person components (group exercise classes, 13/80, 16.3% 55,57,60,62,64,65,72,73,76,116,119–121 ; group education sessions, 9/80, 11.3% 60,67,72,74–76,96,116,117 ; individual counseling, 5/80, 6.3% 57,71,74,115,119 ), and 11 (13.8%) interventions incorporated a telephone call‐based component (counseling, 8/80, 10.0% 53,72,73,75,76,125,126,129 or a reminder to use the intervention, 3/80, 3.8% 81,105,133 ).…”

“…Most (64/80, 80.0%) studies included a measure of efficacy in relation to the targeted movement behavior(s). Of the 74 physical activity interventions, self‐reported methods were most common (i.e., questionnaire and time‐use diary; 31/74, 41.9% 51,61,66,72–75,77,78,86,89,90,93–97,99,105,110,113,116–119,122,123,125,127,131,133 ), followed by device measured (i.e., pedometer, accelerometer, and smartphone app; 24/74, 32.4% 57,60,62,64,65,67,68,70,79–81,83,88,91,96,98,100,102,103,116,120,124,129,130,132 ), and some used a combination of both (6/74, 8.1% 55,58,63,112,115,121 ). There were 14 studies that did not report a specific physical activity‐related outcome measure (14/74, 18.9% 71,76,84,85,91,92,101,104,106–108,114,126,128 ).…”

“…Of these 17 countries/territories, eight are classified as high‐income, six are upper middle‐income, and three are lower middle‐income countries/territories. In total, 52 studies were conducted in high‐income (65.0% 54,55,57–81,90–108,113–116,129,131 ), 23 in upper middle‐ (28.7% 82–84,86–89,109–112,117–124,128,132,133 ), and five in lower middle‐income countries/territories (6.3% 51,125–127,130 ). There were no studies from low‐income countries.…”