Identifying barriers to physical activity among African American women with asthma

Nyenhuis, Sharmilee M.; Shah, Nida; Ma, Jun; Márquez, David X.; Wilbur, JoEllen; Cattamanchi, Adithya; Sharp, Lisa K.

doi:10.1080/2331205x.2019.1582399

Cited by 15 publications

(44 citation statements)

References 45 publications

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“…For example, if exercise sessions or quality and duration of sleep are of direct interest to a study, then clip-on models (Fitbit Zip) that cannot automatically track these behaviors will not be a good fit for the purposes of the study. Successful strategies we adopted in our studies included focus groups [ 21 ], field usability testing followed by a pre-pilot study to assess the feasibility of using Fitbit trackers as part of the study intervention [ 22 ], and surveys [ 23 ] to evaluate participants’ preferences and perceptions about the use of Fitbit for PA self-monitoring. For example, before the main trial in 2 studies (ie, ACTION [ 14 ] and BAILA TECH [ 12 , 13 ]), we obtained input from focus groups regarding their familiarity with using PA trackers and if they would feel comfortable using these devices.…”

Section: Challenges For Fitbit Use In Interventions and Potential Strmentioning

confidence: 99%

Using Fitbit as an mHealth Intervention Tool to Promote Physical Activity: Potential Challenges and Solutions

Balbim¹,

Marques²,

Márquez³

et al. 2021

JMIR Mhealth Uhealth

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Consumer-based physical activity (PA) trackers, also known as wearables, are increasingly being used in research studies as intervention or measurement tools. One of the most popular and widely used brands of PA trackers is Fitbit. Since the release of the first Fitbit in 2009, hundreds of experimental studies have used Fitbit devices to facilitate PA self-monitoring and behavior change via goal setting and feedback tools. Fitbit’s ability to capture large volumes of PA and physiological data in real time creates enormous opportunities for researchers. At the same time, however, it introduces a number of challenges (eg, technological, operational, logistical), most of which are not sufficiently described in study publications. Currently, there are no technical reports, guidelines, nor other types of publications discussing some of these challenges and offering guidance to researchers on how to best incorporate Fitbit devices in their study design and intervention to achieve their research goals. As a result, researchers are often left alone to discover and address some of these issues during the study through “trial and error.” This paper aims to address this gap. Drawing on our cumulative experience of conducting multiple studies with various Fitbit PA trackers over the years, we present and discuss various key challenges associated with the use of Fitbit PA trackers in research studies. Difficulties with the use of Fitbit PA trackers are encountered throughout the entire research process. Challenges and solutions are categorized in 4 main categories: study preparation, intervention delivery, data collection and analysis, and study closeout. Subsequently, we describe a number of empirically tested strategies used in 4 of our interventional studies involving participants from a broad range of demographic characteristics, racial/ethnic backgrounds, and literacy levels. Researchers should be prepared to address challenges and issues in a timely fashion to ensure that the Fitbit effectively assists participants and researchers in achieving research and outcome goals.

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Section: Challenges For Fitbit Use In Interventions and Potential Strmentioning

confidence: 99%

Using Fitbit as an mHealth Intervention Tool to Promote Physical Activity: Potential Challenges and Solutions

Balbim¹,

Marques²,

Márquez³

et al. 2021

JMIR Mhealth Uhealth

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“…Similar themes were noted in a group of middle aged African American women with poorly controlled asthma who participated in focus groups to determine barriers to walking. Domains identified in this group included limited physical capability, lack of knowledge, lack of self-monitoring skills, lack of areas to walk, lack of social support and beliefs about consequences and capability [24].…”

Section: Introductionmentioning

confidence: 99%

Patient perceived barriers to exercise and their clinical associations in difficult asthma

Freeman

Hill

Newell

et al. 2020

asthma res and pract

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Background: Exercise is recommended in guidelines for asthma management and has beneficial effects on symptom control, inflammation and lung function in patients with sub-optimally controlled asthma. Despite this, physical activity levels in patients with difficult asthma are often impaired. Understanding the barriers to exercise in people with difficult asthma is crucial for increasing their activity, and in implementing successful, disease modifying, and holistic approaches to improve their health. Methods: 62 Patients within the WATCH Difficult Asthma Cohort (Southampton, UK) completed an Exercise Therapy Burden Questionnaire (ETBQ). The results were analyzed with contemporaneous asthma-related data to determine relationships between perceived exercise barriers and asthma and comorbidity characteristics Results: Patients were reflective of a difficult asthma cohort, 66% were female, and 63% were atopic. They had a high BMI (median [inter-quartile range]) of 29.3 [25.5-36.2], age of 53.5 [38.75, 65.25], impaired spirometry with FEV1 73% predicted [59.5, 86.6%] and FEV/FVC ratio of 72 [56.5, 78.0] and poor symptom control, as defined by an Asthma Control Questionnaire (ACQ6) result of 2.4 [1.28, 3.2]. A high perceived barriers to exercise score was significantly correlated with increased asthma symptoms (r = 0.452, p < 0.0001), anxiety (r = 0.375, p = 0.005) and depression (r = 0.363, p = 0.008), poor quality of life (r = 0.345, p = 0.015) and number of rescue oral steroid courses in the past 12 months (r = 0.257, p = 0.048). Lung function, blood eosinophil count, FeNO, Njimegen and SNOT22 scores, BMI and hospitalisations in the previous year were not related to exercise perceptions. Conclusion: In difficult asthma, perceived barriers to exercise are related to symptom burden and psychological morbidity. Therefore, exercise interventions combined with psychological input such as CBT to restructure thought processes around these perceived barriers may be useful in facilitating adoption of exercise.

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“…Nineteen articles included patient factors in their analysis, while only ve studies had clinicians as research participants [12][13][14][15][16] . Five other studies that had not involved clinicians as participants had instead included recommendations for clinicians based on their research [17][18][19][20][21] . These recommendations were thereby extracted and mapped according to their respective COM-B domains.…”

Section: Selection Of Sources Of Evidencementioning

confidence: 99%

“…The main theme identi ed for Motivation was the development of autonomous patient motivation. Strong beliefs about capabilities (self-e cacy) were identi ed as strong facilitators developing autonomous motivation for patients in six studies 12,15,21,26,28,29 , whereas weak beliefs about capabilities was a motivational barrier in ve studies 19,20,23,25,27 . Beliefs about social role and identity in uenced beliefs about self-capabilities and had signi cant effects on exercise adherence 21,25 .…”

Section: Motivationmentioning

confidence: 99%

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Identifying The Factors Affecting ‘Patient Engagement’ In Exercise Rehabilitation

Teo

Zheng

Bird

2021

Preprint

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Background Despite the proven benefits of exercise rehabilitation for numerous health conditions, musculoskeletal injuries and recovery from surgery, patient adherence to such programs is reported to often be less than 35%. Increasing patient engagement therefore has the potential to improve patient health outcomes, benefiting the patient, their carers and the services that support them. The aims of this review were to identify the factors that contribute to ‘patient’ engagement in prescribed exercise rehabilitation using the COM-B (Capability, Opportunity, Motivation – Behaviour) framework of behavioural analysis. Methods Five electronic databases (PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov) were searched. ‘COM-B’ was the key word searched for specifically within titles and abstracts, combined with either ‘physical activity’ OR ‘exercise’ included using the ‘AND’ operation. Records were then filtered and excluded following full-text screening based on the predetermined eligibility criteria. Results Twenty studies were included in the review. The main COM-B themes highlighted for improving patient engagement were: Capability - improving patient knowledge and cognitive skills for behavioural regulation, such as ‘Action Planning’ and ‘Action Control’, which could also benefit time-management; Opportunity - a balanced life situation that enabled time to be devoted to the exercise program, social support, easily accessible and affordable resources and services; and Motivation - increasing patient levels of self-efficacy and autonomous motivation, which were noted to be influenced by levels of perceived ‘Capability’, additionally ‘Motivation’ was noted to be influenced by patients perceiving the benefits of the exercise, and adherence to the program was promoted by ‘goal-setting’. Other issues in the ‘Capability’ domain included a fear and/or dislike of exercise. Conclusion Patient engagement behavior has been shown to be influenced by both external (Opportunity) and intrapersonal variables (Capability and Motivation). Those prescribing exercises within a rehabilitation program need to discuss these factors with their patients and co-design the exercise rehabilitation program in partnership with the patient, since this is likely to improve patient engagement, and thereby result in superior health outcomes. Furthermore, these factors need to be a consideration in clinical trials, if the findings from such trials are to translate into mainstream healthcare settings.

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Identifying barriers to physical activity among African American women with asthma

Cited by 15 publications

References 45 publications

Using Fitbit as an mHealth Intervention Tool to Promote Physical Activity: Potential Challenges and Solutions

Using Fitbit as an mHealth Intervention Tool to Promote Physical Activity: Potential Challenges and Solutions

Patient perceived barriers to exercise and their clinical associations in difficult asthma

Identifying The Factors Affecting ‘Patient Engagement’ In Exercise Rehabilitation

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