Motivating Diabetic and Hypertensive Patients to Engage in Regular Physical Activity: A Multi-Component Intervention Derived from the Concept of Photovoice

Abstract

Aims: A community-based multi-component intervention (increasing awareness of the importance of physical activity in chronic illness management through reading comic books, training regarding warm-up stretching exercises, identifying facilitators and barriers to exercise through photosharing, supporting self-reflection and development of action plans) was developed to promote physical activity (PA) among patients with diabetes and hypertension. This study aimed to evaluate the efficacy of this intervention on health behaviour (walking) and health outcomes. Design: A non-randomized controlled trial with waitlisted control and pre- and post-measures. Setting: Community centres for the elderly. Participants: A total of 204 older adults with diabetes and/or hypertension were recruited. They were assigned to either the intervention group (IG) or waitlisted to the control group (CG). Intervention: Under the supervision of a nurse, six weekly group meetings were arranged in community centres for the elderly in which the participants freely exchanged their views regarding the barriers and facilitators of regular physical activity. Participants were encouraged to take photos in their neighbourhood or at home and brought these photos to share at the group meetings. The photos showed both the barriers and the facilitators to PA. In the last meeting, each participant worked out a plan to perform PA in the coming four weeks. Measures: PA referred to the number of steps taken per day and it was measured by a Garmin Accelerometer at baseline, Week 6 and Week 10. Other measures included the nine-item Self-Efficacy Scale for Exercise–Chinese version (SEE-C), and the 23-item Chinese Barriers to Exercise Scale and Senior Fitness Tests. Generalised estimating equations (GEE) models compared the outcomes over time between IG and CG. Results: A statistically significant difference in the changes in the average number of steps taken daily between the two groups at Week 10 (mean difference = 965.4; 95% confidence interval: 92.2, 1838.6, p = 0.030) was observed, although the difference at Week 6 was non-significant (mean difference = 777.6; 95% confidence interval: −35.3, 1590.5, p = 0.061). IG participants also showed significant improvements in lower body strength (mean difference = 0.967; 95% confidence interval: 0.029, 1.904, p = 0.043) and lower limb flexibility (mean difference = 2.068; 95% confidence interval: 0.404, 3.731, p = 0.015) at Week 10 compared to CG participants. Conclusion: This multi-component intervention improved the participants’ physical activity level and physical fitness, particularly in lower limb flexibility and body strength.

Behaviour change techniques that constitute effective planning interventions to improve physical activity and diet behaviour for people with chronic conditions: a systematic review

“…As shown in table 1, there were 45 RCTs 31-75 and 7 quasi-experiments. [76][77][78][79][80][81][82] Thirty-nine studies included PA planning interventions, and 37 included DB planning interventions. Ten trials included a rehabilitation period prior to action planning, eight of which occurred outside the hospital.…”

Use of photo methods in research studies with cancer survivors and their caregivers: a scoping review

“…In accordance with the principles of a scoping literature review and in order to understand more about what a photo methods-based intervention for cancer survivors could resemble and achieve, we looked to literature in other populations with physical and/or mental illness. Identi ed studies fall under one of two categories: photo methods alone [40][41][42] or photo methods as part of a multi-component intervention [43,44]. Lennon-Dearing and Hirschi developed a 7-week photovoice intervention for women with HIV to document their lives with the express purpose of providing community education [40].…”

“…Two studies investigated the use of photovoice in the context of a multi-component intervention for individuals with diabetes [43,44]. Leung and colleagues used photovoice over the course of a 6-week intervention consisting of group meetings, taking and discussing photographs, goal-setting, and developing action plans to promote increased physical activity as a management strategy to improve diabetes and hypertension [43]. Baig and colleagues integrated photovoice with an educational intervention and group discussion to encourage problem-solving skills, social support, and health behavior change [44].…”

“…Both studies conducted qualitative analyses of the themes present in photos taken by participants and also measured outcomes of interest. Both interventions produced positive effects on targeted outcomes including number of steps taken (via accelerometry) [43], lower body strength and limb exibility (via tness testing) [43], con dence in diabetes self-management [44], and social support [44]. While Leung and colleagues did not report data related to intervention adherence or satisfaction, Baig and colleagues found that 75% of participants attended at least one session and 52% took photos; in addition, 82% reported that they enjoyed discussing photos with other group members.…”

Screening Risiko Menderita DM Tipe 2 pada Kelompok Usia ≥40 Tahun di Puskesmas Kota Ambon

“…Yang kedua, memeriksakan kesehatan secara teratur agar dapat dilakukan upaya pencegahan secara dini. Yang ketiga standar penanganan penderita diperbaiki dengan meningkatkan partisipasi dari pelayanan kesehatan primer (den Braver et al, 2017;Leung et al, 2019).…”