An Interactive Computer Session to Initiate Physical Activity in Sedentary Cardiac Patients: Randomized Controlled Trial

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dc.contributor.authorAlmeida, Fabio A.en
dc.contributor.authorSmith-Ray, Renae L.en
dc.contributor.authorDzewaltowski, David A.en
dc.contributor.authorGlasgow, Russell E.en
dc.contributor.authorLee, Rebecca E.en
dc.contributor.authorThomas, Deborah S. K.en
dc.contributor.authorXu, Stanleyen
dc.contributor.authorEstabrooks, Paul A.en
dc.contributor.departmentHuman Nutrition, Foods, and Exerciseen
dc.date.accessioned2019-11-22T13:56:54Zen
dc.date.available2019-11-22T13:56:54Zen
dc.date.issued2015-08en
dc.description.abstractBackground: Physical activity (PA) improves many facets of health. Despite this, the majority of American adults are insufficiently active. Adults who visit a physician complaining of chest pain and related cardiovascular symptoms are often referred for further testing. However, when this testing does not reveal an underlying disease or pathology, patients typically receive no additional standard care services. A PA intervention delivered within the clinic setting may be an effective strategy for improving the health of this population at a time when they may be motivated to take preventive action. Objective: Our aim was to determine the effectiveness of a tailored, computer-based, interactive personal action planning session to initiate PA among a group of sedentary cardiac patients following exercise treadmill testing (ETT). Methods: This study was part of a larger 2x2 randomized controlled trial to determine the impact of environmental and social-cognitive intervention approaches on the initiation and maintenance of weekly PA for patients post ETT. Participants who were referred to an ETT center but had a negative-test (ie, stress tests results indicated no apparent cardiac issues) were randomized to one of four treatment arms: (1) increased environmental accessibility to PA resources via the provision of a free voucher to a fitness facility in close proximity to their home or workplace (ENV), (2) a tailored social cognitive intervention (SC) using a "5 As"-based (ask, advise, assess, assist, and arrange) personal action planning tool, (3) combined intervention of both ENV and SC approaches (COMBO), or (4) a matched contact nutrition control (CON). Each intervention was delivered using a computer-based interactive session. A general linear model for repeated measures was conducted with change in PA behavior from baseline to 1-month post interactive computer session as the primary outcome. Results: Sedentary participants (n=452; 34.7% participation rate) without a gym membership (mean age 58.57 years; 59% female, 78% white, 12% black, 11% Hispanic) completed a baseline assessment and an interactive computer session. PA increased across the study sample (F-1,F-441= 30.03, P<.001). However, a time by condition interaction (F-3,F-441= 8.33, P<. 001) followed by post hoc analyses indicated that SC participants exhibited a significant increase in weekly PA participation (mean 45.1, SD 10.2) compared to CON (mean -2.5, SD 10.8, P=.004) and ENV (mean 8.3, SD 8.1, P<. 05). Additionally, COMBO participants exhibited a significant increase in weekly PA participation (mean 53.4, SD 8.9) compared to CON (P<.001) and ENV (P=.003) participants. There were no significant differences between ENV and CON or between SC and COMBO. Conclusions: A brief, computer-based, interactive personal action planning session may be an effective tool to initiate PA within a health care setting, in particular as part of the ETT system.en
dc.description.notesResearch reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number R01DK070553 (PI Estabrooks). The content is solely of the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We would like to acknowledge the entire Kaiser Permanente Colorado research and practice teams who were instrumental in the development and implementation of the CardiACTION trial, including Drs John Reusch, Scott Smith, Eric France and David Magid, Mark Patterson, Steve Bensen, Amy Thayer, Amy Opperman, Padma Dandmudi, Michelle Gattshall, Jonah Langer, Susan Shetterly, and many others whom we may have not named previously. We also wish to thank the InterVision Media team (Steve Christiansen, Tom Jacobs, and team) for their contributions in the development of the computer-based interventions.en
dc.description.sponsorshipNational Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) [R01DK070553]en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.2196/jmir.3759en
dc.identifier.eissn1438-8871en
dc.identifier.issue8en
dc.identifier.othere206en
dc.identifier.pmid26303347en
dc.identifier.urihttp://hdl.handle.net/10919/95838en
dc.identifier.volume17en
dc.language.isoenen
dc.rightsCreative Commons Attribution 2.0 Genericen
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/en
dc.subjectexercise, physicalen
dc.subjecttreadmill testen
dc.subjecthuman computer interactionen
dc.subjectbehavioral researchen
dc.subjectcardiovascular diseasesen
dc.subjectinteractive mediaen
dc.titleAn Interactive Computer Session to Initiate Physical Activity in Sedentary Cardiac Patients: Randomized Controlled Trialen
dc.title.serialJournal of Medical Internet Researchen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.dcmitypeStillImageen

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