The long-term efficacy of two computer-tailored physical activity interventions for older adults: Main effects and mediators.

Objective: Low-cost (e.g., computer-tailored) interventions with sustained effects are needed to increase and maintain physical activity in older adults. This study examined the long-term efficacy of 2 computer-tailored physical activity interventions for older adults and its psychosocial and environmental mediators. Methods: A clustered randomized controlled trial (N = 1,971) was conducted that included 3 research arms: (a) basic computer-tailored print intervention, targeting psychosocial mediators; (b) environmentally computer-tailored print intervention, targeting psychosocial and environmental mediators; and (c) no-intervention control group. Interventions were developed using the intervention mapping approach and consisted of 3 computer-tailored letters delivered over 4 months. Questionnaires assessed the study outcomes (i.e., total weekly days and total weekly minutes of physical activity) at baseline and 12 months. Potential mediators (i.e., awareness, attitude, self-efficacy, intention, social influence, intrinsic motivation, self-regulation, and perceived environment) were assessed at baseline and at 3 or 6 months. Results: Multilevel regression analyses revealed that both interventions significantly changed total weekly days of physical activity compared with the control group, but only the environmentally computer-tailored print intervention significantly changed weekly minutes of physical activity. Multiple mediation models showed that the effects of both interventions on weekly days of physical activity were mediated by changes in awareness and intention. Conclusions: Computer-tailored interventions were effective in inducing long-term behavioral changes in physical activity behavior of older adults. Awareness and intention were found to be important mediators of changing daily physical activity and should be included in future computer-tailored intervention studies. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Determinants of physical activity in obese children assessed by accelerometer and self-report

Previous research has shown that predictors of activity in adults depend upon the method of measurement. This study is designed to assess the predictors of activity in a sample of 59 obese children. Activity was measured using self-reported and TriTrac accelerometer METs. Self-report and TriTrac accelerometer measures were moderately correlated, r = 0.46, with the self-reported activity (2.3 METs) significantly greater than TriTrac (1.6 METs). Hierarchical regression analysis examined the influence of socioeconomic level, body composition, fitness, hedonics of child and adult activity behaviors, and decisional balance on self-reported and accelerometer-measured activity, controlling for child and parent psychopathology. Child and parent psychological symptoms accounted for 8.3% and 3.4% of the variance in accelerometer and self-reported METs, respectively. The model for accelerometer-measured activity showed socioeconomic level and parent self-report of activity accounted for 14.8% of the incremental variance in child activity. The model for self-report of child activity found that child fitness accounted for 23.5% of the incremental variance in child activity. These results suggest that the predictors of activity level are different based upon the method of measurement, consistent with research in adults.     

Interaction between physical environment, social environment, and child characteristics in determining physical activity at child care.

Objective: To investigate the association between the child-care environment and physical activity of 2- and 3-year-olds. Based on an ecological view of environmental influences on health behavior, we hypothesized that the social and physical environment, as well as child characteristics (age and gender), would show independent and interactive effects on children's physical activity intensity. Design: Observations of physical activity intensity were performed among children (N = 175) at 9 Dutch child-care centers. Aspects of the child-care environment were assessed using the validated Environment and Policy Assessment and Observation (EPAO) Instrument. Multilevel linear regression analyses examined the association of environment and child characteristics with children's activity intensity. Moderation was tested by including interaction terms in the analyses, with subsequent post hoc analyses for significant interaction terms. Main Outcome Measure: Observed child physical activity intensity, measured with the Observational System for Recording Physical Activity in Children—Preschool Version. Results: A large proportion of the observed activities were classified as sedentary, while far fewer observations were classified as moderate or vigorous. Activity opportunities in the physical environment (assessed using EPAO) and prompts by staff and peers were significantly and positively related to physical activity intensity, while group size was negatively related to activity intensity. The influence of the physical environment was moderated by social environment (peer group size), while the social environment in turn interacted with child characteristics (age and gender) in determining activity intensity. Conclusion: Our findings are in line with the ecological perspective regarding environmental influences on behavior, and stress the importance of incorporating the child-care environment in efforts to prevent childhood overweight and obesity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Perceived environmental predictors of physical activity over 6 months in adults: Activity Counseling Trial": Correction to Sallis et al. (2007).

Reports an error in "Perceived environmental predictors of physical activity over 6 months in adults: Activity Counseling Trial" by James F. Sallis, Abby C. King, John R. Sirard and Cheryl L. Albright (Health Psychology, 2007[Nov], Vol 26[6], 701-709). One result in Table 2 was misinterpreted in the text. It was reported that men who responded "yes" to frequently seeing people being active in their neighborhoods did about 75 minutes more physical activity per week (p2007-16656-008.) Purpose: In the present study, the authors extend previous cross-sectional findings by using a prospective design to determine whether physical and social environmental characteristics predict physical activity over 6 months. Design: Inactive adults were recruited to the Activity Counseling Trial, a multicenter, randomized, controlled trial of physical activity intervention in primary care. Participants were 387 women and 474 men aged 35-75 years in 3 regions; 1/3 were minorities; 56% had some college education. Baseline perceived environmental variables were used to predict physical activity at 6 months, adjusting for experimental condition and other potential moderators. Measures: The validated 7-day physical activity recall interview was used to estimate minutes of moderate to vigorous physical activity. A standardized survey was used to measure social and physical environmental variables around the home and neighborhood. Results: Women reporting no unattended dogs and low crime in their neighborhoods and men reporting frequently seeing people being active in their neighborhoods did 50-75 more minutes of physical activity per week than did those with different environmental characteristics. Interactions of environmental variables with age group suggested that older adults may be more affected by environmental variables than are younger adults. Conclusions: Self-reported social and physical environmental variables were significantly related to moderate to vigorous physical activity among a diverse sample of adults living in 3 regions of the United States. These prospective findings strengthen the conclusion from previous cross-sectional studies that environmental variables are important correlates of physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial outcomes of telephone-based counseling for adults with an acquired physical disability: A meta-analysis.

Background: The delivery of mental health services by telephone, referred to as telecounseling, has the potential to improve the health outcomes of adults with an acquired physical disability in a cost-effective way. However, the efficacy of this form of treatment requires further evaluation before it is used on a larger scale. Aim: This meta-analysis provides a critical and quantitative evaluation of the impact of telephone-administered psychological interventions on the psychosocial functioning of adults with an acquired physical disability caused by spinal cord injury, limb amputation, severe burn injury, stroke, or multiple sclerosis. Method: A comprehensive search of eight electronic databases identified eight studies (N = 658 participants) that compared treatment efficacy to that of matched control groups. Differences in the psychosocial outcomes of treatment and control participants were examined using Cohen's d effect sizes. Fail-safe Ns and 95% confidence intervals were used to evaluate the significance of these results. Results: Significant improvements in coping skills and strategies (overall d = 0.57), community integration (overall d = 0.45), and depression (overall d = 0.44) were observed immediately after telecounseling, with modest improvements in quality of life maintained at 12 months post-intervention (overall d = 0.37). Conclusions: The results suggest that telecounseling is an effective treatment modality for adults adjusting to a physical disability; however, further trials are needed to establish the long term psychosocial benefits. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Identifying subgroups that succeed or fail with three levels of physical activity intervention: The activity counseling trial.

The authors used recursive partitioning methods to identify combinations of baseline characteristics that predict 2-year physical activity success in each of 3 physical activity interventions delivered in the multisite Activity Counseling Trial. The sample consisted of 874 initially sedentary primary care patients, ages 35-75 years, who were at risk for cardiovascular disease. Predictors of 2-year success were specific to each intervention and represented a range of domains, including physiological, demographic, psychosocial, health-related, and environmental variables. The results indicate how specific patient subgroups (e.g., obese, unfit individuals; high-income individuals in stable health) may respond differently to varying levels and amounts of professional assistance and support. The methods used provide a practical first step toward identifying clinically meaningful patient subgroups for further systematic investigation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sociodemographic variations in the sense of control by domain: Findings from the MacArthur studies of midlife.

Past research has focused on general control beliefs with little attention to whether control beliefs vary across domains. Also, most age-comparative studies have examined control beliefs in younger and older adults but not in middle-aged adults. This study examined assessments of control in 7 domains for a large probability sample of adults 25–75 years in age. Results revealed differential age patterns across domains: Increases in control by age were found for control over work, finances, and marriage, whereas decreases were found for control over relationship with children and sex life. Control beliefs in some domains also varied by gender and education, but the age patterns were consistent across these sociodemographic groups. Domain-specific control beliefs were significantly related to a variety of domain-relevant experiences and outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telephone versus print delivery of an individualized motivationally tailored physical activity intervention: Project STRIDE.

Objective: Given that only 25% of Americans meet physical activity recommendations, there is a need to develop and disseminate effective, evidence-based interventions to promote physical activity. The authors tested 2 delivery channels, telephone and print, to determine whether one was more effective in promoting physical activity. Design: The authors randomly assigned 239 healthy, sedentary adults to (a) telephone-based individualized feedback, (b) print-based individualized feedback, or (c) contact control. Both intervention arms were guided by a motivationally tailored, theoretically driven computer expert system. Main outcome measures: Physical activity as measured by the 7-day Physical Activity Recall interview. Results: At 6 months, both telephone and print arms significantly increased in minutes of moderate intensity physical activity compared with control, with no differences between the intervention arms. At 12 months, print participants reported a significantly greater number of moderate intensity minutes than both telephone and control participants, who did not differ. Conclusion: Results suggest that both telephone and print enhance the adoption of physical activity among sedentary adults; however, print interventions may be particularly effective in maintaining physical activity in the longer term. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived environmental predictors of physical activity over 6 months in adults: Activity Counseling Trial.

[Correction Notice: An erratum for this article was reported in Vol 27(2) of Health Psychology (see record 2008-12766-001). One result in Table 2 was misinterpreted in the text. It was reported that men who responded "yes" to frequently seeing people being active in their neighborhoods did about 75 minutes more physical activity per week (pPurpose: In the present study, the authors extend previous cross-sectional findings by using a prospective design to determine whether physical and social environmental characteristics predict physical activity over 6 months. Design: Inactive adults were recruited to the Activity Counseling Trial, a multicenter, randomized, controlled trial of physical activity intervention in primary care. Participants were 387 women and 474 men aged 35-75 years in 3 regions; 1/3 were minorities; 56% had some college education. Baseline perceived environmental variables were used to predict physical activity at 6 months, adjusting for experimental condition and other potential moderators. Measures: The validated 7-day physical activity recall interview was used to estimate minutes of moderate to vigorous physical activity. A standardized survey was used to measure social and physical environmental variables around the home and neighborhood. Results: Women reporting no unattended dogs and low crime in their neighborhoods and men reporting frequently seeing people being active in their neighborhoods did 50-75 more minutes of physical activity per week than did those with different environmental characteristics. Interactions of environmental variables with age group suggested that older adults may be more affected by environmental variables than are younger adults. Conclusions: Self-reported social and physical environmental variables were significantly related to moderate to vigorous physical activity among a diverse sample of adults living in 3 regions of the United States. These prospective findings strengthen the conclusion from previous cross-sectional studies that environmental variables are important correlates of physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lifestyle physical activity interventions. History, short- and long-term effects, and recommendations

INTRODUCTION: Lifestyle physical activity interventions have resulted in response to the public health problem of promoting regular amounts of physical activity to the majority of U.S. adults who remain inadequately or completely inactive. These lifestyle interventions allow a person to individualize his/her physical activity programs to include a wide variety of activities that are at least of moderate intensity and to accumulate bouts of these activities in a manner befitting his/her life circumstances. METHODS: We reviewed the history of lifestyle physical activity interventions and defined lifestyle physical activity based on this review. We located 14 studies that met this definition. RESULTS: Lifestyle physical activity interventions are effective at increasing and maintaining levels of physical activity that meet or exceed public health guidelines for physical activity in representative samples of previously sedentary adults and obese children. The majority of these interventions have been delivered by face-to-face contact in small groups, which limits their public health impact. However, a small number of studies demonstrate that these interventions can be delivered by mail and telephone, which may enhance their generalizability. Most of these studies utilized behavior change theories such as Social Cognitive Theory, the Transtheoretical Model, and Behavior Learning to shape the interventions. Lifestyle interventions aimed at modifying the environment, such as signs posted to increase stair climbing, also have been shown to be effective over the short term. CONCLUSIONS: The major issues concerning lifestyle physical activity interventions are: (1) testing their ability to be implemented on a large scale; (2) examining cost-effectiveness for different modes of delivery; and (3) researching the efficacy in populations such as the elderly, minorities, economically disadvantaged, and individuals with concurrent disease. More studies aimed at manipulating the environment to increase physical activity need to be tested over periods of one year or longer. It is possible that lifestyle interventions could be integrated and delivered by new technologies such as interactive computer-mediated programs, telephone, or computer web-based formats. All of these recommended approaches should utilize valid and reliable measures of physical activity and should examine the health effects, particularly on a longitudinal basis. Basic dose-response studies in controlled settings also are needed to help us understand the health effects of accumulated moderate intensity activity.     

Evaluation of an organizational stress management program in a municipal public works organization.

The aim of this study was to investigate the effects of employee participation in an organizational stress management program consisting of several interventions aiming to improve psychosocial work environment and well-being. Pre- and postintervention questionnaires were used to measure the outcomes with a 2-year interval. This article describes the background of the program, results of previously published effect studies, and a qualitative evaluation of the program. The authors also tested the effects of level of participation in all interventions among the employees of the service production units by 2 (time) × 3 (group) repeated measures ANOVAs (n = 625). "Active participation" (more than 5.5 days) had a positive effect on feedback from supervisor and flow of information. Work climate remained on a permanent level while it decreased in the categories of moderate and nonparticipation. The level of participation did not improve individual well-being or other aspects of psychosocial work environment as postulated by the work stress models. The qualitative evaluation and practical conclusions drawn by the management of the Organization provided a positive impression of the impact of the program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical health problems, depressive mood, and cortisol secretion in old age: Buffer effects of health engagement control strategies.

Objective: This study examined the protective role played by control behaviors aimed at overcoming physical health problems (health engagement control strategies; HECS) in the associations between older adults' physical health problems, depressive mood, and diurnal cortisol secretion. It was expected that adaptive levels of HECS would buffer the adverse effects of physical health problems on depressive mood and diurnal cortisol secretion. Design and Measures: Physical health problems and HECS were measured in a cross-sectional sample of 215 community-dwelling older adults. In addition, participants' depressive mood and patterns of diurnal cortisol secretion were assessed across 3 days. Results: The findings demonstrate that physical health problems predicted high levels of depressive mood and diurnal cortisol secretion, but only among older adults who reported low levels of HECS (and not among older adults who reported high levels of HECS). Moreover, depressive mood completely mediated the buffering effect of HECS on the association between physical health problems and cortisol secretion. Conclusion: The results suggest that adaptive levels of HECS represent a psychological mechanism that can protect older adults from experiencing the adverse emotional and biological consequences of physical health problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex comparisons in life satisfaction and psychosocial adjustment scores with an older adult sample: examining the effect of sex role differences in older cohorts

The present study examined how sex and other individual-difference factors (i.e., age level, locus of control orientation, and self-actualization subscale scores) relate to older adults' scores on life satisfaction and psychosocial adjustment. Seventy-eight older adults (n = 39 females) were recruited from independent-living retirement communities located in Pennsylvania. Results indicated that females in the sample were not significantly different in mean life satisfaction scores but were significantly lower in mean psychosocial adjustment scores than males in the sample. There were no significant age-level differences in mean scores. Qualitative data from unstructured post-testing interviews revealed that women were more likely to express regret and sometimes frustration toward perceived "missed opportunities" in life (e.g., career) due to expected social roles of being a wife and mother in the decades ranging from the 1920s through the 1960s; these feelings of regret or frustration were not expressed by any of the males in the study.     

Patterns of sedentary behavior among adolescents.

Objective: Reducing certain sedentary behaviors (e.g., watching television, using a computer) can be an effective weight loss strategy for youth. Knowledge about whether behaviors cluster together could inform interventions. Study Design: Estimates of time spent in 6 sedentary behaviors (watching television, talking on the telephone, using a computer, listening to music, doing homework, reading) were cluster analyzed for a sample of 878 adolescents (52% girls, mean age = 12.7 years, 58% Caucasian). Main Outcome Measures: The clusters were based on the sedentary behaviors listed above and compared on environmental variables (e.g., household rules), psychosocial variables (e.g., self-efficacy, enjoyment), and health behaviors (e.g., physical activity, diet). Results: Four clusters emerged: low sedentary, medium sedentary, selective high sedentary, and high sedentary. Analyses revealed significant cluster differences for gender (p     

Regret and quality of life across the adult life span: The influence of disengagement and available future goals.

Two studies examined the associations between life regrets and indicators of quality of life across the adult life span. Given that opportunities to undo regrets decline with age, regret intensity was expected to be inversely associated with subjective well-being and health among older adults. In addition, the research explored protective factors that have the potential to reduce older adults' regret intensity. It was suggested that being disengaged from undoing the consequences of regrets and having many future goals available may reduce older adults' intensity of regret and thereby contribute to a better quality of life. Across both studies, the findings demonstrate that older adults perceived reduced opportunities to undo the consequences of their regrets and that regret intensity predicted a reduced quality of life only among older adults. Furthermore, the findings support the adaptive value of disengagement and available future goals for managing life regrets in older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Overview of the Activity Counseling Trial (ACT) intervention for promoting physical activity in primary health care settings. Activity Counseling Trial Research Group

Counseling by health care providers has the potential to increase physical activity in sedentary patients, yet few studies have tested interventions for physical activity counseling delivered in health care settings. The Activity Counseling Trial (ACT) is a 5-yr randomized clinical trial to evaluate the efficacy of two primary care, practice-based physical activity behavioral interventions relative to a standard care control condition. A total of 874 sedentary men and women, 35-75 yr of age, have been recruited from primary care physician offices at three clinical centers for 2 yr of participation. They were randomly assigned to one of three experimental conditions that vary, in a hierarchical fashion, by level of counseling intensity and resource requirements. The interventions, which are based on social cognitive theory and the transtheoretical model, are designed to alter empirically based psychosocial mediators that are known to be associated with physical activity. The present paper describes the theoretical background of the intervention, the intervention methods, and intervention training and quality control procedures.     

Young Adults' Perceptions of Children With Cerebral Palsy.

Objective: To examine factors influencing young adults' perceptions of children with cerebral palsy. Participants and Procedure: A total of 180 college students read vignettes about a healthy child or a child with cerebral palsy with mild or moderate physical impairments. Main Outcome Measure: Perceptions of the child (Ratings of the Child Questionnaire). Results: Young adults held less positive perceptions of children with cerebral palsy compared with a healthy child. Women endorsed more positive perceptions for all children than men. Knowledge about cerebral palsy and wanting to work with children were related to positive perceptions of children with cerebral palsy. Conclusions: Young adults' negative perceptions of children with cerebral palsy suggest the need for interventions to improve their knowledge about this condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological interventions for arthritis pain management in adults: A meta-analysis.

Context: The psychosocial impact of arthritis can be profound. There is growing interest in psychosocial interventions for managing pain and disability in arthritis patients. Objective: This meta-analysis reports on the efficacy of psychosocial interventions for arthritis pain and disability. Data Sources: Articles evaluating psychosocial interventions for arthritis were identified through Cochrane Controlled Trials, EMBASE, Ovid MEDLINE, and Ovid PsycINFO data sources. Study Selection: Randomized controlled trials testing the efficacy of psychosocial interventions in arthritis pain management were reviewed. Data Extraction: Twenty-seven randomized controlled trials were analyzed. Pain intensity was the primary outcome. Secondary outcomes included psychological, physical, and biological functioning. Data Synthesis: An overall effect size of 0.177 (95% CI = 0.256-0.094) indicated that patients receiving psychosocial interventions reported significantly lower pain than patients in control conditions (combined p = .01). Meta-analyses also supported the efficacy of psychosocial interventions for the secondary outcomes. Conclusions: These findings indicate that psychosocial interventions may have significant effects on pain and other outcomes in arthritis patients. Ample evidence for the additional benefit of such interventions over and above that of standard medical care was found. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The World Health Organization WHOQOL-100: Tests of the universality of quality of life in 15 different cultural groups worldwide.

The World Health Organization Quality of Life assessment (WHOQOL-100) was developed simultaneously across 15 international field centers and includes 24 facets relating to quality of life, which are grouped into 4 larger domains: physical, psychological, social relationships, and environment. It also includes 1 facet examining overall quality of life and general health perceptions. This article examines the extent to which the WHOQOL-100 assesses quality of life perceptions in different cultures and whether it is structurally comparable in these cultures. Regression analysis showed all 4 domains to be important in assessing quality of life in each of the 15 centers. Structural equation modeling suggested further support for the proposal that there are universal facets and domains that are cross-culturally important in determining quality of life and suggested that the ordering of facets within domains is comparable across cultures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ongoing physical activity advice by humans versus computers: The Community Health Advice by Telephone (CHAT) Trial.

Purpose: Given the prevalence of physical inactivity among American adults, convenient, low-cost interventions are strongly indicated. This study determined the 6- and 12-month effectiveness of telephone interventions delivered by health educators or by an automated computer system in promoting physical activity. Design: Initially inactive men and women age 55 years and older (N = 218) in stable health participated. Participants were randomly assigned to human advice, automated advice, or health education control. Measures: The validated 7-day physical activity recall interview was used to estimate minutes of moderate to vigorous physical activity. Physical activity differences by experimental arm were verified on a random subsample via accelerometry. Results: Using intention-to-treat analysis, at 6 months, participants in both interventions, although not differing from one another, showed significant improvements in weekly physical activity compared with controls. These differences were generally maintained at 12 months, with both intervention arms remaining above the target of 150 min per week of moderate to vigorous physical activity on average. Conclusion: Automated telephone-linked delivery systems represent an effective alternative for delivering physical activity advice to inactive older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)