BMC Public Health | |
Rural Environments and Community Health (REACH): a randomised controlled trial protocol for an online walking intervention in rural adults | |
James Dollman1  Gaynor Parfitt2  Alex V Rowlands2  Ashleigh E Smith2  Nicole R Lewis2  Braden L Mitchell2  | |
[1] University of South Australia, CEA-14, GPO Box2471, Adelaide, South Australia 5001, Australia;Exercise for Health and Human Performance Group, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia | |
关键词: Health behaviour; Lifestyle intervention; Online intervention; Cardiovascular risk; Pedometer; Walking; Physical activity; | |
Others : 1126842 DOI : 10.1186/1471-2458-14-969 |
|
received in 2014-09-05, accepted in 2014-09-10, 发布年份 2014 | |
【 摘 要 】
Background
Rural Australian adults are continually shown to be insufficiently active with higher prevalence of lifestyle-related diseases associated with physical inactivity compared to urban adults. This may, partly, be attributable to the challenges associated with implementing community-based physical activity programs in rural communities. There is a need for broadly accessible physical activity programs specifically tailored to the unique attributes of rural communities. The aim of the Rural Environments And Community Health (REACH) study is to evaluate the effectiveness of an online-delivered physical activity intervention for increasing regular walking among adults living in rural areas of South Australia.
Methods/Design
This is a randomised controlled trial. The intervention is 12-weeks with a 12-month follow-up. Participants will be insufficiently active, aged 18 to 70 years and randomly assigned to either Control or Intervention group. Participants receive a pedometer, but only the Intervention group will receive access to the purpose built REACH website where they will report steps taken, affect and ratings of perceived exertion during daily walking. These variables will be used to establish individualised step goals for increasing walking. Control participants will receive a paper diary to record their variables and generic incremental step goals.
The primary outcome measures are time spent in sedentary, light and moderate-to-vigorous intensity physical activity, measured by accelerometry. Secondary outcomes include 1) health measures (anthropometric and physiological), 2) psychological well-being, 3) diet quality, and 4) correlates of physical activity (exercise self-efficacy and physical activity environments). Measures will be collected at baseline, post-intervention, 6-month and 12-month follow-up.
Discussion
This protocol describes the implementation of a trial testing the effectiveness of an online resource designed to assist rural Australians to become more physically active. The outcomes of this study will guide the efforts of health promotion professionals by providing evidence for a relatively inexpensive, widely accessible and effective method for increasing physical activity that can be utilized by anyone with access to the internet. Findings may indicate future directions for the implementation of physical activity and other health related interventions in rural communities.
Trial registration
Australian New Zealand Clinical Trials Registry:ACTR12614000927628 (registered 28 August 2014).
【 授权许可】
2014 Mitchell et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150219001525311.pdf | 263KB | download | |
Figure 1. | 59KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Australian Institute of Health and Welfare: Australia’s Health. Canberra: Australian Institute of Health and Welfare; 2012.
- [2]Australian Institute of Health and Welfare: Rural, Regional and Remote Health: A Study on Mortality. 2nd edition. Canberra: Australian Institute of Health and Welfare; 2007.
- [3]Australian Institute of Health and Welfare: Rural, Regional and Remote Health: Indicators of Health Status and Determinants of Health. Canberra: Australian Institute of Health and Welfare; 2008.
- [4]O'Donovan G, Blazevich A, Boreham C, Cooper A, Crank H, Ekelund U, Fox K, Gately P, Giles-Corti B, Gill J: The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences. J Sports Sci 2010, 28(6):573-591.
- [5]Tudor-Locke C, Bassett DR: How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med 2004, 34(1):1-8.
- [6]United States Department of Health and Human Services: Physical Activity and Health: A Report of the Surgeon General. Atlanta: United States Department of Health and Human Services; 1996.
- [7]Becker BJ, Tenenbaum G: Physical activity and psychological well-being in advanced age: a meta-analysis of intervention studies. J Psychol Aging 2005, 20(2):272-284.
- [8]Norris R, Carroll D, Cochrane R: The effects of physical activity and exercise training on psychological stress and well-being in an adolescent population. J Psychosom Res 1992, 36(1):55-65.
- [9]Penedo FJ, Dahn JR: Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Behav Med 2005, 18(2):189-193.
- [10]Department of Health and Aged Care: National Physical Activity Guidelines for Australians. Canberra: Department of Health and Aged Care; 1999.
- [11]Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical Activity and Public Health: Updated Recommendations for Adults From the American College of Sports Medicine and the American Heart Association. Circulation 2007, 116(9):1081-1093.
- [12]Choi BCK, Pak AWP, Choi JCL, Choi ECL: Daily step goal of 10,000 steps: a literature review. Clin Invest Med 2007, 30(3):E146-E151.
- [13]Australian Institute of Health and Welfare: Data for figures in Australia’s health 2012 (Chapters 4-6). 2012. [ http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737422183 webcite]
- [14]Vaughan C, Kilkkinen A, Philpot B, Brooks J, Schoo A, Laatikainen T, Chapman A, Janus ED, Dunbar JA: Physical activity behaviours of adults in the Greater Green Triangle region of rural Australia. Aust J Rural Heal 2008, 16:92-99.
- [15]Phillips A: Health status differentials across rural and remote Australia. Aust J Rural Heal 2009, 17:2-9.
- [16]Smith K, Humphreys J, Wilson M: Addressing the health disadvantage of rural populations: how does epidemiological evidence inform rural health policies and research. Aust J Rural Heal 2008, 16:56-66.
- [17]Bandura A: Social cognitive theory of self regulation. Organ Behav Hum Dec 1993, 50(2):248-287.
- [18]Conn V, Minor M, Burks K, Rantz M, Pomeroy S: Integrative review of physical activity intervention research with aging adults. J Am Geriat Soc 2003, 51(8):1159-1168.
- [19]Conn V, Valentine J, Cooper H: Interventions to increase physical activity among aging adults: a meta-analysis. Annals Behav Med 2002, 24(3):190-200.
- [20]King A: Interventions to promote physical activity by older adults. J Geront 2001, 56(2):36-46.
- [21]Locke E, Latham G: Building a practically useful theory of goal setting and task motivation. Am J Psychol 2002, 57(9):705-717.
- [22]Australian Bureau of Statistics: National Regional Profile, Riverland, 2006-2010. 2011. [ http://www.abs.gov.au/AUSSTATS/freenrp.nsf/log?openagent&Region%5F42005%2Exls&42005&2006%2D2010%20National%20Regional%20Profile&26557876FB1160F1CA25793B0014CE6C&0&2006%2D2010&04%2E11%2E2011&Latest webcite]
- [23]Australian Bureau of Statistics: National Regional Profile, Yorke, 2006-2011. 2011. [ http://www.abs.gov.au/AUSSTATS/freenrp.nsf/log?openagent&Region%5F415%2Exls&415&2006%2D2010%20National%20Regional%20Profile&CE49EC035178352BCA25793B0014CB88&0&2006%2D2010&04%2E11%2E2011&Latest webcite]
- [24]Australian Bureau of Statistics: Census of Population and Housing: Socio-Economic Indexes for Areas (SEFA), Australia, 2011. 2013. [ http://www.abs.gov.au/AUSSTATS/subscriber.nsf/log?openagent&2033.0.55.001%20sa2%20indexes.xls&2033.0.55.001&Data%20Cubes&CDCFC46B2A52B3B7CA257B43000E9F0A&0&2011&05.04.2013&Latest webcite]
- [25]Australian Bureau of Statistics: 2006 Census QuickStats: Riverland (Statistical Subdivision). 2007. [ http://www.censusdata.abs.gov.au/census_services/getproduct/census/2006/quickstat/42005?opendocument&navpos=95 webcite]
- [26]Australian Bureau of Statistics: 2006 Census QuickStats : Yorke (Statistical Subdivision). 2007. [ http://www.censusdata.abs.gov.au/census_services/getproduct/census/2011/quickstat/40504?opendocument&navpos=95 webcite]
- [27]Norton K, Norton L: Pre-exercise Screening: Guide to the Australian Adult Pre-exercise Screening System. Australia: Exercise and Sports Science Australia, Fitness Australia and Sports Medicine Australia; 2012.
- [28]Australian Dietary Guidelines 1 - 5 [ http://www.eatforhealth.gov.au/guidelines/australian-dietary-guidelines-1-5 webcite]
- [29]Borg G: Borg’s Perceived Exertion and Pain Scales. Champaign: Human Kinetics; 1998.
- [30]Noble B: Clinical applications of perceived exertion. Med Sci Sports Exerc 1982, 14:406-411.
- [31]Scherer S, Cassady S: Rating of perceived exertion: development and clinical applications for physical therapy exercise testing and prescription. Cardiopulm Phys Ther J 1999, 10:143-147.
- [32]Borg G: Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 1970, 2(2):92-98.
- [33]Horowitz M, Littenberg B, Mahler D: Dyspnea ratings for prescribing exercise intensity in patients with COPD. Chest 1996, 109:1169-1175.
- [34]Mejia R, Ward J, Lentine T, Mahler D: Target dyspnea ratings predict expected oxygen consumption as well as target heart rate values. Am J Respir Crit Care Med 1999, 159:1485-1489.
- [35]Horowitz M, Mahler D: Dyspnea ratings for prescription of cross-modal exercise in patients with COPD. Chest 1988, 113:60-64.
- [36]Noonan V, Dean E: Submaximal exercise testing: clinical applicaiton and interpretation. Phys Ther 2000, 80:782-807.
- [37]Bryan A, Hutchison K, Seals D, Allen D: A transdisciplinary model integrating genetic, physiological and psychological correlates of voluntary exercise. Heal Psychol 2007, 26(1):30-39.
- [38]Hardy CJ, Rejeski WJ: Not what, but how one feels: the measurement of affect during exercise. J Sport Exerc Psychol 1989, 11(3):304-317.
- [39]Ekkekakis P: Let them roam free. Sports Med 2009, 39(10):857-888.
- [40]Ekkekakis P, Parfitt G, Petruzzello S: The pleasure and displeasure people feel when they exercise at different intensities: decennial update and progress towards a tripartite rationale for exercise intensity prescription. Sports Med 2011, 41(8):641-671.
- [41]Parfitt G, Evans H, Eston R: Perceptually regulated training at RPE13 is pleasant and improves physical health. Med Sci Sports Exerc 2012, 44(8):1613-1618.
- [42]Matthews C, Hagströmer M, Pober D, Bowles H: Best practices for using physical activity monitors in population-based research. Med Sci Sports Exerc 2012, 44(1S):S68-S76.
- [43]Esliger D, Rowlands A, Hurst T, Catt M, Murray P, Eston R: Validation of the GENEA Accelerometer. Med Sci Sports Exerc 2011, 43(6):1085-1093.
- [44]Stewart A, Marfell-Jones M, de Ridder J: International Standards for Anthropometric Assessment. Wellington: International Society for the Advancement of Kinanthropometry; 2012.
- [45]Pietrobelli A, Rubiano F, St-Onge M, Heymsfield S: New bioimpedance analysis system: improved phenotyping with whole-body analysis. Eur J Clin Nutr 2004, 58(11):1479-1484.
- [46]Shemesh T, Rowley K, Shephard M, Piers L, O'Dea K: Agreement between laboratory results and on-site pathology testing using Bayer DCA2000+ and Cholestech LDX point-of-care methods in remote Australian Aboriginal communities. Clin Chim Acta 2006, 367(1):69-76.
- [47]Parikh P, Mochari H, Mosca L: Clinical utility of a fingerstick technology to identify individuals with abnormal blood lipids and high-sensitivity C-reactive protein levels. Am J Heal Promot 2009, 23(4):279-282.
- [48]Lovibond S, Lovibond P: Manual for the Depression Anxiety Stress Scales. 2nd edition. Psychological Foundation: Sydney, Australia; 1995.
- [49]Henry J, Crawford J: The short‒form version of the Depression Anxiety Stress Scales (DASS‒21): construct validity and normative data in a large non‒clinical sample. Brit J Clin Psychol 2005, 44(2):227-239.
- [50]Pruessner J, Wolf O, Hellhammer D, Buske-Kirschbaum A, Von Auer K, Jobst S, Kaspers F, Kirschbaum C: Free cortisol levels after awakening: a reliable biological marker for the assessment of adrenocortical activity. Life Sci 1997, 61(26):2539-2549.
- [51]Kirschbaum C, Hellhammer D: Salivary cortisol in psychoneuroendocrine research: recent developments and applications. Psychoneuroendocrino 1994, 19(4):313-333.
- [52]Pruessner J, Kirschbaum C, Meinlschmid G, Hellhammer D: Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrino 2003, 28(7):916-931.
- [53]National Health and Medical Research Council: Australian Dietary Guidelines: Providing the Scientific Evidence for Healthier Australian Diets. Canberra: National Health and Medical Research Council; 2013.
- [54]Hodge A, Patterson A, Brown W, Ireland P, Giles G: The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle‒aged women in a study of iron supplementation. Aust NZ J Publ Heal 2000, 24(6):576-583.
- [55]Cao ZB, Kiyatake N, Aoyama T, Higuchi M, Tabata I: Prediction of maximal oxygen uptake from a 3-minute walk based on gender, age and body composition. J Phys Activ Heal 2013, 10:280-287.
- [56]Buysse D, Reynolds C, Monk T, Kupfer D: The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiat Res 1989, 28(2):193-213.
- [57]Maislin G, Pack A, Kribbs N, Smith P, Schwartz A, Kiline L, Schwab R, Dinges D: A survey screen for prediction of apnea. Sleep 1995, 18(3):158-166.
- [58]Nigg C, Riebe D: The transtheoretical model: research review of exercise behavior and older adults. In Exercise and Behavior Change in Older Adults: Interventions with the Transtheoretical Model. Edited by Burbank P, Riebe D. New York: Springer; 2002:147.
- [59]Schwarzer R, Schuz B, Ziegelmann J, PLippke S, Luszczynska A, Scholz U: Adoption and maintenance of four health behaviours: theory-guided longitudinal studies on dental flossing, seat belt use, dietary behaviour and physical activity. Annals Behav Med 2007, 33:156-166.
- [60]De Bourdeaudhuij I, Sallis J, Saelens B: Environmental correlates of physical activity in a sample of belgian adults. Am J Heal Promot 2003, 18(1):83-92.