Susan Weber Buchholz

Physical Activity Text Messaging Interventions in Adults: A Systematic Review

BACKGROUND Physical inactivity is a leading health risk factor for mortality worldwide. Researchers are examining innovative techniques including the use of mobile technology to promote physical activity. One such technology, text messaging, is emerging internationally as a method to communicate with and motivate individuals to engage in healthy behaviors, including physical activity. AIM Review the existing scientific literature on adult physical activity text messaging interventions. METHODS This systematic review examined research papers that addressed physical activity text messaging intervention studies in adults. Using multiple databases, the search strategy included published English language studies through October 1, 2011. An author-developed data collection tool was used independently by two reviewers to extract and examine the selected study variables. RESULTS The initial search resulted in the identification of 200 publications. Eleven publications representing 10 studies were included in the final review. Studies were conducted in seven countries with over half the studies being randomized controlled trials. Participants of the studies were predominantly young to middle aged women. Physical activity data were mainly obtained by self-report although three studies used pedometers or accelerometers. Interventions ranged from only sending out text messages to combining text messages with educational materials, staff support, and/or Internet technology. Minimal information was given regarding development or number of text messages used. The median effect size for the studies was 0.50. CONCLUSIONS To date, using text messaging as a method to promote physical activity has only been studied by a small group of researchers. Current physical activity text messaging literature is characterized by small sample sizes, heterogeneous but positive effect sizes, and a lack of specificity as to the development of the text messages used in these studies. Further research in this area is imperative to facilitate the expansion of mobile technology to promote physical activity.

Physical fitness assessment of older adults in the primary care setting

Purpose: To explore the relationships between the physical fitness and the demographic characteristics, general health and well‐being, social support, and physical activity in a group of community‐dwelling older adults. This study also assessed the feasibility of obtaining physical fitness measures in the primary care setting. Data sources: Thirty‐four persons older than 60 years completed self‐report measures and the Senior Fitness Test (SFT), a battery of fitness measures normed for older adults. Self‐report measures included demographics, general health and well‐being (SF‐36), social support (Social Support for Physical Activity Scale), and physical activity levels (Physical Activity Scale for the Elderly). Conclusions: Physically active older adults had significantly better upper and lower body strength, aerobic endurance, and dynamic balance. Older adults who reported better general health and had fewer chronic conditions scored better on the physical fitness tests. The SFT took 10‐15 min to complete in the primary care setting. Implications for practice: Physical fitness measures give primary care providers objective information to develop a physical activity program for their patients. A physical activity program that includes recommendations for aerobic endurance, strength, flexibility, and/or balance that is based on objective findings may be a useful tool to promote better health and physical fitness in older adults.

Women’s Walking Program for African American women: Expectations and recommendations from participants as experts

Effective interventions that increase adherence to physical activity are important for African American women because generally they are less active and more obese compared to white American women. The purpose of the authors in this study was to elicit from women who began a 12-month physical activity program between 2002 and 2005: (1) their recollections of outcome expectations and barriers, (2) feedback on program components, and (3) suggestions for program change. In 2007, the authors conducted qualitative post-intervention focus group interviews with women who had participated in the enhanced treatment group. Thirty-three African American women aged 44–69 years at the time of the study participated in one of four focus groups held at their community intervention site. Focus groups were formed on the basis of low (walked < 50% of expected walks) versus high (walked ≥ 50% of expected walks) adherence and low (0–2) versus high (3–4) attendance at the four workshops held during the 6-month adoption phase. Audio-taped sessions were transcribed, coded independently, and then uploaded into NVivo7 for final coding and data analysis. Suggestions for future program components include a lifestyle physical activity prescription, pedometers for self-monitoring, ongoing group support, and automated telephone support. Focus group participants can serve as experts to assist in content development for improving program effectiveness.

Hypertension Outcomes In an Urban Nurse-Managed Center

Purpose To assess the quality of hypertension (HTN) care in an urban nurse‐managed center (NMC) by chart audits of insured and uninsured (N= 52) African Americans who were managed by nurse practitioners. Data Sources A chart audit form was developed by the authors that merged Health Plan Employer Data and Information Set (HEDIS) criteria with the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) criteria. Conclusions There was near comparable hypertension control among the two groups. No difference was found in systolic blood pressure (BP) control; however, the uninsured group had a slightly greater average diastolic BP compared with the insured group. There was no significant difference in the number of HTN medications or the number of risk factors. A significant difference was found in the number of NP visits per year between the two groups; the uninsured group averaged 3.2 more visits per year.

Exploring the relationship between job satisfaction and nursing group outcome attainment capability in nurse administrators

AIM To examine the relationship between job satisfaction and nursing group outcome attainment capability (NOAC) among nurse administrators. BACKGROUND Contributing to the nursing shortage experienced in the USA is job dissatisfaction and a sense of powerlessness. The potential to achieve power exists within nursing and is realized when nurses achieve their goals. Nurse administrators can positively impact their settings by achieving these goals as they engage in the process of NOAC. However, little is known about the relationship between nurse administrators, job satisfaction and NOAC. METHOD In this non-experimental study, nurse administrators (n = 20) employed in mid-size urban and suburban hospitals were recruited using convenience sampling. Using an on-line format, participants completed the Minnesota Satisfaction Questionnaire to measure job satisfaction and the Sieloff-King Assessment of Group Outcome Attainment within Organizations to measure NOAC. RESULTS Moderately strong and strong significant correlations (P < 0.003) were found between job satisfaction and nursing group outcome attainment capability (intrinsic satisfaction r = 0.800; extrinsic satisfaction r = 0.650; total satisfaction r = 0.770). CONCLUSION To increase job satisfaction, it is important that nurse administrators have the power to achieve their professional goals. IMPLICATIONS FOR NURSING MANAGEMENT Nurse administrators can potentially increase their job satisfaction by achieving their professional goals.

Effectiveness, efficiency, duration, and costs of recruiting for an African American women's lifestyle physical activity program

In a 48-week lifestyle physical activity controlled trial in African American women, we analyzed recruitment effectiveness, efficiency, duration, and costs. Social networking was the most effective approach for inviting women to the trial. Of the 609 who responded to invitations, 514 completed telephone screening; of these, 409 (80%) were found eligible. The health assessment screening was completed by 337 women; of these, 297 (88%) were found eligible. The mean number of days from completion of the telephone and health assessment screenings to beginning the intervention was 23.01, and the mean cost was

Prehabilitation Interventions for Older Adults An Integrative Review

74.57 per person. Results suggest that provision of health assessment screening by study staff as part of recruitment is effective for minimizing attrition and also might be cost-effective.

Randomized Clinical Trial of the Women’s Lifestyle Physical Activity Program for African-American Women 24- and 48-Week Outcomes

Prehabilitation aims to increase physical activity and improve physical fitness prior to elective surgery to improve postoperative outcomes. This integrative review examined the effect of prehabilitation randomized clinical trial (RCT) interventions on physical activity behavior and physical fitness in older adults. Seven studies met the search criteria. In two studies, effect sizes from baseline to the preoperative period exceeded d = .2, specifically in physical activity and in the physical-fitness dimensions of strength, cardiorespiratory fitness, and flexibility. For the effect sizes between baseline and the postoperative period, five studies had positive effects greater than d = .2 in strength, flexibility, balance, and speed. This review demonstrated that prehabilitation continues to be important to physical activity and physical-fitness research because it may improve physical-fitness measures and have implications for multiple dimensions of health in older adults.

Using Photos to Develop Text Messages to Promote Walking

Purpose: To compare the effects of a physical activity (PA) intervention of group meetings versus group meetings supplemented by personal calls or automated calls on the adoption and maintenance of PA and on weight stability among African-American women. Design: Randomized clinical trial with three conditions randomly assigned across six sites. Setting: Health settings in predominately African-American communities. Subjects: There were 288 women, aged 40 to 65, without major signs/symptoms of pulmonary/cardiovascular disease. Intervention: Six group meetings delivered over 48 weeks with either 11 personal motivational calls, 11 automated motivational messages, or no calls between meetings. Measures: Measures included PA (questionnaires, accelerometer, aerobic fitness), weight, and body composition at baseline, 24 weeks, and 48 weeks. Analysis: Analysis of variance and mixed models. Results: Retention was 90% at 48 weeks. Adherence to PA increased significantly (p < .001) for questionnaire (d = .56, 128 min/wk), accelerometer (d = .37, 830 steps/d), and aerobic fitness (d = .41, 7 steps/2 min) at 24 weeks and was maintained at 48 weeks (p < .001), with no differences across conditions. Weight and body composition showed no significant changes over the course of the study. Conclusion: Group meetings are a powerful intervention for increasing PA and preventing weight gain and may not need to be supplemented with telephone calls, which add costs and complexity.

Dimensions of Physical Activity in African American Women

PURPOSE Sending text messages (TMs) is a promising global intervention to help adults increase their engagement in walking as a form of physical activity (PA). But, little is known about how effective and acceptable TMs are developed. DESIGN Our study was designed to (a) determine the acceptability, among low-income adults, of receiving TMs to increase their walking and (b) develop, using photos to prompt discussion, a participant-generated database of TMs to promote walking. METHODS In 2011, three focus groups (low-income, sedentary adults) met at community clinics (one focus group at each of three clinics). To promote dialogue to help develop TMs, we created a discussion guide and a set of 40 photos depicting barriers to increasing PA or showing people walking. A content analysis of TMs developed was done using audiotaped transcripts, photo page notes, flip chart notes, and field notes. FINDINGS Twelve TM themes emerged, including 172 TMs developed by the 23 study participants (age 50 ± 6.3 years). CONCLUSIONS Using TMs to help achieve walking goals is an acceptable method of promoting PA with adults. Using culturally relevant photos to prompt discussion, focus groups can develop a database of PA-related TMs to promote walking. CLINICAL RELEVANCE Physical inactivity is a significant contributor to adult health problems worldwide, and walking is a realistic method of increasing PA. Using focus groups and photos, individuals can generate acceptable, personalized and innovative TMs to promote walking.