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Effectiveness of feedback and need-supportive coaching on physical activity among working adults: Validation of a multisensory activity device and evaluation of an intervention

Book - Dissertation

The current physical activity (PA) recommendations advise adults toperform moderate-intensity aerobic PA for a minimum of 30 minutes five days a week or vigorous-intensity aerobic activity for a minimum of 20 minutes three days a week. Despite many evidence supporting PA for the prevention and management of several health problems such as metabolic disorders, cardiovascular disease and certain forms of cancer, 41% of the Belgian population does not take part in these recommended levels of exercise. Even though they are well aware of the health benefits, sometimes they are unable to take action or change their behavior and to adopt a healthier lifestyle. The PA recommendations can be difficult to achieve, especially because physically inactive people are often unaware of their own inactivity. Unlike dichotomous behaviors such as smoking, PAis complex and multi-dimensional which makes it difficult to assess. Itis identified by frequency, duration, intensity and type, takes place in a variety of different domains and can consist of both incidental as habitual activities over a 24-hour period. Evidence to date suggests that48 to 61% of adults of the currently insufficiently active population overestimate their own level of PA. Despite being at greatest risk of health problems, those who fail to recognize their inactivity are unlikely to perceive a need to change and may be less susceptible to health promotion strategies. Therefore inventing simple, easy to implement methods which help to provide awareness of the own PA level and motivation to increase PA should be investigated. Many intervention studies have been performed in the past, trying to increase the PA levels of inactive adults. While most of these studies report moderate success by achievingshort-term improvements, recent reviews show that effect sizes are generally small and longer-term gains are difficult to achieve. However, it is indicated that measurement of the activity behavior and feedback on the activity behavior and/or behavioral outcome may help to increase bothawareness of health behavior and intentions to change that behavior.Interest in monitoring individual PA levels is rising as the benefits of PA are being increasingly emphasized. Researchers are looking for innovative measurement technologies that are accurate, reliable, practical and affordable. Pedometers have been used in numerous research interventions aimed at increasing levels of PA. They provide immediate feedback on levels of PA and in this way acts both as a motivator and a monitorof activity. For motivational purposes, a step counter may suffice, andthese are more feasible from a cost standpoint. However, if PA energy expenditure (EE) is desired outcome variable, more sophisticated accelerometer-based devices have some advantages. The SenseWear Armband (SWA) (BodyMedia, Inc. Pittsburgh, PA) is a PA monitor that is worn onthe upper arm and receives information from different sensors includinga near-body ambient temperature sensor, a skin temperature sensor, a galvanic skin sensor, a heat flux sensor and an accelerometer to estimate EE. The innovation of integrating physiological measurements with accelerometry may enhance EE prediction, particularly in low-intensity activities and during activities with limited body movements (e.g., resistance exercises). The SWA has been validated as an accurate measure of both minute-by-minute as well as average EE for low-to-moderate intensity activities. Because new recommendation of PA states the involvement of higherintensity exercise bouts, it is important to accurately assess the validity of the SWA during vigorous and very vigorous intensities. Recently a new algorithm was developed aiming to further improve estimationof EE during free-living activities. To our knowledge, previous validation studies do not include different speeds ranging from moderate to very vigorous intensity in one single exercise trial. Furthermore, no studyhas ever validated the new SWA algorithm. In addition, the validity of the SWA in different ambient temperature conditions relative to a reference method has never been tested. Measuring the EE of people exercising in various temperatures at different intensities can be interesting to objectively and unobtrusively determine the exercise load. These gaps in the literature were the starting point of the methodological chapter of the doctoral study. The first paper of our methodological chapter examined the ability of the new SWA algorithm to accurately assess EE at different speeds ranging from moderate to very vigorous intensity through comparison with the golden standard of indirect calorimetry (IC)(paper 1). The results indicated that SWA underestimated EE ranging from 0.93 ± 1.21 kcal/min (p The current study demonstrates the potential importance of need-supportive coaching for both short and long-term PA behavioral change. Attention should be paid to providing individuals with feedback onthe progress they made in changing their PA behavior. This should be supported in a need-supportive climate. Mechanisms that can provide feedback in real-time are promising on the short-term but should be supported by need-supportive coaching to expand their effects. An important role is thus predetermined for the Personal Coach which can help increasingthe prevalence of people who are physically active. Particular contributions of the coaches include investigating the determinants of active and insufficiently active lifestyles, developing appropriate theoretical frameworks for interventions, training other professionals in behavioral change strategies, advising on the positive health-related outcomes fromactivity and supporting individuals in becoming more autonomously motivated in changing their lifestyle.
Publication year:2015
Accessibility:Closed