Participation in a workplace smoking cessation program incentivized by lowering the cost of health care coverage: Findings from the LLUH BREATHE cohort.

INTRODUCTION: Systematic analyses of workplace smoking cessation programs indicate that efficacy can be enhanced by using incentives. There is variation in the type of incentives used and their effect on participation and efficacy. The aim of our study was to examine whether lowering employee health plan costs (employee contributions, co-pays) encourage employee smokers to participate in workplace smoking cessation. METHODS: We conducted a 2014-2015 prospective cohort study of 415 employee smokers of Loma Linda University Health (LLUH). The employees were offered participation in a workplace smoking cessation program (LLUH BREATHE Initiative) with the incentive of enrollment in an employer-provided health plan that had a 50% lower employee monthly contribution and co-payment relative to the employer-provided health plan for non-participants. Participation rates and variables associated with participation were analyzed. RESULTS: In the LLUH BREATHE cohort, we found a very high rate of participation (72.7%; 95% CI: 69-77%) in workplace smoking cessation that was encouraged by a lower out-of-pocket health plan cost for the participating employee and/or spouse. Participation did, however, vary by gender and spouse, whereby female employee households with a qualifying smoker were more than two times more likely (employee: OR=2.89, 95% CI: 1.59-5.24; or spouse: OR=2.71, 95% CI: 1.47-5.00) to participate in smoking cessation than male employee households. The point prevalence, at four months, of abstinence from smoking among the participants was 48% (95% CI: 42-54%). CONCLUSIONS: Our findings indicate that a workplace smoking cessation program that uses a novel reward-based incentive of lower out-of-pocket health plan costs results in a participation rate that is much higher than US norms.

Applying the Concept of Nutrient-Profiling to Promote Healthy Eating and Raise Individuals' Awareness of the Nutritional Quality of their Food.

Diet-related chronic diseases are on the rise. Current dietary management approaches are mostly calorie-counter tools that draw our attention away from the nutritional quality of our food choices. To improve consumers' dietary behavior, we need a simple technique to educate them about nutrition and increase their understanding of the nutritional quality of their food. This study aims to design a dietary tool to promote a nutrient-dense diet. To this end, we applied the concept of Nutrient Profiling to classify food recipes based on their nutritional quality, by developing the Intelligent Nutrition Engine. This engine undergirds our mobile-based application, Easy Nutrition, which was designed to enable users to find food recipes and understand their nutritional quality. To evaluate the usability and understandability of our approach, we piloted the prototype of Easy Nutrition on 24 consumers. The results indicate that our approach provides a sustainable avenue to help consumers manage their diets.

Building a Better Mousetrap (Exergame) to Increase Youth Physical Activity.

Although exergames have been demonstrated to induce moderate levels of physical activity (PA) if played as designed, there is conflicting evidence on use of exergaming leading to increased habitual PA. Exergames have increased PA in some home and school studies, but not others. Exergames have been used in community centers to good effect, but this has not generally been validated with research. PA from exergames may be enhanced by innovative use of sensors, "fun"-enhancing procedures, tailored messaging, message framing, story or narrative, goal setting, feedback, and values-based messaging. Research is needed on PA-enhancing procedures used within exergames for youth to provide a firmer foundation for the design and use of exergames in the future.

The effect of virtual reality gaming on dynamic balance in older adults.

BACKGROUND: physical therapy interventions that increase functional strength and balance have been shown to reduce falls in older adults. AIM: this study compared a virtual reality group (VRG) and a control group (CG). DESIGN: randomised controlled 6-week intervention with pre- and post-test evaluations. SETTING: outpatient geriatric orthopaedic and balance physical therapy clinic. POPULATION: forty participants were randomised into two groups. METHOD: the VRG received three different Nintendo® Wii FIT balance interventions three times per week for 6 weeks and the CG received no intervention. RESULTS: compared with the CG, post-intervention measurements showed significant improvements for the VRG in the 8-foot Up & Go test [median decrease of 1.0 versus -0.2 s, (P=0.038) and the Activities-specific Balance Confidence Scale (6.9 versus 1.3%) (P=0.038)]. CONCLUSION: virtual reality gaming provides clinicians with a useful tool for improving dynamic balance and balance confidence in older adults.

Fitness Assessment Comparison Between the "Jackie Chan Action Run" Videogame, 1-Mile Run/Walk, and the PACER.

OBJECTIVE: The purpose of this study was to examine whether a correlation existed among the scores of the "Jackie Chan Studio Fitness(™) Action Run" active videogame (XaviX(®), SSD Company, Ltd., Kusatsu, Japan), the 1-mile run/walk, and Progressive Aerobic Cardiovascular Endurance Run (PACER) aerobic fitness tests of the FITNESSGRAM(®) (The Cooper Institute, Dallas, TX) in order to provide a potential alternative testing method for days that are not environmentally desirable for outdoor testing. SUBJECTS AND METHODS: Participants were a convenience sample from physical education classes of students between the ages of 10 and 15 years. Participants (n=108) were randomly assigned to one of three groups with the only difference being the order of testing. The tests included the "Jackie Chan Action Run" active videogame, the 1-mile run/walk, and the PACER. Testing occurred on three different days during the physical education class. Rating of perceived exertion (RPE) was reported. RESULTS: Significant correlations (r=-0.598 to 0.312) were found among the three aerobic fitness tests administered (P<0.05). The RPE for the "Jackie Chan Action Run" was lower than the RPE for the 1-mile run/walk and the PACER (3.81±1.89, 5.93±1.77, and 5.71±2.14, respectively). CONCLUSIONS: The results suggest that the "Jackie Chan Action Run" test could be an alternative to the 1-mile run/walk and PACER, allowing physical education teachers to perform aerobic fitness testing in an indoor setting that requires less space. Also, children may be more willing to participate in the "Jackie Chan Action Run" based on the lower RPE.

The power of play: Innovations in Getting Active Summit 2011: a science panel proceedings report from the American Heart Association.

BACKGROUND: To examine the influence active-play video gaming (also referred to as exergaming, exertainment, and active gaming) might have on improving health-related skills, enhancing self-esteem and self-efficacy, promoting social support, and ultimately motivating positive changes in health behaviors, the American Heart Association convened The Power of Play: Innovations in Getting Active Summit. The summit, as well as a follow-up science panel, was hosted by the American Heart Association and Nintendo of America. METHODS AND RESULTS: The science panel discussed the current state of research on active-play video gaming and its potential to serve as a gateway experience that might motivate players to increase the amount and intensity of physical activity in their daily lives. The panel identified the need for continued research on the gateway concept and on other behavioral health outcomes that could result from active-play video games and considered how these games could potentially affect disparate populations. CONCLUSIONS: The summit represented an exciting first step in convening healthcare providers, behavioral researchers, and professionals from the active-play video game industry to discuss the potential health benefits of active-play video games. Research is needed to improve understanding of processes of behavior change with active games. Future games and technologies may be designed with the goal to optimize physical activity participation, increase energy expenditure, and effectively address the abilities and interests of diverse and targeted populations. The summit helped the participants gain an understanding of what is known, identified gaps in current research, and supported a dialogue for continued collaboration.