Predictors of physical activity behavior change among patients with heart failure enrolled in home-based cardiac rehabilitation intervention.

BACKGROUND: Physical activity behavior change is considered one of the most challenging lifestyle modifications in patients with heart failure. Even after participation in a cardiac rehabilitation program, most patients do not engage in the recommended level of physical activity. OBJECTIVE: To determine which baseline demographic, physical activity levels, psychological distress, and clinical variables predicted physical activity behavior change to increasing light-to-vigorous physical activity by 10,000 steps/day following participation in home-based cardiac rehabilitation intervention. METHODS: A prospective design involving secondary analysis was used to analyze data obtained from 127 patients (mean, 61; range, 45-69 years) enrolled in and completed an 8-week home-based mobile health app intervention. The intervention was designed to encourage health behavior change with regard to decreasing sedentary behavior and increasing physical activities performed at light or greater intensities. RESULTS: None of the participants accumulated 10,000 steps or more per day pre-intervention (mean, 1549; range, 318-4915 steps/day). Only 55 participants (43%) achieved an average daily step count of 10,000 or more at week 8 of the intervention (10,674 ± 263). The results of the logistic regression showed that higher pre-intervention physical activity levels and anxiety symptoms and lower depressive symptoms were associated with a higher likelihood of achieving physical activity behavior change (p < .003). CONCLUSION: These data highlight that determining pre-intervention physical activity levels and depressive symptoms can be the key to designing an effective home-based cardiac rehabilitation intervention in patients with heart failure.

Effect of a Home-Based Mobile Health App Intervention on Physical Activity Levels in Patients With Heart Failure: A Randomized Controlled Trial.

BACKGROUND: The use of mobile health applications (apps) is an effective strategy in supporting patients' self-management of heart failure (HF) in home settings, but it remains unclear whether they can be used to reduce sedentary behaviors and increase overall physical activity levels. AIM: The aims of this study were to determine the effect of an 8-week home-based mobile health app intervention on physical activity levels and to assess its effects on symptom burden and health-related quality of life. METHOD: In this study, we collected repeated-measures data from 132 participants with HF (60.8 ± 10.47 years) randomized into a usual care group (n = 67) or an 8-week home-based mobile health app intervention group (n = 65). The intervention was tailored to decrease the time spent in sedentary behavior and to increase the time spent in physical activities performed at light or greater intensity levels. Physical activity levels were monitored for 2 weeks before the intervention and during the 8-week intervention using the Samsung mobile health app. Heart failure symptom burden and health-related quality of life were assessed at baseline, 2 weeks from baseline assessment, and immediately post intervention. RESULTS: At week 8, all participants in the intervention group demonstrated an increase in the average daily step counts above the preintervention counts (range of increase: 2351-7925 steps/d). Only 29 participants (45%) achieved an average daily step count of 10 000 or higher by week 6 and maintained their achievement to week 8 of the intervention. Repeated-measures analysis of variance showed a significant group-by-time interaction, indicating that the intervention group had a greater improvement in physical activity levels, symptom burden, and health-related quality of life than the usual care group. CONCLUSION: Home-based mobile health app-based interventions can increase physical activity levels and can play an important role in promoting better HF outcomes.

Osteoporosis education: Evaluation of an awareness program among female university students.

INTRODUCTION: Osteoporosis is a major worldwide health problem represented through decreased bone density. Females at younger ages should be the target for all efforts fighting against this disease aiming toward raising their awareness and promoting healthy behaviours. PURPOSE: To evaluate the effectiveness of an osteoporosis educational program in promoting female Jordanian university students' knowledge, attitudes and self-efficacy regarding osteoporosis. METHOD: The design of the research was a randomized control using a one-day educational program as the intervention. Two times of measurement were conducted (before and four weeks after the educational program) to measure participants' knowledge regarding osteoporosis, attitudes and self-efficacy toward osteoporosis. RESULTS: A total of 184 female university students participated in this study randomly assigned to interventional (n=112, 60.9%) and control groups (n=72, 39.1%). Before attending the educational program, participants in both groups were found to have relatively low level of knowledge, negative attitudes, and poor self-efficacy toward osteoporosis. Results of the post test indicated that participants who attended the program had significant improvement in all study variables compared to those who did not. CONCLUSION: Conducting an osteoporosis education program had positive effects on the female Jordanian university students' knowledge, attitudes, and self-efficacy. Our results support the importance of conducting awareness programs for this population and confirms the need to include an osteoporosis educational program in university curricula.

Sex Differences in the Association Between Inflammation and Event-Free Survival in Patients With Heart Failure.

BACKGROUND: Heart failure (HF) is associated with chronic inflammation, which is adversely associated with survival. Although sex-related differences in inflammation have been described in patients with HF, whether sex-related differences in inflammation are associated with event-free survival has not been examined. AIM: The aim of this study was to determine whether the association between inflammation as indicated by tumor necrosis factor-α and event-free survival differs between men and women with HF after controlling for demographic and clinical variables. METHOD: This was a secondary analysis of data from 301 male (age, 61.0 ± 11.4 years) and 137 female (age, 60.3 ± 12.1 years) patients with HF. Serum levels of soluble tumor necrosis factor receptor 1 were used to indicate inflammatory status. Patients were grouped according to median split of soluble tumor necrosis factor receptor 1 level and sex into male with low inflammation (≤1820 pg/mL) (n = 158) or high inflammation (>1820 pg/mL) (n = 143), and female with low inflammation (n = 63) or high inflammation (n = 74). Cox regression models were run separately for men and women to determine whether inflammation contributed to differences in event-free survival between sexes with HF. RESULTS: There were 84 male (27.9%) and 27 female (19.7%) patients who had an event. Event-free survival in women did not differ by the severity of inflammation in the Cox regression analysis. In contrast, men with high inflammation had 1.85 times higher risk for an event compared with men with low inflammation. CONCLUSION: These data provide evidence that inflammation contributed to differences in event-free survival in men but not women with HF. Clinicians should be aware that men who have higher inflammation may be at a greater risk of HF or cardiac-related events than others with HF.

Occupational-related back pain among Jordanian nurses: A descriptive study.

Back pain is the leading cause of disability, decreased physical performance at work and absenteeism. Activities leading to the occurrence of back pain include patient transfer and long standing hours. This study aimed to explore the prevalence and determine the activities responsible for the presence of back pain among Jordanian nurses. A descriptive cross-sectional study was conducted on a convenience sample of nurses from governmental hospitals in Jordan. A self-report questionnaire was developed by Stubbs et al. and Harber et al. A descriptive method using mean, standard deviations and percentages was used, in addition to chi-square tests. Baseline findings indicated that more than three-quarters of the nurses studied suffered back pain during their work. Among nurses with back pain, about a fifth of them reported it to administration. The highest percentage of back pain was among critical care nurses. Further, the static factors contributed less commonly to back pain compared with the dynamic factors. Nearly half the participants with back pain reported taking days off more frequently. Jordanian nurses demonstrated one of the highest frequencies of back pain compared with other studies. Focus should be placed on education programmes about the appropriate body mechanics.