Promoting Stair Climbing in a Worksite and Public Setting: Are Footprints Enough?

PURPOSE: To evaluate the impact of footprints on stair climbing in different settings. DESIGN: Interrupted time-series design. SETTING: A company (stair/elevator choice) and a mall (stair/escalator choice). PARTICIPANTS: Employees (n = 5676) and visitors of the mall (n = 12 623). INTERVENTION: An intervention comprising 3 consecutive phases was implemented-(1) footprints leading to the stairs were stuck on the floor, (2) a health message referring to the footprints was introduced, and (3) passersby were congratulated for their increased stair use. MEASURES: Stair climbing was observed before (ie, baseline), during, and 6 to 13 weeks after (ie, follow-up) the intervention. ANALYSIS: Proportions of stair climbers were compared using χ2 analyses. RESULTS: The footprints resulted in a closely significant increase in stair climbing in the company (from 27.7% at baseline to 31.2% in phase 1). However, they did not produce any effect in the mall. Introducing a health message yielded an additional 12.4% increase in stair climbing in the company and a significant 11.4% increase in the mall (22.3% in phase 2). Congratulating people did not further increase stair climbing. At follow-up, the proportions of stair climbers dropped but still exceeded baseline. CONCLUSION: Footprints tend to increase stair climbing in a worksite setting with a stair/escalator choice but not in a public setting with a stair/elevator choice. Adding a meaningful message seems essential to obtain stronger and longer term effects.

Is knee extension strength a better predictor of functional performance than handgrip strength among older adults in three different settings?

BACKGROUND: The first purpose was to examine whether knee extension strength is a better predictor of functional performance than handgrip strength among older adults (≥60 years). The second purpose was to identify functionally relevant cut-off values for muscle strength. METHODS: 770 community-dwelling older adults, 104 older adults living in assisted living facilities and 73 nursing home residents were included. Static strength, expressed in kg/kg body weight (BW), was measured using two field tests: handgrip (GRIP/BW) and knee extension (KNEE/BW) test. Functional performance was assessed with 6-Minute Walk Distance (6MWD, N=947) and modified Physical Performance Test (mPPT, N=152). RESULTS: Both GRIP/BW and KNEE/BW were positively correlated with functional performance in all settings (p<0.05). In the community and nursing homes, both strength variables equally contributed to functional performance. In assisted living facilities, KNEE/BW (R(2)6MWD=0.39 and R2mPPT=0.35) was clearly a better predictor of functional performance than GRIP/BW (R(2)6MWD=0.15 and R2mPPT=0.12). GRIP/BW had no added value to KNEE/BW in order to explain the variance in functional performance. Functionally relevant cut-off values for static strength, for men and women respectively, were set at 0.40 and 0.31 for KNEE/BW and at 0.43 and 0.31 for GRIP/BW. CONCLUSIONS: Handgrip and knee extension strength are both important predictors of functional performance in older adults. In assisted living facilities only, knee extension strength was clearly more predictive than handgrip strength. Both cut-off values appear to be highly sensitive to screen for functionally relevant muscle weakness in older adults.

Effects of need-supportive physical activity counseling on well-being: a 2-year follow-up among sedentary older adults.

BACKGROUND: This study evaluated the long-term effectiveness of multiple physical activity counseling strategies on subjective health among older adults. METHODS: Sedentary older adults (n = 442) were randomized to 3 programs: (1) a one-contact referral to locally organized physical activities, (2) a one-contact provision of a walking program, (3) a 10-week multiple-contact physical activity coaching based on the Self-Determination Theory. Self-reports on well-being, trait anxiety and physical activity were completed at baseline (pretest), and 10 weeks after (10-week follow-up), 1 year after (1-year follow-up) and 2 years after (2-year follow-up) pretests. RESULTS: All 3 programs yielded improvements in well-being and trait anxiety from pretest to 10-week follow-up and to 1-year follow-up. From pretest to 2-year follow-up, no changes emerged in well-being whereas trait anxiety increased significantly. Changes over time in well-being and anxiety were not significantly different between the programs. Changes in physical activity contributed significantly to the prediction of changes in well-being and trait anxiety. CONCLUSIONS: The findings demonstrate the year-round effectiveness of physical activity counseling on subjective health among older adults, irrespective of counseling strategy. However, a relapse to baseline level occurred 2 years after the intervention. Physical activity appears to be an important determinant of older adults' well-being.

The added value of a brief self-efficacy coaching on the effectiveness of a 12-week physical activity program.

BACKGROUND: Self-efficacy has been found to be an important precondition for behavioral change in sedentary people. The current study examined the effectiveness and added value of including a 15-minute self-efficacy coaching at the start of a 12-week lifestyle physical activity (PA) program. METHODS: Participants were randomly assigned to a standard-intervention group (without additional self-efficacy coaching, N = 116) or extra-intervention group (with additional self-efficacy coaching, N = 111). Body mass index (BMI), cardiovascular fitness, self-reported PA, and self-efficacy beliefs were assessed at baseline and immediately after the intervention period. Perceived adherence to the PA program was assessed postintervention. RESULTS: At posttest, a significant increase in cardiovascular fitness and decrease in BMI were found in both groups. Significant intervention effects emerged on PA behavior, self-efficacy, and program adherence, in favor of the extra-intervention group. Self-efficacy mediated the intervention effect on program adherence whereas no evidence was found for its role as mediator of PA change. CONCLUSIONS: Adding a 15-minute self-efficacy coaching at the start of a lifestyle PA program is a promising strategy to enhance the intervention effects on PA behavior, self-efficacy beliefs, and program adherence. However, the role of self-efficacy as mediator of the intervention effect on in PA was not fully supported.

The long-term effectiveness of need-supportive physical activity counseling compared with a standard referral in sedentary older adults.

This study compared the long-term effectiveness of three physical activity counseling strategies among sedentary older adults: a 1-contact referral (REFER), a 1-contact individualized walking program (WALK), and multiple-contact, individually tailored, and need-supportive coaching based on the self-determination theory (COACH). Participants (n = 442) completed measurements before (pretest), immediately after (posttest), and 1 yr after (follow-up test) a 10-wk intervention. Linear mixed models demonstrated significant time-by-condition interaction effects from pre- to posttest. More specifically, WALK and COACH yielded larger increases in daily steps and self-reported physical activity than REFER. Similarly, self-reported physical activity increased more from pre- to follow-up test in WALK and COACH compared with REFER. Autonomous motivation mediated the effect of perceived need-support on physical activity, irrespective of counseling strategy. These results demonstrate the long-term effectiveness of both a 1-contact individualized walking program and a more time-consuming, need-supportive coaching, especially in comparison with a standard referral to local opportunities.

Long-term effectiveness and mediators of a need-supportive physical activity coaching among Flemish sedentary employees.

This study examined the long-term and mediation effects of a need-supportive coaching programme on physical activity. Sedentary employees (n = 92) of the university of Leuven received 4 months of physical activity coaching, based on the self-determination theory, by coaches with a bachelor's degree in kinesiology who are specializing in health-related physical activity (n = 30). The programme consisted of a limited number of individual contact moments (i.e. an intake session, three follow-up contacts and an out-take session), either face-to-face, by phone or by e-mail. Self-reported physical activity, social support, self-efficacy and autonomous motivation were assessed in the coaching group (n = 92) and a control group (n = 34) at three moments: before the intervention (i.e. pre-test), after the intervention (i.e. post-test) and 1 year after pre-test measurements (i.e. follow-up test). Results revealed significant 3 (time) × 2 (groups) interaction effects on strenuous and total physical activity. Moreover, whereas the control group remained stable from pre- to post-test, the coaching group increased significantly in moderate, strenuous and total physical activity. Additionally, the coaching group increased significantly in mild, moderate, strenuous and total physical activity from pre- to follow-up tests, whereas the control group did not change. Bootstrapping analyses indicated that self-efficacy and autonomous motivation significantly mediated the intervention effect on physical activity from pre- to post-test, while social support significantly mediated the long-term effect. This study provides evidence for the long-term effectiveness of a need-supportive physical activity programme that might be efficient at the community level.