Browsing by Author "Gill, Dawn P"
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- ItemA lifestyle intervention supported by mobile health technologies to improve the cardiometabolic risk profile of individuals at risk for cardiovascular disease and type 2 diabetes: study rationale and ...(2014-02-13) Stuckey, Melanie I; Shapiro, Sheree; Gill, Dawn P; Petrella, Robert JBACKGROUND Metabolic syndrome is a cluster of cardiovascular risk factors that greatly increase the risk of developing cardiovascular disease and type 2 diabetes Regular exercise improves the risk profile but most people do not successfully change their exercise habits to beneficially reduce risk Tailored exercise prescribed by a family physician has shown promise as a means to increase fitness and reduce cardiometabolic risk but optimal implementation practices remain unknown Mobile health technologies have proved to be a beneficial tool to achieve blood pressure and blood glucose control in patients with diabetes These technologies may address the limited access to health interventions in rural and remote regions However the potential as a tool to support exercise based prevention activities is not well understood This study was undertaken to investigate the effects of a tailored exercise prescription alone or supported by mobile health technologies to improve metabolic syndrome and related cardiometabolic risk factors in rural community dwelling adults at risk for cardiovascular disease and type 2 diabetes METHODS DESIGN Adults n 149 with at least two metabolic syndrome risk factors were recruited from rural communities and randomized to either 1 an intervention group receiving an exercise prescription and devices for monitoring of risk factors with a smartphone data portal equipped with a mobile health application or 2 an active control group receiving only an exercise prescription All participants reported to the research centre at baseline and at 12 24 and 52 week follow up visits for measurement of anthropometrics and blood pressure and for a blood draw to test blood borne markers of cardiometabolic health Vascular and autonomic function were examined Fitness was assessed and exercise prescribed according to the Step Test and Exercise Prescription protocol DISCUSSION This study tested the effects of a prescriptive exercise intervention alone versus one supported by mobile health technology on cardiometabolic risk factors The intervention was designed to be translated into clinical or community based programming Results will contribute to the current literature by investigating the utility of mobile health technology support for exercise prescription interventions to improve cardiometabolic risk status and maintain improvements over time particularly in rural communities TRIAL REGISTRATION CLINICAL TRIALS REGISTRATION NCT01944124
- ItemMobile health, exercise and metabolic risk: a randomized controlled trial.(2014-10-24) Petrella, Robert J; Stuckey, Melanie I; Shapiro, Sheree; Gill, Dawn PBACKGROUND It was hypothesized that a mobile health mHealth intervention would elicit greater improvements in systolic blood pressure and other cardiometabolic risk factors at 12 weeks which would be better maintained over 52 weeks compared to the active control intervention METHODS Eligible participants 2 metabolic syndrome risk factors were randomized to the mHealth intervention n 75 or the active control group n 74 Blood pressure and other cardiometabolic risk factors were measured at baseline and at 12 24 and 52 weeks Both groups received an individualized exercise prescription and the intervention group additionally received a technology kit for home monitoring of biometrics and physical activity RESULTS Analyses were conducted on 67 participants in the intervention group aged 56 7 9 7 years 71 6 female and 60 participants in the active control group aged 59 1 8 4 years 76 7 female At 12 weeks baseline adjusted mean change in systolic blood pressure primary outcome was greater in the active control group compared to the intervention group 5 68 mmHg 95 CI 10 86 to 0 50 mmHg p 0 03 but there were no differences between groups in mean change for secondary outcomes Over 52 weeks the difference in mean change for systolic blood pressure was no longer apparent between groups but remained significant across the entire population time p Under 0 001 CONCLUSIONS In participants with increased cardiometabolic risk exercise prescription alone had greater short term improvements in systolic blood pressure compared to the mHealth intervention though over 52 weeks improvements were equal between interventions TRIAL REGISTRATION ClinicalTrials gov http NCT01944124
- ItemPilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD.(2009-09-14) Nguyen, Huong Q; Gill, Dawn P; Wolpin, Seth; Steele, Bonnie G; Benditt, Joshua OOBJECTIVE To determine the feasibility and efficacy of a six month cell phone based exercise persistence intervention for patients with chronic obstructive pulmonary disease COPD following pulmonary rehabilitation METHODS Participants who completed a two week run in were randomly assigned to either MOBILE Coached n 9 or MOBILE Self Monitored n 8 All participants met with a nurse to develop an individualized exercise plan were issued a pedometer and exercise booklet and instructed to continue to log their daily exercise and symptoms MOBILE Coached also received weekly reinforcement text messages on their cell phones reports of worsening symptoms were automatically flagged for follow up Usability and satisfaction were assessed Participants completed incremental cycle and six minute walk 6MW tests wore an activity monitor for 14 days and reported their health related quality of life HRQL at baseline three and six months RESULTS The sample had a mean age of 68 11 and forced expiratory volume in one second 18 predicted Participants reported that logging their exercise and symptoms FEV 1 of 40 was easy and that keeping track of their exercise helped them remain active There were no differences between groups over time in maximal workload 6MW distance or HRQL p 0 05 however MOBILE Self Monitored increased total steps day whereas MOBILE Coached logged fewer steps over six months p 0 04 CONCLUSIONS We showed that it is feasible to deliver a cell phone based exercise persistence intervention to patients with COPD post rehabilitation and that the addition of coaching appeared to be no better than self monitoring The latter finding needs to be interpreted with caution since this was a purely exploratory study TRIAL REGISTRATION ClinicalTrials gov NCT00373932