Pragmatic intervention for increasing self-directed exercise behaviour and improving important health outcomes in people with multiple sclerosis: a randomised controlled trial A randomized, controlled trial to study the effect of exercise consultation on the promotion of physical activity in people with Type 2 diabetes: a pilot study. Improved physical fitness of cancer survivors: A randomised controlled trial comparing physical training with physical and cognitive-behavioural training The effects of a low-to-moderate intensity pre-conditioning exercise programme linked with exercise counselling for sedentary haemodialysis patients in The Netherlands: results of a randomized clinical trial. A Web-based self-management exercise and diet intervention for breast cancer survivors: pilot randomized controlled trial. Four years of practice-based and exercise-supported behavioural medicine in one community of the German CINDI area. Countrywide Integrated Non-Communicable Diseases Intervention. The Home-Heart-Walk study, a self-administered walk test on perceived physical functioning, and self-care behaviour in people with stable chronic heart failure: A randomized controlled trial Short and long-term adherence to swimming and walking programs in older women--the Sedentary Women Exercise Adherence Trial (SWEAT 2). Exercise therapy in women who have had breast cancer: design of the Sheffield women's exercise and well-being project. Promoting exercise behaviour: an integration of persuasion theories and the theory of planned behaviour. Unexpected effects of cognitive-behavioural therapy on self-reported exercise behaviour and functional outcomes in older adults. Determinants of adherence to exercise in women treated for breast cancer. Effectiveness of counselling over 1 year on changes in lifestyle and coronary heart disease risk factors. Dynamics of exercise induced affect. Improved functional ability and independence in activities of daily living for older adults at high risk of hospital readmission: a randomized controlled trial. Children, parents, and pets exercising together (CPET) randomised controlled trial: study rationale, design, and methods [One-year effect of health counseling on life style and risk factors of heart disease]. A HOME-BASED MULTIDIMENSIONAL EXERCISE PROGRAM REDUCED PHYSICAL IMPAIRMENT AND FEAR OF FALLING Can theory-based messages in combination with cognitive prompts promote exercise in classroom settings? The impact of an employee wellness programme in clothing/textile manufacturing companies: a randomised controlled trial A behaviour change intervention to reduce sedentary time in people with chronic obstructive pulmonary disease: protocol for a randomised controlled trial. Behavioural counselling in general practice for the promotion of healthy behaviour among adults at increased risk of coronary heart disease: randomised trial. Feasibility of a telephone and web-based physical activity intervention for women shift workers
Background : Exercise programmes that can demonstrate evidence of long-lasting clinical effectiveness are needed for people with multiple sclerosis ( PwMS ) . Objective : The objective of this study was to assess the effects of a practically implemented exercise programme on self-directed exercise behaviour and important health outcomes in PwMS to nine months of follow-up . Methods : We conducted a parallel-arm , r and omised controlled trial : 120 PwMS ( Exp and ed Disability Status Scale ( EDSS ) 1.0–6.5 ) r and omised to a three-month exercise intervention plus usual care , or usual care only . Two supervised plus one home-exercise session ( weeks 1–6 ) were followed by one supervised and two home-exercise sessions ( weeks 7–12 ) . Cognitive-behavioural techniques promoted long-term exercise behaviour change . Outcomes were blindly assessed at baseline and at three and nine months after r and omisation . The primary outcome was self-reported exercise behaviour ( Godin Leisure Time Exercise Question naire ( GLTEQ ) ) . Secondary outcomes included fatigue and health-related quality of life ( HRQoL ) . Results : The intervention increased self-reported exercise ( 9.6 points ; 95 % CI : 2.0 to 17.3 points ; p = 0.01 ) and improved fatigue ( p < 0.0001 ) and many HRQoL domains ( p ≤ 0.03 ) at three months . The improvements in emotional well-being ( p = 0.01 ) , social function ( p = 0.004 ) and overall quality of life ( p = 0.001 ) were sustained for nine months . Conclusion : This pragmatic approach to implementing exercise increases self-reported exercise behaviour , improves fatigue and leads to a sustained enhancement of HRQoL domains in PwMS AIM To evaluate the effect of exercise consultation on promotion of physical activity in people with Type 2 diabetes . METHODS Twenty-six sedentary people with Type 2 diabetes were r and omly assigned to receive an exercise consultation and st and ard exercise information ( experimental ) or st and ard exercise information alone ( control ) . Exercise consultation is a one-to-one discussion , based on the transtheoretical model , design ed to educate , strengthen motivation and develop realistic strategies to promote physical activity . Changes from baseline at five weeks were assessed in ( a ) stage of exercise behaviour ( b ) physical activity levels ( 7-day recall question naire and an accelerometer ) ( c ) quality of life ( SF-36 Health Survey and 22-Item Well-Being Question naire ) . RESULTS 82 % ( 9/11 ) of participants receiving a consultation increased their stage of exercise behaviour compared to 33 % ( 4/12 ) of controls ( chi2 = 5.4 , P = 0.02 ) . Physical activity counts/week increased by 4 % ( 1636 067/1696 191 ) in the experimental group and decreased by 9 % ( 1560 960/1725 510 ) in controls . A significant difference was recorded for the change in activity counts per week from baseline to follow-up between the experimental and control group ( 98 % CI = 60 673 - 710 827 ) . The number of participants taking part in sport or leisure activity increased by 55 % ( 6/11 ) in the experimental group and decreased by 6 % ( 1/12 ) in controls . Positive changes were evident in the experimental group , compared to controls , in both quality of life question naires . CONCLUSION Exercise consultation is more effective in stimulating exercise behaviour change in the short term than a st and ard exercise leaflet We compared the effect of a group-based 12-week supervised exercise programme , i.e. aerobic and resistance exercise , and group sports , with that of the same programme combined with cognitive-behavioural training on physical fitness and activity of cancer survivors . One hundred and forty seven cancer survivors ( all cancer types , medical treatment ≥3 months ago ) were r and omly assigned to physical training ( PT , n=71 ) or PT plus cognitive-behavioural training ( PT+CBT , n=76 ) . Maximal aerobic capacity , muscle strength and physical activity were assessed at baseline and post-intervention . Analyses using multilevel linear mixed-effects models showed that cancer survivors ’ physical fitness increased significantly in PT and PT+CBT from baseline to post-intervention . Changes did not differ between PT and PT+CBT . Physical fitness of cancer survivors was improved following an intensive physical training programme . Adding a structured cognitive-behavioural intervention did not enhance the effect OBJECTIVES The purpose of this study is to determine whether a low-to-moderate intensity pre-conditioning exercise programme linked with exercise counselling could improve behavioural change , physical fitness , physiological condition and health-related quality of life of sedentary haemodialysis patients in The Netherl and s. METHODS Ninety-six haemodialysis patients of the Groningen Dialysis Center were r and omized into an exercise group ( n = 53 ) and a control group ( n = 43 ) . The exercise programme consists of cycling during dialysis together with a pre-dialysis strength training programme lasting 12 weeks . The intensity of the exercise programme is condition level 12 - 16 according to the rate of perceived exertion ( RPE ) . Motivational interviewing techniques were used for exercise counselling . Before and after the intervention , both groups were tested on behavioural change and physical fitness components such as reaction time , manual dexterity , lower extremity muscle strength and VO2 peak . Physiological conditions such as weight , blood pressure , haemoglobin and haematocrit values , cholesterol and Kt/V were obtained from the medical records . Health-related quality of life assessment included R AND -36 scores , symptoms and depression . RESULTS A group x time analysis with MANOVA ( repeated measures ) demonstrates that participation in a low-to-moderate intensity exercise programme linked with exercise counselling yields a significant increase in behavioural change , reaction time , lower extremity muscle strength , Kt/V and three components of quality of life , and no significant effects in the control group . CONCLUSION Participating in a low-to-moderate intensity pre-conditioning exercise programme showed beneficial effects on behavioural change , physical fitness , physiological conditions and health-related quality of life BACKGROUND Regular exercise and dietary practice s have been shown to affect the health-related quality of life ( HRQOL ) and survival of breast cancer patients . OBJECTIVE The current study aim ed to investigate whether the WSEDI was a feasible and primarily effective method for promoting exercise and dietary behaviours for breast cancer patients . DESIGN A 12-week r and omized , controlled trial . SETTING Oncology outpatient treatment clinics at 3 university hospitals and 1 National Cancer Center in South Korea . PARTICIPANTS Fifty-nine breast cancer patients who had received curative surgery and completed primary cancer treatment within 12 months prior to the study and who had been diagnosed with stage 0-III cancers within 2 years prior to the study were recruited . METHODS Participants were r and omly assigned to either the intervention group , which used a Web-based self-management exercise and diet intervention program incorporating transtheoretical model (TTM)-based strategies ( n=29 ) , or to the control group , which used a 50-page educational booklet on exercise and diet ( n=28 ) . The intervention efficacy was measured at the baseline and 12 weeks via a Web-based survey that addressed the promotion of exercise and consumption of 5 servings of fruits and vegetables ( F&V ) per day , dietary quality , HRQOL , anxiety , depression , fatigue , motivational readiness , and self-efficacy . RESULTS The proportion of subjects who performed at least moderate-intensity aerobic exercise for at least 150 min per week ; ate 5 servings of F&V per day ; and had overall improvements in dietary quality , physical functioning and appetite loss ( HRQOL ) , fatigue , and motivational readiness was greater in the intervention group than in the control group . The self-efficacy with respect to exercise and F&V consumption was greater in the intervention group than in the control group . A Web-based program that targets changes in exercise and dietary behaviours might be effective for breast cancer survivors if the TTM theory has been used to inform the program strategy , although further research with a larger sample size is required to enable definitive conclusions The main goal of the preventive intervention study in one community of the German CINDI ( Countrywide Integrated Non-Communicable Diseases Intervention programme of the WHO ) area was to improve cardiovascular health by reducing the risk factors smoking , hypertension , obesity , hypercholesterolaemia , and by changing sedentary lifestyle . The intervention was performed by using the special " Three-Level- Strategy " , which is characterised by activities of primary care physicians in the usual consulting hour ( 1st level ) , with patient groups in their practice s ( 2nd level ) , and at community level ( 3rd level ) where a special work group and a co-ordinating general practice are co-operating . To evaluate the occurrence of the risk factors in practice and the local population , four cross-sectional r and om sample s ( N(total ) = 4881 ) were carried out in seven practice s from 1992 to 1995 . On the community level , 23 special exercise-based health groups ( N(total ) = 600 ) were established and were investigated by means of a question naire , related to behaviour and health beliefs . A " Local Health Information System " facilitated the evaluation , the management of the data , and the organisation of the health programme . The results of the practice sample s showed a significant reduction of smoking ( -17.8 % ) and hypertension ( -31.5 % ) ( p < 0.01 ) . The exercise-based groups were combined with nutritional counselling or relaxation and were accepted very well by the participants ( 83.8 % ) . The participants considerably improved their health behaviour : 82 % discussed health in their family , 37.3 % stated an increase of healthy nutrition , 52 % of relaxation ; 86.2 % intended to regularly increase physical activity in leisure time and 82 % could not imagine regular health training without exercise meetings . We conclude that the practice -based " Three-Level- Strategy " provides a strong support for successful long-term prevention of cardiovascular risk , particularly , when exercise-based health training sessions are performed in order to change sedentary lifestyle . When organised on community level , they might have a positive impact on the health behaviour of the whole community . Physical activity can be used as a " prodrug " for health promotion in a holistic way Background : Adherence to self-care recommendations is associated with improved patient outcomes and improved quality of life for people living with heart failure .  The Home-Heart-Walk ( HHW ) is an intervention to promote physical activity adapting the elements of a six minute walk test , a reliable and valid measure . This adaptation was design ed to support self-monitoring of physical functioning and promote the self-care of people with heart failure . The primary outcome of the Home-Heart-Walk was perceived physical functioning and the secondary outcomes were six-minute walk test distance , health related quality of life , self-care behaviour , self-efficacy and physical activity level . Methods : A multicentre r and omized controlled trial . Participants ( N=132 ) were recruited from three academic hospitals in Sydney , Australia . Participants were r and omized to either the  Home-Heart-Walk group or the control group . Perceived physical functioning , health related quality of life , self-care behaviour , exercise self-efficacy and physical activity level were measured at baseline and at three- and six-month follow-up . Results : After adjusting for baseline scores , there were no statistically significant between-group differences in perceived physical functioning , six-minute walk test distance , health related quality of life and exercise self-efficacy at follow-up . The intervention group had improvement in self-care behaviour ( F(1,129 ) = 4.75 , p = 0.031 ) and physical activity level ( U = 1713 , z = −2.12 , p = 0.034 ) at the six-month follow-up compared with the control group . Conclusion : The Home-Heart-Walk did not improve the perceived physical functioning of the intervention group . Although the feasibility and acceptability of this strategy to support self-monitoring and improve self-care behaviour was demonstrated , self-reported adherence was unreliable ; newer technologies may offer better assessment of adherence OBJECTIVE To examine in previously sedentary older women the effects of exercise mode and a behavioural intervention on short and long-term retention and adherence . METHODS Healthy , sedentary women aged 50 - 70 years ( N=116 ) were r and omly assigned to a supervised 6-month swimming or walking program 3 sessions a week . They were further r and omised to usual care or a behavioural intervention . The same program was further continued unsupervised for 6 months . We assessed retention , adherence , stage of exercise behaviour and changes in fitness . RESULTS One hundred women ( 86 % ) completed 6 months and 86 ( 74 % ) continued for 12 months . Retention rates were similar for both exercise modes at 6 and 12 months . Adherence to swimming or walking was similar after 6 months ( 76.3 ( 95 % CI : 69.5 , 83.1)% vs. 74.3 ( 67.7 , 80.9)% ) and 12 months ( 65.8 ( 57.9 , 73.8)% vs. 62.2 ( 54.6 , 70.0)% ) . The behavioural intervention did not enhance retention or adherence . Fitness improved for both exercise modes after 6 months and was maintained at 12 months . CONCLUSIONS Either swimming or walking programs initiated with careful supervision over 6 months result ed in similar high retention and adherence rates by highly motivated older women over 12 months . Behavioural intervention in this setting did not improve these rates further Recovering from cancer treatment can be a difficult experience , both physically and psychologically . This paper describes a r and omized controlled trial that evaluates the effects of exercise therapy upon quality of life in 120 women who have had breast cancer . To facilitate behaviour change , exercise counselling is also included as an integral component in the exercise therapy intervention .  Participants are r and omized to one of three groups : exercise therapy , body conditioning ( placebo control ) or a normal care control group .  The supervised exercise therapy and body conditioning sessions take place 3 times per week for 8 weeks . Outcome measures include quality of life , physical self-perceptions , depression , satisfaction with life , exercise behaviour , aerobic capacity and percentage body fat . All outcomes are assessed at baseline , 4 weeks during the intervention and at the end of the 8-week intervention . Follow-up assessment s of outcomes take place at 3 and 6 months post-intervention . As the number of women surviving breast cancer is increasing and cancer treatment is linked to reduced quality of life , it is critical to evaluate treatments that improve the quality of life of this population or hasten recovery following treatment OBJECTIVES The purpose of this study was to examine the effectiveness of a theoretical integrated persuasive message on exercise motivation in college students . METHOD Four hundred and fifty introductory psychology students ( M age = 20.02 years ; SD = 3.94 ) were r and omly assigned to reading positively or negatively framed strong messages advocating exercise . The messages were attributed to a credible source , a non-credible source or to a no- source control condition .  Theory of planned behaviour ( TPB ) constructs ( i.e. attitude , subjective norm , perceived behavioural control ) and cognitive responses ( i.e. thought listing ) were measured immediately and 2 weeks following the delivery of the intervention . RESULTS Unfortunately , the results did not corroborate previous research , as we did not find any significant effects between experimental groups on any psychological or behavioural variable . CONCLUSIONS There may be several potential explanations for the lack of effects , including the interaction between the type of persuasive information ( TPB implication s ) and sources of persuasion and how these persuasive messages are processed ( elaboration likelihood model/cognitive response implication s ) . The theoretical implication s of this research are discussed with a view towards future directions for exercise promotion initiatives using theoretically driven interventions BACKGROUND nearly 61 % of older adults do not maintain recommended exercise levels emphasising the need for interventions that promote exercise . OBJECTIVES to compare self-reported exercise behaviour and functional outcomes over 1 year across three groups of older adults : a cognitive-behavioural therapy group , an attention-control education group and a control group . DESIGN r and omised intervention . SETTING community exercise facilities . PARTICIPANTS three hundred and thirty-two older adults ( mean age = 71.8 ± 5.1 years ) . METHODS all three groups received exercise training three times per week for 2 weeks and then one time per week for 8 weeks , during which time the therapy and education groups received their interventions . Blinded data collectors measured follow-up exercise behaviour and functional outcomes at 3-month intervals . RESULTS after controlling for previous year exercise behaviour , results showed that relative to the control group , the therapy and education groups increased their strengthening exercises over time ( 0.05 and 0.06 h/week higher , respectively ) ; only the therapy group 's change was significant . Also , relative to the control group , the therapy and education groups significantly reduced their 6-min walking distances over time ( -1.6 m , P = 0.030 and -1.5 m , P = 0.026 , respectively ) . CONCLUSIONS although the therapy group increased their strength training , they reduced their 6-min walking distance We describe adherence to a three group r and omised controlled trial that involved aerobic exercise therapy  ( N=34 ) and exercise-placebo intervention  ( N=36 ) or usual care  ( N=38 ) in women treated for breast cancer . We also investigated relationships between routes of trial recruitment , socio-economic characteristics , health behaviours , cancer treatment regimen(s ) and subsequent adherence to the interventions . Women who had completed breast cancer treatment 12 - 36 months previously were r and omised to one of the groups . The intervention groups attended an exercise facility three times per week for eight weeks . A total of 77 % of the aerobic exercise therapy and 88.9 % of the exercise-placebo groups attended at least 70 % of prescribed sessions . The percentage of women achieving 30min of aerobic exercise per session steadily increased during the intervention but many women were not able to achieve this goal . Routes of trial recruitment , socio-economic characteristics , health behaviours and cancer treatment regimen(s ) were not related to intervention . Exercise therapy participants were able to comply with the progressive nature of the aerobic exercise intervention , although some women were not able to achieve 30min of aerobic exercise per session by intervention completion . Research is still required to tease out all the potential determinants of exercise in this population Many have studied the effects of different lifestyles on disease , mortality or risk factors for a disease , but little is known about how behaviour is changed in the population . We studied the need for counselling and its effect on willingness and ability to change lifestyle , and subsequent changes in CHD risk factors .  All 152 male employees in a computer company , 25 - 45 years of age , were invited to participate . Subjects were r and omized into an intervention group ( I-group ) and a control group . The I-group was divided into subgroups based on baseline behaviour and risk factor status . Changes were evaluated after 1 year . After an initial health examination , participants from the I-group were counselled at baseline and after 5 months . Eighty-five ( 56 % ) males participated . Twenty-nine were assigned to a control group and 56 to an intervention group ( I-group ) ( dropout = 8) . An exercise group ( E-group ) was advised to exercise aerobically three times/week , a diet group to reduce the intake of saturated fat and increase fish products , and smokers to quit smoking . Forty subjects were recommended one or more behavioural changes and eight had no need . Thirty-four were willing to make behavioural changes . Compared to the control group , the fitness level increased ( P < 0.01 ) and body weight decreased in the I-group ( P < 0.05 ) . It may be concluded that individual counselling promotes regular exercise with subsequent improvements in CHD risk factors . The diet- and smoking counselling models were less successful in terms of adherence This study investigated : ( a ) whether moderate intensity aerobic exercise exerted a significant affective influence during , and postexercise , ( b ) the nature of the affective response to exercise in relation to positive and negative affects , and affects associated with physiological distress , and ( c ) whether exercise induced affect was significantly influenced by exercise behaviour . Habitual exercisers ( n = 15 ) and sedentary participants ( n = 13 ) undertook three r and omly allocated interventions ; ( a ) exercise ( EX ; i.e. , 20 min of cycling at 60 % estimated VO2max ) , ( b ) normal workstation duties for 60 min ( WRK ) , and ( c ) a 60 min sedentary lunch break ( SED ) . Affect was measured pre , post , and 90 min postintervention , as well as every 5 min during exercise , using the Subjective Exercise Experiences Scale ( SEES ; McAuley & Courneya , 1994 ) . Exercise behaviour had no significant affect on affective responses to exercise in this study ( p > .05 ) . Significant ( p < .05 ) postintervention increases in positive affect were found for EX compared to WRK and SED indicating that exercise did produce a positive affective influence . Despite enduring postexercise ( i.e. , 90 min ) improvements in both positive and negative affects , and affects related to fatigue , the affective response during exercise was characterised by significant ( p < .05 ) decreases in levels of positive affect and increased levels of affects related to fatigue OBJECTIVE During hospitalization older people often experience functional decline which impacts on their future independence . The objective of this study was to evaluate a multifaceted transitional care intervention including home-based exercise strategies for at-risk older people on functional status , independence in activities of daily living ( ADLs ) and walking ability . METHODS A r and omized controlled trial was undertaken in a metropolitan hospital in Australia with 128 patients ( 64 intervention , 64 control ) aged over 65 years with an acute medical admission and at least one risk factor for hospital readmission . The intervention group received an individually tailored programme for exercise and follow-up care which was commenced in hospital and included regular visits in hospital by a physiotherapist and a registered nurse , a home visit following discharge and regular telephone follow-up for 24 weeks following discharge . The programme was design ed to improve health-promoting behaviours , strength , stability , endurance and mobility . Data were collected at baseline , then 4 , 12 and 24 weeks following discharge using the Index of ADL , Instrumental Activities of Daily Living ( IADL ) and the Walking Impairment Question naire ( WIQ ; modified ) . RESULTS Significant improvements were found in the intervention group in IADL scores ( P < 0.001 ) , ADL scores ( P < 0.001 ) and WIQ scale scores ( P < 0.001 ) in comparison to the control group . The greatest improvements were found in the first 4 weeks following discharge . CONCLUSIONS Early introduction of a transitional model of care incorporating a tailored exercise programme and regular telephone follow-up for hospitalized at-risk older adults can improve independence and functional ability Background Objective ly measured physical activity is low in British children , and declines as childhood progresses . Observational studies suggest that dog-walking might be a useful approach to physical activity promotion in children and adults , but there are no published public health interventions based on dog-walking with children . The Children , Parents , and Pets Exercising Together Study aims to develop and evaluate a theory driven , generalisable , family-based , dog walking intervention for 9 - 11 year olds . Methods / design The Children , Parents , and Pets Exercising Together Study is an exploratory , assessor-blinded , r and omised controlled trial as defined in the UK MRC Framework on the development and evaluation of complex interventions in public health . The trial will follow CONSORT guidance . Approximately 40 dog-owning families will be allocated r and omly in a ratio of 1.5:1 to receive a simple behavioural intervention lasting for 10 weeks or to a ' waiting list ' control group . The primary outcome is change in objective ly measured child physical activity using Actigraph accelerometry . Secondary outcomes in the child , included in part to shape a future more definitive r and omised controlled trial , are : total time spent sedentary and patterning of sedentary behaviour ( Actigraph accelerometry ) ; body composition and bone health from dual energy x-ray absorptiometry ; body weight , height and BMI ; and finally , health-related quality of life using the PedsQL . Secondary outcomes in parents and dogs are : changes in body weight ; changes in Actigraph accelerometry measured physical activity and sedentary behaviour . Process evaluation will consist of assessment of simultaneous child , parent , and dog accelerometry data and brief interviews with participating families . Discussion The Children , Parents , and Pets Exercising Together trial should be the first r and omised controlled study to establish and evaluate an intervention aim ed at dog-based physical activity promotion in families . It should advance our underst and ing of whether and how to use  pet dogs to promote physical activity and /or to reduce sedentary behaviour in children and adults . The trial is intended to lead to a subsequent more definitive r and omised controlled trial , and the work should inform future dog-based public health interventions such as secondary prevention interventions in children or adults . Trial registration numberIS RCT INTRODUCTION We examined the need for counselling and the effect on willingness and ability to change life-style , and subsequent changes in risk factors for CHD . MATERIAL AND METHODS All 152 male employees in a computer company , 25 - 45 years of age , were invited to participate in a controlled intervention study over one year . The subjects were r and omised to an intervention group ( I group ) and a control group . The I group was divided into subgroups based on baseline behaviour and risk factor status . Changes were evaluated after one year . After an initial health examination , participants in the I group were counselled at baseline and at 5 months . RESULTS Eighty-five ( 56 % ) men participated . Twenty-nine were assigned to a control group and 56 to an intervention group ( I group ) ( dropouts = 8) . An exercise group ( E group ) was advised to take up aerobics exercise three times/week , a diet group to reduce the intake of saturated fat and increase fish products , and smokers to stop smoking . Forty were recommended one or more behavioural changes and eight had no need . Thirty-four were willing to make behavioural changes . Compared to the control group , the fitness level increased ( p < 0.01 ) and body weight decreased in the I group ( p < 0.05 ) . DISCUSSION Individual counselling promotes regular exercise with subsequent improvements in CHD risk factors . The diet and smoking counselling models were less successful in terms of compliance Abstract Objective . To investigate the efficacy of a guided and grade d home-based exercise program for improving a range of physical outcomes in older people . Design . Controlled clinical trial of 16 weeks Setting . Two geographical areas in Gent , Belgium Participants . 66 independent-living older people ( age : 71 - 98 ) with a history of falls and moderate physical impairment Intervention . Twenty-four 30-minute training sessions were given by a trained physiotherapist over a period of 16 weeks in the participant ’s home . Different types of exercises on balance , aerobic performance , flexibility , and muscle strength were provided . Main outcome measures . Muscle strength , static and dynamic balance , aerobic performance , activities in daily living , fear of falling and avoidance of daily activities were assessed at baseline and after 16 weeks intervention . Results : At baseline , there were no significant differences in the measured variables between exercise and control groups . After 16 weeks , the exercise group showed significantly improved ankle muscle strength , balance performance and aerobic capacity , and decreased fear of falling , dependency in daily activities and avoidance of daily activities compared to the control group . The improvements in knee muscle strength , timed chair st and s , and functional reach were not significant . Conclusion : The home-based , individualized exercise program was effective in reducing several physical factors associated with falls in community-dwelling older people with moderate physical impairment . The decrease in fear of falling and other behavioural variables needs to be considered with care and needs further investigation A r and omised control trial evaluated the effectiveness of a theory-based persuasive leaflet design ed to encourage students to undertake at least one additional physical exercise session a week . Participants were 503 secondary school students attending a school in South-East Engl and . The leaflet was written to target potentially modifiable cognitive antecedents of exercise specified by the Theory of Planned Behaviour . It was separately augmented with two cognitive change techniques , result ing in three intervention conditions , leaflet alone ; leaflet plus motivational quiz , and leaflet plus implementation intention prompt , as well as a no-leaflet control condition .  Cognitions and behaviour were measured immediately before and 3 weeks after intervention . The results showed that all three-leaflet interventions significantly increased reported exercise , intention to exercise and related cognitions , compared to the control condition , but did not differ in their impact . Mediation analysis showed that intervention effects on exercise were partially mediated by intentions and perceived behavioural control Background The prevalence of health risk behaviours is growing amongst South African employees . Health risk behaviours have been identified as a major contributor to reduced health related quality of life ( HRQoL ) and the increased prevalence of non-communicable diseases . Worksite wellness programmes promise to promote behaviour changes amongst employees and to improve their HRQoL. The aim of this study was to evaluate the short-term effects of an  employee wellness programme  on HRQoL , health behaviour change , body mass index ( BMI ) and absenteeism amongst clothing and textile manufacturing employees . Methods The study used a r and omised control trial design . The sample consisted of 80 subjects from three clothing manufacturing companies in Cape Town , South Africa . The experimental group was subjected to a wellness programme based on the principles of cognitive behaviour therapy ( CBT ) as well as weekly supervised exercise classes over six weeks . The control group received a once-off health promotion talk and various educational pamphlets , with no further intervention . Measurements were recorded at baseline and at six weeks post-intervention . Outcome measures included the EQ-5D , Stanford Exercise Behaviours Scale , body mass index and absenteeism . Data was analysed with the Statistica-8 software program . Non-parametric tests were used to evaluate the differences in the medians between the two groups and to determine the level of significance . The Sign test was used to determine the within group changes . The Mann – Whitney U test was used to determine the difference between the two groups . Results At six weeks post intervention the experimental group ( 39 subjects ) demonstrated improvement in almost every parameter . In contrast , apart from an overall decrease in time off work and a reduction in BMI for all study participants , there was no significant change noted in the behaviour of the control group ( 41 subjects ) . Seventy percent of the experimental group had improved HRQoL EQ-5D VAS scores post intervention , indicating improved perceived HRQoL. In comparison , only 58 % of the control group had improved HRQoL EQ-5D VAS scores post intervention . There was no significant difference between the two groups at baseline or at six weeks post intervention . Conclusion An employee wellness programme based on the principles of CBT combined with weekly aerobic exercise class was beneficial in improving the perceived HRQoL and changing health-related behaviours of clothing manufacturing employees . However , it can not be concluded that the EWP was more effective than the once off health promotion talk as no significant changes were noted between the two groups at 6-weeks post intervention . This trial has been registered with Clinical Trials.gov ( trial registration number NCT01625039 ) INTRODUCTION Replacing sedentary behaviour with light intensity physical activity ( ie , activities classified as less than three metabolic equivalents , such as slow-paced walking ) may be a more realistic strategy for reducing cardiometabolic risk in people with chronic obstructive pulmonary disease than only aim ing to increase levels of moderate-vigorous intensity physical activity . Behaviour change interventions to reduce sedentary behaviour in people with chronic obstructive pulmonary disease have not yet been developed or tested . RESEARCH QUESTIONS Is a 6-week behaviour change intervention effective and feasible in reducing sedentary time in people with chronic obstructive pulmonary disease ? DESIGN This study will be a multi-centre , r and omised , controlled trial with concealed allocation , assessor blinding , and intention-to-treat analysis , comparing a 6-week behaviour change intervention aim ed at reducing sedentary time with a sham intervention in people with chronic obstructive pulmonary disease . PARTICIPANTS AND SETTING Seventy participants will be recruited from the waiting lists for pulmonary rehabilitation programs at Royal Prince Alfred Hospital and Prince of Wales Hospital , Sydney , Australia . INTERVENTION The behaviour change intervention aims to reduce sedentary time through a process of guided goal setting with participants to achieve two target behaviours : ( 1 ) replace sitting and lying down with light-intensity physical activity where possible , and ( 2 ) st and up and move for 2minutes after 30minutes of continuous sedentary time . Three face-to-face sessions and three phone sessions will be held with a physiotherapist over the 6-week intervention period . The ' capability ' , ' opportunity ' , ' motivation ' and ' behaviour ' ( COM-B ) model will be applied to each participant to determine which components of behaviour ( capability , opportunity or motivation ) need to change in order to reduce sedentary time . Based on this ' behavioural diagnosis ' , the Behaviour Change Wheel will be used to systematic ally select appropriate behaviour change techniques to assist participants in achieving their weekly goals . Behaviour change techniques will include providing information about the health consequences of sedentary behaviour , self-monitoring and review of weekly goals , problem-solving of barriers to achieving weekly goals , and providing feedback on sedentary time using the Jawbone UP3 activity monitor . CONTROL The sham intervention will consist of weekly phone calls for 6 weeks , to enquire whether the participants ' health status has changed over the intervention period ( eg , hospitalised for an acute exacerbation ) . No instructions regarding physical activity or exercise will be given . MEASUREMENTS Outcomes will be assessed at baseline , at the end of the 6-week intervention period , and at the 3-month follow-up . Primary outcome measures will be : ( 1 ) total sedentary time , including the pattern of accumulation of sedentary time , assessed by the activPAL3 activity monitor , and ( 2 ) feasibility of the intervention assessed by uptake and retention of participants , participant compliance , self-reported achievement of weekly goals , and adverse events . Secondary outcome measures will include functional exercise capacity , health-related quality of life , domain-specific and behaviour-specific sedentary time , patient activation , and anxiety and depression .  Semi-structured interviews will be conducted with participants who receive the behaviour change intervention to explore acceptability and satisfaction with the different components of the intervention . ANALYSIS Analysis of covariance ( ANCOVA ) will be used to calculate between-group comparisons of total sedentary time and the number of bouts of sedentary time>30minutes after adjusting baseline values . Uncertainty about the size of the mean between-group differences will be quantified with 95 % CI . Within-group comparisons will be examined using paired t-tests and described as mean differences with 95 % CIs . Secondary outcome measures will be analysed similarly . The feasibility measures will be analysed descriptively . Semi-structured interviews will be conducted until data saturation is achieved and there are no new emerging themes . De-identified interview transcripts will be coded independently by two research ers and analysed alongside data collection using the COM-B model as a thematic framework . DISCUSSION / SIGNIFICANCE If behaviour change interventions are found to be an effective and feasible method for reducing sedentary time , such interventions may be used to reduce cardiometabolic risk in people with chronic obstructive pulmonary disease . An approach that emphasises participation in light-intensity physical activity may increase the confidence and willingness of people with chronic obstructive pulmonary disease to engage in more intense physical activity , and may serve as an intermediate goal to increase uptake of pulmonary rehabilitation Abstract Objective : To measure the effect of behaviourally oriented counselling in general practice on healthy behaviour and biological risk factors in patients at increased risk of coronary heart disease . Design : Cluster r and omised controlled trial . Participants : 883 men and women selected for the presence of one or more modifiable risk factors : regular cigarette smoking , high serum cholesterol concentration ( 6.5 - 9.0 mmol/l ) , and high body mass index ( 25 - 35 ) combined with low physical activity . Intervention : Brief behavioural counselling , on the basis of the stage of change model , carried out by practice nurses to reduce smoking and dietary fat intake and to increase regular physical activity . Main outcome measures : Question naire measures of diet , exercise , and smoking habits , and blood pressure , serum total cholesterol concentration , weight , body mass index , and smoking cessation ( with biochemical validation ) at 4 and 12 months . Results : Favourable differences were recorded in the intervention group for dietary fat intake , regular exercise , and cigarettes smoked per day at 4 and 12 months . Systolic blood pressure was reduced to a greater extent in the intervention group at 4 but not at 12 months No differences were found between groups in changes in total serum cholesterol concentration , weight , body mass index , diastolic pressure , or smoking cessation . Conclusions : Brief behavioural counselling by practice nurses led to improvements in healthy behaviour . More extended counselling to help patients sustain and build on behaviour changes may be required before differences in biological risk factors emerge INTRODUCTION Shift work ( an occupation requiring work between 2200 and 0500H ) comprises approximately 20 % of the workforce in Europe and North America [ 1 ] . This is likely to increase , with many shift workers ( SWs ) in emergency services , retail , hospitality , healthcare , transportation and manufacturing [ 2 ] . SWs are at increased risk for negative health outcomes , including cancer and other chronic diseases [ 3 , 4 ] . Biological changes from poor lifestyle habits related to shift work ( e.g. low physical activity ( PA ) , poor nutrition , obesity ) are thought to contribute to this risk ; these factors are also amenable to lifestyle intervention [ 5 ] . PA in particular , reduces cancer risk [ 6 ] , and has many positive physical and psychological benefits [ 7 ] . It is a simple , cost-effective strategy that may be implemented by individual workers or within workplaces to mitigate risk . Unfortunately , SWs are unlikely to engage in regular PA [ 8 ] . In Canada , only 15.9 % of SWsmeet the PA guidelines and have lower levels of aerobic fitness than those of day workers [ 9 ] . Few behavioural interventions improving health outcomes in SWs have been published [ 10 ] . In a targeted PA intervention , nurses r and omised to 4 months of supervised PA  improved aerobic fitness , muscular strength , fatigue and musculoskeletal symptoms . However , authors reported low adherence and large loss to follow-up , perhaps due to the supervised scheduled sessions [ 11 , 12 ] . Sustained behaviour change is a challenge and requires targeted efforts to encourage individuals to reach an adequate dose of PA to change health outcomes [ 13 ] . Due to irregular schedules and time constraints , SWs may be less likely to adhere to a traditional supervised PA intervention with face-to-face behavioural support [ 12 ] . Women SWs cite work schedule interference and lack of time as PA barriers and report scheduling flexibility as the most important in PA [ 14 ] . This highlights the need for a creative and innovative programming to promote PA in SWs . Distance-based interventions , in which individuals exercise independent of study staff or participants , may include telephone counselling and website or smart phone app-based technology . These interventions are highly flexible and may help overcome barriers related to timing and scheduling that are important for SWs . In a review of telephone-based PA interventions , 14 of 17 found evidence for behaviour change [ 15 ] . These may be a way to implement scalable , individuallytailored interventions in SWs . The primary objective of this study was to test the feasibility of a distance-based PA intervention in women SWs . Feasibility studies are important for establishing effective processes and underst and ing re sources required before attempting a r and omised controlled trial ( RCT ) , in order to put forward interventions that are most likely to be efficacious [ 16 ] . As this work was funded by a grant to examine the role of lifestyle in reducing breast cancer risk in SWs , only women were included . A secondary objective was to conduct a preliminary evaluation of intervention efficacy , to estimate effect size for future studies
Interventions to promote exercise in cancer survivors who report better levels of adherence share some common behaviour change techniques .
These involve setting programme goals , prompting practise and self-monitoring and encouraging participants to attempt to generalise behaviours learned in supervised exercise environments to other , non-supervised context s. However , expecting most sedentary survivors to achieve current guideline recommendations of at least 150 minutes per week of aerobic exercise is likely to be unrealistic .
BACKGROUND The beneficial effects of regular exercise for people living with or beyond cancer are becoming apparent .
However , how to promote exercise behaviour in sedentary cancer cohorts is not as well understood .
A large majority of people living with or recovering from cancer do not meet exercise recommendations .
Hence , review ing the evidence on how to promote and sustain exercise behaviour is important .
OBJECTIVES To assess the effects of interventions to promote exercise behaviour in sedentary people living with and beyond cancer and to address the following questions : Which interventions are most effective in improving aerobic fitness and skeletal muscle strength and endurance ?
What adverse effects are attributed to different exercise interventions ?
Which interventions are most effective in improving exercise behaviour amongst patients with different cancers ?
Which interventions are most likely to promote long-term ( 12 months or longer ) exercise behaviour ?
What frequency of contact with exercise professionals is associated with increased exercise behaviour ?
What theoretical basis is most often associated with increased exercise behaviour ?
What behaviour change techniques are most often associated with increased exercise behaviour ?