Behavioral Intervention to Increase Physical Activity in Patients With Asthma
Condition: Asthma
MeSH terms: Asthma
Study type: Interventional

Summary: 
      The health benefits of physical activity (PA) are well documented and include improving in
      cardiovascular, obesity, mental health and all-cause mortality. Although higher levels of
      activity in patients with asthma are also associated with better outcomes, patients still
      avoid physical activity due to concern about exacerbating their asthma symptoms by the
      exercise induced bronchoconstriction (EIB), sustaining a vicious cycle of inactivity and
      worse asthma control. Many studies have reported the benefits of supervised exercise training
      on several asthma outcomes, such as exacerbations, asthma control, cardiopulmonary fitness,
      airway inflammation and psychosocial symptoms; however, the translation of the improvements
      in the exercise capacity into increments in PA levels is less evident and still
      controversial. Therefore, the hypothesis of this study is that behavioural interventions
      using strategies based on well-established psychosocial models are effective in increasing
      physical activity levels and decrease sedentary behaviour in adults with asthma, which will
      be associated with improvements in the asthma control.
    

Detailed description: 
      This is prospective and randomized controlled trial (RCT) with 2 arms and blinded outcome
      assessments. Forty-six moderate or severe patients with asthma under optimized medication
      will be randomly assigned (computer-generated) into either Control Group (CG) or Intervention
      Group (IG). Both groups will receive similar educational program. However, only the IG will
      be submitted to the behavioral intervention through physical activity counseling program
      combined with a monitoring-and-feedback tool aiming to increase physical activity levels
      (total of 8 weekly goal-setting consultation, face-to-face, each lasting 40 minutes). Before
      and after the interventions, clinical control of asthma, physical activity levels,
      health-related quality of life, asthma exacerbation, levels of anxiety and depression
      symptoms and anthropometric indices will be assessed. Data about onset of asthma,
      comorbidities, lung function and asthma medication will be collected from the patient's
      medical record. The data normality will be analyzed by Kolmogorov-Smirnov, and a two-way
      ANOVA with repeated measures with appropriate post hoc of Holm-sidak will be used to compare
      inter and intra-groups differences. The significance level will be set to 5% for all tests.
    

Intervention name(s): Education Program; Behavioral intervention
Intervention type(s): Other; Behavioral
Intervention description(s): The educational program will consist of 2 classes held once a week, each lasting 90 minutes. The classes will be based on an education videotape, presentations and group discussions. The first class will address the asthma education, which will include information about the pathophysiology of asthma, medication and peak flow meter instructions, self-monitoring techniques, environmental control techniques and avoidance strategies. The second class will be about the current international physical activity recommendations and the importance and benefits of being physically active and maintain a healthy lifestyle.; The behavioural intervention will be performed in 8 weekly goal-setting consultation, face-to-face, each lasting 40 minutes. Patients will be offered a commercially-available activity tracker to wear during 3 days prior to each consultation. According to their own PA data and the behavioural change stage, an individual action plan will be established with realistic goals to increase PA. Each participant will receive individual counselling with the goal of increasing participation in PA and reducing their sedentary time. Techniques such as weekly goal-setting, motivational interviewing, activity tracker vibration instructions, self-management, positive reinforcement, relapse prevention and strategies to overcome barriers will be included.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Physical activity; Behavioral intervention; Asthma clinical control