sarah hardcastle - Academia.edu (original) (raw)
Papers by sarah hardcastle
BMJ Open
IntroductionNovel therapies for pulmonary hypertension (PH) have improved survival and slowed dis... more IntroductionNovel therapies for pulmonary hypertension (PH) have improved survival and slowed disease progression. However, patients still present with symptoms of exertional dyspnoea and fatigue, which impacts their ability to perform activities of daily living, reduces exercise tolerance and impairs their quality of life (QoL). Exercise training has shown to be safe and effective at enhancing QoL and physical function in PH patients, yet it remains an underused adjunct therapy. Most exercise training for PH patients has been offered through hospital-based programmes. Home-based exercise programmes provide an alternative model that has the potential to increase the availability and accessibility of exercise training as an adjunct therapy in PH. The purpose of this study is to investigate the feasibility, acceptability, utility and safety of a novel remotely supervised home-based PH exercise programme.MethodsSingle arm intervention with a pre/post comparisons design and a follow-up ...
Frontiers in Psychology, 2016
Routledge eBooks, Feb 17, 2015
Despite the compelling evidence of the health benefits of being physically active, few people are... more Despite the compelling evidence of the health benefits of being physically active, few people are sufficiently active to benefit their health and there is a need to focus on effective interventions to increase motivation for continued physical activity participation. Counselling interventions, such as motivational interviewing show promise in facilitating lifestyle behavioural changes through the promotion of autonomous motives for change. This chapter summarises the key principles and strategies used in motivational interviewing and outlines what exercise professionals can do to increase the likelihood that counselling will promote behaviour change. Based on the underlying principles of motivational interviewing and the strategies employed, there is real promise that motivational interviewing interventions are likely to promote long-lasting, sustained behaviour change. This is because of its central emphasis on eliciting personal motives for change, working through ambivalence, building confidence and promoting more autonomous forms of motivation
There has been increasing interest in promoting health-enhancing exercise in primary-care service... more There has been increasing interest in promoting health-enhancing exercise in primary-care services. One popular approach in the U.K. has been general practitioner (GP) exercise-referral plans in which mostly sedentary patients are referred by GPs to an exercise program at a local leisure center. It is not clear, however, how older women assimilate such a referral system into cognitive processes associated with physical activity involvement. This interpretivist study adopted unstructured interviewing and life-story technique to embrace subjectivity and contextuality in an attempt to capture the complex processes and to explore both common and diverse experience. The study explored referred older women's accounts of their past and current experiences of physical activity and their perceptions of what blocks or motivates them to be active. Fifteen newly referred older women (50–80 years old) were interviewed at various points during their prescribed 10-week exercise program. The findings highlight the importance of psychosocial dimensions and informal networks in the referral processes.
Frontiers in Psychology, 2016
PLOS ONE, 2020
There has been growing interest in the use of smart wearable technology to promote physical activ... more There has been growing interest in the use of smart wearable technology to promote physical activity (PA) behaviour change. However, little is known concerning PA patterns throughout an intervention or engagement with trackers. The objective of the study was to explore patterns of Fitbit-measured PA and wear-time over 24-weeks and their relationship to changes in Actigraph-derived moderate-to-vigorous PA (MVPA). Methods Twenty-nine intervention participants (88%) from the wearable activity technology and action-planning (WATAAP) trial in colorectal and endometrial cancer survivors accepted a Fitbit friend request from the research team to permit monitoring of Fitbit activity. Daily steps and active minutes were recorded for each participant over the 12-week intervention and throughout the follow-up period to 24-weeks. Accelerometer (GT9X) derived MVPA was assessed at end of intervention (12-weeks) and end of follow-up (24-weeks). Results Fitbit wear-time over the 24-weeks of data was remarkably consistent, with median adherence score of 100% for all weeks. During the intervention, participants recorded a median 8006 steps/day. Daily step count was slightly increased through week-13 to week-24 with a median of 8191 steps/day (p = 0.039). Actigraph and Fitbit derived measures were highly correlated but demonstrated poor agreement overall. Fitbit measured activity was closest to MVPA measured using Freedson cut-points as no bias was observed.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, Jan 8, 2018
To investigate knowledge, attitudes, and practices of oncologists towards physical activity (PA) ... more To investigate knowledge, attitudes, and practices of oncologists towards physical activity (PA) in cancer survivors, and the association between oncologists' own PA behavior and PA promotion. Oncologists (n = 123) completed a survey based on the Theory of Planned Behavior (TPB). Participants reported PA promotion behavior, PA involvement, attitudes, intentions, social norm, perceived behavioral control (PBC), and confidence and knowledge of exercise prescription. Structural equation modeling (SEM) evaluated these associations. Less than half of oncologists reported regularly promoting PA to patients (46%), with 20% providing written information and 23% referrals. Only 26% were physically active. TPB SEM pathways explained 54.6% of the variance in PA promotion (comparative fit index (CFI) = 0.905, standardized root mean square residual (SRMR) = 0.040). Social norm was not only the significant pathway to intention but also a significant indirect pathway to PA promotion (p = 0.007...
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 26, 2018
Adams et al, 1 Lopez et al, 2 and Newton et al 3 have raised issues in response to our article 4 ... more Adams et al, 1 Lopez et al, 2 and Newton et al 3 have raised issues in response to our article 4 that include the safety of home-based interventions, adherence and efficacy, the role of the oncologist in promoting physical activity, and the definition of home-based interventions. To clarify, our article refers to the promotion of physical activity to survivors of cancer after the completion of active treatment, as increasing physical activity is associated with a reduction in cardiovascular disease, mortality, and cancer recurrence. 5-8 We agree with Adams et al 1 that there has been significant progress in the field of exercise oncology. It was not our intention to imply that "the growing evidence base in exercise oncology has failed on the basis of oncologist practice behavior," 1 but to draw attention to studies that have demonstrated that few oncologists actively promote physical activity or refer patients to exercise specialists. 9-13 Given the increasing evidence for the benefits of physical activity in survivors of cancer, it is imperative that the oncology and exercise oncology community work to bridge the gap between research and implementation in clinical practice. Both Adams et al 1 and Newton et al 3 raise safety concerns with home-based physical activity interventions. Adams et al suggest that we failed to acknowledge factors concerning "safety, tolerability, and patient need (efficacy)" 1 ; however, it is precisely for these reasons that we advocate lifestyle physical activities, such as brisk walking. We contend that walking is safe, well tolerated, and the preferred exercise for many survivors of cancer. 14-16 Newton et al also suggest that survivors of cancer "will be older and have numerous comorbidities, which places them at risk when exercising unsupervised." 3 We agree that most survivors are older and likely have comorbidities, but contend that moderate-intensity physical activity, in most cases, will be safe and may be undertaken independently without supervision. Newton et al give few reasons why the exercise recommendations would be "ineffective or unachievable…if undertaken at home," 3 but do refer to limited equipment; however, even bodyweight strength training performed from home without equipment has shown results that were comparable with gym-based activities in mortality risk reduction. 17 Newton and colleagues' preferred model is for the oncologist to refer patients to an allied health professional, such as an exercise physiologist. We agree with this model, but suggest that most oncologists do not have access to, or referral pathways to, exercise physiologists. 9-13,18 A variety of approaches to physical activity promotion are required to engage a diverse clinical population. Some survivors of cancer will desire supervised facility-based exercise sessions, whereas others will prefer to undertake exercise independently; however, it is not feasible to offer ongoing supervised exercise sessions to all survivors for an indefinite period of time. Adams et al argue that "compliance and attrition rates are excellent" 1 in supervised facility-based supervised programs and jco.org
Journal of Aging and Physical Activity, 2001
There has been increasing interest in promoting health-enhancing exercise in primary-care service... more There has been increasing interest in promoting health-enhancing exercise in primary-care services. One popular approach in the U.K. has been general practitioner (GP) exercise-referral plans in which mostly sedentary patients are referred by GPs to an exercise program at a local leisure center. It is not clear, however, how older women assimilate such a referral system into cognitive processes associated with physical activity involvement. This interpretivist study adopted unstructured interviewing and life-story technique to embrace subjectivity and contextuality in an attempt to capture the complex processes and to explore both common and diverse experience. The study explored referred older women's accounts of their past and current experiences of physical activity and their perceptions of what blocks or motivates them to be active. Fifteen newly referred older women (50–80 years old) were interviewed at various points during their prescribed 10-week exercise program. The fi...
Eating Behaviors, 2016
The purpose of this qualitative study was to explore the perceptions and attitudes that underlie ... more The purpose of this qualitative study was to explore the perceptions and attitudes that underlie food choices, and, the impact of a school-based healthy eating intervention in mothers from an economically-disadvantaged community. The aim of the intervention was to educate children to act as 'health messengers' to their families. Sixteen semi-structured phone interviews were conducted with mothers with four receiving a second interview. Interviews were conducted following their child's participation in a six-week after school healthy cooking intervention. Thematic content analysis revealed four main themes: Cost and budget influence on food choices, diversity in household rules controlling food, role of socialisation on diet, and improved cooking skills and confidence to make homemade meals. The interview findings demonstrated the positive influence of the after-school cooking intervention on children and their families in cooking skills, promoting healthier cooking methods and increasing confidence to prepare homemade meals. The findings demonstrated the wider economic and social influences on food choices and eating practices. Socialisation into, and strong cultural norms around, eating habits were significant influences on family diet and on parental decisions underpinning food choices and attitudes towards the control of food within the family. The intervention was perceived to be successful in terms of improving nutritional knowledge, cooking skills and increasing confidence to make healthy and tasty homemade meals. The study demonstrates the importance of parental involvement in school-based interventions if improvements in healthy eating are to be evidenced at the family level and maintained.
Global perspectives and fundamental concepts, 2013
Despite the compelling evidence of the health benefits of being physically active, few people are... more Despite the compelling evidence of the health benefits of being physically active, few people are sufficiently active to benefit their health and there is a need to focus on effective interventions to increase motivation for continued physical activity participation. Counselling interventions, such as motivational interviewing show promise in facilitating lifestyle behavioural changes through the promotion of autonomous motives for change. This chapter summarises the key principles and strategies used in motivational interviewing and outlines what exercise professionals can do to increase the likelihood that counselling will promote behaviour change. Based on the underlying principles of motivational interviewing and the strategies employed, there is real promise that motivational interviewing interventions are likely to promote long-lasting, sustained behaviour change. This is because of its central emphasis on eliciting personal motives for change, working through ambivalence, building confidence and promoting more autonomous forms of motivation
Supportive Care in Cancer
Purpose This study explored colorectal and endometrial cancer survivors’ experiences of participa... more Purpose This study explored colorectal and endometrial cancer survivors’ experiences of participation in a wearable intervention and the dimensions that influenced intervention engagement and physical activity behaviour change. Methods Semi-structured interviews (n= 23) were conducted with intervention participants (mean age 65.8 (SD ±7.1) and analysed using thematic analysis. Results Four main themes were identified: (i) commitment, (ii) accountability and monitoring, (iii) routine, (iv) Fitbit as health coach. Those that assigned a higher priority to PA were more likely to schedule PA and be successful in PA change. Those less successful presented more barriers to change and engaged in more incidental PA. The Fitbit acting as health coach was the active ingredient of the intervention. Conclusions Commitment evidenced through prioritising PA was the foundational dimension that influenced PA engagement. Interventions that foster commitment to PA through increasing the value and impo...
International Journal of Behavioral Nutrition and Physical Activity, 2013
Background: Intensive diet and physical activity interventions have been found to reduce cardiova... more Background: Intensive diet and physical activity interventions have been found to reduce cardiovascular disease (CVD) risk, but are resource intensive. The American Heart Association recently recommended motivational interviewing (MI) as an effective approach for low-intensity interventions to promote health-related outcomes such as weight loss. However, there is limited research evaluating the long-term effectiveness of MI-based interventions on health-related outcomes associated with CVD risk. The current research evaluated the effectiveness of a six-month low-intensity MI intervention in a UK primary-care setting in maintaining reductions in CVD risk factors at12 months post-intervention. Methods: Primary-care patients were randomised to an intervention group that received standard exercise and nutrition information plus up to five face-to-face MI sessions, delivered by a physical activity specialist and registered dietician over a 6-month period, or to a minimal intervention comparison group that received the standard information only. Follow-up measures of behavioural (vigorous and moderate physical activity, walking, physical activity stage-of-change, fruit and vegetable intake, and dietary fat intake) and biomedical (weight, body mass index [BMI], blood pressure, cholesterol) outcomes were taken immediately post-intervention and at a 12-month follow-up occasion. Results: Intent-to-treat analyses revealed significant differences between groups for walking and cholesterol. Obese and hypercholesterolemic patients at baseline exhibited significant improvements in BMI and cholesterol respectively among those allocated to the intervention group compared to the comparison group. Post-intervention improvements in other health-related outcomes including blood pressure, weight, and BMI were not maintained. Conclusions: The present study suggests that a low-intensity MI counselling intervention is effective in bringing about long-term changes in some, but not all, health-related outcomes (walking, cholesterol levels) associated with CVD risk. The intervention was particularly effective for patients with elevated levels of CVD risk factors at baseline. Based on these findings future interventions should be conducted in a primary care setting and target patients with high risk of CVD. Future research should investigate how the long-term gains in health-related outcomes brought about by the MI-counselling intervention in the current study could be extended to a wider range of health outcomes.
Appetite, 2021
To investigate the role of foodbanks in the context of food insecurity and explore food choices a... more To investigate the role of foodbanks in the context of food insecurity and explore food choices and eating behaviours amongst users. Methods: Face-to-face interviews were conducted with individuals who had visited the Margaret Court Community Outreach foodbanks in Perth? In Western Australia. Participants were thirty-three service users (mean age 44.12 years, SD 13.74) who had collected a food hamper from the foodbank. Interview transcripts were analysed using thematic analysis. Results: Five main themes emerged: Ties you over until pay day; Food hamper supporting meals and fruit and vegetable consumption; Food choices supplementing hamper; Household gatekeeping and food control, and, Informal referral. Conclusions: Opposite to previous findings, participants were very complimentary about the content of the food hamper received which included a variety of fresh produce. One of the key new findings was the frequent purchase and consumption of meat and processed meat. Future work and interventions to improve eating behaviour and reduce food-related financial pressure for those vulnerable to food insecurity include further exploration of the dimensions influencing food choices (i.e., cultural norms, habits, symbols); exposure to healthy and tasty plant-based meals, (i.e., tasting low-cost and tasty vegetable based meals); parenting training focused on handling child/partner food choice influences, and, enforcing household rules governing food.
Journal of Cancer Survivorship, 2021
Purpose Previous research has not examined the utility of the Health Action Process Approach (HAP... more Purpose Previous research has not examined the utility of the Health Action Process Approach (HAPA) to predict physical activity (PA) change in cancer survivors. The aim of the study was to investigate the efficacy of a HAPA-based model in predicting temporal change in moderate-to-vigorous physical activity (MVPA) in cancer survivors. Methods Participants enrolled in the Wearable Activity Technology and Action Planning (WATAAP) trial completed validated questionnaires (n = 64) to assess HAPA constructs (action and maintenance self-efficacy, outcome expectancies, action planning, risk perceptions, and intention) and wore an ActiGraph to measure PA at baseline, 12 weeks, and 24 weeks later. Data were analyzed using variance-based structural equation modeling with residualized change scores for model variables. Results Consistent with predictions, changes in action self-efficacy (β = 0.490, p < 0.001, ES = 0.258) and risk perceptions (β = 0.312, p = 0.003, ES = 0.099) were statistic...
BMJ Open
IntroductionNovel therapies for pulmonary hypertension (PH) have improved survival and slowed dis... more IntroductionNovel therapies for pulmonary hypertension (PH) have improved survival and slowed disease progression. However, patients still present with symptoms of exertional dyspnoea and fatigue, which impacts their ability to perform activities of daily living, reduces exercise tolerance and impairs their quality of life (QoL). Exercise training has shown to be safe and effective at enhancing QoL and physical function in PH patients, yet it remains an underused adjunct therapy. Most exercise training for PH patients has been offered through hospital-based programmes. Home-based exercise programmes provide an alternative model that has the potential to increase the availability and accessibility of exercise training as an adjunct therapy in PH. The purpose of this study is to investigate the feasibility, acceptability, utility and safety of a novel remotely supervised home-based PH exercise programme.MethodsSingle arm intervention with a pre/post comparisons design and a follow-up ...
Frontiers in Psychology, 2016
Routledge eBooks, Feb 17, 2015
Despite the compelling evidence of the health benefits of being physically active, few people are... more Despite the compelling evidence of the health benefits of being physically active, few people are sufficiently active to benefit their health and there is a need to focus on effective interventions to increase motivation for continued physical activity participation. Counselling interventions, such as motivational interviewing show promise in facilitating lifestyle behavioural changes through the promotion of autonomous motives for change. This chapter summarises the key principles and strategies used in motivational interviewing and outlines what exercise professionals can do to increase the likelihood that counselling will promote behaviour change. Based on the underlying principles of motivational interviewing and the strategies employed, there is real promise that motivational interviewing interventions are likely to promote long-lasting, sustained behaviour change. This is because of its central emphasis on eliciting personal motives for change, working through ambivalence, building confidence and promoting more autonomous forms of motivation
There has been increasing interest in promoting health-enhancing exercise in primary-care service... more There has been increasing interest in promoting health-enhancing exercise in primary-care services. One popular approach in the U.K. has been general practitioner (GP) exercise-referral plans in which mostly sedentary patients are referred by GPs to an exercise program at a local leisure center. It is not clear, however, how older women assimilate such a referral system into cognitive processes associated with physical activity involvement. This interpretivist study adopted unstructured interviewing and life-story technique to embrace subjectivity and contextuality in an attempt to capture the complex processes and to explore both common and diverse experience. The study explored referred older women's accounts of their past and current experiences of physical activity and their perceptions of what blocks or motivates them to be active. Fifteen newly referred older women (50–80 years old) were interviewed at various points during their prescribed 10-week exercise program. The findings highlight the importance of psychosocial dimensions and informal networks in the referral processes.
Frontiers in Psychology, 2016
PLOS ONE, 2020
There has been growing interest in the use of smart wearable technology to promote physical activ... more There has been growing interest in the use of smart wearable technology to promote physical activity (PA) behaviour change. However, little is known concerning PA patterns throughout an intervention or engagement with trackers. The objective of the study was to explore patterns of Fitbit-measured PA and wear-time over 24-weeks and their relationship to changes in Actigraph-derived moderate-to-vigorous PA (MVPA). Methods Twenty-nine intervention participants (88%) from the wearable activity technology and action-planning (WATAAP) trial in colorectal and endometrial cancer survivors accepted a Fitbit friend request from the research team to permit monitoring of Fitbit activity. Daily steps and active minutes were recorded for each participant over the 12-week intervention and throughout the follow-up period to 24-weeks. Accelerometer (GT9X) derived MVPA was assessed at end of intervention (12-weeks) and end of follow-up (24-weeks). Results Fitbit wear-time over the 24-weeks of data was remarkably consistent, with median adherence score of 100% for all weeks. During the intervention, participants recorded a median 8006 steps/day. Daily step count was slightly increased through week-13 to week-24 with a median of 8191 steps/day (p = 0.039). Actigraph and Fitbit derived measures were highly correlated but demonstrated poor agreement overall. Fitbit measured activity was closest to MVPA measured using Freedson cut-points as no bias was observed.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, Jan 8, 2018
To investigate knowledge, attitudes, and practices of oncologists towards physical activity (PA) ... more To investigate knowledge, attitudes, and practices of oncologists towards physical activity (PA) in cancer survivors, and the association between oncologists' own PA behavior and PA promotion. Oncologists (n = 123) completed a survey based on the Theory of Planned Behavior (TPB). Participants reported PA promotion behavior, PA involvement, attitudes, intentions, social norm, perceived behavioral control (PBC), and confidence and knowledge of exercise prescription. Structural equation modeling (SEM) evaluated these associations. Less than half of oncologists reported regularly promoting PA to patients (46%), with 20% providing written information and 23% referrals. Only 26% were physically active. TPB SEM pathways explained 54.6% of the variance in PA promotion (comparative fit index (CFI) = 0.905, standardized root mean square residual (SRMR) = 0.040). Social norm was not only the significant pathway to intention but also a significant indirect pathway to PA promotion (p = 0.007...
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 26, 2018
Adams et al, 1 Lopez et al, 2 and Newton et al 3 have raised issues in response to our article 4 ... more Adams et al, 1 Lopez et al, 2 and Newton et al 3 have raised issues in response to our article 4 that include the safety of home-based interventions, adherence and efficacy, the role of the oncologist in promoting physical activity, and the definition of home-based interventions. To clarify, our article refers to the promotion of physical activity to survivors of cancer after the completion of active treatment, as increasing physical activity is associated with a reduction in cardiovascular disease, mortality, and cancer recurrence. 5-8 We agree with Adams et al 1 that there has been significant progress in the field of exercise oncology. It was not our intention to imply that "the growing evidence base in exercise oncology has failed on the basis of oncologist practice behavior," 1 but to draw attention to studies that have demonstrated that few oncologists actively promote physical activity or refer patients to exercise specialists. 9-13 Given the increasing evidence for the benefits of physical activity in survivors of cancer, it is imperative that the oncology and exercise oncology community work to bridge the gap between research and implementation in clinical practice. Both Adams et al 1 and Newton et al 3 raise safety concerns with home-based physical activity interventions. Adams et al suggest that we failed to acknowledge factors concerning "safety, tolerability, and patient need (efficacy)" 1 ; however, it is precisely for these reasons that we advocate lifestyle physical activities, such as brisk walking. We contend that walking is safe, well tolerated, and the preferred exercise for many survivors of cancer. 14-16 Newton et al also suggest that survivors of cancer "will be older and have numerous comorbidities, which places them at risk when exercising unsupervised." 3 We agree that most survivors are older and likely have comorbidities, but contend that moderate-intensity physical activity, in most cases, will be safe and may be undertaken independently without supervision. Newton et al give few reasons why the exercise recommendations would be "ineffective or unachievable…if undertaken at home," 3 but do refer to limited equipment; however, even bodyweight strength training performed from home without equipment has shown results that were comparable with gym-based activities in mortality risk reduction. 17 Newton and colleagues' preferred model is for the oncologist to refer patients to an allied health professional, such as an exercise physiologist. We agree with this model, but suggest that most oncologists do not have access to, or referral pathways to, exercise physiologists. 9-13,18 A variety of approaches to physical activity promotion are required to engage a diverse clinical population. Some survivors of cancer will desire supervised facility-based exercise sessions, whereas others will prefer to undertake exercise independently; however, it is not feasible to offer ongoing supervised exercise sessions to all survivors for an indefinite period of time. Adams et al argue that "compliance and attrition rates are excellent" 1 in supervised facility-based supervised programs and jco.org
Journal of Aging and Physical Activity, 2001
There has been increasing interest in promoting health-enhancing exercise in primary-care service... more There has been increasing interest in promoting health-enhancing exercise in primary-care services. One popular approach in the U.K. has been general practitioner (GP) exercise-referral plans in which mostly sedentary patients are referred by GPs to an exercise program at a local leisure center. It is not clear, however, how older women assimilate such a referral system into cognitive processes associated with physical activity involvement. This interpretivist study adopted unstructured interviewing and life-story technique to embrace subjectivity and contextuality in an attempt to capture the complex processes and to explore both common and diverse experience. The study explored referred older women's accounts of their past and current experiences of physical activity and their perceptions of what blocks or motivates them to be active. Fifteen newly referred older women (50–80 years old) were interviewed at various points during their prescribed 10-week exercise program. The fi...
Eating Behaviors, 2016
The purpose of this qualitative study was to explore the perceptions and attitudes that underlie ... more The purpose of this qualitative study was to explore the perceptions and attitudes that underlie food choices, and, the impact of a school-based healthy eating intervention in mothers from an economically-disadvantaged community. The aim of the intervention was to educate children to act as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;health messengers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; to their families. Sixteen semi-structured phone interviews were conducted with mothers with four receiving a second interview. Interviews were conducted following their child&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s participation in a six-week after school healthy cooking intervention. Thematic content analysis revealed four main themes: Cost and budget influence on food choices, diversity in household rules controlling food, role of socialisation on diet, and improved cooking skills and confidence to make homemade meals. The interview findings demonstrated the positive influence of the after-school cooking intervention on children and their families in cooking skills, promoting healthier cooking methods and increasing confidence to prepare homemade meals. The findings demonstrated the wider economic and social influences on food choices and eating practices. Socialisation into, and strong cultural norms around, eating habits were significant influences on family diet and on parental decisions underpinning food choices and attitudes towards the control of food within the family. The intervention was perceived to be successful in terms of improving nutritional knowledge, cooking skills and increasing confidence to make healthy and tasty homemade meals. The study demonstrates the importance of parental involvement in school-based interventions if improvements in healthy eating are to be evidenced at the family level and maintained.
Global perspectives and fundamental concepts, 2013
Despite the compelling evidence of the health benefits of being physically active, few people are... more Despite the compelling evidence of the health benefits of being physically active, few people are sufficiently active to benefit their health and there is a need to focus on effective interventions to increase motivation for continued physical activity participation. Counselling interventions, such as motivational interviewing show promise in facilitating lifestyle behavioural changes through the promotion of autonomous motives for change. This chapter summarises the key principles and strategies used in motivational interviewing and outlines what exercise professionals can do to increase the likelihood that counselling will promote behaviour change. Based on the underlying principles of motivational interviewing and the strategies employed, there is real promise that motivational interviewing interventions are likely to promote long-lasting, sustained behaviour change. This is because of its central emphasis on eliciting personal motives for change, working through ambivalence, building confidence and promoting more autonomous forms of motivation
Supportive Care in Cancer
Purpose This study explored colorectal and endometrial cancer survivors’ experiences of participa... more Purpose This study explored colorectal and endometrial cancer survivors’ experiences of participation in a wearable intervention and the dimensions that influenced intervention engagement and physical activity behaviour change. Methods Semi-structured interviews (n= 23) were conducted with intervention participants (mean age 65.8 (SD ±7.1) and analysed using thematic analysis. Results Four main themes were identified: (i) commitment, (ii) accountability and monitoring, (iii) routine, (iv) Fitbit as health coach. Those that assigned a higher priority to PA were more likely to schedule PA and be successful in PA change. Those less successful presented more barriers to change and engaged in more incidental PA. The Fitbit acting as health coach was the active ingredient of the intervention. Conclusions Commitment evidenced through prioritising PA was the foundational dimension that influenced PA engagement. Interventions that foster commitment to PA through increasing the value and impo...
International Journal of Behavioral Nutrition and Physical Activity, 2013
Background: Intensive diet and physical activity interventions have been found to reduce cardiova... more Background: Intensive diet and physical activity interventions have been found to reduce cardiovascular disease (CVD) risk, but are resource intensive. The American Heart Association recently recommended motivational interviewing (MI) as an effective approach for low-intensity interventions to promote health-related outcomes such as weight loss. However, there is limited research evaluating the long-term effectiveness of MI-based interventions on health-related outcomes associated with CVD risk. The current research evaluated the effectiveness of a six-month low-intensity MI intervention in a UK primary-care setting in maintaining reductions in CVD risk factors at12 months post-intervention. Methods: Primary-care patients were randomised to an intervention group that received standard exercise and nutrition information plus up to five face-to-face MI sessions, delivered by a physical activity specialist and registered dietician over a 6-month period, or to a minimal intervention comparison group that received the standard information only. Follow-up measures of behavioural (vigorous and moderate physical activity, walking, physical activity stage-of-change, fruit and vegetable intake, and dietary fat intake) and biomedical (weight, body mass index [BMI], blood pressure, cholesterol) outcomes were taken immediately post-intervention and at a 12-month follow-up occasion. Results: Intent-to-treat analyses revealed significant differences between groups for walking and cholesterol. Obese and hypercholesterolemic patients at baseline exhibited significant improvements in BMI and cholesterol respectively among those allocated to the intervention group compared to the comparison group. Post-intervention improvements in other health-related outcomes including blood pressure, weight, and BMI were not maintained. Conclusions: The present study suggests that a low-intensity MI counselling intervention is effective in bringing about long-term changes in some, but not all, health-related outcomes (walking, cholesterol levels) associated with CVD risk. The intervention was particularly effective for patients with elevated levels of CVD risk factors at baseline. Based on these findings future interventions should be conducted in a primary care setting and target patients with high risk of CVD. Future research should investigate how the long-term gains in health-related outcomes brought about by the MI-counselling intervention in the current study could be extended to a wider range of health outcomes.
Appetite, 2021
To investigate the role of foodbanks in the context of food insecurity and explore food choices a... more To investigate the role of foodbanks in the context of food insecurity and explore food choices and eating behaviours amongst users. Methods: Face-to-face interviews were conducted with individuals who had visited the Margaret Court Community Outreach foodbanks in Perth? In Western Australia. Participants were thirty-three service users (mean age 44.12 years, SD 13.74) who had collected a food hamper from the foodbank. Interview transcripts were analysed using thematic analysis. Results: Five main themes emerged: Ties you over until pay day; Food hamper supporting meals and fruit and vegetable consumption; Food choices supplementing hamper; Household gatekeeping and food control, and, Informal referral. Conclusions: Opposite to previous findings, participants were very complimentary about the content of the food hamper received which included a variety of fresh produce. One of the key new findings was the frequent purchase and consumption of meat and processed meat. Future work and interventions to improve eating behaviour and reduce food-related financial pressure for those vulnerable to food insecurity include further exploration of the dimensions influencing food choices (i.e., cultural norms, habits, symbols); exposure to healthy and tasty plant-based meals, (i.e., tasting low-cost and tasty vegetable based meals); parenting training focused on handling child/partner food choice influences, and, enforcing household rules governing food.
Journal of Cancer Survivorship, 2021
Purpose Previous research has not examined the utility of the Health Action Process Approach (HAP... more Purpose Previous research has not examined the utility of the Health Action Process Approach (HAPA) to predict physical activity (PA) change in cancer survivors. The aim of the study was to investigate the efficacy of a HAPA-based model in predicting temporal change in moderate-to-vigorous physical activity (MVPA) in cancer survivors. Methods Participants enrolled in the Wearable Activity Technology and Action Planning (WATAAP) trial completed validated questionnaires (n = 64) to assess HAPA constructs (action and maintenance self-efficacy, outcome expectancies, action planning, risk perceptions, and intention) and wore an ActiGraph to measure PA at baseline, 12 weeks, and 24 weeks later. Data were analyzed using variance-based structural equation modeling with residualized change scores for model variables. Results Consistent with predictions, changes in action self-efficacy (β = 0.490, p < 0.001, ES = 0.258) and risk perceptions (β = 0.312, p = 0.003, ES = 0.099) were statistic...