The feasibility and RE-AIM evaluation of the TAME health pilot study

Zakkoyya H Lewis, Kenneth J Ottenbacher, Steve R Fisher, Kristofer Jennings, Arleen F Brown, Maria C Swartz, Eloisa Martinez, Elizabeth J Lyons, Zakkoyya H Lewis, Kenneth J Ottenbacher, Steve R Fisher, Kristofer Jennings, Arleen F Brown, Maria C Swartz, Eloisa Martinez, Elizabeth J Lyons

Abstract

Background: Conducting 5 A's counseling in clinic and utilizing technology-based resources are recommended to promote physical activity but little is known about how to implement such an intervention. This investigation aimed to determine the feasibility and acceptability, using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, of a pragmatic, primary care-based intervention that incorporated 5 A's counseling and self-control through an activity monitor.

Methods: Primary care patients (n = 40) 55-74 years of age were recruited and randomized to receive a pedometer or an electronic activity monitor (EAM), Jawbone UP24, to monitor activity for 12 weeks. Participants were also invited to a focus group after completing the intervention. Stakeholders (n = 36) were recruited to provide feedback.

Results: The intervention recruitment rate was 24.7%. The attrition rate was 20% with a significantly higher rate for the pedometer group (p = 0.02). The EAM group increased their minutes of physical activity by 11.1 min/day while the pedometer maintained their activity (0.2 min/day), with no significant group difference. EAM participants liked using their monitor and would continue wearing it while the pedometer group was neutral to these statements (p < 0.05). Over the 12 weeks there were 490 comments and 1094 "likes" given to study peers in the corresponding application for the UP24 monitor. Some EAM participants enjoyed the social interaction feature while others were uncomfortable talking to strangers. Participants stated they would want counseling from a counselor and not their physician or a nurse. Other notable comments included incorporating multiple health behaviors, more in-person counseling with a counselor, and having a funding source for sustainability.

Conclusions: Overall, the study was well-received but the results raise a number of considerations. Practitioners, counselors, and researchers should consider the following before implementing a similar intervention: 1) utilize PA counselors, 2) target multiple health behaviors, 3) form a social support group, 4) identify a funding source for sustainability, and 5) be mindful of concerns with technology.

Trial registration: clinicaltrials.gov- NCT02554435 . Registered 24 August 2015.

Keywords: Activity monitor; Jawbone; Older adults; Pedometer; Physical activity; Pragmatic; Primary care; RE-AIM; Technology.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Board at the University of Texas Medical Branch and all participants provided informed consent.

Consent for publication

Not applicable

Competing interests

While the American Heart Association funded this study, MCS’s spouse has an equity interest in Apple Inc., a company that may potentially benefit from the research results. In addition, ZHL is employed by Beachbody, a company that may potentially benefit from the research results. UTMB’s Conflicts of Interest Committee has reviewed these conflicts and a management plan was implemented to prevent any appearance of a conflict of interests. Any inquiries regarding this management plan can be directed to UTMB’s Office of Institutional Compliance, (409) 747–8701.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Recruitment flow diagram
Fig. 2
Fig. 2
Social Interaction on the UP app

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