Pilot study on increased adherence to physical activity on prescription (PAP) through mindfulness: study protocol

Peter Nymberg, Eva Ekvall Hansson, Emelie Stenman, Susanna Calling, Kristina Sundquist, Jan Sundquist, Bengt Zöller, Peter Nymberg, Eva Ekvall Hansson, Emelie Stenman, Susanna Calling, Kristina Sundquist, Jan Sundquist, Bengt Zöller

Abstract

Background: In the Swedish population aged between 50 and 64 years only 7.1% reach the recommended level of physical activity. Physical activity on prescription (PAP) has been used in Sweden since the beginning of the twenty-first century with moderate adherence of approximately 50%. Mindfulness seems to affect motivation to and satisfaction with physical activity. The aim is to test the feasibility of a study in routine care; i.e. to test if mindfulness can improve adherence to PAP, measured by changes in physical activity.

Methods/design: We will include 90 sedentary individuals, aged 40-65 years, from primary health care centres in Sweden. Individuals will be randomised to only PAP, mindfulness and PAP or mindfulness only. The PAP group will be based on patients' preferences. The mindfulness groups will meet once a week for 8 weeks and practise 20 min of individual training per day. There will not be any motivational interview or physical activity on prescription in the group assigned to only mindfulness. The participants will complete the Five Facet Mindfulness Questionnaire, the Insomnia Severity Index and also answer questions concerning their lifestyle. Physical activity will be measured by ACTi Graph GT1X activity monitor at baseline and after 3 and 6 months. Patients with a severe psychological disease, unstable angina or a recent myocardial infarction will be excluded. The main outcome will be adherence to PAP in an ordinary primary health care setting. In this pilot study, we will also evaluate measures such as the recruitment rate, number of dropouts and adherence to mindfulness practice.

Discussion: This study is the first to explore the effect of mindfulness on adherence to PAP and test the feasibility of the study design.

Trial registration: ClinicalTrials.gov, NCT02869854 . Registered on 26 August 2016.

Keywords: Health care; Lifestyle change; Motivation; Physical activity.

Conflict of interest statement

Ethics approval and consent to participate

All parts of the study will be conducted according to the principles of the 1964 Helsinki Declaration, and the study has been approved by the Regional Ethical Review Board in Lund (registration number 2016/404). The study is registered at Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

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

Figures

Fig. 1
Fig. 1
Study design
Fig. 2
Fig. 2
SPIRIT figure: schedule of forms and procedures per study time point

References

    1. Ding D, Lawson KD, Kolbe-Alexander TL, Finkelstein EA, Katzmarzyk PT, van Mechelen W, Pratt M. The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet. 2016;388(10051):1311–1324. doi: 10.1016/S0140-6736(16)30383-X.
    1. Reis RS, Salvo D, Ogilvie D, Lambert EV, Goenka S, Brownson RC. Scaling up physical activity interventions worldwide: stepping up to larger and smarter approaches to get people moving. Lancet. 2016;388(10051):1337–1348. doi: 10.1016/S0140-6736(16)30728-0.
    1. Maher JP, Doerksen SE, Elavsky S, Hyde AL, Pincus AL, Ram N, Conroy DE. A daily analysis of physical activity and satisfaction with life in emerging adults. Health Psychol. 2013;32(6):647–656. doi: 10.1037/a0030129.
    1. Gerovasili V, Agaku IT, Vardavas CI, Filippidis FT. Levels of physical activity among adults 18–64 years old in 28 European countries. Prev Med. 2015;81:87–91. doi: 10.1016/j.ypmed.2015.08.005.
    1. Loyen A, Van Hecke L, Verloigne M, Hendriksen I, Lakerveld J, Steene-Johannessen J, Vuillemin A, Koster A, Donnelly A, Ekelund U, et al. Variation in population levels of physical activity in European adults according to cross-European studies: a systematic literature review within DEDIPAC. Int J Behav Nutr Phys Act. 2016;13:72. doi: 10.1186/s12966-016-0398-2.
    1. Ekblom-Bak E, Olsson G, Ekblom O, Ekblom B, Bergstrom G, Borjesson M. The daily movement pattern and fulfilment of physical activity recommendations in Swedish middle-aged adults: the SCAPIS pilot study. PLoS One. 2015;10(5):e0126336. doi: 10.1371/journal.pone.0126336.
    1. Leijon ME, Bendtsen P, Nilsen P, Festin K, Stahle A. Does a physical activity referral scheme improve the physical activity among routine primary health care patients? Scand J Med Sci Sports. 2009;19(5):627–636. doi: 10.1111/j.1600-0838.2008.00820.x.
    1. Morgan O. Approaches to increase physical activity: reviewing the evidence for exercise-referral schemes. Public Health. 2005;119(5):361–370. doi: 10.1016/j.puhe.2004.06.008.
    1. Orrow G, Kinmonth AL, Sanderson S, Sutton S. Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ. 2012;344:e1389. doi: 10.1136/bmj.e1389.
    1. Hertel AW, Finch EA, Kelly KM, King C, Lando H, Linde JA, Jeffery RW, Rothman AJ. The impact of expectations and satisfaction on the initiation and maintenance of smoking cessation: an experimental test. Health Psychol. 2008;27(3 Suppl):S197–S206. doi: 10.1037/0278-6133.27.3(Suppl.).S197.
    1. Baldwin AS, Rothman AJ, Jeffery RW. Satisfaction with weight loss: examining the longitudinal covariation between people's weight-loss-related outcomes and experiences and their satisfaction. Ann Behav Med. 2009;38(3):213–224. doi: 10.1007/s12160-009-9148-x.
    1. Williams DM, Lewis BA, Dunsiger S, Whiteley JA, Papandonatos GD, Napolitano MA, Bock BC, Ciccolo JT, Marcus BH. Comparing psychosocial predictors of physical activity adoption and maintenance. Ann Behav Med. 2008;36(2):186–194. doi: 10.1007/s12160-008-9054-7.
    1. Baldwin AS, Baldwin SA, Loehr VG, Kangas JL, Frierson GM. Elucidating satisfaction with physical activity: an examination of the day-to-day associations between experiences with physical activity and satisfaction during physical activity initiation. Psychol Health. 2013;28(12):1424–1441. doi: 10.1080/08870446.2013.822078.
    1. Tsafou KE, De Ridder DT, van Ee R, Lacroix JP. Mindfulness and satisfaction in physical activity: a cross-sectional study in the Dutch population. J Health Psychol. 2016;21(9):1817–1827. doi: 10.1177/1359105314567207.
    1. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2003;84(4):822–848. doi: 10.1037/0022-3514.84.4.822.
    1. Kabat-Zinn J. Wherever you go, there you are: mindfulness meditation for everyday life. London: Piatkus; 1994.
    1. Bishop SR, Lau M, Shapiro S, Carlson L, Anderson ND, Carmody J, Segal ZV, Abbey S, Speca M, Velting D, et al. Mindfulness: a proposed operational definition. Clin Psychol Sci Pract. 2004;11(3):230–241. doi: 10.1093/clipsy.bph077.
    1. Ruffault A, Bernier M, Juge N, Fournier JF. Mindfulness may moderate the relationship between intrinsic motivation and physical activity: a cross-sectional study. Mindfulness. 2016;7(2):445–452. doi: 10.1007/s12671-015-0467-7.
    1. Mothes H, Klaperski S, Seelig H, Schmidt S, Fuchs R. Regular aerobic exercise increases dispositional mindfulness in men: a randomized controlled trial. Ment Health and Phys Act. 2014;7:111–119. doi: 10.1016/j.mhpa.2014.02.003.
    1. Sundquist J, Lilja A, Palmer K, Memon AA, Wang X, Johansson LM, Sundquist K. Mindfulness group therapy in primary care patients with depression, anxiety and stress and adjustment disorders: randomised controlled trial. Br J Psychiatry. 2015;206(2):128–135. doi: 10.1192/bjp.bp.114.150243.
    1. Pocock SJ, Simon R. Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics. 1975;31(1):103–115. doi: 10.2307/2529712.
    1. Lilja JL, Frodi-Lundgren A, Hanse JJ, Josefsson T, Lundh LG, Skold C, Hansen E, Broberg AG. Five Facets Mindfulness Questionnaire—reliability and factor structure: a Swedish version. Cogn Behav Ther. 2011;40(4):291–303. doi: 10.1080/16506073.2011.580367.
    1. Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001;2(4):297–307. doi: 10.1016/S1389-9457(00)00065-4.
    1. King A. C. Group- vs home-based exercise training in healthy older men and women. A community-based clinical trial. JAMA: The Journal of the American Medical Association. 1991;266(11):1535–1542. doi: 10.1001/jama.1991.03470110081037.
    1. Gluck TM, Maercker A. A randomized controlled pilot study of a brief web-based mindfulness training. BMC Psychiatry. 2011;11:175. doi: 10.1186/1471-244X-11-175.
    1. Leijon ME, Bendtsen P, Stahle A, Ekberg K, Festin K, Nilsen P. Factors associated with patients self-reported adherence to prescribed physical activity in routine primary health care. BMC Fam Pract. 2010;11:38. doi: 10.1186/1471-2296-11-38.
    1. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937–952. doi: 10.1016/S0140-6736(04)17018-9.
    1. Nymberg P, Drevenhorn E. Patients' experience of a nurse-led lifestyle clinic at a Swedish health centre. Scand J Caring Sci. 2016;30(2):349–355. doi: 10.1111/scs.12254.
    1. Leijon ME, Stark-Ekman D, Nilsen P, Ekberg K, Walter L, Stahle A, Bendtsen P. Is there a demand for physical activity interventions provided by the health care sector? Findings from a population survey. BMC Public Health. 2010;10:34. doi: 10.1186/1471-2458-10-34.
    1. Leijon ME, Bendtsen P, Nilsen P, Ekberg K, Stahle A. Physical activity referrals in Swedish primary health care - prescriber and patient characteristics, reasons for prescriptions, and prescribed activities. BMC Health Serv Res. 2008;8:201. doi: 10.1186/1472-6963-8-201.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel