Physical Activity Program Delivery by Professionals Versus Volunteers: The TEAM Randomized Trial

Stanford Prevention Research Center, Stanford University School of Medicine, USA.
Health Psychology (Impact Factor: 3.59). 05/2011; 30(3):285-94. DOI: 10.1037/a0021980
Source: PubMed


Older adults have low rates of physical activity participation, but respond positively to telephone-mediated support programs. Programs are often limited by reliance on professional staff. This study tested telephone-based physical activity advice delivered by professional staff versus trained volunteer peer mentors.
A 12-month, randomized, controlled clinical trial was executed from 2003-2008. Twelve volunteer peer mentors and 181 initially inactive adults ages 50 years and older were recruited from the San Francisco Bay Area. Participants were randomized to: (1) telephone-based physical activity advice delivered by professional staff, (2) telephone-based physical activity advice delivered by trained volunteer peers, or (3) an attention-control arm of staff-delivered telephone support for nutrition.
Moderate-intensity or more vigorous physical activity (MVPA) was assessed at baseline, 6, and 12 months with the Community Healthy Activities Model Program for Seniors (CHAMPS) Questionnaire, with accelerometry validation (Actigraph) in a randomly selected subsample. Treatment fidelity was examined through analysis of quantity and quality of intervention delivery.
At 6 and 12 months, both physical activity arms significantly increased MVPA relative to the control arm. Both physical activity arms were comparable in quantity of intervention delivery, but peers demonstrated more versatility and comprehensiveness in quality of intervention content.
This study demonstrates that trained peer volunteers can effectively promote physical activity increases through telephone-based advice. The results support a program delivery model with good dissemination potential for a variety of community settings.

Download full-text


Available from: Matthew P Buman, Apr 01, 2015
  • Source
    • "Unlike these earlier paradigms where lay or professional individuals are the sole provider of treatment, more recent models are testing lay and professional individuals as health coaches [4, 5]. In the health coach treatment model, health care professionals deliver treatment and health coaches are used to supplement treatment; between treatment visits, coaches provide ongoing support, accountability, and information to promote behavior change. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite their popularity, empirical support for health coaches is limited. This study examined the feasibility and preliminary efficacy of three types of coaching models for obesity treatment. Participants (N = 44) were randomized to 6 months of reduced intensity group behavioral weight loss (rBWL) plus one of three types of health coaches: (i) Professional (rBWL interventionist), (ii) Peer (group members randomly paired and coached one another), or (iii) Mentor (successful weight loser). Groups met weekly for the first 6 weeks, biweekly for the next 6 weeks, and monthly thereafter, for a total of 12 meetings. During weeks that group did not meet, participants emailed their weight loss information to their coach and received feedback. Coaches were trained on appropriate coaching strategies and feedback delivery. Retention was 95%. Participants emailed their progress to their coach 10.8 ± 1.9 of the 12 weeks that there were no group meetings. Coaches responded with feedback 94% of the time. Percent weight losses at 6 months were 9.6 ± 8.1, 9.1 ± 5.0, and 5.7 ± 5.6 for the Professional, Peer, and Mentor conditions, respectively. More participants in the Professional and Peer conditions lost 10% of their initial body weight (Professional: 56% Peer: 50% and Mentor: 17%), with a statistically significant difference between the Professional and Mentor conditions (P = 0.03). These preliminary data suggest that combining a rBWL program with health coaching may hold significant promise as a cost-effective obesity treatment paradigm. Larger trials are needed to conclusively determine whether adding coaches improves weight loss outcomes in reduced intensity treatments and to examine which type of coach is most effective.
    Obesity 05/2013; 21(5):928-34. DOI:10.1002/oby.20271 · 3.73 Impact Factor
  • Source
    • "Three-month stability coefficients are in the .70–.84 range in community samples of older adults [32]. The instrument has also been shown to have concurrent validity when compared with interviewer-collected physical activity data [32], as well as sensitivity to change in a number of community samples of midlife and older women and men [5], [31], [33]. Given the intervention focus on moderate-intensity activities such as brisk walking and related activities, in light of their particular importance for health and well-being [2], the brisk walking and total moderate-to-vigorous intensity variables were of particular interest. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Mobile devices are a promising channel for delivering just-in-time guidance and support for improving key daily health behaviors. Despite an explosion of mobile phone applications aimed at physical activity and other health behaviors, few have been based on theoretically derived constructs and empirical evidence. Eighty adults ages 45 years and older who were insufficiently physically active, engaged in prolonged daily sitting, and were new to smartphone technology, participated in iterative design development and feasibility testing of three daily activity smartphone applications based on motivational frames drawn from behavioral science theory and evidence. An "analytically" framed custom application focused on personalized goal setting, self-monitoring, and active problem solving around barriers to behavior change. A "socially" framed custom application focused on social comparisons, norms, and support. An "affectively" framed custom application focused on operant conditioning principles of reinforcement scheduling and emotional transference to an avatar, whose movements and behaviors reflected the physical activity and sedentary levels of the user. To explore the applications' initial efficacy in changing regular physical activity and leisure-time sitting, behavioral changes were assessed across eight weeks in 68 participants using the CHAMPS physical activity questionnaire and the Australian sedentary behavior questionnaire. User acceptability of and satisfaction with the applications was explored via a post-intervention user survey. The results indicated that the three applications were sufficiently robust to significantly improve regular moderate-to-vigorous intensity physical activity and decrease leisure-time sitting during the 8-week behavioral adoption period. Acceptability of the applications was confirmed in the post-intervention surveys for this sample of midlife and older adults new to smartphone technology. Preliminary data exploring sustained use of the applications across a longer time period yielded promising results. The results support further systematic investigation of the efficacy of the applications for changing these key health-promoting behaviors.
    PLoS ONE 04/2013; 8(4):e62613. DOI:10.1371/journal.pone.0062613 · 3.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study explores how older women have their transportation needs met following driving cessation and the factors influencing the transition to driving cessation. Eleven women age 70 and older who ceased driving participated in face-to-face interviews. They often used different mobility options to continue their participation in different types of activities, and they experienced reductions in social activity participation. Location and access to public transportation, access to stable mobility options, control over mobility options, and planning for driving cessation influenced adaptation to driving cessation. The results provide direction for the development of appropriate mobility options and the development of effective programs to reduce the negative impact of driving cessation.
    Activities Adaptation & Aging 08/2010; 34(3):181-195. DOI:10.1080/01924788.2010.501483
Show more