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Twelve month adherence of adults who joined a fitness program with a spouse vs without a spouse

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The purpose was to determine adherence of apparently healthy adults who joined an exercise program with a spouse (Married Pairs) vs. without a spouse (Married Singles). It was hypothesized that Married Pairs would have significantly higher adherence than Married Singles; and that self motivation would be associated with adherence. Twelve month adherence of Married Pairs and Married Singles were compared to self motivation in a retrospective design. Subjects in this study did not volunteer for a scientific investigation, instead they were spontaneous participants in a university fitness program. Married Pairs were 16 couples and Married Singles were 16 married men and 14 married women. This study observed the 12 month spontaneous participation in a fitness program. The only intervention was the self motivation questionnaire. Adherence was defined as monthly attendance, compliance to the exercise prescription, dropout, and reason(s) for dropout. Self motivation was also measured. For Married Pairs, monthly attendance was significantly higher (54.2% +/- 10.3 vs 40.3% +/- 14.3) and dropout (6.3% vs 43.0%) was significantly lower than for Married Singles. Compliance to the exercise prescription was good for all of the groups except for the Married Single Men. Fifty percent of the dropouts left because of family responsibilities/lack of spousal support; 25% dropped-out to continue exercising on their own. Self motivation did not differ between Married Pairs and Married Singles. Monthly attendance of spouses in the Married Pairs demonstrated a significant correlation. Married Pairs had significantly higher attendance and lower dropout than Married Singles which appeared to be primarily influenced by spousal support rather than by self motivation.
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... Though parallel decreases in spouse physical activity have not been studied among couples coping with cancer, spouse care partners self-report lower physical activity levels than non-caregiving spouses [44]. Marital status and/or spousal physical activity are important determinants of physical activity behavior within the couple [45,46] and may be explained by the spouse's support for physical activity in their partner [46,47]. Having couples exercise together could build the teamwork and support that optimizes the benefits of exercise on the physical and mental health of both patients and their care partners. ...
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Introduction Prostate cancer can negatively impact the health of patients and their spouse, particularly early on in the cancer trajectory. Purpose To determine the feasibility and acceptability of dyadic exercises during radiation therapy and preliminary efficacy on physical, mental, and relational outcomes for men and their spouses. Exercising Together© , originally designed as a 6-month dyadic resistance training program for couples post-treatment, was adapted for the radiation setting. Methods We conducted a single-group pilot feasibility study of Exercising Together© in men scheduled for radiation therapy for prostate cancer and their spouse . Couples attended supervised exercise sessions thrice weekly throughout radiation treatment and were followed up 8 weeks later. Primary outcomes were feasibility and acceptability with secondary outcomes of changes in physical (physical functioning (short physical performance battery (sPPB)), gait speed (m/s), functional capacity (400-m walk (min), physical activity (min/week)), mental (depressive symptoms (CES-D), and anxiety (SCL-90 ANX)), and relationship (Dyadic Coping, Role Overload, and Physical Intimacy Behavior Scales) health outcomes for each partner. Participants completed an evaluation post-intervention. Results Ten couples enrolled and 8 completed the intervention, attending 83% of scheduled sessions. Couple satisfaction with the intervention was high (patients: mean difference (MD) = 9.4 ± 1.9 and spouses: MD = 10.0 ± 0.0, on a 1–10 scale). At post-intervention, gait speed (MD = 0.1; 95%CI: 0.1, 0.2; p = 0.003; d = 0.94) and functional capacity (MD = −0.6; 95%CI: −0.9, 0.3; p = 0.002; d = −0.42) improved in patients and sPPB in spouses (MD = 1.3; 95%CI: 0.3, 2.2; p = 0.02; d = 0.71). Total physical activity increased non-significantly for patients and significantly for spouses at post-intervention and decreased at follow-up (MD = 179.6; 95%CI: 55.4, 303.7; p = 0.01; d = 1.35 and MD = −139.9; 95%CI: −266.5, 13.3; p = 0.03; d =1.06). Among patients, anxiety and active engagement significantly improved post-intervention (MD = −2.3; 95%CI: −3.8, 0.7; p = 0.01; d = −0.43 and MD = 2.5; 95%CI: 0.7, 4.3; p = 0.01; d = 0.98, respectively). There were modest effects on other physical, mental, and relationship health domains in patients and spouses. Conclusion A modified version of Exercising Together© is a feasible and acceptable program during radiation therapy for prostate cancer and shows preliminary evidence for improvements on physical, mental, and relational health in both patient and spouse. A larger, fully powered randomized controlled trial is warranted and could help shift the landscape toward dyadically targeted interventions. Trial registration This study was registered on ClinicalTrials.gov on February 18th, 2018 ( NCT03418025 ).
... Accountability partners were frequently used by initiative participants. Accountability partner(s) and "fitness communities" promote increased physical activity and should be a focus of future physical wellness initiatives [33][34][35]. Interestingly, despite making up 43.6% of the department, female residents and attendings had lower participation in the wellness initiative (22 female versus 22 male) and lower response rates for the survey (18 female versus 38 male). ...
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Introduction: The COVID-19 pandemic has taken a significant toll on societal, physical, and psychological health. Emergency physicians (EPs) are susceptible to burnout under ordinary circumstances and may be particularly vulnerable during the pandemic. To reduce pandemic-related burnout, we implemented a residency-led physical wellness initiative and evaluated the effect on burnout among EPs. Methods: In the spring of 2020, we invited all resident and attending EPs in our department to participate in a four-week physical wellness initiative as part of a prospective study. After completing or opting out of this wellness initiative, EPs responded to an online survey comprised of five sections: demographics, participation, opinion on wellness initiative, opinion on the impact of COVID-19, and the Maslach Burnout Index (MBI-HSS). We stratified respondents by initiative participation, described the characteristics of each group, and then compared the perceived impact of COVID-19 and the MBI-HSS results between the two groups. Results: Out of 110 eligible participants, 57 EPs completed the survey (51.8%). Thirty-five respondents completed the wellness initiative. Few (37.1%) documented their progress, though most worked with accountability partners (85.7%). Most enrollees enjoyed participation (Likert Score 3.2-5, CI 2.9-3.5) and would participate again (3.3, CI 3.0-3.6). The reported effect of the COVID-19 pandemic on mental wellbeing was lower for participants, although this was not significant (2.1, CI 1.5-2.1 vs 2.4, CI 2.0-2.7, p=0.312). On the MBI-HSS, participants had a lower emotional exhaustion score (1.4, 95% CI 0.9-1.8) than non-participants (2.2, 95%CI 1.8-2.6, p=0.005).
... Family therapists could discuss how clients can engage in physical activity as a family (as a family leisure activity; Pluta et al., 2017) or with a partner to boost effects and increase the likelihood of long-term physical activity. Indeed, marriage pairs had significantly higher attendance and lower dropout in exercise programs than married singles, which appeared to be primarily influenced by spousal support rather than by self-motivation (Wallace et al., 1995). This has been found in many populations and conditions, including couples coping with prostate cancer (Lyons et al., 2016), older married couples (Osuka et al., 2017), and African American couples (Hornbuckle et al., 2020). ...
Article
Physical activity can have a profound impact on the cognitive, emotional, and social aspects of our clients’ lives, and can even boost and sustain therapy outcomes. And yet, family therapists may not be trained or educated in the importance of physical activity nor how to assess, educate, and collaborate with health professionals to incorporate physical activity in treatment. As the evidence grows on the connection between physical activity and biopsychosocial functioning and more family therapists enter medical and healthcare settings, a framework for physical activity competencies is needed. As such, the purpose of this conceptual and empirical review paper is to (a) review the important brain‐boosting benefits of physical activity for mental, cognitive, and social health, (b) provide a framework for the domains for family therapists for incorporating exercise in assessment and treatment, and finally, (c) outline recommendations for practice, education and supervision, and research for family therapists.
... Though parallel decreases in spouse physical activity have not been studied among couples coping with cancer, spouse care partners self-report lower physical activity levels than non-caregiving spouses [44]. Marital status and/or spousal physical activity are important determinants of physical activity behavior within the couple [45,46] and may be explained by the spouse's support for physical activity in their partner [46,47]. Having couples exercise together could build the teamwork and support that optimizes the bene ts of exercise on physical and mental health of both patients and their care partners. ...
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Introduction: Prostate cancer can negatively impact the health of patients and their spouse, particularly early on in the cancer trajectory. Purpose: To determine the feasibility and acceptability of dyadic exercise during radiation therapy and preliminary efficacy on physical, mental and relational outcomes for men and their spouses. Exercising Together©, originally designed as a 6-month dyadic resistance training program for couples post-treatment, was adapted for the radiation setting. Methods: We conducted a single-group pilot feasibility study of Exercising Together© in men scheduled for radiation therapy for prostate cancer and their spouse. Couples attended supervised exercise sessions thrice weekly throughout radiation treatment and were followed-up 8 weeks later. Primary outcomes were feasibility and acceptability with secondary outcomes of changes in physical (physical functioning (short physical performance battery (SPPB)), gait speed (m/sec), functional capacity (400-meter walk (min), physical activity (min/week)), mental (depressive symptoms (CES-D) and anxiety (SCL-90 ANX)), and relationship (Dyadic Coping, Role Overload and Physical Intimacy Behavior Scales) health outcomes for each partner. Participants completed an evaluation post-intervention. Results: Ten couples enrolled and 8 completed the intervention, attending 83% of scheduled sessions. Couple satisfaction with the intervention was high (patients: x̄=9.4±1.9 and spouses: x̄=10.0±0.0, on a 1-10 scale). At post-intervention, gait speed (x̄=0.1; 95%CI: 0.1, 0.2; p=0.003; d=0.94) and functional capacity (x̄=-0.6; 95%CI: -0.9, 0.3; p=0.002; d=-0.42) improved in patients and SPPB in spouses (x̄=1.3; 95%CI: 0.3, 2.2; p=0.02; d=0.71). Total physical activity increased non-significantly for patients and significantly for spouses at post-intervention and decreased at follow-up (x̄=179.6; 95%CI: 55.4, 303.7; p=0.01; d=1.35 and x̄=-139.9; 95%CI: -266.5,13.3; p=0.03; d=1.06). Among patients, anxiety and active engagement significantly improved post-intervention (x̄=-2.3; 95%CI: -3.8, 0.7; p=0.01; d=-0.43 and x̄=2.5; 95%CI: 0.7, 4.3; p=0.01; d=0.98, respectively). There were modest effects on other physical, mental, and relationship health domains in patients and spouses. Conclusion: A modified version of Exercising Together© is a feasible and acceptable program during radiation therapy for prostate cancer and shows preliminary evidence for improvements on physical, mental, and relational health in both patient and spouse. A larger, fully powered randomized controlled trial is warranted and could help shift the landscape toward dyadically-targeted interventions. Trial Registration: This study was registered on ClinicalTrials.gov on February 18th, 2018 (NCT03418025; https://clinicaltrials.gov/ct2/show/NCT03418025).
... However, as supported by the behavioral literature, we are confident that a dyadic design increases feasibility, particularly retention. 38,39 In contrast, the two-month retention rate of a large psychosocial intervention trial enrolling patients with advanced cancer was 40%. 40 Here, we were able to retain 62% at the three-month follow-up. ...
Article
Purpose: Although patients with primary and metastatic brain tumors (BT) and their partners are at risk of experiencing high symptom burden, they are often excluded from psychosocial intervention studies. Thus, we sought to examine the feasibility and preliminary efficacy of a couple-based meditation (CBM) program targeting symptom and well-being outcomes. Methods: Couples completed baseline measures assessing symptom and well-being outcomes and were randomized to the CBM or a usual care control (UC) group. Couples in the CBM groups attended four, weekly (60 min. each) therapist-led sessions that were delivered via FaceTime. The CBM program focused on cultivating mindfulness, compassion, gratitude and purpose and integrated emotional disclosure exercises. Both groups were reassessed 6 and 12 weeks after baseline. Results: We approached 60 eligible dyads of which 37 (62%) consented and 35 (95%) were randomized and 22 (63%) completed all assessments. Couples in the CBM group attended a mean of 3.33 sessions (SD=1.09). For patients, significant group differences in favor of the CBM group were found for cognitive (d=1.05) and general disease symptoms (d=.93), and relationship well-being (d=.68) and compassion (d=.96). No significant group differences were revealed for partners. Conclusions: It seems to be feasible, acceptable and possibly efficacious to deliver a dyadic intervention via FaceTime to BT couples. Although both patients and partners in the CBM group rated the intervention as beneficial, significant group differences with medium to large effect sizes were only found for patients.
... 16 This suggests that individual IIs may be strengthened by considering an individual's social environment. 6,[17][18][19] In a dyadic study of couples with T2D, spousal involvement was related to higher levels of physical activity, energy expenditure, and efficacy to exercise. 20 Similarly, a focus group of couples where at least 1 partner had a diagnosis of diabetes revealed that couples who felt they were "in this together" were better able to communicate and support each other and were more likely to engage in regular physical activity. ...
Article
Purpose The purpose of the study was to examine feasibility outcomes and obtain initial efficacy data on an intervention testing collaborative implementation intentions (IIs) for physical activity (PA) among participants with type 2 diabetes. Methods The study used a pilot randomized design and enrolled people with diabetes (PWD) and their partners (N = 40 couples, 80 individuals). PWD reported psychosocial measures, including self-efficacy for PA, diabetes partner investment in diabetes self-management, and PA-related social support. Accelerometers (objective) and the International Physical Activity Questionnaire (self-report) were used to assess PA. Results Participants in both experimental conditions reported being satisfied with the intervention and highly committed to their PA plans. Participants were able to follow instructions and completed the intervention in less than 30 minutes. Participants in the collaborative IIs condition reported a greater increase in PA-related social support (partial ² = .185, P < .05) and self-reported recreational PA (partial ² = .210, P < .05) at 6 weeks compared to the other 2 conditions. In this pilot study, there were no significant group differences on other psychosocial outcomes or for objective PA; however, time in light PA trended higher for the collaborative IIs condition compared to the other 2 conditions (partial ² = .237, P = .056). Conclusions This study provides initial support for collaborative IIs for PA with PWD and their partners. This brief intervention was feasible and highly acceptable, and it may improve relationship dynamics around PA as well as ultimately increase PA.
... Given the shared cancer experience, a dyadic intervention may be advantageous because distress and QOL are interdependent (patient outcomes influence caregiver outcomes and vice versa) in families coping with cancer [45][46][47][48][49]. Thus, a dyadic intervention that offers supportive care in a holistic manner may optimize efficacy. According to evidence in the health-behavior literature, dyadic interventions may also be more feasible regarding participant retention and treatment adherence compared to individual programs [34,50,51]. ...
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Background: Although the diagnosis and treatment of a primary brain tumor present unique challenges to patients and their family caregivers, evidence-based supportive care interventions are generally lacking. The primary aim of this research protocol is to determine the feasibility of implementing a dyadic yoga (DY) versus a caregiver yoga (CY) intervention or a wait-list control (WLC) group using a randomized controlled trial design. Methods: Seventy-five glioma patients undergoing radiotherapy and their family caregivers are randomized to the DY, CY, or a WLC group. Patient-caregiver dyads in the DY group and caregivers in the CY group receive 15 sessions (45 min each) over the course of patients' standard radiotherapy (6 weeks). Patients and caregivers in all groups complete baseline assessments of symptoms, quality of life (QOL), and health utilization outcomes prior to randomization. Follow-up assessments are performed 6 weeks and then again 3 months later. The primary outcome is feasibility (i.e., ≥ 50% of eligible dyads consent, ≥ 70% of enrolled dyads complete all assessments, and ≥ 50% of all practice sessions are attended). We will also perform primarily descriptive analyses of the self-reported outcomes (e.g., fatigue, overall QOL) and explore potential intervention moderators (e.g., performance status) to inform a larger future trial. Conclusion: This trial will provide important information regarding the feasibility of a dyadic versus a caregiver yoga intervention regarding symptom, QOL, and health utilization outcomes in glioma patients and their caregivers. Trial registration: ClinicalTrials.gov NCT02481349.
To investigate the efficacy of exercise intervention using a real-time video conferencing platform (ZOOM) on inter-recti distance, abdominal muscle thickness, static trunk endurance, and maternal quality of life, 37 women with diastasis recti between six months and one year postpartum were randomly divided into the online (n = 19) and offline (n = 18) groups. The online group underwent 40-min trunk stabilization exercise sessions twice a week for six weeks, through a real-time video conference platform, while the offline group attended the same program in person. The inter-recti distance and muscle thickness between the abdominal muscles were measured by rehabilitation ultrasound imaging, the Torso endurance test was used to compare the static trunk endurance, and the maternal quality of life questionnaire (MAPP-QOL, score) was applied. Significant improvements were observed in the inter-recti distance between the rectus abdominis, abdominal muscle thickness, static trunk endurance, and maternal quality of life in both groups (p < 0.001); a more significant improvement was observed in the offline group. No significant differences were observed between groups except for the left rectus abdominis thickness and Psychological/Baby and Relational/Spouse-Partner subscale in the maternal quality of life index (p > 0.05). Exercise interventions delivered in a real-time videoconferencing platform are effective at improving the inter-recti distance, trunk stability, and quality of life in postpartum women and may be an alternate to face-to-face intervention.
Article
Many people have goals to increase their physical activity levels through engaging in exercise, but have difficulty establishing and maintaining an exercise routine. Research shows that people are more successful at exercising if they do so together with their romantic partner. In this study, we examined how exercising with a romantic partner may influence the experience of exercise itself, as well as people’s daily experiences. Specifically, we examined how joint exercise influences daily and exercise affect, daily relationship satisfaction, and amount of daily exercise. Young adults who were currently involved in a romantic relationship (N = 95) completed intake questionnaires and 14 daily reports of their exercise behavior, exercise and daily affect, and daily relationship satisfaction. Multilevel models showed that on days when people exercised with their romantic partner, they experienced higher positive affect during exercise, higher daily positive affect, and were more satisfied with their relationship compared to days when they exercised without their partner. No effects were found on daily and exercise negative affect, or amount of exercise. This study illustrates how exercising with a romantic partner may improve people’s experience of both exercising and their daily experiences, and may help provide a reason why people might be more successful at maintaining their exercise routine when they exercise together with their romantic partner.
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